Tag: adverse effects

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

December 25, 2025December 23, 2025

Antihypertensives Test Prep and Practice Pearls; Part 3 – Aldosterone Antagonists and Vasodilators

Podcast: Play in new window | Download (Duration: 14:28 — 6.6MB) | Embed

Subscribe: RSS | More

Aldosterone antagonists, such as spironolactone and eplerenone, are potassium-sparing diuretics that block aldosterone at the mineralocorticoid receptor in the distal nephron. By reducing sodium and water reabsorption while conserving potassium, they play a key role in heart failure, resistant hypertension, and primary hyperaldosteronism. Clinically, they improve mortality in heart failure with reduced ejection fraction, making them much more than just “add-on” diuretics.

From a safety standpoint, the biggest concerns with aldosterone antagonists are hyperkalemia and renal function decline. These risks increase in patients with chronic kidney disease or when combined with ACE inhibitors, ARBs, or potassium supplements. Spironolactone can also cause endocrine-related adverse effects such as gynecomastia and menstrual irregularities, which is why eplerenone may be preferred in some patients.

Direct-acting vasodilators, most notably hydralazine and minoxidil, lower blood pressure by relaxing arteriolar smooth muscle and reducing systemic vascular resistance. Hydralazine is commonly used in heart failure in combination with nitrates, particularly in select patient populations, while minoxidil is reserved for severe, refractory hypertension due to its potency.

Despite their effectiveness, direct-acting vasodilators come with important clinical trade-offs. Reflex tachycardia and fluid retention are common, so they are typically prescribed alongside a beta blocker and a diuretic. Hydralazine is associated with drug-induced lupus, while minoxidil can cause significant edema and hypertrichosis, making careful patient selection and monitoring essential.

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

Support The Podcast and Check Out These Amazing Resources!

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

December 18, 2025December 18, 2025

Antihypertensives Test Prep and Practice Pearls; Part 2 – ARBs and Thiazides

Podcast: Play in new window | Download (Duration: 16:43 — 15.3MB) | Embed

Subscribe: RSS | More

This podcast is designed to help pharmacy and nursing learners cut through the noise and focus on the high-yield concepts that matter most when it comes to angiotensin receptor blockers (ARBs) and thiazide diuretics. These two medication classes show up constantly on exams and in clinical practice, yet small details about their mechanisms, adverse effects, and monitoring parameters are often where test questions try to trip you up. Each episode is built to reinforce those key points in a clear, practical way.

We’ll break down how ARBs and thiazide diuretics work, why they are commonly used in hypertension and other disease states, and how to quickly differentiate them from similar drug classes. Special attention is given to classic exam “gotchas,” such as electrolyte changes, renal considerations, and patient populations where these medications are especially beneficial or should be used with caution.

Beyond test prep, this podcast emphasizes real-world practice pearls that translate directly to patient care. You’ll hear concise explanations of what to monitor, what side effects matter most clinically, and how to recognize problems early. These insights are especially helpful for nurses, pharmacy students, and new clinicians who want to feel confident applying pharmacology knowledge at the bedside or in clinic.

Whether you’re studying for boards, preparing for a pharmacology exam, or just looking to sharpen your clinical skills, this podcast delivers focused, high-yield content in an easy-to-follow format. By the end of each episode, you’ll walk away with practical takeaways that improve both your test performance and your day-to-day medication management.

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

Support The Podcast and Check Out These Amazing Resources!

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

November 27, 2025November 25, 2025

Albuterol Pharmacology

Podcast: Play in new window | Download (Duration: 17:29 — 8.0MB) | Embed

Subscribe: RSS | More

On this episode of the Real Life Pharmacology Podcast, I cover albuterol pharmacology, adverse effects, and a rare indication for this classic respiratory medication.

Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that works by stimulating beta-2 receptors in the bronchial smooth muscle. This stimulation activates adenylate cyclase, increases cyclic AMP, and leads to relaxation of airway smooth muscle. The end result is rapid bronchodilation, making albuterol effective for quick relief of acute bronchospasm in conditions such as asthma and COPD.

