Real Life Pharmacology - Pharmacology Education For Health Care Professionals

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 levels and renal function.

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. You must keep an eye out for withdrawal symptoms when initiating and adjusting doses of buprenorphine/naloxone. They include sweating, nausea, tachycardia, and mood changes.

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 the most commonly tested adverse effects of spironolactone. Be sure you don't miss this one on your board and pharmacology exams!

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. Meloxicam has a longer half-life than many NSAIDs and because of this can be dosed once daily for pain relief.

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. NSAIDs and diuretics can increase the risk of acute renal failure when an ACE inhibitor like enalapril is being used.

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 thoughts on this topic. The GINA update a few years ago has been a game changer in asthma, hear from Beth how this has been implemented in her practice. Beth also discusses some of the everyday drug interactions and adverse effects of asthma medications in this podcast episode. Neither Beth nor I have any conflicts of interest in regard to discussing these medications. If you'd like to contact Beth, you can reach out to her at zerr@arizona.edu

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 abuse and dependence.

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. Immunosuppression from etanercept can lead to an increased risk for infection and malignancy.

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 the overwhelming majority of situations. Ideally, we should be more proactive about insulin administration to reduce the risk of hyperglycemia spikes.

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 frequently used in practice for neuropathic pain syndromes.

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 manage this adverse effect.

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 deplete numerous vitamins such as vitamin D, folic acid, and vitamin B12. Monitoring of these is important.

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 psychiatric changes are rare adverse effects associated with isotretinoin.

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 ideal to dose this medication at night for maximal efficacy.

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 many gram-positive organisms like Staph and Strep as well as anaerobic activity.

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 dextroamphetamine due to its ability to increase the acidity of the GI tract.

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.

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 effects of niacin. High doses, immediate-release formulations, and the use of alcohol can increase the risk.

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, hallucinations, and other CNS effects, but also cause cardiovascular complications.

On this podcast episode, I discuss bexagliflozin pharmacology, adverse effects, drug interactions, and much more. I wasn't wowed by the A1C reduction of this medication. I get into the specifics on bexagliflozin in the podcast episode. SGLT2 inhibitors like bexagliflozin increase the glucose in the urine which can facilitate the growth of bacteria and fungi in the genitourinary tract. Limb amputation and euglycemic DKA are two rare, reported adverse effects to be aware of with the use of bexagliflozin.