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September 5, 2019
Benzodiazepines act by enhancing the effect of GABA, an inhibitory neurotransmitter. Benzodiazepines can cause confusion, sedation, and respiratory depression. There are many potential indications for benzodiazepines. They can be used in anxiety, status epilepticus, insomnia, and alcohol withdrawal amongst other things. There is a boxed warning for the use of opioids with benzodiazepines. The primary risk of the combination is respiratory depression.
August 29, 2019
Celecoxib is easy to remember as its mechanism of action is "COX"-2 Inhibition. This can result in result in reduced prostaglandin formation and help with pain and inflammation. Kidney function is important to monitor in our patient on celecoxib. It is especially important in patients taking ACE inhibitors, ARBs, and/or diuretics. While GI bleed may be less likely with celecoxib compared to traditional NSAIDs like indomethacin and ibuprofen, it still needs to be monitored for. Digoxin concentrations may be increased with the use of celecoxib. Celecoxib is generally dosed twice per day as the half-life of the drug is in the ballpark of 10-12 hours.
August 15, 2019
Dolutegravir is an integrase inhibitor that is used in the management of HIV infection/ Carbamazepine along with other enzyme inducers can substantially lower the concentrations of dolutegravir. Dolutegravir can potentially increase blood sugars, this should be closely monitored in our patients with diabetes. CNS adverse effects like insomnia and dizziness can happen with dolutegravir.
August 8, 2019
On this podcast episode, I cover medroxyprogesterone acetate injection pharmacology (DMPA or Depo-Provera) Medroxyprogesterone acetate injection is given every three months for the prevention of pregnancy. Medroxyprogesterone acetate has a boxed warning for its risk of causing low bone mineral density. Classic enzyme inducers can cause lower concentrations of medroxyprogesterone which can potentially lead to contraceptive failure. Examples of enzyme inducers that can lower concentrations of medroxyprogesterone include carbamazepine, phenytoin, rifampin, and some agents used in the management of HIV.
August 1, 2019
Budesonide/formoterol inhalation is sold under the brand name Symbicort. Budesonide/formoterol is a combination agent that is used in the management of COPD and asthma. Budesonide/formoterol is a combination of an inhaled corticosteroid and long-acting beta-agonist. GINA guidelines now allow for the use of budesonide/formoterol in the management of acute asthma exacerbation.
July 25, 2019
Benztropine is a highly anticholinergic medication that is primarily used for movement disorders. Antipsychotics can cause extrapyramidal adverse effects that can help be managed with benztropine. Because benztropine is highly anticholinergic, it can cause dry eyes, dry mouth, urinary retention, constipation and contribute to falls and confusion, particularly in our elderly population. While benztropine is classified as an anti-Parkinson's agent, it is rarely used for that indication as it has a high incidence of anticholinergic adverse effects (particularly at the doses that are required for benefit).
July 18, 2019
Budesonide is a corticosteroid that can be given orally or rectally for management of Crohn's disease or ulcerative colitis. Because budesonide has a high first pass metabolism, the relative impact of systemic effects may be less than other steroids like prednisone. Remember that CYP3A4 inhibitors can increase the concentrations of budesonide. I discuss this further on the podcast. Different dosage forms of budesonide (oral versus rectal) can be used for different reasons. The site of the inflammation in Ulcerative colitis can determine which dosage form is most appropriate.
July 11, 2019
Cimetidine blocks histamine 2 receptors which can suppress acid production and reduce symptoms of heartburn. One of the major downsides to cimetidine is that it has a ton of drug interactions. I discuss many of the common ones in this episode. Cimetidine is one of a few drugs that has the potential to cause gynecomastia. I discuss the mechanism of this adverse effect in this episode. Phenytoin concentrations can rise due to the use of cimetidine. I discuss this in the drug interactions section of this episode.
July 4, 2019
Clopidogrel is an antiplatelet agent that is often used in combination with aspirin to help reduce the risk of an MI. The risk of bleed is a high priority with the use of clopidogrel. Patients must be monitored for signs and symptoms of bleeding and bruising. Clopidogrel is a prodrug that is converted to its active metabolite by CYP2C19. Fluconazole can inhibit CYP2C19 which may reduce the effectiveness of clopidogrel.
June 27, 2019
Sulfasalazine is a medication that can be used for diseases like rheumatoid arthritis, Crohn's disease, and Ulcerative Colitis. Because sulfasalazine can cause GI upset, this is a major reason why we try to break up the dose and give it multiple (at least two) times per day. LFT and CBC monitoring are recommended with sulfasalazine due to its low potential to cause liver dysfunction, aplastic anemia, and agranulocytosis. Sulfasalazine can impair folic acid absorption and lead to potential deficiency. A patient deficient in folic acid is at higher risk for developing anemia.
