Episodes

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 medication may increase concentrations and the chance for toxicity. Be sure to check out our free To...

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 are frequently used in clinical practice for their ability to lower blood pressure and slow the hear...

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 diuretics in the drug interaction section. Fiasp is a slightly modified insulin aspart molecule t...

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 podcast. Ototoxicity is another risk associated with gentamicin. Loop diuretics like furosemide can...

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, checking CPK may be considered. Fenofibrate is a weak CYP2C9 inhibitor. Warfarin and phenytoin are two i...

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 other cations can block the absorption of this medication. I discuss tendon rupture in relation to le...

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 tolterodine. Darifenacin’s pharmacology is selective for the Muscarinic-3 (M3) receptor in bladde...

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 formulation of naltrexone that can be used for opioid and alcohol use disorder treatment. Be su...

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. Unlike naltrexone, acamprosate avoids liver metabolism making it an alternative option in alcohol use d...

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 can raise concentrations and increase the chance of alfuzosin toxicity. Be sure to check out our f...

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 drug interactions. I discuss them in detail in this podcast episode. Be sure to check out our free ...

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 its neurotoxic metabolite normeperidine. I discuss this further in this podcast episode. Be sur...

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 action is slow in the management of ADHD with guanfacine. I discuss this further in this podcast episod...

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 have previously discussed this on the Meded101 blog which you can find here. Be sure to check ou...

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 and specifically how this may impact our patients. Be sure to check out our free Top 200 study gu...

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, antiplatelets, diuretics, and ACEs/ARBs are all common medication classes that can interact with diclo...

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. Be sure to check out our free Top 200 study guide – a 31 page PDF that...

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 buprenorp...

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 y...

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 p...

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 enalapri...

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 Be...

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. Be sure to check out our free Top 200 study guide – a 31 page PDF that is your...

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. Be sur...