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Save My Thyroid: Healing Tips for Hyperthyroidism and Hashimoto'sThe Thyroid Reset Diet with Dr. Alan ChristiansonIodine is a critical nutrient for thyroid function, yet there is a lot of controversy around iodine and thyroid health. Unlike other nutrients, iodine is selectively taken up by the parts of the body that use it. This generally means that when it’s in low supply, more is pulled in, and when there’s too much, it’s blocked from coming in. This creates the iodine paradox, where both excessive and insufficient iodine can lead to thyroid dysfunction.For people with autoimmune thyroid conditions, their genetic predispositions can impact how their bodies respond to iodine. So, while...2024-12-0359 min
Real Life Pharmacology - Pharmacology Education for Health Care ProfessionalsClonazepam Pharmacology PodcastOn 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 death.
Clonazepam is an intermediate-acting benzodiazepine that is only commercially available as an oral dosage form.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!...2022-10-0613 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPhentermine Pharmacology PodcastIn 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 controlled substance so the risk of addiction and dependence is possible.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
2022-09-2912 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsGlimepiride Pharmacology PodcastOn 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 and weight gain are problematic adverse effects of this medication and are the primary reasons it has fallen out of favor.
Be sure to check out our free Top 200 study guide – a...2022-09-2216 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsCephalexin (Keflex) Pharmacology PodcastOn 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.
Warfarin, probenecid, zinc, and a couple of others are potential medications that can interact with cephalexin. I discuss this further in this podcast episode.
Be sure to check out our free Top 200 study guide – a 31 pa...2022-09-1512 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsCeftriaxone PharmacologyOn 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 pneumonia, meningitis, gonorrhea, and many more.
It is important to remember that ceftriaxone can cover many staph and strep species but it does NOT cover MRSA.
Ceftriaxone...2022-09-0813 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsLactulose PharmacologyLactulose 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 episode.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Ch...2022-09-0111 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsTicagrelor PharmacologyOn 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 parameters.
I discuss CYP3A4 drug interactions on this episode and how it may affect ticagrelor.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FR...2022-08-2512 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsLurasidone PharmacologyOn 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 which is a nice advantage.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Out Th...2022-08-1816 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsIsavuconazole PharmacologyIsavuconazole 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 conversions between IV and oral are typically not difficult to navigate.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Out These Amazing Re...2022-08-1113 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsEthinyl EstradiolOn 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 might prefer a higher dose.
Blood clot risk is a real problem with ethinyl estradiol. There are numerous situations where we should avoid ethinyl estradiol and I cover...2022-08-0412 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsOlmesartan PharmacologyOn 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 might be advantageous in clinical practice.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Out These Amazing Resources!
NA...2022-07-2813 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsDesvenlafaxine PharmacologyOn 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 risk with desvenlafaxine as it has a significantly short half-life.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Out These Am...2022-07-2116 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPramipexole (Mirapex) PharmacologyPramipexole (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 urine. I discuss how this matters clinically in greater detail in this podcast episode.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podc...2022-07-1411 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPrednisolone PharmacologyI 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 numerous effects if used long-term.
CYP3A4 is an important enzyme in the breakdown of prednisolone. Inhibitors or inducers may raise or lower drug levels respectively.
Be sure to check out our free Top 200 study...2022-07-0716 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsBisoprolol (Zebeta) PharmacologyOn this episode, I discuss bisoprolol (Zebeta) pharmacology, adverse effects, drug interactions, and other important clinical pearls.
Bisoprolol is a beta-1 selective antagonist that can be used for atrial fibrillation, angina, and other cardiovascular indications.
It is important to remember that bisoprolol and other beta-blockers are not considered first-line agents for hypertension alone.
Beta-receptor selectivity does start to disappear with bisoprolol as you get to higher dosages. I discuss this further in the podcast.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FR...2022-06-3015 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsLansoprazole PharmacologyLansoprazole is a proton pump inhibitor that can be commonly used for GERD, PUD, and GI prophylaxis.
Lansoprazole can inhibit CYP2C19 which can cause concentrations of drugs like escitalopram and citalopram to rise.
Hypomagnesemia, low B12, osteoporosis, and an increase in C. Diff risk are potential complications with longer-term PPI use.
PPIs like lansoprazole are best given 30-60 minutes before meals. This is something that patients often forget.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on m...2022-06-2311 min
It Matters To Me35: Authentic Leadership with Eric Christianson“If you’re not vested in the mission; if you’re not trusting your leadership, personally, like do they care about you and if you’re not having fun, you know it’s time to go”
Welcome everyone and thanks for tuning in to episode 35 of the It Matters To Me Podcast, a show that celebrates the random through 1-on-1 conversations with people and the passions they pursue. With me on today’s journey is Eric Christianson, military veteran, and CEO of Nutrient Survival, a disruptive end-to-end food and beverage nutrition tech company based in Reno-Tahoe, Nevada.
Born at th...2022-06-191h 06Real Life Pharmacology - Pharmacology Education for Health Care ProfessionalsRopinirole PharmacologyRopinirole (Requip) is a dopamine agonist that can be used in Parkinson’s disease and Restless Legs Syndrome.
Dopamine agonists like ropinirole 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 ropinirole.
Ropinirole has drug interactions with antipsychotics and CYP1A2 inhibitors. I discuss these in greater detail in this podcast episode.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
2022-06-1614 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsInhaled Budesonide PharmacologyOn this episode of the podcast, I cover budesonide (Pulmicort) pharmacology. Our sponsor (Pyrls.com/rlp) for this episode is providing a FREE PDF of their inhaled corticosteroid categorizations chart (i.e. low/medium/high dose ICS) when you sign up for a free account!
The onset of action of inhaled budesonide is several hours up to a few days. Patient education is critical to ensure that patients stick with its use.
Budesonide does have a nebulized formulation that is often used in pediatrics and geriatrics.
There aren’t a ton of critical dr...2022-06-0914 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsEpoetin PharmacologyEpoetin alfa (Epogen, Procrit) is an erythropoiesis-stimulating agent that can be used for various types of anemia.
