Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Minocycline is a tetracycline antibiotic. I discuss pharmacology, adverse effects, and drug interactions. Minocycline can cause sun sensitivity. Be sure to educate patients about this risk. Metal cations like iron, zinc, calcium, and magnesium can bind minocycline and reduce the oral absorption of the medication. Tooth discoloration is a possible adverse effect if minocycline is given to pediatric...

In this podcast episode, I cover propylthiouracil pharmacology, adverse effect, drug interaction, and much more! Propylthiouracil carries a boxed warning for hepatotoxicity which is a significant downside compared to the other agent in its class (methimazole). What about dosing? I discuss why this medication has to be dosed multiple times per day. Drug interactions aren’t incredibly common w...

Brexpiprazole (Rexulti) is a second generation antipsychotic. I discuss its pharmacology, adverse effects, drug interactions, and more in this podcast episode. I like to associate brexpiprazole with aripiprazole. They have a lot of overlapping characteristics, particularly in relation to the adverse effect profile. Brexpiprazole tends to have a low incidence of metabolic adverse effects which make...

On this episode, I discuss indapamide pharmacology, adverse effects, drug interactions, and pharmacokinetics. I discuss how indapamide differs from other thiazide diuretics. Particularly, I discuss indapamide compared to hydrochlorothiazide. Frequent urination, hypokalemia, and dehydration are all possible risks with indapamide. Pay attention to medications that can increase the risk for acute ren...

On this episode, I discuss tadalafil pharmacology, adverse effects, pharmacokinetics, and drug interactions. Tadalafil has a significantly longer half-life than sildenafil. I discuss how this is going to impact a patient that may need a nitrate. PDE-5 inhibitors like tadalafil are most commonly used for erectile dysfunction but I talk about other unique indications in the podcast. Daily use or as-...

Sitagliptin is a DPP4 inhibitor. I discuss the pharmacology of this medication on the podcast. Which diabetes medication works similarly to sitagliptin? I discuss that further on this episode of the Real Life Pharmacology podcast. Renal elimination plays a significant role with sitagliptin. I discuss how this impacts the appropriate dosing. Cost is a significant issue with sitagliptin at this time...

On this podcast episode, I discuss gabapentin (Neurontin) pharmacology, adverse effects, drug interactions, and much more! Gabapentin’s GI absorption is a little wacky. I discuss on the podcast the clinical effects that this may have on our patients. Renal elimination is critical to gabapentin. Worsening renal function will significantly impact the action of the drug. CNS sedation can be a p...

Ranolazine is primarily used for chronic angina management. I discuss pharmacology, drug interactions, adverse effects, and more in this podcast episode. Ranolazine is well known to have drug interactions. CYP3A4 is of major importance but there are other subtle drug interactions that are important. QTc prolongation has been reported with ranolazine so it is important to recognize risk factors and...

On this podcast episode, I discuss lorazepam (Ativan) pharmacology, adverse effects, and common drug interactions. Lorazepam has numerous dosage forms and the IV formulation does contain propylene glycol which can accumulate if it is used for longer periods of time. There is a boxed warning for lorazepam when it is used with opioids. The risk for opioid overdose, coma, and death increases signific...

On this podcast episode, I discuss valsartan pharmacology, adverse effects, drug interactions, and much more. Valsartan is a fairly common ARB. I mostly see losartan and valsartan used as the most common ARBs in hypertension management. Valsartan has a longer half-life than losartan which is why we can often get away with once daily dosing compared to losartan which sometimes requires twice daily....

On this podcast episode, I discuss famotidine pharmacology, adverse effects, uses, and drug interactions. Famotidine is generally pretty well tolerated, but one thing I look out for with chronic use is B12 deficiency. Famotidine is eliminated by the kidney so you should pay attention to the dose in patients with CKD. Famotidine is occasionally used as a pretreatment to help prevent infusion-type r...

On this podcast episode, I discuss clonazepam pharmacology, adverse effects, pharmacokinetics, and drug interactions. Clonazepam is a benzodiazepine that enhances the activity of GABA which is an inhibitory neurotransmitter in the central nervous system. It is important to try to avoid using benzodiazepines like clonazepam with opioids as it can increase the risk of respiratory depression and deat...

In this podcast episode, I break down the pharmacology, adverse effects, pharmacokinetics, and drug interactions of phentermine. Phentermine has some CNS stimulant activity so adverse effects like insomnia, hypertension, and tachycardia are possible. Pay attention to drugs that can oppose the effects of phentermine and cause weight gain such as mirtazapine and sulfonylureas. Phentermine is a contr...

