Real Life Pharmacology - Pharmacology Education for Health Care Professionals – Details, episodes & analysis

This episode is sponsored by Freed - Freed is an amazing time saver for busy healthcare professionals! It listens, transcribes, and writes medical notes for you! Go check them out and support our sponsor! In this episode, we highlight some of the most important clinical pearls (and highly testable pearls) on the following medications; Suboxone, lisdexamfetamine, nortriptyline, insulin lispro, and valproic acid. Suboxone is a combination of buprenorphine and naloxone used for opioid use disorder. Lisdexamfetamine is a stimulant medication that can be used to manage ADHD. Common side effects include weight loss, insomnia, hypertension, and tachycardia. Nortriptyline is a TCA medication known for its ability to cause anticholinergic side effects like constipation, dry eyes, dry mouth, urinary retention, and confusion. Insulin lispro is a rapid-acting insulin medication that is most often used to bring down post-prandial blood sugar. Valproic acid is an antiepileptic medication that can also be used for migraines.

This episode is sponsored by Freed - Freed is an amazing time saver for busy healthcare professionals! It listens, transcribes, and writes medical notes for you! Go check them out and support our sponsor! In this episode, we highlight some of the most important clinical pearls on the following medications; nitrofurantoin, fentanyl patches, isosorbide mononitrate, fluoxetine, and triamcinolone. Nitrofurantoin is an antibiotic used for UTIs. We need to be careful with this medication in patients with CKD. Fentanyl is an opioid. There are many clinical quirks with fentanyl patches. For a full rundown, check out this previous podcast episode. Isosorbide mononitrate is a nitrate medication so we need to be careful with the use of PDE-5 inhibitors. Fluoxetine is an SSRI. It has a longer half-life than most SSRIs. I discuss what that means in this episode. Triamcinolone (topical) is most frequently used for redness, itching, and skin irritation.

Metformin is a medication used in the management of diabetes. It can cause significant diarrhea, B12 deficiency, and in rare cases, lactic acidosis. Atorvastatin (Lipitor) is a statin medication used for cholesterol management. It lowers LDL and is associated with myopathy. Omeprazole is a PPI used for GERD and has drug interactions with citalopram and clopidogrel. Ciprofloxacin is a quinolone antibiotic used to treat gram-negative infections and UTIs. It carries numerous risks such as tendon rupture. Ondansetron is an antiemetic medication used in the management of nausea and vomiting. I discuss the prescribing cascade in relation to this medication.

In this podcast episode, I break down the pharmacology, adverse effects, pharmacokinetics, and drug interactions of phentermine. Phentermine has some CNS stimulant activity so adverse effects like insomnia, hypertension, and tachycardia are possible. Pay attention to drugs that can oppose the effects of phentermine and cause weight gain such as mirtazapine and sulfonylureas. Phentermine is a controlled substance so the risk of addiction and dependence is possible.

On this podcast episode, I discuss glimepiride pharmacology, adverse effects, hypoglycemia symptoms, and drug interactions. CYP2C9 is an important enzyme in the breakdown of glimepiride. I discuss a few drugs that can cause interactions via this enzyme. Renal function is important to consider with glimepiride. The active metabolites are cleared by the kidney and can accumulate in CKD. Hypoglycemia and weight gain are problematic adverse effects of this medication and are the primary reasons it has fallen out of favor.

On this podcast episode, I discuss cephalexin pharmacology, adverse effects, drug interactions, and much more! Penicillin allergies and cross-reactivity are common questions with regard to the use of cephalexin and I discuss this briefly in the podcast episode. Cephalexin is a first-generation cephalosporin with its primary sweet spot being gram-positive bacteria like Staph and Strep species. Warfarin, probenecid, zinc, and a couple of others are potential medications that can interact with cephalexin. I discuss this further in this podcast episode.

On this episode, I discuss ceftriaxone pharmacology, adverse effect, coverage, and drug interactions. Ceftriaxone is currently a drug of choice for the STI Gonorrhea. Pyrls.com has an amazing chart on all the STIs and their drugs of choice that you can get for free when you sign up for a free account! Ceftriaxone is a third-generation cephalosporin that is used for numerous indications such as pneumonia, meningitis, gonorrhea, and many more. It is important to remember that ceftriaxone can cover many staph and strep species but it does NOT cover MRSA. Ceftriaxone does have some risks, particularly in pediatric patients. I discuss elevated bilirubin and calcium binding risks in the podcast.

Lactulose is an osmotic laxative but it is rarely used for this purpose. I discuss lactulose pharmacology in this episode. Elevated ammonia levels are an issue in hepatic encephalopathy. Lactulose can help manage this issue. Lactulose is dosed to 2-3 soft stools per day when used to reduce ammonia levels. Lactulose can increase the effect of warfarin and raise INR; I discuss this further on this episode.

On this episode, I discuss ticagrelor pharmacology, adverse effects, and important drug interactions. Ticagrelor has a warning with regards to the use of aspirin. Higher doses of aspirin can impair the effectiveness of ticagrelor and I discuss this further on this episode. Bleeding is the major adverse effect from ticagrelor and naturally, hematocrit and hemoglobin are important monitoring parameters. I discuss CYP3A4 drug interactions on this episode and how it may affect ticagrelor.

On this podcast episode, I discuss lurasidone pharmacology, adverse effects, and drug interactions. CYP3A4 is an important enzyme in the breakdown of lurasidone. I discuss this further on this episode. Lurasidone is best taken with food as this enhances absorption and helps improve drug concentrations. Lurasidone tends to have a lower risk for metabolic syndrome compared to other antipsychotics which is a nice advantage.