June 20, 2019
On this episode, I discuss the pharmacology of cholestyramine. Cholestyramine was originally developed as an agent to manage cholesterol, but has fallen out of favor for some of the more effective agents like statins. Cholestyramine is notorious for binding drug interactions. It can reduce concentrations of drugs like amiodarone, digoxin, oral contraceptives, immunosuppressive and many more! In patients with chronic diarrhea, cholestyramine is occasionally used off label to help manage symptoms because it tends to have constipating effects.
June 13, 2019
Rifampin is classified as an antibiotic and an antituberculosis agent. It primarily works by inhibiting bacterial RNA polymerase. While not extremely common, rifampin is well known to cause hepatic dysfunction. You should remind patients who are taking rifampin that it can alter the color of tears, sweat, saliva and urine. It can change these fluids to a reddish/brown color. Rifampin is very well known for causing drug interactions. It is an enzyme inducer that can reduce the concentrations of numerous medications such as warfarin, apixaban, cyclosporin, levothyroxine, and oral contraceptives to name a few. Rifampin can be used to help prevent meningococcal infection. Learn more on rifampin by listening to this podcast!
June 6, 2019
Heparin is an interesting drug with a lot of unique clinical quirks. This drug ultimately inhibits the formation of fibrin. Fibrin is an essential component of a blood clot. Because heparin has blood thinning effects, it is critical to assess a patient's bleed risk. Look out for other agents that may increase the risk of bleeding. Examples include; NSAIDs, antiplatelet agents, and other anticoagulants. One classic test question about heparin that often comes up is the reversal agent. Protamine can be used to help reverse the effects of heparin. Heparin-induced thrombocytopenia is a critical adverse effect to understand. I discuss both subtypes on the podcast and let you know what to look out for. Rarer side effects of heparin include hyperkalemia and osteoporosis (only with long term use).
May 30, 2019
On this episode, I discuss montelukast pharmacology Montelukast is a leukotriene receptor antagonist. Leukotrienes play an important role in causing inflammation and smooth muscle contraction in asthma and allergic rhinitis. Because montelukast blocks the effects of leukotrienes, it can be advantageous to use this medication for allergies and asthma. It is important to remind patients that montelukast is NOT a substitute for an acute relief medication like albuterol in the management of asthma symptoms. Montelukast has been reported to cause mood and behavioral changes and it is important to monitor our patients for these rare concerns.
May 23, 2019
On this episode, I discuss clozapine pharmacology. This drug has multiple mechanisms of action: Dopamine blockade, anticholinergic activity, and alpha blocking activity all contribute to the complexity of this drug. Smoking cessation can significantly increase the concentrations of clozapine. This is because smoking can induce CYP1A2. Listen to the podcast for more details on how this can impact our patients clinically. Clozapine has 5 boxed warnings. I discuss them all in this podcast. The most well-known boxed warning is for agranulocytosis. Because clozapine has alpha blocking activity, it can cause orthostasis. We need to monitor for this. Clozapine can cause QTc prolongation. Keep an eye out for other medications that the patient may be taking that can also cause this. Examples include: amiodarone, ondansetron, quinolones, and macrolides
May 16, 2019
On this episode, I discuss carbamazepine pharmacology. This drug is most commonly used for seizures, bipolar disorder, or trigeminal neuralgia. Carbamazepine is an autoinducer and can reduce the concentrations of numerous drugs. Some examples include apixaban, warfarin, rivaroxaban, diltiazem, verapamil, and many more! Carbamazepine has the potential to cause Steven Johnson's Syndrome. This has a much greater chance of happening in patients with certain genetics. Carbamazepine can contribute to SIADH and cause significant hyponatremia. Carbamazepine has boxed warning for numerous potential events like aplastic anemia, agranulocytosis, and the above-mentioned SJS.
May 9, 2019
On this episode, I discuss the pharmacology of commonly used stimulant laxatives like sennosides and bisacodyl. Stimulant laxatives "stimulate" the GI tract smooth muscle which helps propel fecal material out of the body and thus helping to relieve constipation. Patients who are having diarrhea and are unsure of what medications they are taking should have their regimen assessed for these medications. Chronic opioid therapy is a situation where chronic stimulant laxative therapy may be used. Stimulant laxatives have very few drug interactions. However, bisacodyl effectiveness can be reduced by the use of antacids like calcium carbonate.
