Category: Endocrine Medications

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Glucagon Pharmacology

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On this episode of the RLP podcast, I discuss glucagon pharmacology.

It is important to remember with glucagon that patients will still require glucose following administration to improve their blood sugar numbers.

Glucagon is typically reserved for moderate to severe episodes of hypoglycemia when patients have altered consciousness.

The major adverse effect with glucagon is nausea and vomiting which often may prevent oral intake of glucose for some time after administration.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Dulaglutide Pharmacology

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Dulaglutide is a GLP-1 agonist used in the management of diabetes.

Dulaglutide has 4 different dosages that can be used to help lower A1C. As the dose goes up, so does the potential for adverse effects however.

Like most of the GLP-1 agonists, dulaglutide is only available as an injection. Semaglutide is an exception to this.

Nausea is the primary adverse effect of dulaglutide which some patients may get used to over time.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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Dapagliflozin Pharmacology

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Dapagliflozin is an SGLT-2 Inhibitor that reduces blood sugar by increasing the excretion of sugar through the urine.

Genital and urinary infections is a potential risk with the use of SGLT2 Inhibitors like dapagliflozin.

Dapagliflozin has received FDA approval for use in heart failure (in patients even without diabetes).

Be aware of agents that may enhance the risk for hypoglycemia such an insulin and sulfonylureas.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Dexamethasone Pharmacology

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Dexamethasone has numerous possible indications such as asthma, chemotherapy-induced nausea and vomiting, and pain associated with inflammation.

Dexamethasone is more potent than prednisone. Approximately 0.75 mg of dexamethasone is equivalent to 5 mg of prednisone.

When using dexamethasone, recall that it can raise blood sugars. Monitor this closely in patients with diabetes.

A dexamethasone suppression test helps detect excessive endogenous production of cortisol.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Oral Semaglutide Pharmacology

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On this episode, I discuss the pharmacology of oral semaglutide. It is a GLP-1 agonist that is the first one in the class to have an oral formulation.

There is a recommended dose titration with oral semaglutide that can take a month or two to get therapeutic doses. I disucss this further in this episode.

The most common adverse effect of oral semaglutide is nausea.

Oral semaglutide is dosed once daily which is nice to try to maximize patient adherence.

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

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Testosterone Pharmacology

testosterone pharmacology

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Testosterone replacement is primarily utilized in patients with hypogonadism. I discuss testosterone pharmacology, adverse effects, and drug interactions on this podcast episode.

Testosterone is a controlled substance because it is most often diverted for its potential to build muscle in athletes for competitive sports.

There is cardiovascular risks associated with the use of testosterone.

Testosterone can raise blood pressure and also raise cholesterol levels which may be a contributing factor to its potential to cause cardiovascular events.

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

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Pioglitazone Pharmacology

pioglitazone pharmacology

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On this episode, I cover pioglitazone pharmacology. The primary mechanism of action with pioglitazone is that it is an agonist at Peroxisome Proliferator Activated Receptor Gamma receptor. This improves insulin sensitivty in the periphery.

Two common side effects exist with pioglitazone. This drug can cause weight gain and also contribute to edema.

Pioglitazone has a boxed warning and is contraindicated in patients who have symptomatic heart failure.

There are a few potential interactions with pioglitazone. Trimethoprim and gemfibrozil can inhibit the breakdown of pioglitazone.

A couple of advantages of pioglitazone include that it is generic (inexpensive) and that it is dosed once daily.

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

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GLP-1 Agonist Pharmacology

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The GLP-1’s are a relatively newer class of medications used to lower blood sugars in diabetes.

GLP-1’s work by simulating the effects of incretin hormones in the body. They can help promote fullness, lower weight, and stimulate insulin release following a meal.

GLP-1’s can cause significant GI side effects. Nausea is by far the most common adverse effect. It can even lead to diarrhea and vomiting in some cases.

There is boxed warning on the GLP-1 agonists. Be aware of patients who have had a history of thyroid cancer as this may be a contraindication.

GLP-1 agonists can help lower A1C and stimulate weight loss which is a huge benefit for most patients with Type 2 diabetes.

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

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SGLT-2 Inhibitors Pharmacology

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On this episode, I discuss the mechanism of action of the SGLT-2 Inhibitors and how they lower blood sugar.

These drugs are classically used for diabetes and eliminate blood sugar through the urine.

One of the potential side effects is that these drugs can increase the risk of genital infections and urinary tract infections.

There is a boxed warning on canagliflozin for its potential to increase the risk of amputation.

These drugs also have a mild diuretic type effect and can potentially cause hypotension.

Enjoy the show and be sure to sign up to follow the podcast and get your FREE 31 Page Pharmacology Study Guide!

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Cheers!

Eric Christianson, PharmD, BCGP, BCPS