Category: Cardiovascular Medications

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July 27, 2023December 6, 2024

Lovastatin Pharmacology Podcast

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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.

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June 29, 2023June 27, 2023

Niacin Pharmacology Podcast

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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 increase the risk.

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May 18, 2023May 9, 2023

Isosorbide Mononitrate Pharmacology Podcast

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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 isosorbide mononitrate and can be very bothersome for patients. Vasodilation is primarily responsible for this adverse effect.

PDE-5 inhibitors are notorious for causing drug interactions with any nitrate medication. I discuss management strategies in this podcast episode.

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May 4, 2023April 17, 2023

Amlodipine Pharmacology Podcast

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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 interactions and how to monitor patients.

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April 13, 2023April 6, 2023

Bempedoic Acid Pharmacology Podcast

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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 medication but could happen throughout the treatment.

Tendon problems can happen as well, especially in patients who are greater than 60 years old, on fluoroquinolones, have renal failure, or are taking corticosteroids.

If Bempedoic acid is taken along with Simvastatin, it is recommended to avoid doses greater than 20mg. This is partly because Bempedoic Acid 180mg along with 40mg of Simvastatin was found to increase Simvastatin AUC by 2-fold. The mechanism of this interaction has yet to be reported. Pravastatin doses greater than 40mg are to be avoided as well due to an increased risk of myopathy. Atorvastatin and Rosuvastatin didn’t have any maximum dose considerations.

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March 16, 2023February 28, 2023

Fosinopril (Monopril) Pharmacology Podcast

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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.

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January 19, 2023January 17, 2023

Prazosin (Minipress) Pharmacology Podcast

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

Prazosin is an alpha-blocker but lacks selectivity. A reduction in blood pressure is expected, but it is notorious for causing orthostatic hypotension.

Prazosin may be used off-label for nightmares, when this is the case, you will likely only see this drug dosed at bedtime.

Alpha agonist medications (such as pseudoephedrine and ADHD stimulants) may counteract the effects of prazosin.

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December 1, 2022November 23, 2022

Indapamide (Lozol) Pharmacology Podcast

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

I discuss how indapamide differs from other thiazide diuretics. Particularly, I discuss indapamide compared to hydrochlorothiazide.

Frequent urination, hypokalemia, and dehydration are all possible risks with indapamide.

Pay attention to medications that can increase the risk for acute renal failure when added to indapamide. NSAIDs, ACEIs, ARBs, and other diuretics can increase this risk.

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