title: Importance of a thorough drug history in presurgical patients.
abstract: A 72-year-old woman was admitted for a routine elective total knee replacement. By day 1 postoperative, she became hyponatraemic following an Addisonian crisis, leading to an admission into the intensive therapy unit (ITU). It was later during this stay in the ITU and on a retrospective drug history review that she was found to have taken clobetasol, a high strength topical steroid cream over the past 2 years. The authors alert the reader to the importance of specially asking patients about their use of current or recent topical steroid creams as they may not always volunteer this information. Sudden withdrawal of steroid supplementation in these patients in the preoperative period may result in catastrophic consequences.
authors.affiliation: Department of Trauma and Orthopaedics, East Kent University Hospitals, Margate, UK.
authors.forename: Shibby
authors.initials: S
authors.lastname: Robati
authors.forename: Mohammad Kamren
authors.initials: MK
authors.lastname: Shahid
authors.forename: Adrian
authors.initials: A
authors.lastname: Vella
authors.forename: Adrien
authors.initials: A
authors.lastname: Vella
authors.forename: Simon
authors.initials: S
authors.lastname: Rang
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D002990:Clobetasol / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced*; D011183:Postoperative Complications / Q000175:diagnosis; D011300:Preoperative Care; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000209:etiology*
chemical_list: D005938:Glucocorticoids; D002990:Clobetasol