May 2, 2019
On this episode, I discuss ezetimibe pharmacology. Ezetimibe works by inhibiting Niemann-Pick C1-Like1 (NPC1L1) transporter. This transporter aids in cholesterol absorption so by blocking it, we can reduce cholesterol levels (and LDL) in the bloodstream. Ezetimibe is usually very well tolerated. Diarrhea, myopathy, and elevations in LFT's are adverse effects that have been reported but do not occur at high rates. Ezetimibe is dosed at 10 mg once daily. This is a nice advantage because this is a starting dose and the usual treatment dose. With the most recent cholesterol guideline updates, I do expect ezetimibe to be utilized a little more than it used to be. They place more emphasis on a target LDL and getting patients to goal. Statins are going to be used first line for cholesterol and ezetimibe will be an add on therapy to consider. They don't, unfortunately, lower cholesterol as much as high-intensity statins do.
April 25, 2019
On this episode, I cover azithromycin pharmacology. This drug primarily acts by inhibiting protein synthesis. It binds to the 50s ribosomal subunit. GI adverse effects like nausea and diarrhea are going to be the most common with azithromycin. Azithromycin has been associated with prolonging the QT interval. Drugs like amiodarone, ondansetron, citalopram, antipsychotics, and quinolone antibiotics can also prolong the QT interval. One major advantage that azithromycin has over other antibiotics is that it has a long half life which allows for once daily dosing. Azithromycin has numerous uses like pneumonia, MAC, alternative for ear infections in patients with a beta-lactam allergy, certain STD's, and also is rarely used in long term COPD exacerbation prevention.
April 18, 2019
Rivaroxaban is a factor 10a inhibitor that inhibits clot formation and thins the blood. Rivaroxaban needs to be monitored for bleed risk. Checking periodic CBC can help us assess if hemoglobin and hematocrit are remaining stable. Enzyme inducers like rifampin, St. John's Wort, and carbamazepine can reduce concentrations and increase the risk of treatment failure. NSAIDs and antiplatelet medications can significantly increase the risk of bleed with rivaroxaban. Rivaroxaban should not be used with dual P-glycoprotein and CYP3A4 inhibitors. Examples include ketoconazole, itraconazole, and ritonavir.
April 11, 2019
Valproate (valproic acid, Depakote) has numerous uses which includes migraines, seizures, and bipolar disorder. In a patient who is taking valproate, it is important to monitor for signs and symptoms of confusion as this drug can cause elevated ammonia levels. When switching between dosage forms of valproate, you must recognize that the bioavailability is not the same between each different dosage form. This could lead to toxicity or treatment failure. Valproic acid has a boxed warning for hepatotoxicity and liver function needs to be monitored. Valproic acid can increase lamotrigine levels which ultimately could lead to an increased risk of lamotrigine induced SJS.
April 4, 2019
On this episode I discuss the pharmacology of donepezil. Donepezil is an acetylcholinesterase inhibitor. In dementia, that is a deficiency in acetylcholine and donepezil helps preserve this neurotransmitter. Donepezil can cause weight loss, GI upset, and diarrhea. This is an important monitoring parameter in our dementia patients. There is the possibility for donepezil to cause bradycardia and insomnia. Keep an eye out for these adverse effects as they can and do happen in real practice. Anticholinergics are notorious for blunting the effects of donepezil. We must look out for drug interactions from older anticholinergics like diphenhydramine, amitriptyline, and hydroxyzine.
March 28, 2019
Linezolid is an antibiotic used for bacterial infection. It primarily works by inhibiting bacterial protein synthesis. Linezolid is primarily bacteriostatic against most bacteria which means that it inhibits the growth and doesn't necessarily kill the bacteria itself. Caution must be used with linezolid and serotonergic drugs as there is a risk for serotonin syndrome. Clinical risk/benefit analysis needs to be done. Linezolid overall has good coverage for VRE and MRSA. It is an option for MRSA pneumonia where daptomycin is not. Linezolid has both an oral and an IV option which allows for good continuity of inpatient and outpatient use.
March 21, 2019
On this episode, I cover pioglitazone pharmacology. The primary mechanism of action with pioglitazone is that it is an agonist at Peroxisome Proliferator Activated Receptor Gamma receptor. This improves insulin sensitivty in the periphery. Two common side effects exist with pioglitazone. This drug can cause weight gain and also contribute to edema. Pioglitazone has a boxed warning and is contraindicated in patients who have symptomatic heart failure. There are a few potential interactions with pioglitazone. Trimethoprim and gemfibrozil can inhibit the breakdown of pioglitazone. A couple of advantages of pioglitazone include that it is generic (inexpensive) and that it is dosed once daily.