On this podcast episode, I discuss glimepiride pharmacology, adverse effects, hypoglycemia symptoms, and drug interactions. CYP2C9 is an important enzyme in the breakdown of glimepiride. I discuss a few drugs that can cause interactions via this enzyme. Renal function is important to consider with glimepiride. The active metabolites are cleared by the kidney and can accumulate in CKD. Hypoglycemia...

On this podcast episode, I discuss cephalexin pharmacology, adverse effects, drug interactions, and much more! Penicillin allergies and cross-reactivity are common questions with regard to the use of cephalexin and I discuss this briefly in the podcast episode. Cephalexin is a first-generation cephalosporin with its primary sweet spot being gram-positive bacteria like Staph and Strep species. Warf...

On this episode, I discuss ceftriaxone pharmacology, adverse effect, coverage, and drug interactions. Ceftriaxone is currently a drug of choice for the STI Gonorrhea. Pyrls.com has an amazing chart on all the STIs and their drugs of choice that you can get for free when you sign up for a free account! Ceftriaxone is a third-generation cephalosporin that is used for numerous indications such as pne...

Lactulose is an osmotic laxative but it is rarely used for this purpose. I discuss lactulose pharmacology in this episode. Elevated ammonia levels are an issue in hepatic encephalopathy. Lactulose can help manage this issue. Lactulose is dosed to 2-3 soft stools per day when used to reduce ammonia levels. Lactulose can increase the effect of warfarin and raise INR; I discuss this further on this e...

On this episode, I discuss ticagrelor pharmacology, adverse effects, and important drug interactions. Ticagrelor has a warning with regards to the use of aspirin. Higher doses of aspirin can impair the effectiveness of ticagrelor and I discuss this further on this episode. Bleeding is the major adverse effect from ticagrelor and naturally, hematocrit and hemoglobin are important monitoring paramet...

On this podcast episode, I discuss lurasidone pharmacology, adverse effects, and drug interactions. CYP3A4 is an important enzyme in the breakdown of lurasidone. I discuss this further on this episode. Lurasidone is best taken with food as this enhances absorption and helps improve drug concentrations. Lurasidone tends to have a lower risk for metabolic syndrome compared to other antipsychotics wh...

Isavuconazole is an azole antifungal that can be used for various fungal infections. In this episode, I discuss isavuconazole pharmacology, adverse effect, drug interactions, and pharmacokinetics. Isavuconazole is interestingly associated with QT shortening which is different from most azole antifungals that cause QT prolongation. Oral bioavailability of isavuconazole is nearly 100% so dose conver...

On this episode, I cover ethinyl estradiol pharmacology. This is a common component of oral contraceptives. You have to check out this free resource (with free account) from Pyrls.com/rlp which lists all the different combinations and brand names. All it takes is to simply sign up for a free account here. Ethinyl estradiol dosing can vary. Breakthrough bleeding is a major reason why a patient migh...

On this episode, I discuss olmesartan (Benicar) pharmacology, adverse effects, drug interactions, and pharmacokinetics. Olmesartan can cause a unique GI adverse effect called enteropathy. I discuss this on this podcast episode. Important monitoring parameters for olmesartan include potassium, renal function, and blood pressure. Olmesartan has a longer half-life than losartan. I discuss how this mi...

On this episode, I discuss desvenlafaxine pharmacology, adverse effects, pharmacokinetics, and drug interactions. Desvenlafaxine is a serotonin and norepinephrine reuptake inhibitor that can be used for depression. Renal elimination is an important method of deactivation of desvenlafaxine. Dose adjustments may be recommended as renal function drops below 50 mls/min. Withdrawal syndrome due is a ri...

Pramipexole (Mirapex) is a dopamine agonist that can be used in Parkinson’s disease and Restless Legs Syndrome. Dopamine agonists like pramipexole can worsen psychiatric symptoms in some patients by causing hallucinations, and obsessive/compulsive symptoms. Nausea, vomiting, hypotension, and fatigue are the most common adverse effects of pramipexole. Pramipexole is primarily eliminated through the...

I mentioned prednisolone to prednisone conversion in this podcast. Please go check out Pyrls.com for a free steroid conversion downloadable PDF with a free account! On this episode, I discuss prednisolone (Orapred, Pediapred) pharmacology, adverse effects, practice pearls, and drug interactions. Prednisolone is a systemic corticosteroid that can cause insomnia, elevations in blood sugars, and nume...