Real Life Pharmacology - Pharmacology Education for Health Care Professionals

In this podcast episode, I discuss methadone pharmacology, adverse effects, drug interactions, and pharmacokinetics. Methadone is a full opioid agonist that may be used for pain management and opioid use disorder. Transitioning from methadone to another opioid is complicated. I discuss conversion in this podcast episode. Methadone can increase the risk of QTc prolongation and also has a lot of dru...

On this podcast episode, I discuss meperidine pharmacology, adverse effects, pharmacokinetics, drug interactions, and much more! Meperidine is an opioid that is seldom used due to neurotoxicity. I describe how this can happen in this podcast episode. Meperidine has numerous drug interactions and using a CYP3A4 inhibitor may increase the risk for toxicity. Seizures are a risk with meperidine due to...

On this episode of the podcast, I cover guanfacine pharmacology, adverse effects, drug interactions, and much more. Guanfacine is a central acting alpha-2 agonist that has the brand names of Tenex and Intuniv. Because of guanfacine’s mechanism of action, it suppresses the sympathetic response leading to a drop in pulse and blood pressure. It is important to remind patients that the onset of...

On this podcast episode, I discuss fluvastatin pharmacology, adverse effects, pharmacokinetics, and much more. Fluvastatin is only a low to moderate-intensity statin which explains its limited use compared to rosuvastatin or atorvastatin. I discuss drug interactions in the podcast but one important one to recognize is drugs that can inhibit CYP2C9. Fluvastatin is considered a lipophilic statin. I...

In this episode, I discuss oxymorphone pharmacology, adverse effects, drug interactions, and more! Oxymorphone is approximately 3 times more potent than morphine. I break down some common opioid comparisons in this episode. Oxymorphone avoids many of the CYP interactions. I discuss some of the common interactions in this episode. I discuss histamine release in relation to opioids and oxymorphone a...

On this podcast episode, I discuss diclofenac pharmacology, adverse effects, drug interactions, and much more. Diclofenac is one of the highest-risk NSAIDs when it comes to cardiovascular risk. You can find more information on this in the Meded101 NSAID comparison table . Diclofenac carries two boxed warnings. One is for GI bleed risk and the other is for cardiovascular risks. Anticoagulants, anti...

On this episode, I discuss aliskiren pharmacology, adverse effects, drug interactions, and much more. Aliskiren should not be used with ACE Inhibitors or ARBs. I discuss why that is in this episode. Aliskiren has a long enough half-life at approximately 24 hours so it is recommended to only take this once daily. Hyperkalemia is a major concern with aliskiren. It is important to monitor potassium l...

On this episode, I discuss the use of buprenorphine/naloxone in managing opioid use disorder. I cover the kinetics, dosage forms, adverse effect, interactions and much more. Buprenorphine/naloxone has numerous dosage form and they are not interchangeable. I discuss this further on the podcast. Liver impairment is a potential reason to avoid the use of buprenorphine. I discuss this on the podcast....

On this episode, I discuss spironolactone pharmacology, adverse effects, drug interactions and much more. Spironolactone has numerous indications including hypertension, CHF, ascites, and acne. I break them all down in this podcast episode. Hyperkalemia is a major concern with spironolactone. Patients with baseline levels at 5 or above should generally avoid this medication. Gynecomastia is one of...

I discuss meloxicam pharmacology, adverse effects, drug interactions, and much more on this episode of the Real Life Pharmacology Podcast. Meloxicam tends to have a greater affinity to COX-2 versus COX-1. I discuss what this means clinically on this episode. Important meloxicam drug interactions include anticoagulants, antiplatelet medications, renal impairing drugs, and lithium amongst others. Me...

On this episode, I discuss enalapril pharmacology, adverse effects, drug interactions, and much more! Enalapril has a shorter half-life compared to some of the other ACE inhibitors so it may need to be dosed twice daily in patients with adequate renal function. Hyperkalemia, cough, renal impairment, and angioedema and four adverse effects associated with enalapril that you should monitor for. NSAI...

On this very special episode of the Real Life Pharmacology podcast, we tackle asthma pharmacotherapy and some of the things that Beth sees in her everyday practice as an ambulatory care pharmacist. When discussing asthma pharmacotherapy with pediatric patients and their families, it is critical to address the concern of suppressed growth with corticosteroid use. Beth shares her expertise and thoug...