March 14, 2019
On this episode I breakdown nitrofurantoin pharmacology. Nitrofurantoin is an antibiotic that is used in the treatment of UTI's. Nitrofurantoin has activity by creating reactive metabolites that can disrupt protein synthesis and ultimately kills the bacteria causing the infection. It is important to remember with nitrofurantoin, that in the setting of systemic infection and/or kidney involvement, the drug may not be very effective. Nitrofurantoin can potentially reduce the effectiveness of certain vaccines. Be sure to look this up prior to administration. Nitrofurantoin can cause pulmonary symptoms as well as neuropathy. This is very important to monitor for.
March 7, 2019
Hydralazine Pharmacology Hydralazine works as a direct vasodilator. It primarily works on the arterioles versus the venous system. Hydralazine can cause a unique adverse reaction. It can cause a Lupus type syndrome that can result in fever, myopathy and symptoms that mimic arthritis. I discuss drug interactions with hydralazine and how you need to be aware of certain medications that can have additive effects and also those that can oppose the effects of the drug. One of the downsides to using hydralazine is that patients don't like to take it as often as it requires. It is typically dosed three to four times per day. Orthostasis is a risk with any drug that reduces blood pressure and hydralazine is no different.
February 28, 2019
On this episode of the Real Life Pharmacology Podcast, I discuss aspirin pharmacology. The two most common adverse effects with aspirin are GI upset and increasing the risk for bleeding and bruising. A commonly asked test question about aspirin is whether it can be used in pediatrics and what risk we encounter if we use it. Another rare effect with aspirin is tinnitus which I discuss further on this episode. It is critical to pay attention to other medications that can thin the blood in a patient taking aspirin. Examples include anticoagulants like warfarin, apixaban, rivaroxaban; antiplatelets like clopidogrel or prasugrel; or NSAIDs.
February 22, 2019
Clonidine is classified as an antihypertensive. Clonidine pharmacology involves having agonist activity at central alpha 2 receptors. This leads to lower sympathetic outflow and a reduction in blood pressure. Clonidine has numerous reported uses in addition to its antihypertensive effect. It can potentially be used for ADHD, menopausal type symptoms, and opioid withdrawal. Clonidine has historically been on the Beers' list of drugs as it can cause some CNS side effects like sedation, dizziness, and rarely delirium. Clonidine is unique in the antihypertensive class as it does have a patch formulation. Because of the blood pressure lowering effect of clonidine, we have to be aware of patients who report dizziness. Monitoring is critical. Clonidine can also lower heart rate and contribute to dry mouth. Keep an eye out for drugs that can have a cumulative effect on these symptoms. Drugs like beta-blockers, non-DHP CCB's, and digoxin can all have a cumulative effect with clonidine and lower pulses. Monitoring is important.
February 14, 2019
Memantine is classified as an NMDA receptor antagonist. Memantine pharmacology is complex as is the pharmacology of any medication working in the brain. This drug can help reduce the activity of glutamate, an excitatory neurotransmitter which can play a role in Alzheimer's dementia. Memantine has an extended release dosage form that is dosed once per day compared to twice per day for the immediate release. However, the cost of the extended release is much more expensive, so it is recommended to begin with the immediate release. Memantine is cleared by the kidney. In patients with reduced kidney function, you must review to assess if the memantine dose needs to be adjusted. When using memantine or other dementia medications, be sure to look out for medications that can cause dementia type symptoms. CNS depressants like benzodiazepines, sleep medicines, and anticholinergics are all examples of meds that could exacerbate dementia.
February 7, 2019
On this episode, I discuss magnesium pharmacology and the clinical applications. Magnesium plays numerous important functions in the body and you may see patients take these supplements under the direction of a healthcare professional and sometimes on their own. It is very important to remember that magnesium can cause GI upset and diarrhea. This is often overlooked in our polypharmacy patient. Magnesium can accumulate in renal disease. This is important to remember especially in patients who have a tendency to take a lot of supplements without discussing them with a healthcare professional. PPI's are a notorious cause of low magnesium. Loop diuretics can increase magnesium excretion and also cause low magnesium levels. Magnesium can bind up numerous drugs reducing concentrations and leading to treatment failure. A few examples include quinolone antibiotics, tetracycline antibiotics, and levothyroxine.
