Category: Psychiatric Medications

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Methylphenidate Pharmacology

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Methylphenidate has an FDA approved indication for ADHD. In this podcast episode, I cover the pharmacology, adverse effects, kinetics, and drug interaction.

Because methylphenidate has stimulant type effects, it can raise blood pressure and heart rate.

Weight, blood pressure, and pulse are important monitoring parameters in patients taking a stimulant type medication like methylphenidate.

There are numerous dosage forms of methylphenidate which can help accommodate many different patients’ needs.

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

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Buspirone Pharmacology

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Buspirone is an anti-anxiety medication that has the potential of having some serotonin agonist activity.

Buspirone has a very high first-pass metabolism. This means that the body breaks much of the medication down prior to it getting into the systemic circulation.

Buspirone is broken down by CYP3A4, so concomitant use with inhibitors or inducers can alter its concentrations

Buspirone should not be used as needed as this medication takes a while to start to show benefit.

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

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Benzodiazepine Pharmacology

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Benzodiazepines act by enhancing the effect of GABA, an inhibitory neurotransmitter.

Benzodiazepines can cause confusion, sedation, and respiratory depression.

There are many potential indications for benzodiazepines. They can be used in anxiety, status epilepticus, insomnia, and alcohol withdrawal amongst other things.

There is a boxed warning for the use of opioids with benzodiazepines. The primary risk of the combination is respiratory depression.

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Clozapine Pharmacology

Clozapine Pharmacology

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On this episode, I discuss clozapine pharmacology. This drug has multiple mechanisms of action: Dopamine blockade, anticholinergic activity, and alpha blocking activity all contribute to the complexity of this drug.

Smoking cessation can significantly increase the concentrations of clozapine. This is because smoking can induce CYP1A2. Listen to the podcast for more details on how this can impact our patients clinically.

Clozapine has 5 boxed warnings. I discuss them all in this podcast. The most well-known boxed warning is for agranulocytosis.

Because clozapine has alpha blocking activity, it can cause orthostasis. We need to monitor for this.

Clozapine can cause QTc prolongation. Keep an eye out for other medications that the patient may be taking that can also cause this. Examples include: amiodarone, ondansetron, quinolones, and macrolides

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

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Trazodone Pharmacology

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Trazodone pharmacology is complex. It can inhibit serotonin reuptake, block histamine receptors, and possibly have alpha-blocking activity.

Side effects of trazodone include sedation, dizziness, and dry mouth. Rarely, priapism may occur. I’ve seen this nugget come up on pharmacology exams!

While trazodone is classified as antidepressant, it is often used to help manage insomnia.

Trazodone can possibly prolong the QT interval. Risk of other medications and patient specific parameters should be considered.

Trazodone concentrations can be increased with the use of CYP3A4 inhibitors and reduced with 3A4 inducers.

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

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Lithium Pharmacology

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Lithium is a drug that has a ton of clinical pearls.  On this episode, I talk about the pharmacology, side effects, drug interactions, and critical practice pearls.

Kidney function is very important to monitor in our patients taking lithium.  Lithium can accumulate in renal impairment.

Thyroid function can be altered by lithium.  Be sure to regularly monitor TSH in a patient on chronic lithium.

Over-the-counter NSAID can interact and raise lithium levels.  This is something you need to watch out for as patients can begin taking these medications on their own without supervision.

Be sure to assess lithium levels.  Signs of toxicity can include GI upset, tremor, motor movement issues, sedation, and CNS changes.

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Bupropion Pharmacology – Real Life Pharmacology

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In this episode I discuss bupropion pharmacology.  I cover the mechanism of action, side effects, and some relevant drug interactions.

Important information in this episode includes:

  • Possible indications for bupropion like depression and smoking cessation
  • Risk of lowering seizure threshold
  • Inhibition of CYP2D6
  • Dosage form considerations
  • Pearls for onset of bupropion’s action
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Mirtazapine Pharmacology

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On this episode, I cover mirtazapine pharmacology.

We will review how mirtazapine works in the body and how those cause adverse effects and benefit out patient.

I will also look at the side effect profile and why mirtazapine may be harmful or helpful in our patients.

We cover drug interactions for mirtazapine in the podcast as well.

Mirtazapine is an antidepressant and I mention discontinuation syndrome as well as what I see as being done when converting a patient from one antidepressant to another.

Enjoy the show and don’t for get to get your free gift by subscribing!

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Serotonin and Norepinephrine Reuptake Inhibitors Pharmacology

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The Serotonin and Norepinephrine Reuptake Inhibitors are a class of medication used for various mental health disorder and pain syndromes.  I talk about the pharmacology of the SNRI’s and how it relates to their adverse effect profile.  The pharmacology of SNRI’s also plays an important role in why they are efficacious for treatment of pain compared to the SSRI’s.  In addition to the adverse effects, I will outline some common drug interactions and which medications might be affected by the SNRI’s. Enjoy the episode and I hope you pick up some clinical practice pearls with the SNRI’s!  Don’t forget to take advantage of our free giveaway as well, nearly 1,000 healthcare professionals and students have already done so!