Category: Cardiovascular Medications

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Rivaroxaban Pharmacology

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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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Hydralazine Pharmacology

Hydralazine Pharmacology

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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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Aspirin Pharmacology

Aspirin Pharmacology

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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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Clonidine Pharmacology

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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.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Loop Diuretics Pharmacology

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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!

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Apixaban Pharmacology

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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)

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Thiazide and Thiazide Like Diuretics RLP Episode 24

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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!