January 31, 2019
Trazodone pharmacology is complex. It can inhibit serotonin reuptake, block histamine receptors, and possibly have alpha-blocking activity. Side effects of trazodone include sedation, dizziness, and dry mouth. Rarely, priapism may occur. I've seen this nugget come up on pharmacology exams! While trazodone is classified as antidepressant, it is often used to help manage insomnia. Trazodone can possibly prolong the QT interval. Risk of other medications and patient specific parameters should be considered. Trazodone concentrations can be increased with the use of CYP3A4 inhibitors and reduced with 3A4 inducers.
January 24, 2019
The GLP-1's are a relatively newer class of medications used to lower blood sugars in diabetes. GLP-1's work by simulating the effects of incretin hormones in the body. They can help promote fullness, lower weight, and stimulate insulin release following a meal. GLP-1's can cause significant GI side effects. Nausea is by far the most common adverse effect. It can even lead to diarrhea and vomiting in some cases. There is boxed warning on the GLP-1 agonists. Be aware of patients who have had a history of thyroid cancer as this may be a contraindication. GLP-1 agonists can help lower A1C and stimulate weight loss which is a huge benefit for most patients with Type 2 diabetes.
January 17, 2019
Iron supplements frequently cause GI upset. Monitor patients for nausea, vomiting, and constipation issues. There are three main salt forms of iron. Ferrous fumurate has the most elemental iron, ferrous sulfate (2nd most), and ferrous gluconate has the least. Iron can bind up antibiotics and reduce their effectiveness. Two classic examples include the quinolone and tetracycline antibiotics. Anemia can be caused by numerous concerns, however, iron deficiency is a very common cause. Ferritin is a lab that we commonly monitor in a patient who may be iron deficient. Iron deficiency can also lead to symptoms of Restless Leg Syndrome.
January 10, 2019
On this episode, I cover common loop diuretics. They include furosemide, torsemide, and bumetanide. Loop diuretics are potent agents that can help in the management of heart failure and ascites. Loops diuretics help promote the loss of excessive fluid through the urine. A common patient complaint from loop diuretics is that they can cause frequent urination. Because of this, we typically dose these drugs earlier in the day. Kidney function and electrolyte monitoring is critical with the use of loop diuretics. Enjoy the episode!
January 3, 2019
On this episode of the Real Life Pharmacology Podcast, I cover the pharmacology of methotrexate. Methotrexate has a few different indications. It can be used for treatment of cancer. These doses are typically going to be much higher than standard low doses for other conditions. Lower dose methotrexate is often used for autoimmune type conditions like rheumatoid arthritis and psoriasis. Folic acid should be supplemented with use of methotrexate to help reduce the risk of adverse effects. Liver toxicity and immune system suppression are two important factors to monitor in a patient taking chronic methotrexate. I also talk about important cumulative drug interactions with methotrexate such as immunosuppressives and other agents that may impact liver function. Be sure to listen to the end as I talk about the potential impact of methotrexate on some vaccines!
December 27, 2018
On this episode, I discuss cyclobenzaprine pharmacology. Cyclobenzaprine is an older skeletal muscle relaxant. Cyclobenzaprine can have a significant number of anticholinergic side effects. The anticholinergic side effects of cyclobenzaprine can include sedation, dry eyes, dry mouth, urinary retention, and confusion. Cyclobenzaprine is not well tolerated in the elderly and cause more problems in that patient population. Cyclobenzaprine has a similar structure to the Tricyclic antidepressants.
December 20, 2018
Lithium is a drug that has a ton of clinical pearls.  On this episode, I talk about the pharmacology, side effects, drug interactions, and critical practice pearls. Kidney function is very important to monitor in our patients taking lithium.  Lithium can accumulate in renal impairment. Thyroid function can be altered by lithium.  Be sure to regularly monitor TSH in a patient on chronic lithium. Over-the-counter NSAID can interact and raise lithium levels.  This is something you need to watch out for as patients can begin taking these medications on their own without supervision. Be sure to assess lithium levels.  Signs of toxicity can include GI upset, tremor, motor movement issues, sedation, and CNS changes.
December 13, 2018
Pseudoephedrine is commonly used to help relieve nasal congestion. There are some adverse effects you need to be aware of with pseudoephedrine. Insomnia, increase in blood pressure, and urinary retention are all possible. When I assess a patient using pseudoephedrine, I like to investigate blood pressure, history of urinary problems and insomnia history. Pseudoephedrine can cause the prescribing cascade.  I lay out examples in the podcast. Pseudoephedrine should not be utilized with MAOI's if possible - I discuss the reason for this in the podcast. Enjoy the show and don't for get your FREE 31 page resource!
