Q; 53 year old male with newly diagnosed lung cancer and has been found to have recurrent pleural effusion is scheduled to have talc pleurodesis. Patient has following list of medications. Which one of the following should be preferably discontinued for a successful pleurodesis 

A) Vancomycin 
B) Cefepime 
C) Hydrocortisone 
D) Lopressor 
E) Albuterol 



Answer: C

Understandably, any drug which has anti-inflammatory effect will decrease the effect of pleurodesis. Steroids, NSAIDs or any anti-anti-inflammatory drug should be taken off list, if absolutely not needed, few days prior to procedure.



Reference: 

 Xie C, Teixeira LR, McGovern JP, Light RW. Systemic corticosteroids decrease the effectiveness of talc pleurodesis. Am J Respir Crit Care Med 1998; 157:1441.