Linagliptin Pharmacology

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On this episode of the Real Life Pharmacology Podcast, I cover linagliptin pharmacology, adverse effects, drug interactions, and much more.

Linagliptin is a DPP-4 inhibitor used to help control blood sugar levels in adults with type 2 diabetes. It works by increasing the levels of incretin hormones, which stimulate insulin release and decrease glucagon levels in the blood.

Linagliptin is usually taken once daily and can be used alone or in combination with other diabetes medications.

Unlike some other diabetes drugs, linagliptin does not usually cause weight gain or low blood sugar (hypoglycemia) when used alone.

Linagliptin should not be used with GLP-1 agonists as it works on a similar pathway as that medication class.

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Continuous Glucose Monitors Podcast

Continuous Glucose Monitors (CGMs) are becoming an important tool in the management of diabetes. I break down some of the most common clinical practice pearls you should know.

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Beers Criteria Podcast Part 2 or 2

On this podcast episode, I finish up my breakdown of the Beers Criteria.

I cover the use of sliding-scale insulin and sulfonylureas in geriatric patients. Hypoglycemia is a major concern with both of these diabetes management strategies.

PPIs show up on the Beers criteria list as they can increase the risk of C. diff, pneumonia, fractures, and GI malignancies.

Metoclopramide has dopamine antagonist activity and can increase the risk of EPS and tardive dyskinesia.

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Teplizumab For Diabetes Episode 315 – Real Life Pharmacology Podcast

Teplizumab is a relatively new agent that helps delay the progression of type 1 diabetes. It slows the rate of beta-cell destruction in the pancreas.

Teplizumab is associated with cytokine release syndrome which can result in flu-like symptoms of fever, aches, and headache.

Cytokine release syndrome due to teplizumab can be reduced by using appropriate pretreatment medications. Those medications can include analgesics, antihistamines, and/or antiemetics.

Teplizumab is associated with suppressing the immune system so it is ideal to get vaccinations completed before using this medication. I go over the specific recommendations in the podcast episode.

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Insulin Aspart (Novolog) Pharmacology Podcast Episode 312

On this podcast episode, I discuss insulin aspart pharmacology, adverse effects, drug interactions, and much more.

Insulin apart is a rapid acting insulin product meant to bring down blood sugars quickly (most often after meals).

It is important to remember a couple of medications that may counteract the effects of insulin and apart and raise blood sugar. I talk about corticosteroids and thiazide diuretics in the drug interaction section.

Fiasp is a slightly modified insulin aspart molecule that allows for quicker absorption. This quicker absorption will allow for blood sugars to come down sooner than the Novolog formulation.

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Insulin Lispro (Humalog) Pharmacology Podcast

On this podcast episode, I discuss the pharmacology, adverse effects, and drug interactions of insulin lispro (Humalog).

I spend some time on this podcast episode discussing carb ratios and sliding scale insulin when using insulin lispro.

Potassium is critical to monitor in diabetic ketoacidosis as insulin therapy can cause significant hypokalemia.

Sliding-scale insulin lispro is discouraged in the overwhelming majority of situations. Ideally, we should be more proactive about insulin administration to reduce the risk of hyperglycemia spikes.

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Bexagliflozin Pharmacology Podcast

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

I wasn’t wowed by the A1C reduction of this medication. I get into the specifics on bexagliflozin in the podcast episode.

SGLT2 inhibitors like bexagliflozin increase the glucose in the urine which can facilitate the growth of bacteria and fungi in the genitourinary tract.

Limb amputation and euglycemic DKA are two rare, reported adverse effects to be aware of with the use of bexagliflozin.

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Exenatide Pharmacology Podcast

On this podcast episode, I discuss exenatide pharmacology, adverse effects, drug interactions, and much more!

Exenatide has an immediate release formulation (Byetta) and a long acting formulation (Bydureon). I discuss the differences in this podcast episode.

Byetta use has fallen out of favor due to frequent dosing, patient inconvenience and needing to time the dose 60 minutes prior to meals.

I discuss the risk of pancreatitis related to GLP-1 agonists like exenatide in this podcast episode.

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Tirzepatide (Mounjaro) Pharmacology Podcast

On this episode I discuss the pharmacology of tirzepatide. I’m appreciative of Derek Borkowski who operates Pyrls for providing a free PDF of the 2023 ADA Diabetes Guidelines when you subscribe for an account at Pyrls.com/rlp – Tirzepatide makes its first appearance in the diabetes guidelines for its ability to promote weight loss.

Tirzepatide is a combination GIP and GLP-1 agonist that is currently indicated for diabetes with reductions of A1C in the range of about 2 points.

Much like GLP-1 agonists, tirzepatide can cause GI upset and other gastrointestinal adverse effects like diarrhea.

Tirzepatide doesn’t have a large number of drug interactions which is nice. Corticosteroids can counteract its blood sugar-lowering effects while sulfonylureas and insulin may significantly increase the risk for hypoglycemia.

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Methimazole Pharmacology Podcast

On this episode of the Real Life Pharmacology podcast, I cover methimazole adverse effects, mechanism of action, drug interactions, and much more!

Methimazole and propylthiouracil are from the same class of medications and are used for hyperthyroidism. I go over some of the differences between these agents in this podcast episode.

Methimazole is dosed once daily but can be split if the patient experiences significant GI adverse effects.

T3 plays an important role in hyperthyroidism. I discuss the physiologic of T3 production and how methimazole creates its effects to lower thyroid hormone levels.

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