December 6, 2018
On this episode, I discuss fentanyl pharmacology. I address important considerations that you must remember with fentanyl patches. Those considerations include how pharmacokinetics can impact our patients. I also break down common side effects of opioids as well as potential common drug interactions. Drug diversion and illicit use is an important consideration when using fentanyl.  I also touch on this topic. Nearly 1,000 healthcare professionals have signed up and received this FREE Top 200 Study Guide - Why haven't you?
November 29, 2018
Quinolones are a class of antibiotics that can be used for various infections. I discuss the pharmacology, adverse effects, drug interactions and other items on this podcast episode. On this episode, I talk about the warnings associated with quinolones. Quinolone use has subsided over time, not due to the fact that they are ineffective, but to rising concerns and warnings about adverse effects. Quinolones can interact with quite a few medications.  I've seen a case of amiodarone and levofloxacin contributing to QTc prolongation which I discuss on this episode. It is critical to remember the binding interactions associated with quinolones as these can potentially lead to treatment failure. Enjoy the show and be sure to snag your FREE 31 page PDF on the top 200 drugs, a gift simply for following the podcast!
November 22, 2018
On this episode I discuss why we may need to use potassium supplements. I also talk about a medication error situation involving potassium that lead to a death. It is important to remember other medications that can raise potassium levels. I also talk about a dosage form of potassium that might make patients ask some questions. Enjoy the show and I hope you sign up to get our free 31 page PDF!
November 15, 2018
On this episode, I talk about apixaban (Eliquis) pharmacology. I also cover adverse effects like bleeding and what to monitor. Drug interactions are a concern with apixaban and I discuss a few items that you may want to look out for. It is important to remember that apixaban does require dose adjustments in certain situations as well. Check out our free giveaway for healthcare professionals and students.  It is a top 200 study guide of highly testable pearls! (Free 31 page PDF)
November 8, 2018
Metoclopramide Pharmacology Metoclopramide can block dopamine receptors as part of it's mechanism of action.  I discuss the clinical implications from this in the podcast. Metoclopramide can exacerbate Parkison's disorder so you need to be careful in that type of patient. Metoclopramide is dosed frequently, which can potentially be a downside as far as patient adherence goes. Metoclopramide has a few potential interactions that you should be aware of.  I talk about those in this episode. Be sure to check out The Thrill of the Case on Amazon as I do have a clinical scenario about Reglan (metoclopramide) in that 200+ page book. As always, check out my free Top 200 study guide!
November 1, 2018
On 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 sure to sign up to follow the podcast and get your FREE 31 Page Pharmacology Study Guide! If you find the show helpful, please leave us a kind rating and review wherever you are listening! Cheers! Eric Christianson, PharmD, BCGP, BCPS
October 25, 2018
On this episode, I discuss how the tetracyclines impact bacterial protein synthesis. I also remind you of several medications that fall in the tetracycline class.  Doxycycline is by far the medication I see used the most. You'll also learn about common side effects like GI upset and photosensitivity. I cover why this class of medication is typically avoided in pediatrics and pregnancy. I hope you enjoy the show and don't forget to snag your FREE 31 page PDF study guide!
October 18, 2018
I break down the mechanism of action, side effects, and important drug interactions you need to know. I give you a sense of what things you might actually encounter in practice when working with patients who take allopurinol. Allopurinol is a top 200 drug. Remember to subscribe to the website reallifepharmacology.com for the Free 31 page PDF where I give you three highly testable pearls on the top 200 drugs. In addition to the 31 page PDF for subscribing, you will get a free 100 question pharmacology test designed for healthcare professionals. I hope you enjoy this episode the pharmacology of allopurinol!
October 11, 2018
In this episode I discuss bupropion pharmacology.  I cover the mechanism of action, side effects, and some relevant drug interactions. Important information in this episode includes: Possible indications for bupropion like depression and smoking cessation Risk of lowering seizure threshold Inhibition of CYP2D6 Dosage form considerations Pearls for onset of bupropion's action
October 4, 2018
On this episode, I cover mirtazapine pharmacology. We will review how mirtazapine works in the body and how those cause adverse effects and benefit out patient. I will also look at the side effect profile and why mirtazapine may be harmful or helpful in our patients. We cover drug interactions for mirtazapine in the podcast as well. Mirtazapine is an antidepressant and I mention discontinuation syndrome as well as what I see as being done when converting a patient from one antidepressant to another. Enjoy the show and don't for get to get your free gift by subscribing!
