Tag: adverse effects

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April 14, 2022April 6, 2022

Esomeprazole (Nexium) Pharmacology

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On this episode, I discuss esomeprazole (Nexium) pharmacology, adverse effects, tapering, kinetics, and drug interactions.

I spend a good amount of time discussing the esomeprazole and clopidogrel interaction in this podcast episode.

Esomeprazole inhibits CYP2C19. This can cause an increase in citalopram concentrations and raise the potential for QTc prolongation.

It is critical to reassess the length of therapy and the dose of PPIs like esomeprazole.

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March 24, 2022March 21, 2022

Denosumab (Prolia) Pharmacology

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

Whenever I see an osteoporosis medication like denosumab used, I review the medications to ensure that we avoid medications that can cause osteoporosis.

Denosumab is often used as a potential alternative in osteoporosis management for those that cannot tolerate bisphosphonates.

We need to monitor calcium levels when using denosumab as levels can be dangerously low, especially when used in combination with other calcium lowering drugs.

Loop diuretics and cinacalcet can have additive hypocalcemia effects when used in combination with denosumab.

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March 17, 2022March 2, 2022

Roflumilast (Daliresp) Pharmacology

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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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March 10, 2022March 2, 2022

Trihexyphenidyl (Artane) Pharmacology

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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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March 3, 2022March 1, 2022

Liraglutide Pharmacology

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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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February 17, 2022February 16, 2022

Pravastatin Pharmacology

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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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February 10, 2022February 6, 2022

Clomiphene Pharmacology

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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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February 3, 2022February 1, 2022

Fluticasone Nasal Pharmacology

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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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January 27, 2022January 10, 2022

Sucralfate Pharmacology

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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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