Roflumilast (Daliresp) Pharmacology

On this episode I discuss roflumilast (Daliresp) pharmacology, adverse effects, and important drug interactions.

Roflumilast is indicated to reduce the incidence of COPD exacerbations.

Roflumilast is significantly broken down by CYP3A4 so there are numerous drug interactions that we have to take into account.

Psychiatric issues, GI upset, and weight loss are all potential adverse effects due to roflumilast.

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Trihexyphenidyl (Artane) Pharmacology

On this episode, I breakdown trihexyphenidyl (Artane) pharmacology, adverse effects, and drug interactions.

Trihexyphenidyl is highly anticholinergic and can cause constipation, dry eyes, dry mouth, and urinary retention.

Dementia medications like donepezil can have their effects blunted by the use of trihexyphenidyl.

Trihexyphenidyl is an older anticholinergic that is rarely used for the management of EPS caused by antipsychotics.

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Liraglutide Pharmacology

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

Liraglutide is well known to cause nausea. It is important to assess the severity of nausea as it may subside in some patients as they gain tolerability to the medication.

We mentioned the 2022 Diabetes Guideline Cheat Sheet in the podcast – you can get that for free at pyrls.com/rlp

Liraglutide has a fairly low risk of hypoglycemia when used alone, but this risk increases when it is used with insulin or sulfonylureas.

Saxenda is the weight loss formulation of liraglutide and dosing is higher for weight management than it is for diabetes management.

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Losartan Pharmacology

On this episode, I discuss losartan pharmacology, adverse effects, drug interactions, and appropriate monitoring.

Losartan is an ARB and can increase potassium levels. Keep an eye out for medications like spironolactone and trimethoprim which can increase this risk further.

Losartan has been shown to lower uric acid levels which could potentially be helpful in patients with gout.

Monitoring renal function is very important with losartan. The risk of ARF goes significantly higher when used with NSAIDs or diuretics.

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Pravastatin Pharmacology

On this episode, I breakdown pravastatin pharmacology, adverse effects, drug interactions and when you might see this drug used in practice.

Pravastatin is a statin and will lower LDL. Its use is a little limited in the fact that it is not as potent as other agents in its LDL lowering effects.

Pravastatin is hydrophilic which differentiates it from simvastatin, atorvastatin, and lovastatin.

I describe rhabdomyolysis in this podcast as it is a potential rare adverse effect of pravastatin.

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Clomiphene Pharmacology

On this episode, I discuss clomiphene pharmacology, adverse effects, clinical practice pearls, and drug interactions.

Clomiphene is a commonly used medication to help manage female infertility.

Clomiphene is oral and relatively inexpensive compared to other agents that are used for infertility management.

Clomiphene is a SERM so you can anticipate that some patients may report vasomotor symptoms like flushing and hot flashes.

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Fluticasone Nasal Pharmacology

Fluticasone (Flonase) is a nasal corticosteroid that is used in the management of allergic rhinitis.

A primary adverse effect that I have seen in practice with fluticasone is the risk for nose bleeds.

Flonase can have some interactions via CYP3A4. Inhibitors of CYP3A4 like clarithromycin can increase concentrations.

While the risk for systemic exposure is low with nasal fluticasone, long-term, high dose, and frequent use should be monitored appropriately.

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Sucralfate Pharmacology

On this episode, I discuss (Carafate) sucralfate pharmacology, adverse effect, kinetics, and drug interactions.

Sucralfate is notorious for drug binding interactions and can reduce the concentrations of many drugs which I cover in the podcast.

Four times daily dosing is a big downside to sucralfate and why it isn’t used terribly often for GI issues like esophagitis.

The suspension formulation of sucralfate does contain some sugar so be aware of this in our diabetes patients.

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Atenolol Pharmacology

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

Atenolol is primarily cleared by the kidney which should tell you that we need to pay attention to dose adjustments as renal function declines.

Atenolol is a beta-1 selective agent that is NOT a preferred beta-blocker in HFrEF.

Pulse and blood pressure monitoring is essential with any beta-blocker like atenolol.

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Hydromorphone Pharmacology

On this episode, I discuss hydromorphone pharmacology, adverse effect, and drug interactions.

I discuss the pharmacokinetics of hydromorphone and also discuss the relative potency compared to other opioids.

Hydromorphone drug interactions are mostly additive effects. Drugs that cause sedation or constipation can have additive effects on hydromorphone.

Be extremely careful with hydromorphone dosage forms. There are numerous different concentrations and strengths. I discuss this in this episode.

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