ESA’s like epoetin carry a boxed warning as they increase the risk of cardiovascular events like MI, stroke, and blood clots.
Assessing iron stores is critical when epoetin is used to ensure that a non-response is not due to deficiency.
I discuss dosing adjustments of epoetin in the podcast. One must be careful about raising hemoglobin too quickly.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is your...2022-06-0214 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsCanagliflozin PharmacologyCanagliflozin is an SGLT2 inhibitor. I discuss the pharmacology, dosing, adverse effects, and drug interactions of this medication.
Canagliflozin reduces blood sugar, by facilitating its exit through the urine. This can increase the risk of genitourinary infections.
A diuresis type effect can happen due to canagliflozin and this effect may be exacerbated by the use of thiazide and loop diuretics.
Hyperkalemia has been reported with the use of canagliflozin; the risk for this is increased with the use of medications like ACE inhibitors, ARBs, and aldosterone antagonists.
Be sure to check...2022-05-2613 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsCabergoline PharmacologyCabergoline is a dopamine agonist. I discuss the pharmacology, adverse effects, and drug interactions in this podcast episode.
Be on the lookout for drugs that could oppose the effects of cabergoline such as antipsychotics and metoclopramide.
Cabergoline can be used for hyperprolactinemia management and may cause adverse effects like hypotension and GI upset.
Cabergoline has a very long half-life so it is most often only dosed 1-2 times per week.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support Th...2022-05-1911 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsVenlafaxine PharmacologyIn this episode, I discuss venlafaxine pharmacology, adverse effect, dose conversion of IR to ER, and drug interactions.
Venlafaxine is notorious for producing withdrawal symptoms when discontinued abruptly. I discuss these in detail on the podcast.
How significant is the interaction of venlafaxine with antiplatelet agents? I discuss that in this episode.
The onset of action is a critical education point that patients must be aware of as it takes some time for venlafaxine to work.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yo...2022-05-1216 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsChlorthalidone PharmacologyOn this episode I discuss chlorthalidone pharmacology, adverse effects, and recent literature regarding cardiovascular disease reduction. Our friends at Pyrls.com are offering a free diagram of the nephron including the mechanism of action AND a summary of diuretic effects that I discussed on the podcast – Go sign up and get these for free and support this awesome sponsor!
Chlorthalidone is a thiazide diuretic that uniquely raises blood calcium levels compared to loop diuretics which lower calcium levels.
There was a recent piece of literature (2020) comparing chlorthalidone versus hydrochlorothiazide. It found that chlorthalidone was no mo...2022-05-0515 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsVerapamil Pharmacology PodcastOn this episode, I discuss verapamil pharmacology, adverse effects, and important drug interactions.
There are numerous drug interactions to be aware of with verapamil as it inhibits the enzyme CYP3A4.
Verapamil is a calcium channel blocker (non-dihydropyridine) that blocks calcium channels in the heart and vessels.
In addition to hypotension and bradycardia, verapamil can cause constipation which may be more prominent in our geriatric patients.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Ou...2022-04-2813 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsSalmeterol (Serevent) PharmacologyIn this episode, I cover salmeterol (Serevent) pharmacology, adverse effects, drug interactions and special warnings with this medication.
Salmeterol is a long acting beta agonist that can be used in combination with inhaled corticosteroids for management of asthma.
Salmeterol can be used as monotherapy in COPD and should not be used as monotherapy in asthma.
Elevations in pulse and blood pressure can happen with a beta agonist like salmeterol.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Po...2022-04-2114 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsEsomeprazole (Nexium) PharmacologyOn this episode, I discuss esomeprazole (Nexium) pharmacology, adverse effects, tapering, kinetics, and drug interactions.
I spend a good amount of time discussing the esomeprazole and clopidogrel interaction in this podcast episode.
Esomeprazole inhibits CYP2C19. This can cause an increase in citalopram concentrations and raise the potential for QTc prolongation.
It is critical to reassess the length of therapy and the dose of PPIs like esomeprazole.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Ch...2022-04-1415 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsCarvedilol (Coreg) PharmacologyOn this episode of the Real Life Pharmacology podcast, I discuss carvedilol pharmacology, drug interactions, and adverse effects.
Carvedilol is one of the few beta-blockers that has alpha-blocking activity.
Carvedilol is almost exclusively metabolized by various CYP enzymes so renal function changes typically don’t change drug concentrations to a significant extent.
Beta-blockers like carvedilol are well known to cause the adverse effects of fatigue and sexual dysfunction.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and...2022-04-0715 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsUmeclidinium PharmacologyOn this episode, I discuss umeclidinium pharmacology, adverse effects, patient education pearls, and drug interactions.
Umeclidinium is used in the management of COPD. Below is an excellent quick overview of the COPD guidelines from pyrls.com – You can get the full PDF by signing up for a free account at pryls.com/rlp
Umeclidinium is a long-acting anticholinergic (anti-muscarinic) LAMA and as you can see from the figure above drugs from this class are frequently used in COPD management.
The brand name of umeclidinium is Incruse Ellipta. Ellipta refers to the device and no...2022-03-3112 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsDenosumab (Prolia) PharmacologyOn this episode, I discuss denosumab pharmacology, adverse effects, clinical pearls, and drug interactions.
Whenever I see an osteoporosis medication like denosumab used, I review the medications to ensure that we avoid medications that can cause osteoporosis.
Denosumab is often used as a potential alternative in osteoporosis management for those that cannot tolerate bisphosphonates.
We need to monitor calcium levels when using denosumab as levels can be dangerously low, especially when used in combination with other calcium lowering drugs.
Loop diuretics and cinacalcet can have additive hypocalcemia effects when used in...2022-03-2414 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsRoflumilast (Daliresp) PharmacologyOn this episode I discuss roflumilast (Daliresp) pharmacology, adverse effects, and important drug interactions.
Roflumilast is indicated to reduce the incidence of COPD exacerbations.
