Real Life Pharmacology - Pharmacology Education for Health Care Professionals
324 episodes - English - Latest episode: 10 days ago - ★★★★★ - 643 ratingsA Meded101.com Production
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Episodes
Clopidogrel Pharmacology
July 04, 2019 17:34 - 13 minutes - 19.2 MBClopidogrel 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.
Sulfasalazine Pharmacology
June 27, 2019 13:34 - 9 minutes - 13.1 MBSulfasalazine 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 ...
Cholestyramine Pharmacology
June 20, 2019 09:20 - 11 minutes - 15.9 MBOn 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 sym...
Rifampin Pharmacology
June 13, 2019 15:09 - 13 minutes - 19.5 MBRifampin 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 concentratio...
Heparin Pharmacology
June 06, 2019 13:34 - 16 minutes - 23.4 MBHeparin 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. Protam...
Montelukast Pharmacology
May 30, 2019 14:19 - 11 minutes - 16 MBOn 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 as...
Clozapine Pharmacology
May 23, 2019 14:11 - 14 minutes - 20.3 MBOn 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...
Carbamazepine Pharmacology
May 16, 2019 19:10 - 12 minutes - 18.2 MBOn 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 contribu...
Stimulant Laxatives Pharmacology
May 09, 2019 16:37 - 14 minutes - 20.3 MBOn 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 use...
Ezetimibe Pharmacology
May 02, 2019 14:54 - 10 minutes - 15.3 MBOn 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 ...
Azithromycin Pharmacology
April 25, 2019 13:52 - 14 minutes - 20.8 MBOn 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 antibio...
Rivaroxaban Pharmacology
April 18, 2019 13:55 - 16 minutes - 23.8 MBRivaroxaban 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 us...
Valproate Pharmacology
April 11, 2019 16:06 - 14 minutes - 20.8 MBValproate (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...
Donepezil Pharmacology
April 04, 2019 17:33 - 13 minutes - 18.9 MBOn 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....
Linezolid Pharmacology
March 28, 2019 18:18 - 13 minutes - 18.8 MBLinezolid 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 fo...
Pioglitazone Pharmacology
March 21, 2019 18:24 - 12 minutes - 17.1 MBOn 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 interactio...
Nitrofurantoin Pharmacology
March 14, 2019 16:28 - 11 minutes - 16.2 MBOn 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...
Hydralazine Pharmacology
March 07, 2019 19:52 - 11 minutes - 16.2 MBHydralazine 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 t...
Aspirin Pharmacology
February 28, 2019 17:52 - 13 minutes - 19.5 MBOn 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...
Clonidine Pharmacology
February 22, 2019 03:05 - 12 minutes - 17.7 MBClonidine 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, dizzi...
Memantine Pharmacology
February 14, 2019 21:24 - 11 minutes - 15.8 MBMemantine 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 recommend...
Magnesium Pharmacology
February 07, 2019 17:46 - 10 minutes - 14.6 MBOn 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 ...
Trazodone Pharmacology
January 31, 2019 14:21 - 10 minutes - 14.4 MBTrazodone 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 shou...
GLP-1 Agonist Pharmacology
January 24, 2019 19:16 - 11 minutes - 16.2 MBThe 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 hav...
Iron Supplement Pharmacology
January 17, 2019 18:02 - 14 minutes - 19.8 MBIron 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. Ferr...
Loop Diuretics Pharmacology
January 10, 2019 20:10 - 13 minutes - 19.4 MBOn 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...
Methotrexate Pharmacology
January 03, 2019 12:30 - 12 minutes - 17.4 MBOn 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....
Cyclobenzaprine Pharmacology
December 27, 2018 21:05 - 11 minutes - 16 MBOn 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 antidepressa...
Lithium Pharmacology
December 20, 2018 19:07 - 12 minutes - 17.5 MBLithium 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 wat...
Pseudoephedrine Pharmacology
December 13, 2018 20:29 - 13 minutes - 19.1 MBPseudoephedrine 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'...
Fentanyl Pharmacology
December 06, 2018 22:09 - 12 minutes - 18 MBOn 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...
Quinolone Antibiotic Pharmacology
November 29, 2018 18:58 - 9 minutes - 12.9 MBQuinolones 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 levofl...
Potassium Supplement Pharmacology
November 22, 2018 19:16 - 9 minutes - 13.3 MBOn 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!
Apixaban Pharmacology
November 15, 2018 18:37 - 10 minutes - 15.5 MBOn 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)
Metoclopramide (Reglan) Pharmacology
November 08, 2018 18:21 - 9 minutes - 13.4 MBMetoclopramide 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. ...
SGLT-2 Inhibitors Pharmacology
November 01, 2018 17:19 - 11 minutes - 15.8 MBOn 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 ...
Tetracyclines Pharmacology Episode 038
October 25, 2018 18:54 - 9 minutes - 13 MBOn 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!
Allopurinol Pharmacology
October 18, 2018 14:59 - 8 minutes - 11.8 MBI 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 ph...
Bupropion Pharmacology – Real Life Pharmacology
October 11, 2018 21:46 - 13 minutes - 19.5 MBIn 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
Mirtazapine Pharmacology
October 04, 2018 18:45 - 14 minutes - 20 MBOn 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 ...
Serotonin and Norepinephrine Reuptake Inhibitors Pharmacology
September 28, 2018 00:30 - 11 minutes - 16.4 MBThe 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 S...
Tricyclic Antidepressant Pharmacology
September 20, 2018 19:21 - 12 minutes - 18.1 MBThe 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.
Warfarin Pharmacology Episode 032
September 13, 2018 15:12 - 12 minutes - 17 MBWarfarin 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!
Carbidopa/Levodopa Pharmacology RLP Episode 031
September 06, 2018 20:37 - 12 minutes - 18.2 MBOn 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!
Aldosterone Antagonist Pharmacology RLP Episode 030
August 30, 2018 15:03 - 12 minutes - 17 MBOn 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!
Hydrocodone and Acetaminophen Pharmacology RLP Episode 029
August 23, 2018 12:31 - 12 minutes - 17.9 MBOn 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!
Gabapentin and Pregabalin Pharmacology Episode 28
August 16, 2018 13:57 - 14 minutes - 20.6 MBOn 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.
Sulfonylurea Pharmacology RLP Episode 027
August 09, 2018 02:06 - 11 minutes - 16.2 MBSulfonylureas 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.
Sulfamethoxazole and Trimethoprim RLP Episode 026
August 02, 2018 11:49 - 12 minutes - 17.4 MBOn 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!
Urinary Anticholinergics RLP Episode 25
July 26, 2018 18:06 - 11 minutes - 16.9 MBIn 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!