Tag: diabetes

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April 6, 2023April 6, 2023

Exenatide Pharmacology Podcast

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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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January 12, 2023January 9, 2023

Tirzepatide (Mounjaro) Pharmacology Podcast

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On this episode I discuss the pharmacology of tirzepatide. I’m appreciative of Derek Borkowski who operates Pyrls for providing a free PDF of the 2023 ADA Diabetes Guidelines when you subscribe for an account at Pyrls.com/rlp – Tirzepatide makes its first appearance in the diabetes guidelines for its ability to promote weight loss.

Tirzepatide is a combination GIP and GLP-1 agonist that is currently indicated for diabetes with reductions of A1C in the range of about 2 points.

Much like GLP-1 agonists, tirzepatide can cause GI upset and other gastrointestinal adverse effects like diarrhea.

Tirzepatide doesn’t have a large number of drug interactions which is nice. Corticosteroids can counteract its blood sugar-lowering effects while sulfonylureas and insulin may significantly increase the risk for hypoglycemia.

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December 29, 2022December 16, 2022

Semaglutide (subQ) Pharmacology Podcast

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On this podcast episode, I discuss the pharmacology, adverse effects, and drug interactions of semaglutide.

Semaglutide has two primary uses: Type 2 diabetes and Weight Management – the dosing varies depending upon the indication.

When using semaglutide, pay attention to GI adverse effects. Nausea, diarrhea, and vomiting are the most common ADRs and are dose-dependent.

Pay attention to corticosteroid bursts. They can cause substantial hyperglycemia and counteract the effects of diabetes medications like semaglutide.

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November 17, 2022November 16, 2022

Sitagliptin Pharmacology Podcast

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Sitagliptin is a DPP4 inhibitor. I discuss the pharmacology of this medication on the podcast.

Which diabetes medication works similarly to sitagliptin? I discuss that further on this episode of the Real Life Pharmacology podcast.

Renal elimination plays a significant role with sitagliptin. I discuss how this impacts the appropriate dosing.

Cost is a significant issue with sitagliptin at this time. In addition, it’s A1C-lowering effects aren’t anything to write home about. I discuss how much it will lower A1C in this podcast episode.

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September 22, 2022September 17, 2022

Glimepiride Pharmacology Podcast

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On this podcast episode, I discuss glimepiride pharmacology, adverse effects, hypoglycemia symptoms, and drug interactions.

CYP2C9 is an important enzyme in the breakdown of glimepiride. I discuss a few drugs that can cause interactions via this enzyme.

Renal function is important to consider with glimepiride. The active metabolites are cleared by the kidney and can accumulate in CKD.

Hypoglycemia and weight gain are problematic adverse effects of this medication and are the primary reasons it has fallen out of favor.

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July 7, 2022June 27, 2022

Prednisolone Pharmacology

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I mentioned prednisolone to prednisone conversion in this podcast. Please go check out Pyrls.com for a free steroid conversion downloadable PDF with a free account!

On this episode, I discuss prednisolone (Orapred, Pediapred) pharmacology, adverse effects, practice pearls, and drug interactions.

Prednisolone is a systemic corticosteroid that can cause insomnia, elevations in blood sugars, and numerous effects if used long-term.

CYP3A4 is an important enzyme in the breakdown of prednisolone. Inhibitors or inducers may raise or lower drug levels respectively.

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May 26, 2022May 24, 2022

Canagliflozin Pharmacology

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Canagliflozin is an SGLT2 inhibitor. I discuss the pharmacology, dosing, adverse effects, and drug interactions of this medication.

Canagliflozin reduces blood sugar, by facilitating its exit through the urine. This can increase the risk of genitourinary infections.

A diuresis type effect can happen due to canagliflozin and this effect may be exacerbated by the use of thiazide and loop diuretics.

Hyperkalemia has been reported with the use of canagliflozin; the risk for this is increased with the use of medications like ACE inhibitors, ARBs, and aldosterone antagonists.

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