September 27, 2018
The Serotonin and Norepinephrine Reuptake Inhibitors are a class of medication used for various mental health disorder and pain syndromes.  I talk about the pharmacology of the SNRI's and how it relates to their adverse effect profile.  The pharmacology of SNRI's also plays an important role in why they are efficacious for treatment of pain compared to the SSRI's.  In addition to the adverse effects, I will outline some common drug interactions and which medications might be affected by the SNRI's. Enjoy the episode and I hope you pick up some clinical practice pearls with the SNRI's!  Don't forget to take advantage of our free giveaway as well, nearly 1,000 healthcare professionals and students have already done so!
September 20, 2018
The TCA's are one of the older antidepressant type medications that can be used for a whole host of reasons.  They are not without potential concerns however.  I cover the MOA, drug interactions, side effects and clinical practice pearls of the tricyclic antidepressants in this episode.
September 13, 2018
Warfarin is one of the most notorious medications when it comes to drug interactions.  I cover the MOA, side effects, drug interactions, and pharmacology of the medication.  Enjoy the episode and don't for get to subscribe to get our free study resources!
September 6, 2018
On today's episode, I talk about the pharmacology of carbidopa/levodopa.  We cover drug interactions, adverse effects, mechanism of action and why is this drug dose so frequently? Hope you enjoy the show and take advantage of our FREE giveaway, simply for following the show!
August 30, 2018
On today's episode, I discuss spironolactone and eplerenone.  We cover the mechanism of action, monitoring parameters, adverse effects, and of course notable drug interactions.  Enjoy the show and please take advantage of our FREE giveaway by following the podcast via email!
August 23, 2018
On this episode, I discuss the pharmacology of hydrocodone.  We also cover adverse effects, clinical use, and important genetic and drug interactions.  Enjoy the show and don't forget to subscribe to the podcast and receive a couple of free gifts!
August 16, 2018
On today's episode, I breakdown the pharmacology of gabapentin and pregabalin and what you will see in clinical practice.  These drugs are most often utilized for pain syndromes.  I cover adverse effects, drug interactions, drug/disease interactions, mechanism of action in this episode.
August 9, 2018
Sulfonylureas are an older, cheaper class of medication that is used to stimulate insulin secretion and lower blood sugar.  I discuss the pharmacology and what to look out for in real life practice.
August 2, 2018
On this episode, I discuss sulfamethoxazole and trimethoprim. We cover mechanism of action, adverse effects, and some really important, clinically relevant drug interactions.  Hope you enjoy the show and be sure to take advantage of our FREE 31 page PDF document on the highly testable pearls of the Top 200 Drugs.  A great resource for any nursing, pharmacy, or midlevel, or med student!
July 26, 2018
In this episode I discuss urinary anticholinergics and their effects.  I cover mechanism of action, side effects, clinical practice pearls, and of course some drug interactions to look out for.  Enjoy the episode and be sure to check out our free 31 page pharmacology study guide!
July 19, 2018
Thiazide diuretics are well-known to help with edema and hypertension. Thiazides need to monitored for electrolyte imbalances. Hypokalemia is a real and significant possibility. Thiazide diuretics can also raise uric acid which can impact our patients with gout. Pay attention to use in this patient population. I also cover drug interactions and the mechanism of action of thiazide diuretics on this episode. Enjoy the show!
July 12, 2018
On this episode we are going to break down the pharmacology of albuterol and levalbuterol.  Other items addressed; Difference between beta-agonists and beta-blockers Rule of 2 Administration pearls and clinical practice problems Enjoy the episode and share it with your friends if you are benefitting from it!
July 5, 2018
On today's Episode, I discuss Amoxcillin and Augmentin. Enjoy the education!
June 28, 2018
In this episode on tramadol I cover; Mechanism of action Adverse effects Precautions Drug Interactions Clinical Pearls Enjoy the episode!
June 21, 2018
Oh boy...Phenytoin is one of those medications that has a ton of clinical pearls.  I've seen mistakes with phenytoin that has led to hospitalizations.  You need to pay attention for this one!  Also be sure to check out our Top 200 drugs and 3 highly testable pearls!  A FREE 31 page PDF resource, simply for following the blog!