Roflumilast is significantly broken down by CYP3A4 so there are numerous drug interactions that we have to take into account.
Psychiatric issues, GI upset, and weight loss are all potential adverse effects due to roflumilast.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
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NA...2022-03-1710 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsTrihexyphenidyl (Artane) PharmacologyOn this episode, I breakdown trihexyphenidyl (Artane) pharmacology, adverse effects, and drug interactions.
Trihexyphenidyl is highly anticholinergic and can cause constipation, dry eyes, dry mouth, and urinary retention.
Dementia medications like donepezil can have their effects blunted by the use of trihexyphenidyl.
Trihexyphenidyl is an older anticholinergic that is rarely used for the management of EPS caused by antipsychotics.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Out These Amazing Resources!
NAPLEX St...2022-03-1009 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsLiraglutide PharmacologyOn this episode, I discuss liraglutide pharmacology, drug interactions, and adverse effects.
Liraglutide is well known to cause nausea. It is important to assess the severity of nausea as it may subside in some patients as they gain tolerability to the medication.
We mentioned the 2022 Diabetes Guideline Cheat Sheet in the podcast – you can get that for free at pyrls.com/rlp
Liraglutide has a fairly low risk of hypoglycemia when used alone, but this risk increases when it is used with insulin or sulfonylureas.
Saxenda is the weight loss formulation of...2022-03-0312 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsLosartan PharmacologyOn this episode, I discuss losartan pharmacology, adverse effects, drug interactions, and appropriate monitoring.
Losartan is an ARB and can increase potassium levels. Keep an eye out for medications like spironolactone and trimethoprim which can increase this risk further.
Losartan has been shown to lower uric acid levels which could potentially be helpful in patients with gout.
Monitoring renal function is very important with losartan. The risk of ARF goes significantly higher when used with NSAIDs or diuretics.
Be sure to check out our free Top 200 study guide – a 31 page PDF th...2022-02-2414 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPravastatin PharmacologyOn this episode, I breakdown pravastatin pharmacology, adverse effects, drug interactions and when you might see this drug used in practice.
Pravastatin is a statin and will lower LDL. Its use is a little limited in the fact that it is not as potent as other agents in its LDL lowering effects.
Pravastatin is hydrophilic which differentiates it from simvastatin, atorvastatin, and lovastatin.
I describe rhabdomyolysis in this podcast as it is a potential rare adverse effect of pravastatin.
Be sure to check out our free Top 200 study guide – a 31 page PD...2022-02-1711 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsClomiphene PharmacologyOn this episode, I discuss clomiphene pharmacology, adverse effects, clinical practice pearls, and drug interactions.
Clomiphene is a commonly used medication to help manage female infertility.
Clomiphene is oral and relatively inexpensive compared to other agents that are used for infertility management.
Clomiphene is a SERM so you can anticipate that some patients may report vasomotor symptoms like flushing and hot flashes.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Out These Amazing Resources!2022-02-1010 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsFluticasone Nasal PharmacologyFluticasone (Flonase) is a nasal corticosteroid that is used in the management of allergic rhinitis.
A primary adverse effect that I have seen in practice with fluticasone is the risk for nose bleeds.
Flonase can have some interactions via CYP3A4. Inhibitors of CYP3A4 like clarithromycin can increase concentrations.
While the risk for systemic exposure is low with nasal fluticasone, long-term, high dose, and frequent use should be monitored appropriately.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Su...2022-02-0312 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsSucralfate PharmacologyOn this episode, I discuss (Carafate) sucralfate pharmacology, adverse effect, kinetics, and drug interactions.
Sucralfate is notorious for drug binding interactions and can reduce the concentrations of many drugs which I cover in the podcast.
Four times daily dosing is a big downside to sucralfate and why it isn’t used terribly often for GI issues like esophagitis.
The suspension formulation of sucralfate does contain some sugar so be aware of this in our diabetes patients.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is your...2022-01-2712 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsAtenolol PharmacologyOn this episode, I discuss atenolol pharmacology, adverse effects, pharmacokinetics, and drug interactions.
Atenolol is primarily cleared by the kidney which should tell you that we need to pay attention to dose adjustments as renal function declines.
Atenolol is a beta-1 selective agent that is NOT a preferred beta-blocker in HFrEF.
Pulse and blood pressure monitoring is essential with any beta-blocker like atenolol.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Out These Amazing Re...2022-01-2011 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsHydromorphone PharmacologyOn this episode, I discuss hydromorphone pharmacology, adverse effect, and drug interactions.
I discuss the pharmacokinetics of hydromorphone and also discuss the relative potency compared to other opioids.
Hydromorphone drug interactions are mostly additive effects. Drugs that cause sedation or constipation can have additive effects on hydromorphone.
Be extremely careful with hydromorphone dosage forms. There are numerous different concentrations and strengths. I discuss this in this episode.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Ch...2022-01-1313 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsDuloxetine PharmacologyOn this episode, I discuss duloxetine pharmacology, adverse effects, and common drug interactions.
Duloxetine is an SNRI that is used for depression, anxiety, and various pain syndromes like neuropathy and fibromyalgia.
Duloxetine can inhibit CYP2D6 which can lead to higher concentrations of clozapine and propranolol and lower activity of tamoxifen.
CYP1A2 inhibitors like ciprofloxacin can raise concentrations of duloxetine leading to an increased potential for adverse effects.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Po...2022-01-0615 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsLasmiditan PharmacologyLasmiditan (Reyvow) is an agent that is utilized for acute migraine treatment. It works slightly differently than triptans which I discuss on this episode.
Lasmiditan is a relatively new agent and cost will often limit its use at this time.
Rosuvastatin and sulfasalazine are two common medications that may have concentrations increase when lasmiditan is used. I discuss this in detail on this episode.
Lasmiditan is an oral tablet that is only recommended to give once per day which differs from commonly used triptans where the dose can be repeated.
Be...2021-12-3013 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsSumatriptan PharmacologyOn this episode, I discuss sumatriptan pharmacology, adverse effects, drug interactions and more.
