Relevant Pharmacology and Interventions

This chapter provides a comprehensive overview of pharmacological interventions and medications relevant to prehabilitation programs. The text explores how various agents intersect with the prehabilitation population, highlighting their pleiotropic effects across multiple pillars of pre-procedural preparation. The chapter discusses medications that enhance exercise performance and recovery, including hormone replacement therapy, testosterone replacement therapy, and other anabolic agents. It also delves into pharmaceuticals targeting weight loss, nutrition, and substance use cessation, including the gut peptide hormone analogues like semaglutide or tirzepatide, bupropion/naltrexone combinations, and phentermine. The chapter covers neuropsychological aspects, including sleep medications, antidepressants, and pain management therapeutics. It explores the use of corticosteroids, platelet-rich plasma, and hyaluronic acid injections for musculoskeletal conditions. The text then discusses nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and emerging treatments like low-dose naltrexone and cannabis. The potential of psychedelic medicines such as ketamine and psilocybin for treating depression, chronic pain, and end-of-life care is also addressed. Additionally, the chapter examines off-label therapeutics for metabolic health, including sodium–glucose cotransporter 2 (SGLT2) inhibitors, mirabegron, and metformin. It concludes with a section on medications in the research pipeline (at the time of publication), such as myostatin pathway inhibitors, peroxisome proliferator-activated receptor (PPAR) agonists, and selective androgen receptor modulators (SARMs). Throughout, the text emphasizes the importance of considering the unique needs of prehabilitation patients and the potential interactions between various pharmacological interventions and their overall health goals. The chapter aims to provide healthcare professionals with a nuanced understanding of these interventions within the context of prehabilitation and common disease states.