Where a published interaction study exists it usually reports an area-under-curve ratio, and that number is far more informative than a yes-or-no answer.
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Practice · Interactions · continued
Anaesthesia and elective surgery: the aspiration question posts 61–90
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
l.salinas, post #36: Where a published interaction study exists it usually reports an area-under-curve ratio, and that number is far more informative than a yes-or-no answer. A modest claim, modestly supported. Go to post
Anticoagulant questions come up regularly and are the clearest case for professional advice rather than discussion, because the consequence of being wrong is not gradual.
I checked the source rather than the summary, and they differ.
Post #62 is right about the mechanism and I think understates the practical bit.
Agreed on anaesthesia and elective surgery, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states.
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Coming back to post #60, because the follow-up matters more than the original answer.
A methods point on anaesthesia and elective surgery rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method.
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A supplement is a drug for interaction purposes, and the fact that it is sold without a prescription tells you nothing about whether it interacts. The paperwork is usually worse rather than better.
Where I would look next, rather than where I would stop.
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y.adeyemi, post #45: The arithmetic in post #43 is right; the assumption feeding it is the part to check. A supplement is a drug for interaction purposes, and the fact that it is sold without a prescription tells you nothing about whether it interacts. The paperwork is usually worse rather than better. Go to post
Post #64 describes the usual case. This is about the unusual one.
Anaesthesia and elective surgery is well covered in the tag pages, and the older discussions are better than the recent ones because they were argued out properly. Worth twenty minutes before adding to this one.
t.verhoeven, post #1: Posting this under the heading it deserves: Anaesthesia and elective surgery: the aspiration question Everything below is what sits behind that. A narrow question about anaesthesia and elective surgery, deliberately narrow, because the broad version has been asked here four times and produced four long threads and no answer. One… Go to post
Right, and stated more narrowly than I would have dared to state it.
e.kuusela, post #16: Anaesthesia and elective surgery has a well-known answer and a correct answer, and the interesting work is establishing that they are the same. Nobody has done that here yet. Go to post
Taking anaesthesia and elective surgery seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences.
Taking post #66 at face value and following it one step further.
Insulin and sulfonylureas are the interaction that the labelling in this class flags most explicitly, because the risk is additive glucose lowering. That is a prescribing question and not a forum question.
I would rather say I do not know than round it up to an answer.
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Collapsed as off-topic by two members at trust level 3 or above
Nothing here is medical advice and an interaction question is one where the cost of a wrong forum answer is genuinely high. Ask the prescriber or the pharmacist.
ambient_review, post #21: Small methodological point on anaesthesia and elective surgery: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone. Go to post
Confirming post #71 from a second method, which matters more than confirming it from a second person.
Adding a null result on anaesthesia and elective surgery. I looked, carefully, and found nothing, and null results deserve posting precisely because they never are.
Wendelboe, post #71: A note on scope: what I am saying about anaesthesia and elective surgery applies to the case in the first post and I would not extend it further without checking. Go to post
Post #71 describes the usual case. This is about the unusual one.
Anaesthesia and elective surgery would be much easier to settle if anyone reported the denominator. Almost nobody reports the denominator.
vial_desk, post #56: Where I have landed on anaesthesia and elective surgery, having got it wrong once in public: the direction is clear, the magnitude is not, and anyone quoting a precise magnitude has borrowed it from somewhere that did not measure it. Go to post
The most defensible general position in this subcategory: identify the plausible mechanism, check whether it has been studied, and where it has not, say that rather than filling the gap.
The uncertainty is in the assumption, not in the calculation.
The strongest argument against my own position on anaesthesia and elective surgery, stated as well as I can state it, since nobody else has yet.
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peak_purity, post #67: Right, and stated more narrowly than I would have dared to state it. Go to post
Clear enough that I do not think I have a follow-up, which is unusual.
crossover_entry, post #50: Two sentences on anaesthesia and elective surgery and then I will stop, because the rest is speculation and the thread is better without mine. What is documented is narrow. What is inferred from it is broad. The gap between them is where every argument here lives. Go to post
Taking post #78 at face value and following it one step further.
Mechanistic reasoning about interactions has a poor predictive record. It is a good way to generate a question and a bad way to answer one.
Building on post #80 rather than restating it.
Anaesthesia and elective surgery sits at the boundary between what this community can usefully discuss and what it cannot, and I think it falls on the discussable side, narrowly.
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Adding a note of thanks rather than an opinion. I did not know most of that.
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p.novotny, post #75: Post #71 describes the usual case. This is about the unusual one. Anaesthesia and elective surgery would be much easier to settle if anyone reported the denominator. Almost nobody reports the denominator. Go to post
Anyone asking an interaction question should list everything, including the things they consider irrelevant. The irrelevant one is the answer more often than chance would suggest.
Worth saying I have only my own numbers here, and n is small.
j.castellanos, post #11: Something worth flagging about anaesthesia and elective surgery: the strongest-sounding claims in this thread are the ones with no source attached, which is the usual pattern and not a coincidence. Go to post
Where I would push back on the anaesthesia and elective surgery consensus is the confidence, not the direction. The direction looks right. The confidence is borrowed.
Post #83 and I disagree about the size of the effect, not about the direction.
An honest declaration on anaesthesia and elective surgery: I have a prior here and it is strong enough that you should weight what I say downward. Stating it rather than hiding it.
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d.bakker, post #70: My experience of anaesthesia and elective surgery contradicts the reply above. I am posting it as a data point rather than as a refutation, because one person's experience is exactly that. Go to post
A supplement is a drug for interaction purposes, and the fact that it is sold without a prescription tells you nothing about whether it interacts. The paperwork is usually worse rather than better.
Appreciated. The plain phrasing does more work here than a longer post would.
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