UW MSK Residents' Manual

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====== MSK MEDICATION POLICY ======

  * Medication policy should be administered with the **__referring MD's approval__**. 
  * Patient should call his/her physician who prescribed the medications.
===== Blood Thinners =====

|//Procedures//         | **NSAIDS, Aspirin**|**Coumadin**|**Others***|
|**Arthrograms**|No restrictions|No restrictions|No restrictions|
|**Steroid injection**|No restrictions|No restrictions|No restrictions|
|**Joint aspiration**|No restrictions|No restrictions|No restrictions|
|**Bone and soft tissue biopsy**|No restrictions|Stop 5 days prior to procedure<sup>A</sup>|See below|
==== Others*: ====
 
=== No Restrictions ===
  * Arixtra (fondarinus)
  * Ticlid (ticlopidine)
  * Effient (prasugrel)
  * Ibuprofen/Diciofenac/Ketoprofen/Indomethacin
  * Meloxicam/Nabumetone/Piroxicam
  * Naproxan/Sulindac/Diflunisal/Celecoxib  

=== Hold ===
 
  * Plavix (clopidogrel) : Hold for 5 days
  * Eliquis (apixaban) : Hold for 2 days
  * Pradaxa :  Hold for 2 days
  * Xeralto (rivaroxaban) :  Hold for 2 days
  * IV Heparin : Hold for 4 hours
  * SQ Heparin : Hold one dose
  * LMWH (Lovenox) : Hold one dose

A: Check INR on the day of procedure

  * CBC and Platelet (Platelet: ≥ 50,000 within 30 days)
  * INR (INR: ≤ 2  on the procedure day). If INR is > 2, procedures should be rescheduled. 


===== Metformin =====
No restrictions are necessary. 
===== Contrast Allergy =====

Follow [[https://depts.washington.edu/uwerad/wordpress/?page_id=64 | UW radiology premedication]] policies. 
===== NPO =====
  - NPO is not necessary for arthrograms, steroid injections and joint aspirations. 
  - 6 hours of NPO is required for bone biopsies.

UW MSK Residents' Manual

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