Vortioxetine Pharmacology Podcast

On this podcast episode, I discuss vortioxetine pharmacology, adverse effects, drug interactions, and much more.

Because of vortioxetine’s long half-life, antidepressant discontinuation syndrome is going to be less prominent compared to ADPs with shorter half-lives.

Vortioxetine is metabolized by CYP2D6. Drugs that inhibit this enzyme will likely raise concentrations and place the patient more at risk for adverse effects.

I discuss rare vortioxetine adverse effects like hyponatremia and bleeding in this podcast episode.

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Isosorbide Mononitrate Pharmacology Podcast

On this episode, I discuss isosorbide mononitrate pharmacology, adverse effects, and important drug interactions.

Isosorbide mononitrate is a vasodilator that works by relaxing and widening the blood vessels (primarily veins) through nitric oxide action. This reduces the preload and oxygen demand on the heart.

The primary use for isosorbide mononitrate is angina prevention. It is important to remember that it is NOT meant for acute relief of chest pain.

Headache is a major adverse effect of isosorbide mononitrate and can be very bothersome for patients. Vasodilation is primarily responsible for this adverse effect.

PDE-5 inhibitors are notorious for causing drug interactions with any nitrate medication. I discuss management strategies in this podcast episode.

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Azelastine Nasal Spray Pharmacology Podcast

On this episode of the RLP podcast, I discuss azelastine nasal spray pharmacology, adverse effects, administration, and much more!

While most nasal sprays for allergic rhinitis are corticosteroids, azelastine is classified as an antihistamine.

Systemic absorption of azelastine is about 40%, so while not common, systemic adverse effects like sedation can happen.

On this podcast episode, I use azelastine to remind you about important education points regarding the use of nasal sprays.

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Amlodipine Pharmacology Podcast

On this episode of the Real Life Pharmacology Podcast, I discuss amlodipine pharmacology, adverse effects, and important drug interactions.

I break down why edema occurs with amlodipine on this episode of the Real Life Pharmacology podcast.

While beta-blockers are typically the first-line agent for the prevention of chronic angina symptoms, CCBs like amlodipine can be used as an alternative.

There are some potential CYP3A4 interactions with amlodipine. I discuss the severity of these interactions and how to monitor patients.

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Pyridoxine Pharmacology

On this episode, I discuss pyridoxine pharmacology, adverse effects, and important clinical uses.

Pyridoxine is most well known for its potential to reduce the likelihood of isoniazid-induced neuropathy.

Another common indication of pyridoxine is its use for nausea and vomiting associated with pregnancy.

Pyridoxine plays an important role in the production of heme, so deficiency will increase the risk for anemia.

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Vibegron Pharmacology Podcast

On this episode of the Real Life Pharmacology podcast, I discuss vibegron pharmacology, adverse effects, drug interactions and more!

I spend some time comparing and contrasting vibegron to mirabegron. Both are beta-3 agonists used for overactive bladder.

Vibegron dosing is very simple. It is dosed once daily with no alternative dosage forms available. The starting dose is the target dose.

Being primarily excreted in the feces and urine, vibegron doesn’t have many drug interactions.

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Bempedoic Acid Pharmacology Podcast

Bempedoic acid, also known as Nexletol, is a once-daily medication used in lipid management. I discuss its pharmacology, side effects, and much more on this podcast episode.

Bempedoic is a once-daily medication that doesn’t need to be titrated. Standard dosing is 180mg once daily which can be taken with or without food. 

What are the most common side effects of bempedoic acid? One of the most notable adverse effects is hyperuricemia. This is usually seen within the first 4 weeks of being on the medication but could happen throughout the treatment.

Tendon problems can happen as well, especially in patients who are greater than 60 years old, on fluoroquinolones, have renal failure, or are taking corticosteroids.

If Bempedoic acid is taken along with Simvastatin, it is recommended to avoid doses greater than 20mg. This is partly because Bempedoic Acid 180mg along with 40mg of Simvastatin was found to increase Simvastatin AUC by 2-fold. The mechanism of this interaction has yet to be reported. Pravastatin doses greater than 40mg are to be avoided as well due to an increased risk of myopathy. Atorvastatin and Rosuvastatin didn’t have any maximum dose considerations.

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Exenatide Pharmacology Podcast

On this podcast episode, I discuss exenatide pharmacology, adverse effects, drug interactions, and much more!

Exenatide has an immediate release formulation (Byetta) and a long acting formulation (Bydureon). I discuss the differences in this podcast episode.

Byetta use has fallen out of favor due to frequent dosing, patient inconvenience and needing to time the dose 60 minutes prior to meals.

I discuss the risk of pancreatitis related to GLP-1 agonists like exenatide in this podcast episode.

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Pyridostigmine Pharmacology Podcast

I discuss Pyridostigmine Pharmacology in this podcast episode in addition to adverse effects, drug interactions, and much more!

Pyridostigmine is an acetylcholinesterase inhibitor that can be used for myasthenia gravis or orthostasis.

Pyridostigmine can blunt the effect of neuromuscular blocking agents so patients undergoing surgery should be sure to have a game plan with their surgery team.

Similar to donepezil, pyridostigmine can cause diarrhea and bradycardia.

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Simethicone (Gas-X) Pharmacology Podcast

On this podcast episode, I discuss simethicone pharmacology, adverse effects, drug interactions, and much more!

Simethicone is primarily used for anti-gas purposes. It is most often used on an as needed basis for relief of flatulence and bloating associated with gas.

Systemic absorption is minimal with simethicone so the occurrence of any systemic-type side effects at therapeutic doses is low.

Simethicone may interfere with levothyroxine absorption. Timing levothyroxine at least a few hours prior to simethicone should help reduce the significance of this interaction.

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