Common adverse effects occur due to both beta-2 and some unintended beta-1 receptor stimulation. Patients may experience tremors, nervousness, headache, or tachycardia. Higher doses or frequent use can lead to hypokalemia because beta-2 stimulation drives potassium into cells. Some individuals may also report palpitations or feelings of anxiety. These effects are generally mild and transient but can be more pronounced in older adults, those with cardiovascular disease, or when albuterol is used excessively.

Albuterol has several clinically relevant drug interactions. Concomitant use with non-selective beta-blockers (such as propranolol) can blunt its bronchodilatory effect and may precipitate bronchospasm in susceptible individuals. Using albuterol with other sympathomimetics can enhance cardiovascular stimulation, increasing the risk of tachycardia or hypertension. Diuretics, especially loop or thiazide types, may compound albuterol-induced hypokalemia. Additionally, monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants can potentiate the effects of albuterol and increase the risk of cardiovascular adverse reactions.

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

Support The Podcast and Check Out These Amazing Resources!

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

November 20, 2025November 20, 2025

Glycopyrrolate Pharmacology

Podcast: Play in new window | Download (Duration: 11:47 — 5.4MB) | Embed

Subscribe: RSS | More

Glycopyrrolate is an anticholinergic medication commonly used to reduce excessive secretions, particularly in palliative care, postoperative settings, and certain neurologic conditions. It works by blocking acetylcholine at muscarinic receptors, which decreases salivary and respiratory secretions. Clinically, glycopyrrolate is often used to manage terminal respiratory secretions (“death rattle”).

Adverse effects of glycopyrrolate are primarily related to its anticholinergic properties. These may include dry mouth, constipation, urinary retention, blurred vision, tachycardia, and decreased sweating. While it has fewer central effects than agents like scopolamine, caution is still warranted in patients with glaucoma, gastrointestinal obstruction, or significant urinary retention risk. Monitoring hydration and bowel function is important, especially in elderly or frail patients.

Dosing strategies depend on the clinical need. In palliative care, low doses may be given subcutaneously or intravenously every 4–6 hours as needed, while oral dosing is common for chronic sialorrhea.

Clinicians should consider the patient’s overall medication burden, as cumulative anticholinergic load can worsen cognitive impairment and contribute to falls or constipation. I discuss drug interactions and other commonly used medications that may contribute to anticholinergic burden.

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

Support The Podcast and Check Out These Amazing Resources!

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

November 13, 2025November 12, 2025

Bisacodyl (Dulcolax) Pharmacology

Podcast: Play in new window | Download (Duration: 15:53 — 7.3MB) | Embed

Subscribe: RSS | More

Bisacodyl, commonly known by the brand name Dulcolax, is a stimulant laxative widely used for short-term relief of constipation and bowel preparation before procedures. It works by directly stimulating the enteric nerves in the colon, increasing peristalsis, and promoting bowel evacuation.

Mechanism of Action:
Bisacodyl acts primarily on the large intestine. It stimulates intestinal smooth muscle and alters water and electrolyte transport, increasing fluid accumulation in the bowel and triggering defecation. The result is a bowel movement typically within 6–12 hours orally or within 15–60 minutes when given rectally.

Dosage Forms and Dosing:
Bisacodyl is available as oral tablets (5 mg) and rectal suppositories (10 mg). Typical adult dosing is 5–15 mg by mouth once daily or 10 mg rectally as needed. It’s often used for acute constipation, bowel prep, or to prevent straining in specific medical situations.

Adverse Effects:
Common side effects include abdominal cramping, diarrhea, and nausea. Chronic or excessive use may lead to electrolyte imbalances, dehydration, and laxative dependence.

Drug Interactions and Monitoring:
Concurrent use with antacids, proton pump inhibitors, or milk may cause premature dissolution of enteric-coated tablets, leading to gastric irritation. Monitoring for bowel regularity, hydration status, and signs of electrolyte imbalance is important—especially in elderly or debilitated patients.

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

Support The Podcast and Check Out These Amazing Resources!