Dosage forms can provide different methods of drug delivery and I talk about many different sumatriptan dosage forms in this episode.
Cardiovascular risks need to be assessed when using a drug like sumatriptan. I discuss this in greater detail in the podcast.
Sumatriptan has serotonergic activity and we need to assess the risk of serotonin syndrome in our patients.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
2021-12-2314 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsBumetanide PharmacologyOn this episode of the Real Life Pharmacology Podcast, I discuss bumetanide pharmacology, adverse effects, and drug interactions.
Bumetanide is a loop diuretic and it is critical to monitor renal function and electrolytes with this medication.
Ototoxicity is a rare adverse effect that is dose-dependent and can be worsened by aminoglycosides.
It is critical to look for drugs that can worsen edema when using bumetanide to ensure that we avoid the prescribing cascade.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!...2021-12-1613 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsOxycodone PharmacologyOn this episode, I discuss oxycodone pharmacology, adverse effect, pharmacokinetics, and drug interactions.
Oxycodone is broken down by CYP3A4 and CYP2D6. I discuss this further on the podcast and how interactions may alter concentrations.
When a patient stops taking oxycodone after being on it for some time, you must recognize common symptoms of withdrawal.
Oxycodone comes as in an extended-release and immediate-release oral formulation.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
Support The Podcast and Check Ou...2021-12-0913 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsDoxycycline PharmacologyOn this episode of the Real Life Pharmacology podcast, I explore doxycycline pharmacology, adverse effects, and drug interactions.
Doxycycline can be bound by numerous minerals like calcium, magnesium, and iron. Coadministration can lead to reduced concentrations.
Sun sensitivity is a really important adverse effect that can be caused by doxycycline. Be sure to educate your patients.
Doxycycline can be used as an alternative to beta-lactams and macrolides in the management of community-acquired pneumonia.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!...2021-11-2514 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsTolterodine PharmacologyOn this episode, I discuss tolterodine pharmacology, adverse effects, and drug interactions.
Tolterodine (Detrol) is an anticholinergic medication used to manage the symptoms of overactive bladder.
Tolterodine’s anticholinergic activity can lead to a significant number of adverse effects like dry mouth, dry eyes, constipation, and urinary retention.
Elderly patients may be at greater risk for anticholinergic adverse effects from tolterodine compared to younger patients.
Tolterodine can have additive effects from other anticholinergics like diphenhydramine or TCAs which enhance its potential for side effects.
Be sure to check out ou...2021-11-1813 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsClarithromycin PharmacologyOn this episode, I discuss clarithromycin pharmacology, adverse effects, and drug interactions.
Clarithromycin is a macrolide antibiotic that can be used for many similar indications as azithromycin.
Clarithromycin has numerous drug interactions as it can inhibit CYP3A4. This limits its use in practice.
Clarithromycin can be used in the treatment of H. pylori in combination with other antibiotics and a PPI.
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Support The Podcast and Check Out These Amazing Resources!2021-11-1112 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsAzathioprine PharmacologyOn this episode, I discuss azathioprine pharmacology, adverse effects, monitoring parameters, and drug interactions.
Azathioprine is classified as an immunosuppressive agent so it is naturally going to be used for autoimmune type disorders and transplantation.
Azathioprine has a boxed warning for myelosuppression. I talk more about this in the episode.
Genetic testing is recommended by the AGA prior to the use of azathioprine. I discuss which tests might be helpful to reduce the risk of toxicity.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yo...2021-11-0414 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsAmitriptyline PharmacologyOn this episode, I discuss amitriptyline pharmacology, adverse effects, and drug interactions.
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2021-10-2811 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsGrapefruit Juice InteractionsOn this episode of the podcast, I discuss my approach and strategies to handle grapefruit juice interactions.
Grapefruit juice causes drug interactions by inhibiting the CYP enzyme system. More specifically, it inhibits CYP3A4 which is responsible for the breakdown of many medications.
Quantity is always an important consideration when assessing grapefruit juice interactions. The more that is taken, typically, the more drug concentrations will be affected.
It is important to assess the use of grapefruit juice when your patient has a history of cardiovascular disease, cardiac conditions, pain, mental health disease, or...2021-10-2116 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPantoprazole PharmacologyOn this episode, I cover pantoprazole pharmacology, adverse effects, and drug interactions.
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2021-10-1414 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsRosuvastatin PharmacologyOn this episode, I discuss rosuvastatin pharmacology, adverse effects, drug interactions and pharmacokinetics.
Rosuvastatin is a hydrophilic statin which differs from some of the most commonly used statins like simvastatin and atorvastatin.
Rosuvastatin is minimally affected by CYP3A4 drug interactions so that is a small potential advantage over simvastatin and atorvastatin.
At dosages of 20-40 mg, rosuvastatin is considered a high intensity statin and can bring down LDL by over 50%.
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Su...2021-10-0714 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsAtorvastatin PharmacologyOn this episode, I discuss atorvastatin pharmacology, adverse effects, monitoring parameters, and drug interactions.
Atorvastatin (Lipitor) is an HMG-CoA reductase inhibitor, the rate-limiting step in the production of cholesterol. It is used to prevent atherosclerotic cardiovascular diseases by decreasing cholesterol.
Atorvastatin is more lipophilic in comparison to other statins such as rosuvastatin. If a patient does not tolerate a statin, switching from a lipophilic to a hydrophilic or vice versa may decrease the chances of those side effects reoccurring.
It can be a high-intensity statin depending on the dose. 10-20mg is considered...2021-09-3015 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsGemfibrozil PharmacologyOn this episode, I discuss gemfibrozil pharmacology, adverse effects, and important drug interactions.
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2021-09-2313 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsTrospium PharmacologyOn this episode, I discuss trospium pharmacology, adverse effects, and important drug interactions you should know.
Trospium chloride (Sanctura) is a bladder antimuscarinic or anticholinergic. It blocks the action of acetylcholine in bladder smooth muscle. It is used for urinary frequency and overactive bladder. The immediate-release formulation is taken twice a day. There is an extended-release version that is more expensive.
