Losartan Pharmacology

On this episode, I discuss losartan pharmacology, adverse effects, drug interactions, and appropriate monitoring.

Losartan is an ARB and can increase potassium levels. Keep an eye out for medications like spironolactone and trimethoprim which can increase this risk further.

Losartan has been shown to lower uric acid levels which could potentially be helpful in patients with gout.

Monitoring renal function is very important with losartan. The risk of ARF goes significantly higher when used with NSAIDs or diuretics.

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Pravastatin Pharmacology

On this episode, I breakdown pravastatin pharmacology, adverse effects, drug interactions and when you might see this drug used in practice.

Pravastatin is a statin and will lower LDL. Its use is a little limited in the fact that it is not as potent as other agents in its LDL lowering effects.

Pravastatin is hydrophilic which differentiates it from simvastatin, atorvastatin, and lovastatin.

I describe rhabdomyolysis in this podcast as it is a potential rare adverse effect of pravastatin.

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Clomiphene Pharmacology

On this episode, I discuss clomiphene pharmacology, adverse effects, clinical practice pearls, and drug interactions.

Clomiphene is a commonly used medication to help manage female infertility.

Clomiphene is oral and relatively inexpensive compared to other agents that are used for infertility management.

Clomiphene is a SERM so you can anticipate that some patients may report vasomotor symptoms like flushing and hot flashes.

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Fluticasone Nasal Pharmacology

Fluticasone (Flonase) is a nasal corticosteroid that is used in the management of allergic rhinitis.

A primary adverse effect that I have seen in practice with fluticasone is the risk for nose bleeds.

Flonase can have some interactions via CYP3A4. Inhibitors of CYP3A4 like clarithromycin can increase concentrations.

While the risk for systemic exposure is low with nasal fluticasone, long-term, high dose, and frequent use should be monitored appropriately.

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Sucralfate Pharmacology

On this episode, I discuss (Carafate) sucralfate pharmacology, adverse effect, kinetics, and drug interactions.

Sucralfate is notorious for drug binding interactions and can reduce the concentrations of many drugs which I cover in the podcast.

Four times daily dosing is a big downside to sucralfate and why it isn’t used terribly often for GI issues like esophagitis.

The suspension formulation of sucralfate does contain some sugar so be aware of this in our diabetes patients.

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Atenolol Pharmacology

On this episode, I discuss atenolol pharmacology, adverse effects, pharmacokinetics, and drug interactions.

Atenolol is primarily cleared by the kidney which should tell you that we need to pay attention to dose adjustments as renal function declines.

Atenolol is a beta-1 selective agent that is NOT a preferred beta-blocker in HFrEF.

Pulse and blood pressure monitoring is essential with any beta-blocker like atenolol.

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Hydromorphone Pharmacology

On this episode, I discuss hydromorphone pharmacology, adverse effect, and drug interactions.

I discuss the pharmacokinetics of hydromorphone and also discuss the relative potency compared to other opioids.

Hydromorphone drug interactions are mostly additive effects. Drugs that cause sedation or constipation can have additive effects on hydromorphone.

Be extremely careful with hydromorphone dosage forms. There are numerous different concentrations and strengths. I discuss this in this episode.

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Duloxetine Pharmacology

On this episode, I discuss duloxetine pharmacology, adverse effects, and common drug interactions.

Duloxetine is an SNRI that is used for depression, anxiety, and various pain syndromes like neuropathy and fibromyalgia.

Duloxetine can inhibit CYP2D6 which can lead to higher concentrations of clozapine and propranolol and lower activity of tamoxifen.

CYP1A2 inhibitors like ciprofloxacin can raise concentrations of duloxetine leading to an increased potential for adverse effects.

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Lasmiditan Pharmacology

Lasmiditan (Reyvow) is an agent that is utilized for acute migraine treatment. It works slightly differently than triptans which I discuss on this episode.

Lasmiditan is a relatively new agent and cost will often limit its use at this time.

Rosuvastatin and sulfasalazine are two common medications that may have concentrations increase when lasmiditan is used. I discuss this in detail on this episode.

Lasmiditan is an oral tablet that is only recommended to give once per day which differs from commonly used triptans where the dose can be repeated.

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Sumatriptan Pharmacology

On this episode, I discuss sumatriptan pharmacology, adverse effects, drug interactions and more.

Dosage forms can provide different methods of drug delivery and I talk about many different sumatriptan dosage forms in this episode.

Cardiovascular risks need to be assessed when using a drug like sumatriptan. I discuss this in greater detail in the podcast.

Sumatriptan has serotonergic activity and we need to assess the risk of serotonin syndrome in our patients.

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