Real Life Pharmacology - Pharmacology Education for Health Care Professionals

On this episode, I discuss the pharmacology surrounding QTc prolongation and drug interactions. I discuss which medications are more likely to cause QTc prolongation and which patient populations we should be more concerned about. Antiarrhythmics are a common class of medication that can exacerbate QTc prolongation when used with other interacting medications. 500 ms is a common value utilized to...

On this podcast episode, I cover risedronate pharmacology, adverse effects, drug interactions, and much more. There is a strict administration procedure with risedronate which is designed to reduce adverse effects and enhance absorption. I discuss this in the podcast. Many medications may cause osteoporosis and may precipitate treatment with risedronate. Corticosteroids and excessive thyroid hormo...

On this podcast episode, I discuss some of the most common antihypertensive drug interactions you need to know. One major interaction I discuss is the trifecta of a diuretic, an ACE or ARB, and an NSAID. This combination significantly increases the risk for acute renal failure. Nitrates aren’t classically referred to as an antihypertensive but they can definitely cause some problems when com...

Teplizumab is a relatively new agent that helps delay the progression of type 1 diabetes. It slows the rate of beta-cell destruction in the pancreas. Teplizumab is associated with cytokine release syndrome which can result in flu-like symptoms of fever, aches, and headache. Cytokine release syndrome due to teplizumab can be reduced by using appropriate pretreatment medications. Those medications c...

On this podcast episode, I discuss captopril pharmacology, kinetics, interactions, and much more! Captopril is an ACE Inhibitor. It can cause hyperkalemia, cough, and renal impairment. One of the notable issues with captopril is its relatively short half-life which requires it to be dose frequently throughout the day. Lithium is an important drug interaction and the use of captopril with this medi...

On this episode of the Real Life Pharmacology podcast, I take a dive into the most common mechanisms of drug interactions. Below I list some of the common drug interactions seen in practice and how they work! Opposing Effects Many drugs will work on various receptors throughout the body. To use as an educational point, there is no better example to point to than the beta receptor. Beta-blockers ar...

On this podcast episode, I discuss insulin aspart pharmacology, adverse effects, drug interactions, and much more. Insulin apart is a rapid acting insulin product meant to bring down blood sugars quickly (most often after meals). It is important to remember a couple of medications that may counteract the effects of insulin and apart and raise blood sugar. I talk about corticosteroids and thiazide...

On this podcast episode, I discuss gentamicin pharmacology, adverse effects, monitoring, drug interactions and much more! Drug monitoring is critical with gentamicin. Trough and peak concentrations can guide therapy and identify someone at risk of toxicity. Nephrotoxicity is a major concern with gentamicin. There are numerous nephrotoxic agents that can increase this risk. I discuss them on the po...

On this podcast episode, I discuss fenofibrate pharmacology, adverse effects, kinetics, drug interactions, and much more! Fenofibrate is typically only used for hypertriglyceridemia. The primary risk of hypertriglyceridemia is pancreatitis so we treat these levels because of this risk. LFTs elevation has been associated with fenofibrate use as well as myopathy. In the presence of myopathy, checkin...

On this podcast episode, I discuss levofloxacin pharmacology, adverse effects, boxed warnings, interactions, and much more. Levofloxacin is well known to cause QTc prolongation and many drugs can increase this risk such as antiarrhythmics, citalopram, antipsychotics, and many more. Binding interactions are important when discussing levofloxacin pharmacology. Calcium, iron, magnesium, and many othe...

On this podcast episode, I discuss darifenacin pharmacology, adverse effects, drug interactions and much more. CYP3A4 and CYP2D6 are important enzymes in relation to darifenacin. I breakdown the importance of these enzymes and how they can impact drug therapy. Darifenacin has anticholinergic activity but affects the central nervous system less than other agents in its class such as oxybutynin and...

In this podcast episode, I discuss naltrexone pharmacology, adverse effects, drug interactions, and much more. Naltrexone is an opioid antagonist and can blunt the effects of opioid agonists. Because of this, the medication can be used to manage opioid use disorder. Hepatotoxicity is a concern of naltrexone and because of this, it is recommended to monitor LFTs. There is an injectable, long-acting...

On this podcast episode, I discuss acamprosate pharmacology, adverse effects, drug interactions, and much more! Acamprosate’s most common adverse effect is diarrhea. It is a primary reason why patients will ask to stop taking this medication. It is critical to assess renal function prior to using acamprosate. Dose adjustments are recommended when patients have a CrCl of less than 50 ml/min....

On this podcast episode, I discuss alfuzosin pharmacology, adverse effects, drug interactions, and much more! Alfuzosin is an alpha blocker used to help relieve the symptoms of BPH. Low blood pressure is a possible adverse effect of alfuzosin and is more likely when combined with PDE-5 inhibitors like sildenafil. CYP3A4 is an important enzyme in the metabolism of alfuzosin. Inhibitors of CYP3A4 ca...

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...