As its classification suggests it is going to have anticholinergic effects that include dry eyes, dry mouth, constipation, urinary retention, GI tract slowing down, CNS sedation, and increased risk of falls. Compared to older...2021-09-1611 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPropranolol PharmacologyOn this episode, I discuss propranolol pharmacology, adverse reactions, and important drug interactions you should know.
Propranolol (Inderal) is a non-selective beta-blocker. There are many indications for it including hypertension, tachycardia, atrial fibrillation, post-MI, chronic stable angina, essential tremors, migraine prophylaxis, esophageal varices, performance anxiety disorder, lithium-induced tremor, psychotic induced akathisia, and thyroid storm.
Propranolol blocks beta-1 receptors that are commonly referred to as the cardiac receptors and beta-2 receptors that are in the lungs. Albuterol is a beta-2 agonist meaning that propranolol can block its effects. This may lead to bronchospasms and worsening of...2021-09-0914 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsQuetiapine PharmacologyOn this episode, I discuss quetiapine pharmacology, adverse effects, pharmacokinetics, and drug interactions.
Quetiapine (Seroquel) is a medication seen a fair amount, particularly in the geriatric population where there is psychosis associated with dementia. It is classified as an antipsychotic. Mechanistically it’s going to block dopamine receptors, specifically D2. It also has some serotonin receptor blockade antagonism. It does have other activity as well from a mechanism of action standpoint. There is alpha-blocking activity potentially as well as an antihistamine/anticholinergic type of activity. Uses of this medication are schizophrenia, bipolar disorder with associated mania, miscellaneous ps...2021-09-0214 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPhenazopyridine PharmacologyOn this episode, I discuss phenazopyridine pharmacology, adverse effects, and potential drug interactions.
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2021-08-2612 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsFluvoxamine PharmacologyOn this episode, I discuss fluvoxamine pharmacology, adverse effects, and most importantly, drug interactions.
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2021-08-1913 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsOxybutynin PharmacologyOn this episode, I discuss oxybutynin pharmacology, drug interactions, and adverse effects.
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2021-08-1213 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsGlyburide PharmacologyOn this episode, I will discuss glyburide pharmacology.
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2021-08-0509 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsZaleplon PharmacologyOn this episode, I discuss the pharmacology of zaleplon including side effects, drug interactions, and important clinical pearls.
Zaleplon is a non-benzodiazepine sleep aide commonly known as Sonata. It is commonly used for sedation and the management of insomnia. Zaleplon is a controlled medication, with a high risk for dependence, and because of that, it is best used to treat short-term insomnia. The pharmacology of zaleplon is similar to other sleep aids like Ambien, and Lunesta; they all have an impact on GABA. Specifically, zaleplon regulates the GABABZ receptor. The GABABZ receptor has been shown to be...2021-07-2910 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsHydrochlorothiazide PharmacologyOn this episode, I breakdown the pharmacology of hydrochlorothiazide including adverse effects, drug interactions, and other clinical pearls.
Hydrochlorothiazide has common brand names of Microzide, Hydrodiuril, and its common abbreviation is HCTZ. Extra caution should be taken with “HCTZ”; it may be mistaken for other abbreviations. Hydrochlorothiazide works pharmacologically by blocking the reabsorption of sodium in the distal tubule of the kidney. The result of the pharmacology of hydrochlorothiazide is increased water, sodium, and potassium excretion. Due to hydrochlorothiazide’s mechanism of action, it makes it advantageous when used for blood pressure, edema, and heart failure in additi...2021-07-2213 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsTorsemide PharmacologyOn this episode, I discuss torsemide pharmacology, adverse effects, drug interactions and pharmacokinetics. Torsemide is commonly known as Demadex. It is a loop diuretic, and like other loop diuretics, it acts by inhibiting the reabsorption of Na+ and Cl- in the ascending loop of Henle. What results is a decrease in the reabsorption of water, causing a loss of electrolytes as well as water. The pharmacology of torsemide makes it useful in cases of heart failure, cirrhosis, or hypertension. Torsemide, and other loop diuretics, can also be a part of the prescribing cascade. For example, pregabalin and gabapentin, along...2021-07-1514 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsDoxylamine PharmacologyIn the podcast this week, I talk about doxylamine pharmacology. Doxylamine is a first-generation antihistamine; it is commonly an active ingredient in night-time medications like Unisom, Nyquil, and Mucinex. The pharmacology of doxylamine is similar to other first-generation antihistamines, it competitively inhibits the binding of histamine at H1 receptors. Its main uses are as sleep aides, in cough-and-cold medications, but doxylamine has also been given with pyridoxine to treat nausea and vomiting during pregnancy.
Doxylamine’s adverse reactions are related to its anticholinergic properties, they include dry eyes, dry mouth, increased fall risk, sedation, urinary retention, constipation, an...2021-07-0811 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsSacubitril Valsartan PharmacologyOn this episode, I breakdown the sacubitril valsartan pharmacology.
The drug for this week is the combination drug sacubitril/valsartan, also known as Entresto. Entresto has a novel dual mechanism of action to treat HFrEF. Sacubitril, currently, is the only FDA-approved medication that is a neprilysin inhibitor. For background, neprilysin is an enzyme that breaks down natriuretic peptides. The inhibition of neprilysin results in an increase in natriuretic peptides, which causes vasodilation, fluid loss, and a decrease in blood pressure. Valsartan is an angiotensin II receptor blocker; it prevents angiotensin II from binding to AT1 to reduce...2021-07-0112 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsGlipizide PharmacologyGlipizide, or Glucotrol, is a sulfonylurea used for the treatment of Type 2 Diabetes. Pharmacologically, glipizide acts by stimulating beta-cells in the pancreas to release insulin. Specifically, glipizide will block the opening of ATP-sensitive potassium channels on the plasma membrane of beta-cells on the pancreas. The result of that is depolarization, which then causes stimulation of voltage-sensitive calcium channels, eventually causing the exocytosis of insulin. The increased insulin will then promote the storage of glucose, decreasing the amount of glucose in the blood.
