Clinics (Sao Paulo). 2017 June; 72(6): 386-390.

Copyright © 2017 CLINICS

Perioperative management of drugs commonly used in patients with rheumatic diseases: a review

André Silva Franco , Leandro Ryuchi Iuamoto , Rosa Maria Rodrigues Pereira *

Rheumatology Division, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, BR

*Corresponding author. E-mail:

received October 18, 2016; revised December 27, 2016; accepted February 24, 2017.


Rheumatic diseases are very prevalent, affecting about 7 million people in North America; they affect the musculoskeletal system, often with systemic involvement and potential for serious consequences and limitation on quality of life. Clinical treatment is usually long-term and includes drugs that are considered either simple or complex and are occasionally unknown to many health professionals who do not know how to manage these patients in emergency units and surgical wards. Thus, it is important for clinicians, surgeons and anesthesiologists who are involved with rheumatic patients undergoing surgery to know the basic principles of therapy and perioperative management. This study aims to do a review of the perioperative management of the most commonly used drugs in rheumatologic patients. Manuscripts used in this review were identified by surveying MEDLINE, LILACS, EMBASE, and COCHRANE databases and included studies containing i) the perioperative management of commonly used drugs in patients with rheumatic diseases: and ii) rheumatic diseases. They are didactically discussed according to the mechanism of action and pharmacokinetics; and perioperative management. In total, 259 articles related to the topic were identified. Every medical professional should be aware of the types of drugs that are appropriate for continuous use and should know the various effects of these drugs before indicating surgery or assisting a rheumatic patient postoperatively. This information could prevent possible complications that could affect a wide range of patients.

Keywords: Rheumatic Diseases, Drugs, Perioperative Period, Inflammation Mediators

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