June 14, 2018
On today's episode, I cover the angiotensin receptor blockers. Pharmacology Drug Interactions Adverse effects Clinical Pearls
June 7, 2018
On today's episode I talk about the dopamine agonists and their role in Parkinson's as well as RLS.  I cover adverse effects, mechanism of action and drug interactions amongst other things! Enjoy! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
May 31, 2018
On this episode, I discuss the pharmacology and side effects of alpha blockers as well as the differences between a selective alpha blocker versus a non-selective alpha blocker. Enjoy! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
May 24, 2018
5 Alpha-Reductase Inhibitors are most often used in the setting of BPH.  I discuss mechanism of action, uses, adverse drug reactions as well as some medications that can exacerbate BPH.  Hope you enjoy the episode! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
May 17, 2018
On this episode, I talk about the side effect profile of antipsychotics as well as how the mechanism of action plays into those adverse effects.  Hope you enjoy the episode! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
May 10, 2018
On today's episode I discuss all the unique clinical pearls associated with amiodarone (Cordarone).  Hope you enjoy the episode! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
May 3, 2018
On this episode, I breakdown the Selective Serotonin Reuptake Inhibitors.  They are the first line medication often used in the management of depression, anxiety, OCD, and other mental health disorders.  I talk about drug interactions and the subtle differences between the agents.  Hope you enjoy the episode! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
April 26, 2018
On this episode, I discuss the pharmacology of calcium channel blockers.  There is a few common side effects with these medications and they can lead to the prescribing cascade.  I talk about an example in the podcast where they can cause edema which leads to a prescription for a diuretic.  I also talk about a really common drug interaction.  Hope you enjoy the episode, and please feel free to reach out with comments and questions! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
April 19, 2018
On 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe Eric Christianson, PharmD, BCGP, BCPS
April 12, 2018
On this episode I discuss the basics with acetaminophen and which disease states and other medications to look out for when you have patients taking acetaminophen.  Other items discussed on the podcast Mechanism of action Adverse effects Dosing Drug interactions Comparison to NSAIDs 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
April 5, 2018
Proton Pump Inhibitors are one of the most commonly used agents for heartburn and other GI disorders.  In this episode I discuss the pharmacology, adverse effects, and a couple of really common drug interactions that are often tested on.  Hope you enjoy the episode! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
March 29, 2018
In this podcast episode I discuss the pharmacology of NSAIDs and the potential collateral damage that can result from these medications.  We'll cover: Side effects Mechanism of Action Important Drug Interactions Pharmacokinetics between ibuprofen and naproxen Boxed Warnings Hope you enjoy the episode! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
March 22, 2018
In this episode, I talk about levothyroxine pharmacology and how it is one of the most commonly prescribed medications.  Levothyroxine gets converted from T4 to T3 in the body. I also talk about some of the side effects that are encountered if we oversupplement as well as what we look for as far as lab work goes. Drug interactions are important with levothyroxine and I do discuss this as well as mention a couple of really common medications that can cause issues with thyroid hormone. 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
March 15, 2018
On this episode, I will discuss aminoglycoside pharmacology.  Gentamicin and tobramycin are the two classic examples of aminoglycosides.  We will review how these medication work in the body, adverse effects, and the importance of pharmacokinetics and laboratory monitoring. 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
March 8, 2018
In this episode, I talk about the most commonly used statins.  In my practice I see simvastatin, atorvastatin, rosuvastatin, and pravastatin used most frequent. In addition, I also discuss why statins are dosed at night, possible side effects, and important drug interactions. Statins can help lower cholesterol and reduce the risk of cardiovascular events like heart attack.  I mentioned cvriskcalculator.com on the podcast and wanted to give that link to you. Hope you enjoy the episode! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
March 2, 2018
Beta-blockers are commonly used in the management of hypertension as well as rate control for atrial fibrillation.  On this episode, I breakdown some of the most common agent and what to look out for.  Enjoy the show! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
February 25, 2018
In the episode, I break down the pharmacology of lisinopril (and all ACE inhibitors).  I also outline common adverse effects, drug interactions and its role in managing hypertension.  Hope you enjoy the show and please feel free to reach out with 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
February 25, 2018
In this episode, I talk about the most important and common adverse effects with metformin and what you will likely see in clinical practice.  I also will talk about the benefits of the medication and its role in the management of type 2 diabetes.  Hope you enjoy the episode! 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 100 question pharmacology test.  Both resources are free, simply for following the podcast!  What are you waiting for? Click Here to Subscribe
February 25, 2018
In this introduction episode of Real Life Pharmacology, I discuss the two major reasons why I wanted to start this podcast.  I also share a little bit about my background which you can also find here. Reason 1: I want to help young healthcare professionals by providing an alternative option to help them learn pharmacology. Reason 2: I have had professors in college that don't practice in the real world and really have a tough time relaying important and relevant clinical information.  I wanted a way to share some of my experiences as a clinical pharmacist, which I believe will help you provide better care for your patients. If you'd like to be updated about future episodes and get a free 100 question pharmacology test (with answers), feel free to subscribe!  If you have any questions, feedback or concerns, please shoot us a message!
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