Due to the pharmacology of glipizide, the concerning adverse drug reactions are hypoglycemia and weight g...2021-06-2412 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsCetirizine PharmacologyOn this episode of the Real Life Pharmacology Podcast, I discuss cetirizine pharmacology.
Cetirizine, commonly known as Zyrtec, is a 2nd generation antihistamine. Compared to 1st generation antihistamines, like diphenhydramine and chlorpheniramine, 2nd generation antihistamines have fewer anticholinergic effects. Pharmacologically, cetirizine works by selectively blocking histamine from binding to the H1 receptor. The uses for cetirizine are allergic rhinitis, itching, and sometimes acute allergic reactions. Commonly, cetirizine is dosed at 10 mg daily, and can even be escalated to 10 mg twice daily in rare situations. In adults 77 years old and older, the manufacturer recommended dose tops out at 5...2021-06-1710 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsFolic Acid PharmacologyFolic acid is a water-soluble vitamin; compared to fat-soluble vitamins, accumulation is not as much of an issue. It is responsible for the formation of coenzymes, DNA synthesis, erythropoiesis, and certain metabolic processes. Due to the mechanism of folic acid, if there is a deficiency present, anemia can manifest. Although the recommended dietary intake is 0.2 mg, supplementation may be necessary. Some situations where supplementation may be desired are prevention of neural tube defects in pregnancy, patients suffering from alcohol abuse disorder, bariatric surgery patients, and certain types of GI disorders where malabsorption may be present. If a patient is...2021-06-1012 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsInsulin Glargine PharmacologyOn this episode, I discuss insulin glargine pharmacology. Insulin glargine is a long-acting insulin that has the common brand names Lantus, Basaglar, and Toujeo. Due to the pharmacology of insulin glargine, it provides a baseline coverage of insulin. It cannot manage acute elevations in blood glucose like target-specific meals. Instead, insulin glargine is used to decrease blood sugar throughout the day.
It is normally dosed once a day, and sometimes a patient will have another type of insulin that’s rapid-acting, like Humalog. The daily insulin dose will vary, but it’s frequently a 50/50 split between long-acting, and r...2021-06-0317 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPrimidone PharmacologyOn this episode, I discuss primidone pharmacology, adverse effects, and drug interactions.
Primidone, or Mysoline, is an anticonvulsant most commonly used for essential tremors. The primary pharmacological mechanism of action of primidone is similar to other anticonvulsants, like phenobarbital. It causes a reduction in the activity of neurons. Both primidone and its metabolites are potent anticonvulsants. Primidone alters the transmembrane Na/Cl transport channel to reduce the frequency of nerve firing. Phenobarbital, one of primidone’s active metabolites, interacts with GABA-A receptors and chloride channels to reduce nerve excitability.
Typically B-blockers are used first for essen...2021-05-2712 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsMelatonin PharmacologyI cover melatonin pharmacology on this episode of the Real Life Pharmacology Podcast.
Melatonin, commonly taken by patients for insomnia, is an endogenous hormone produced by the pineal gland. It is an over-the-counter supplement available in dosage forms such as liquid drops, gummies, and tablets. The pharmacology of melatonin is primarily through the activation of melatonin receptors in the suprachiasmatic nucleus; it is also a derivative of L-tryptophan. The production and secretion of melatonin is stimulated by darkness and is inhibited by light. Melatonin concentrations are also shown to vary with age. Its production primarily begins between...2021-05-2014 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsFurosemide PharmacologyFurosemide is a loop diuretic most commonly recognized by its brand name, Lasix. Pharmacologically, it acts by inhibiting the reabsorption of Na/Cl in the thick ascending limb of the loop of Henle. The inhibition of electrolyte reabsorption results in a loss of fluids causing diuresis. Since it has a diuretic effect, it is commonly used to treat congestive heart failure, general edema, ascites due to cirrhosis, and to aid in fluid elimination.
If a patient has a new prescription of furosemide, it’s important to look for drug-induced causes of edema. Common causes of drug-induced edema are...2021-05-1316 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsHydroxyzine PharmacologyBackground: – Hydroxyzine Pharmacology Hydroxyzine, common brands Atarax, and Vistaril, is a first-generation antihistamine. It is a part of the piperazine drug class[1], sharing structural similarities to other antihistamines like Cetirizine, but also drugs of other classes like ranolazine, buspirone, clozapine. Being an H1 blocker, hydroxyzine is commonly used for itching, anxiety, analgesia, urticaria, and insomnia. The main adverse drug reactions associated with hydroxyzine are the anticholinergic effects common with most antihistamines, dry mouth, headache, urinary retention, QTC prolongation, drowsiness[2].
Interactions: Due to hydroxyzine’s pharmacology and mechanism of action, it can exacerbate or worsen gastroparesis by decreasing smooth...2021-05-0613 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsVitamin B12 PharmacologyOn this episode, I cover clinical tips and practice pearls surrounding vitamin B12 pharmacology.
Vitamin B12 deficiency plays a critical role in the development of macrocytic anemia.
There are medications that you have to be aware that can deplete vitamin B12. Metformin, colchicine, and PPIs are some common examples.
A lack of intrinsic factor can lead to B12 deficiency. Intrinsic factor is necessary for adequate GI absorption of vitamin B12.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book...2021-04-2914 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsKetamine PharmacologyOn this episode, I discuss ketamine pharmacology.
Ketamine is primarily broken down by CYP2B6 which fortunately does not have a lot of common medications that can interfere with its action.
Ketamine can cause psychiatric type adverse effects such as hallucinations, nightmares, and vivid dreams.
At lower to moderate dosages, ketamine does have some mild sympathetic activity which can raise blood pressure and heart rate.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in...2021-04-2212 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsTopiramate PharmacologyOn this episode of the Real Life Pharmacology Podcast, I cover topiramate pharmacology.
Topiramate is indicated for migraine prevention, seizures, and weight loss which are the most common uses that I see this medication used for.
