Tag: drug interactions

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Duloxetine Pharmacology

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

Duloxetine is an SNRI that is used for depression, anxiety, and various pain syndromes like neuropathy and fibromyalgia.

Duloxetine can inhibit CYP2D6 which can lead to higher concentrations of clozapine and propranolol and lower activity of tamoxifen.

CYP1A2 inhibitors like ciprofloxacin can raise concentrations of duloxetine leading to an increased potential for adverse effects.

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Lasmiditan Pharmacology

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Lasmiditan (Reyvow) is an agent that is utilized for acute migraine treatment. It works slightly differently than triptans which I discuss on this episode.

Lasmiditan is a relatively new agent and cost will often limit its use at this time.

Rosuvastatin and sulfasalazine are two common medications that may have concentrations increase when lasmiditan is used. I discuss this in detail on this episode.

Lasmiditan is an oral tablet that is only recommended to give once per day which differs from commonly used triptans where the dose can be repeated.

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Bumetanide Pharmacology

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

Bumetanide is a loop diuretic and it is critical to monitor renal function and electrolytes with this medication.

Ototoxicity is a rare adverse effect that is dose-dependent and can be worsened by aminoglycosides.

It is critical to look for drugs that can worsen edema when using bumetanide to ensure that we avoid the prescribing cascade.

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Doxycycline Pharmacology

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On this episode of the Real Life Pharmacology podcast, I explore doxycycline pharmacology, adverse effects, and drug interactions.

Doxycycline can be bound by numerous minerals like calcium, magnesium, and iron. Coadministration can lead to reduced concentrations.

Sun sensitivity is a really important adverse effect that can be caused by doxycycline. Be sure to educate your patients.

Doxycycline can be used as an alternative to beta-lactams and macrolides in the management of community-acquired pneumonia.

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Tolterodine Pharmacology

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

Tolterodine (Detrol) is an anticholinergic medication used to manage the symptoms of overactive bladder.

Tolterodine’s anticholinergic activity can lead to a significant number of adverse effects like dry mouth, dry eyes, constipation, and urinary retention.

Elderly patients may be at greater risk for anticholinergic adverse effects from tolterodine compared to younger patients.

Tolterodine can have additive effects from other anticholinergics like diphenhydramine or TCAs which enhance its potential for side effects.

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Clarithromycin Pharmacology

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

Clarithromycin is a macrolide antibiotic that can be used for many similar indications as azithromycin.

Clarithromycin has numerous drug interactions as it can inhibit CYP3A4. This limits its use in practice.

Clarithromycin can be used in the treatment of H. pylori in combination with other antibiotics and a PPI.

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Azathioprine Pharmacology

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On this episode, I discuss azathioprine pharmacology, adverse effects, monitoring parameters, and drug interactions.

Azathioprine is classified as an immunosuppressive agent so it is naturally going to be used for autoimmune type disorders and transplantation.

Azathioprine has a boxed warning for myelosuppression. I talk more about this in the episode.

Genetic testing is recommended by the AGA prior to the use of azathioprine. I discuss which tests might be helpful to reduce the risk of toxicity.

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Amitriptyline Pharmacology

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

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Grapefruit Juice Interactions

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On this episode of the podcast, I discuss my approach and strategies to handle grapefruit juice interactions.

Grapefruit juice causes drug interactions by inhibiting the CYP enzyme system. More specifically, it inhibits CYP3A4 which is responsible for the breakdown of many medications.

Quantity is always an important consideration when assessing grapefruit juice interactions. The more that is taken, typically, the more drug concentrations will be affected.

It is important to assess the use of grapefruit juice when your patient has a history of cardiovascular disease, cardiac conditions, pain, mental health disease, or gout as some medications used to treat these diseases can interact with grapefruit juice.

If you are looking for more content on drug food interactions, be sure to check out my book in the links below.

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Pantoprazole Pharmacology

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On this episode, I cover pantoprazole pharmacology, adverse effects, and drug interactions.

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