Episodes

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. Be sure to check out our free Top 200 stud...

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

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 im...

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. Be sure to check out our free...

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. Be sure to check out our free Top 2...

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. Be sure to check...

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. Be sure to check out ou...

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. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE! Support The Podcast ...

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 increa...

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. Be sure to c...

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 bexa...

On this episode, I discuss cefuroxime pharmacology, adverse effects, drug interaction, pharmacokinetics, and much more. Cefuroxime is a 2nd generation cephalosporin that binds Penicillin-binding proteins and prevents bacterial cell wall synthesis. Medications that create a higher pH in the stomach such as antacids can ultimately reduce the concentrations of cefuroxime. Cefuroxime is primarily eliminated by the kidney. Dose adjustments are recommended for patients with a CrCL less than 30 mls/...

On this episode, I discuss risperidone pharmacology, adverse effects, monitoring, and common indications. There are numerous drug interactions that I discuss in this podcast episode. CYP2D6 inhibitors may increase drug concentrations. Risperidone increases prolactin more than most 2nd generation antipsychotics. This can lead to sexual adverse effects. QTC prolongation is a concern with all antipsychotics like risperidone. We can monitor EKG to monitor for this risk. Be sure to check out our ...

On this podcast episode, I discuss vortioxetine pharmacology, adverse effects, drug interactions, and much more. Because of vortioxetine’s long half-life, antidepressant discontinuation syndrome is going to be less prominent compared to ADPs with shorter half-lives. Vortioxetine is metabolized by CYP2D6. Drugs that inhibit this enzyme will likely raise concentrations and place the patient more at risk for adverse effects. I discuss rare vortioxetine adverse effects like hyponatremia and bleed...

On this episode, I discuss isosorbide mononitrate pharmacology, adverse effects, and important drug interactions. Isosorbide mononitrate is a vasodilator that works by relaxing and widening the blood vessels (primarily veins) through nitric oxide action. This reduces the preload and oxygen demand on the heart. The primary use for isosorbide mononitrate is angina prevention. It is important to remember that it is NOT meant for acute relief of chest pain. Headache is a major adverse effect of i...

On this episode of the RLP podcast, I discuss azelastine nasal spray pharmacology, adverse effects, administration, and much more! While most nasal sprays for allergic rhinitis are corticosteroids, azelastine is classified as an antihistamine. Systemic absorption of azelastine is about 40%, so while not common, systemic adverse effects like sedation can happen. On this podcast episode, I use azelastine to remind you about important education points regarding the use of nasal sprays. Be sure ...

On this episode of the Real Life Pharmacology Podcast, I discuss amlodipine pharmacology, adverse effects, and important drug interactions. I break down why edema occurs with amlodipine on this episode of the Real Life Pharmacology podcast. While beta-blockers are typically the first-line agent for the prevention of chronic angina symptoms, CCBs like amlodipine can be used as an alternative. There are some potential CYP3A4 interactions with amlodipine. I discuss the severity of these interact...

On this episode, I discuss pyridoxine pharmacology, adverse effects, and important clinical uses. Pyridoxine is most well known for its potential to reduce the likelihood of isoniazid-induced neuropathy. Another common indication of pyridoxine is its use for nausea and vomiting associated with pregnancy. Pyridoxine plays an important role in the production of heme, so deficiency will increase the risk for anemia. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours...

On this episode of the Real Life Pharmacology podcast, I discuss vibegron pharmacology, adverse effects, drug interactions and more! I spend some time comparing and contrasting vibegron to mirabegron. Both are beta-3 agonists used for overactive bladder. Vibegron dosing is very simple. It is dosed once daily with no alternative dosage forms available. The starting dose is the target dose. Being primarily excreted in the feces and urine, vibegron doesn’t have many drug interactions. Support T...

Bempedoic acid, also known as Nexletol, is a once-daily medication used in lipid management. I discuss its pharmacology, side effects, and much more on this podcast episode. Bempedoic is a once-daily medication that doesn’t need to be titrated. Standard dosing is 180mg once daily which can be taken with or without food. What are the most common side effects of bempedoic acid? One of the most notable adverse effects is hyperuricemia. This is usually seen within the first 4 weeks of being on the...

On this podcast episode, I discuss exenatide pharmacology, adverse effects, drug interactions, and much more! Exenatide has an immediate release formulation (Byetta) and a long acting formulation (Bydureon). I discuss the differences in this podcast episode. Byetta use has fallen out of favor due to frequent dosing, patient inconvenience and needing to time the dose 60 minutes prior to meals. I discuss the risk of pancreatitis related to GLP-1 agonists like exenatide in this podcast episode. ...

I discuss Pyridostigmine Pharmacology in this podcast episode in addition to adverse effects, drug interactions, and much more! Pyridostigmine is an acetylcholinesterase inhibitor that can be used for myasthenia gravis or orthostasis. Pyridostigmine can blunt the effect of neuromuscular blocking agents so patients undergoing surgery should be sure to have a game plan with their surgery team. Similar to donepezil, pyridostigmine can cause diarrhea and bradycardia. Be sure to check out our fre...

On this podcast episode, I discuss simethicone pharmacology, adverse effects, drug interactions, and much more! Simethicone is primarily used for anti-gas purposes. It is most often used on an as needed basis for relief of flatulence and bloating associated with gas. Systemic absorption is minimal with simethicone so the occurrence of any systemic-type side effects at therapeutic doses is low. Simethicone may interfere with levothyroxine absorption. Timing levothyroxine at least a few hours p...

On this podcast episode, I discuss fosinopril (Monopril) pharmacology, adverse effects, drug interactions and much more. Fosinopril is an ACE inhibitor so it should absolutely NOT be used in pregnancy as it poses fetus risks. Like other ACE inhibitors, hyperkalemia, cough, angioedema, and acute renal failure represent possible risks in using fosinopril. Drugs that can raise potassium when used in combo with fosinopril include spironolactone, trimethoprim, calcineurin inhibitors, and heparin. ...