Surgery in a warfarinized patient (365/1700)

A man on warfarin posted for hemicolectomy. As the pt is about to undergo surgery. What
option is the best for him?
a. Continue with warfarin
b. Continue with warfarin and add heparin
c. Stop warfarin and add aspirin
d. Stop warfarin and add heparin
e. Stop warfarin

answer: D

pre-operative medications to stop

oral hypoglycemics
antidepressants: stop on morning of surgery
ACE inhibitors and angiotension receptor blockers: stop on morning of surgery
warfarin (consider bridging with heparin)
anti-platelet agents (e.g. clopidogrel)