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

November 6, 2025November 6, 2025

Fludrocortisone (Florinef) Pharmacology

Podcast: Play in new window | Download (Duration: 14:44 — 13.5MB) | Embed

Subscribe: RSS | More

On this podcast episode, I cover fludrocortisone. Fludrocortisone is a synthetic corticosteroid with potent mineralocorticoid activity and minimal glucocorticoid effects. It works primarily by promoting sodium reabsorption and potassium excretion in the distal renal tubules, leading to increased water retention and expansion of extracellular fluid volume. This pharmacologic action helps maintain blood pressure and electrolyte balance.

Fludrocortisone is most commonly indicated for the treatment of adrenocortical insufficiency, such as Addison’s disease, and for managing orthostatic hypotension by enhancing vascular tone and volume status.

Adverse effects are typically related to its mineralocorticoid potency and may include hypertension, edema, hypokalemia, and weight gain. Long-term use can also lead to complications such as heart failure exacerbation, osteoporosis, and mood changes. Because of its sodium-retaining effects, careful monitoring of blood pressure, electrolytes, and signs of fluid overload is recommended during therapy.

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

Support The Podcast and Check Out These Amazing Resources!

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

October 30, 2025October 30, 2025

10 Common Examples of The Prescribing Cascade

Podcast: Play in new window | Download (Duration: 13:46 — 6.3MB) | Embed

Subscribe: RSS | More

One of the most important yet often overlooked concepts in pharmacology is the prescribing cascade. It occurs when a new medication is prescribed to treat a side effect caused by another drug, without realizing that the first medication is the root cause. This leads to a chain reaction of additional prescriptions, unnecessary complexity, and often, new adverse effects.

Prescribing cascades can sneak up on even the most careful clinicians. A patient develops a new symptom after starting a medication—perhaps swelling, dizziness, or urinary changes—and instead of identifying the drug as the culprit, another medication is added to manage the symptom. Over time, this cycle contributes to polypharmacy, drug interactions, and reduced quality of life.

These cascades are particularly concerning in older adults, where multiple comorbidities and high medication counts make it easy for adverse effects to be misinterpreted as new conditions. But they can occur at any age and in any clinical setting.

The key to preventing prescribing cascades is maintaining a critical mindset:

Assume any new symptoms could be an adverse effect.
Review the timing of medication changes relative to the onset of symptoms.
Consider deprescribing or adjusting doses before adding new drugs.
Encourage thorough medication reconciliation and communication across providers.

Recognizing and interrupting the prescribing cascade is one of the simplest and most impactful ways we can improve medication safety. In this podcast, I share some of my favorite real-world examples that illustrate just how easily these cascades can happen.

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

Support The Podcast and Check Out These Amazing Resources!

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

October 23, 2025October 23, 2025

Airsupra (Albuterol/budesonide) Pharmacology

Podcast: Play in new window | Download (Duration: 11:54 — 5.4MB) | Embed

Subscribe: RSS | More

Airsupra is a combination inhaler that contains albuterol and budesonide, approved for as-needed use in adults with asthma. It represents the first rescue inhaler to combine a short-acting beta-2 agonist (SABA) with an inhaled corticosteroid (ICS) in a single device. The albuterol component provides rapid bronchodilation by relaxing airway smooth muscle, while budesonide works to reduce airway inflammation and mucus production. This dual mechanism allows Airsupra to not only relieve acute bronchoconstriction but also address the underlying inflammatory process that contributes to asthma exacerbations.

Clinically, Airsupra is indicated for as-needed treatment or prevention of bronchoconstriction in adults with asthma, but it is not approved for COPD. The typical dosing is two inhalations as needed, with a maximum of six doses (12 inhalations) in a 24-hour period.

The rationale for its use aligns with recent asthma guideline updates, which emphasize minimizing SABA-only use because it fails to address inflammation and may contribute to worse outcomes over time.

Common adverse effects include tremor, nervousness, tachycardia, and hypokalemia from albuterol, as well as oral thrush and hoarseness from budesonide. Patients should rinse and spit after each use to reduce the risk of oral candidiasis.

Drug interactions can occur with non-selective beta-blockers, which may blunt albuterol’s effects. CYP3A4 also plays a role in budesonide metabolism. Systemic absorption typically isn’t too much of an issue with infrequent use.

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

Support The Podcast and Check Out These Amazing Resources!

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)