Topiramate has carbonic anhydrase activity, so rarely, use of this drug may induce metabolic acidosis.
By far, the most common patient complaint I get with the use of topiramate is that it causes cognitive slowing or impairment.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is...2021-04-1512 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsColchicine PharmacologyOn this episode I discuss colchicine pharmacology, adverse effects, drug interactions, and pharmacokinetics.
Colchicine ultimately works by reducing the activity of neutrophils that help contribute to pain and inflammation associated with gout.
Colchicine does have some drug interactions with medications and grapefruit juice via CYP3A4.
The most common dose limiting side effect of colchicine is diarrhea.
Colchicine can be used as a potential alternative to NSAIDs or corticosteroids in the management of a gout flare.
Be sure to check out our free Top 200 study guide – a 31 page PDF th...2021-04-0812 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsFexofenadine PharmacologyFexofenadine is a 2nd generation antihistamine that is primarily used for allergic rhinitis. I cover fexofenadine pharmacology on this podcast episode.
Fruit juices can actually impair the absorption of fexofenadine and increase the risk of treatment failure.
Fexofenadine is mildly anticholinergic but overall has low to no CNS penetration.
Because fexofenadine has low CNS penetration, the risk for sedation and dizziness is much lower than older antihistamines like diphenhydramine.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on...2021-04-0114 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsEmpagliflozin PharmacologyOn this episode I discuss empagliflozin pharmacology and how this medication lowers blood sugar.
In this episode, I talk about empagliflozin pharmacology. Empagliflozin is more commonly known by the brand name Jardiance and is in the class of sodium-glucose co-transporter-2 inhibitors or SGLT2 inhibitors. Jardiance use has definitely escalated over the last few years in the management of type 2 diabetes, but this has been changing a little bit as well due to recent evidence for the cardiovascular benefits from this medication.
The sodium-glucose co-transporter-2 is found in the kidney and is responsible for helping the...2021-03-2512 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsRifaximin PharmacologyOn this episode, I discuss rifaximin pharmacology.
Rifaximin is most commonly used in hepatic encephalopathy and C. difficile infection.
Rifaximin systemic absorption is minimal so that is why it is primarily only used for GI conditions.
Drug interactions with rifaximin are fairly minimal compared to its cousin rifampin which has tons of drug interactions.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.
Be sure to check out our free...2021-03-1812 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsNaproxen PharmacologyOn this episode of the Real Life Pharmacology Podcast, I discuss naproxen pharmacology.
Naproxen can raise the concentrations of lithium and increase the risk for toxicity.
Compared to most other NSAIDs, naproxen tends to have a lower cardiovascular risk.
Naproxen can contribute to renal insufficiency, GI bleed risk, and CHF exacerbations.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.
Be sure to check out our free Top 200 study guide – a...2021-03-1113 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsCyclosporine PharmacologyOn this episode, I discuss cyclosporine pharmacology. This medication is an immunosuppressant used to reduce the risk of transplant rejection.
Cyclosporine has a long list of potential adverse effects such as hyperglycemia, renal impairment, GI toxicity, and hypertriglyceridemia.
Important monitoring parameters for cyclosporine include drug levels, electrolytes, renal function, and blood sugars.
CYP3A4 interactions are critical with cyclosporine. Inhibitors can raise concentrations and inducers can lower concentrations.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
2021-03-0414 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsLeflunomide PharmacologyOn this episode, I discuss leflunomide pharmacology. It is classified as a DMARD and is primarily used in rheumatoid arthritis.
Leflunomide carries a boxed warning for hepatoxicity. LFTs must be monitored with its use.
Leflunomide can inhibit CYP2C8 which plays an important role in pioglitazone metabolism. Concentrations of pioglitazone can go up on account of this interaction.
TB screening should be done prior to beginning the immunosuppressant leflunomide.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on...2021-02-2512 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsBaclofen PharmacologyBaclofen is primarily used for its ability to help relieve muscle spasms. I discuss baclofen pharmacology on this podcast episode.
Baclofen should not be abruptly discontinued as it can cause a significant withdrawal reaction whose symptoms may include fever, spasticity, rhabdomyolysis, and death.
While baclofen generally avoids any issues with CYP enzyme interactions, it is eliminated by the kidney. Renal function changes can alter drug concentrations.
Sedation, confusion, dizziness, hypotension, and GI upset are some of the more common adverse effects of baclofen.
Be sure to check out our free Top 200...2021-02-1814 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsBromocriptine PharmacologyOn this episode, I discuss bromocriptine pharmacology. It is a dopamine agonist that can be used for hyperprolactinemia and Parkinson’s symptoms.
One of the major side effects of bromocriptine is nausea which stems from its dopamine agonist action.
Because bromocriptine is a dopamine agonist, it can counteract the action of antipsychotics.
Bromocriptine is broken down by CYP3A4, so drug interactions can be common. Erythromycin, some of the azole antifungals, verapamil, grapefruit juice, and diltiazem are all medications that can increase concentrations.
Be sure to check out our free Top 200 st...2021-02-1111 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsTacrolimus PharmacologyOn this episode, I discuss tacrolimus pharmacology. This medication is an immunosuppressant used to reduce the risk of transplant rejection.
Tacrolimus has a long list of potential adverse effects such as hyperglycemia, renal impairment, GI toxicity, and hypertriglyceridemia.
Important monitoring parameters for tacrolimus include drug levels, electrolytes, renal function, and blood sugars.
CYP3A4 interactions are critical with tacrolimus. Inhibitors can raise concentrations and inducers can lower concentrations.
Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!
2021-02-0414 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsIbuprofen PharmacologyOn this episode of the Real Life Pharmacology Podcast, I discuss ibuprofen pharmacology.
Ibuprofen can raise the concentrations of lithium and increase the risk for toxicity.
Compared to most other NSAIDs, ibuprofen has a relatively short half-life. This explains why it needs to be dosed more frequently than other agents.
Ibuprofen can contribute to renal insufficiency, GI bleed risk, and CHF exacerbations.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.