On this podcast episode, I discuss lisdexamfetamine (Vyvanse) pharmacology, adverse effects, drug interactions, and much more. Lisdexamfetamine is a stimulant medication that is used in the management of ADHD. Stimulants like lisdexamfetamine can increase heart rate, raise blood pressure, and suppress appetite. Lisdexamfetamine is a schedule 2 controlled substance and has a high potential for abus...

On this podcast episode, I cover etanercept pharmacology, adverse effects, drug interactions and much more. Etanercept is classified as a DMARD but is different from older DMARDs in that it is a biologic agent and needs to be injected. Vaccination assessment in patients is important prior to initiating etanercept due to the fact that the medication may blunt the effectiveness of the vaccines. Immu...

On this podcast episode, I discuss the pharmacology, adverse effects, and drug interactions of insulin lispro (Humalog). I spend some time on this podcast episode discussing carb ratios and sliding scale insulin when using insulin lispro. Potassium is critical to monitor in diabetic ketoacidosis as insulin therapy can cause significant hypokalemia. Sliding-scale insulin lispro is discouraged in th...

On this podcast episode, I discuss (Lyrica) pregabalin pharmacology, adverse effects, drug interactions, and much more. I compare pregabalin and gabapentin in this episode and one important difference is the percent absorption of gabapentin compared to pregabalin. Pregabalin can exacerbate the risk of respiratory depression and overdose in patients who are taking opioids. Pregabalin is most freque...

On this podcast episode, I discuss tamoxifen pharmacology, adverse effects, drug interaction, and much more. Tamoxifen is converted to a more active compound in the body by CYP2D6. CYP2D6 inhibitors such as paroxetine, fluoxetine, or bupropion can essentially reduce the effectiveness of tamoxifen. Hot flashes are a common adverse effect of tamoxifen and I discuss a few pharmacologic options to man...

On this episode of the Real Life Pharmacology Podcast, I cover phenobarbital pharmacology, adverse effects, important drug interactions and much more. Phenobarbital is an enzyme inducer. It is an inducer at CYP3A4 so this can lead to numerous drug interactions. Phenobarbital can exacerbate the risk for opioid overdose and increase the risk for respiratory depression and death. Phenobarbital can de...

On this episode, I discuss isotretinoin pharmacology, side effects, drug interactions, and much more. The iPLEDGE program is in place to ensure that pregnant patients do not receive this medication. I discuss this in more detail on this episode. Sun sensitivity is an important adverse effect that patients should be aware of during seasons of high sun exposure. Hepatic issues, myalgia, and psychiat...

On this episode of the Real Life Pharmacology Podcast, I discuss lovastatin pharmacology, adverse effect, drug interactions, and more! Lovastatin is broken down by CYP3A4 so drugs like clarithromycin, diltiazem, and others may increase concentrations. Lovastatin is a lipophilic statin and I discuss the importance of this on the podcast. Lovastatin has a very short half-life which means that it is...

On this podcast episode, I discuss clindamycin pharmacology, adverse effects, drug interactions, and much more! Clindamycin (oral administration) can cause esophageal irritation and it is recommended to take this medication with a full glass of water. C. Diff risk and frequent dosing are two of the biggest downsides to using clindamycin to manage infections. Clindamycin has good activity against m...

On this podcast episode, I discuss dextroamphetamine’s pharmacology, adverse effects, drug interactions, and much more! Dextroamphetamine is a stimulant medication. Weight loss, insomnia, tachycardia, and hypertension are all possible complications. There is a patch dosage form of dextroamphetamine available called Xelstrym. I discuss it on this episode. Vitamin C can reduce GI absorption of...

On this podcast episode, I discuss vardenafil pharmacology, adverse effects, drug interactions, and much more. Vardenafil is a PDE-5 inhibitor used primarily for erectile dysfunction in males. Using nitrates with vardenafil is contraindicated due to the risk of profound hypotension. I have discussed how long to wait between vardenafil and nitrates in a previous post on Meded101.com . Be sure to ch...

On this podcast episode, I discuss niacin pharmacology, adverse effects, drug interactions, and much more. Niacin has historically been used to manage lipids but has fallen out of favor due to adverse effects, and newer, more effective therapies being developed. Niacin can elevate uric acid. Be sure to use this medication cautiously in patients with gout. Flushing is one of the most common adverse...

I discuss dextromethorphan pharmacology, adverse effects, drug interactions, and more on this podcast episode. CYP2D6 metabolizes Dextromethorphan. A commonly used antidepressant is a CYP2D6 inhibitor. I discuss this on the podcast. Dextromethorphan is a commonly used OTC cough suppressant. There is potential for abuse with this medication. In excessive doses, dextromethorphan may cause euphoria,...