2021-01-2815 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsAripiprazole PharmacologyAripiprazole is metabolized by CYP2D6 and CYP3A4. Because of this, drug interactions can happen. I discuss specific examples in this episode.
Partial dopamine agonist activity and serotonergic activity make up a significant amount of aripiprazole’s pharmacology.
Aripiprazole is classified as an antipsychotic and can be used in schizophrenia, bipolar disorder, and depression augmentation.
Aripiprazole can cause significant akathesia. I discuss this adverse effect on this episode.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on ma...2021-01-2114 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsEscitalopram PharmacologyOn this episode of the Real Life Pharmacology Podcast, I discuss escitalopram pharmacology.
Escitalopram is an SSRI and can be used to manage depression, anxiety, OCD, PTSD, and other psychiatric disorders.
If you consider fluoxetine the most activation SSRI and paroxetine the most sedating, escitalopram probably falls somewhere in the middle.
Sexual dysfunction is a potential adverse effect with escitalopram. I discuss it further on this episode.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug...2021-01-1415 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsZiprasidone PharmacologyOn this episode of the Real Life Pharmacology Podcast, I cover ziprasidone pharmacology.
Ziprasidone has dopamine blocking activity and is classified as a second generation antipsychotic.
Ziprasidone tends to have lower metabolic syndrome risks compared to other antipsychotics like clozapine and olanzapine.
QTc prolongation is a significant risk with ziprasidone and be aware of drug interactions and electrolyte imbalances that may increase this risk.
I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary...2021-01-0713 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsTiotropium PharmacologyOn this episode, I discuss tiotropium pharmacology. In addition, I cover adverse effects, administration pearls, and drug interactions.
Tiotropium blocks acetylcholine from binding the M3 receptor in the lungs. This leads to a relaxation of the bronchial smooth muscle.
Because tiotropium has anticholinergic activity, there is a potential for anticholinergic adverse effects like constipation, urinary retention, and dry mouth.
The tiotropium Handihaler can be confusing to patients. I discuss medication misadventures in this podcast episode.
I discuss important drug interactions on the podcast, be sure to check out my latest project...2020-12-3113 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsPalivizumab PharmacologyOn this episode, I discuss palivizumab pharmacology and how it is used in pediatric patients.
Palivizumab is a monoclonal antibody that is used to prevent RSV infections in pediatric patients.
Palivizumab is an IM injection that is dosed by weight. Learn more on this podcast episode.
RSV can be devastating in pediatric patients under the age of two. Palivizumab can be used in select populations to help prevent the infection.
Injection and skin reactions are possible with the use of palivizumab.
Be sure to check out our free Top 200...2020-12-2413 min
Backcountry BSingBackcountry BSing #58 - Eric Christianson - Former Army Ranger and Current CEO of Nutrient SurvivalEric Christianson is a former US Army ranger, food services executive, and current CEO of Nutrient survival. We sit down, crack some bourbon, and talk to Eric about his past experience as an army ranger, the current (poor) state of backpacking food, what it was like transitioning to be the CEO of nutrient survival, some upcoming nutrient food entrees, and when they are coming out with some alcoholic drink mixes??!
Thanks for BSing Eric! Be sure to check out Nutrient Survival (this is NOT sponsored): https://nutrientsurvival.com/
Thank you to this episode's sponsor - ar...2020-12-1052 min
Sounding Point PodcastSounding Point Podcast Ep. 15: Eric SilbergerEric Silberger is a top prizewinner in both the Tchaikovsky International Competition and Michael Hill International Violin Competition. He is co-founder and artistic director of Hawaii International Music Festival and Executive Director of Classical Bridge Festival.
I first met Eric at Lorin Maazel's Castleton Festival back in 2012, where Eric saved the day in a particularly uncomfortable situation... We start the podcast recalling this memorable event! We go on to discuss Eric's new album, exploring the compositions of Hawaiian Queen Liliuokalani. ORDER HERE:
https://manamusichawaii.com/store/mana-music-quartet-album-queen-liliuokalani
We went on to discuss Eric's amazing performances of all 24 Paganini Caprices in...2020-11-0800 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsSGLT-2 Inhibitors PharmacologyOn this episode, I discuss the mechanism of action of the SGLT-2 Inhibitors and how they lower blood sugar.
These drugs are classically used for diabetes and eliminate blood sugar through the urine.
One of the potential side effects is that these drugs can increase the risk of genital infections and urinary tract infections.
There is a boxed warning on canagliflozin for its potential to increase the risk of amputation.
These drugs also have a mild diuretic type effect and can potentially cause hypotension.
Enjoy the show and be...2018-11-0111 minReal Life Pharmacology - Pharmacology Education for Health Care ProfessionalsDigoxin Pharmacology – RLP Episode 011On this episode I explain digoxin pharmacology and also run through some scenarios where I’ve seen digoxin toxicity actually happen.
I also discuss the relationship of low potassium and how digoxin can have an exacerbated effect in this setting. Hope you enjoy the episode and please feel free to reach out and give me some feedback!
All subscribers to the website/podcast will get access to a FREE Top 200 Drug Study Guide where I highlight the 3 most highly testable pearls from each medication (this is a 31 page PDF!) In addition, you’ll get a free 1...2018-04-1909 min
Pharmacy Future LeadersPharmacy Future Leaders - Eric Christianson, PharmD - Pharmacy Podcast Episode 414
#PharmacyFutureLeaders
Preparing for the NAPLEX
Guest: Eric Christianson
MED ED 101 Clinical Pharmacy Education – Improving Practice, Protecting Patients
Eric Christianson is a clinical pharmacist passionate about patient safety, geriatrics, MTM, and clinical pharmacy. He is the owner of the blog at www.meded101.com a valuable resource for practicing healthcare professionals and students alike who are interested in learning more about the practical application of clinical pharmacy. He has 2 wonderful children and the best wife in the world.
Among his professional accomplishments, he is Board certified in geriatrics and pharmacotherapy, has been quoted in the Wall Street Journal, American Journal of Nurs...2017-04-1130 min