Tadalafil (Cialis) Pharmacology Podcast

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

Tadalafil has a significantly longer half-life than sildenafil. I discuss how this is going to impact a patient that may need a nitrate.

PDE-5 inhibitors like tadalafil are most commonly used for erectile dysfunction but I talk about other unique indications in the podcast.

Daily use or as-needed use of tadalafil are both acceptable options but there are some quirks you need to know with these two methods of use.

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Sitagliptin Pharmacology Podcast

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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Gabapentin (Neurontin) Pharmacology Podcast

On this podcast episode, I discuss gabapentin (Neurontin) pharmacology, adverse effects, drug interactions, and much more!

Gabapentin’s GI absorption is a little wacky. I discuss on the podcast the clinical effects that this may have on our patients.

Renal elimination is critical to gabapentin. Worsening renal function will significantly impact the action of the drug.

CNS sedation can be a problem with gabapentin, especially in combination with other CNS depressants. I discuss this further on the podcast.

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Ranolazine (Ranexa) Pharmacology Podcast

Ranolazine is primarily used for chronic angina management. I discuss pharmacology, drug interactions, adverse effects, and more in this podcast episode.

Ranolazine is well known to have drug interactions. CYP3A4 is of major importance but there are other subtle drug interactions that are important.

QTc prolongation has been reported with ranolazine so it is important to recognize risk factors and other medications that may contribute to this concern.

Enzyme inducers like carbamazepine, phenytoin, and St. John’s wort are all associated with reducing the concentrations of ranolazine.

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Lorazepam (Ativan) Pharmacology Podcast

On this podcast episode, I discuss lorazepam (Ativan) pharmacology, adverse effects, and common drug interactions.

Lorazepam has numerous dosage forms and the IV formulation does contain propylene glycol which can accumulate if it is used for longer periods of time.

There is a boxed warning for lorazepam when it is used with opioids. The risk for opioid overdose, coma, and death increases significantly.

Lorazepam is an intermediate acting benzodiazpine. It’s half-life for most adult patients is in the 12-18 hour range.

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Valsartan Pharmacology Podcast

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

Valsartan is a fairly common ARB. I mostly see losartan and valsartan used as the most common ARBs in hypertension management.

Valsartan has a longer half-life than losartan which is why we can often get away with once daily dosing compared to losartan which sometimes requires twice daily.

Hyperkalemia is a major concern with ARBs like valsartan. Trimethoprim and spironolactone are two medications that can increase this risk.

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Famotidine Pharmacology Podcast

On this podcast episode, I discuss famotidine pharmacology, adverse effects, uses, and drug interactions.

Famotidine is generally pretty well tolerated, but one thing I look out for with chronic use is B12 deficiency.

Famotidine is eliminated by the kidney so you should pay attention to the dose in patients with CKD.

Famotidine is occasionally used as a pretreatment to help prevent infusion-type reactions for certain chemotherapy agents.

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Clonazepam Pharmacology Podcast

On this podcast episode, I discuss clonazepam pharmacology, adverse effects, pharmacokinetics, and drug interactions.

Clonazepam is a benzodiazepine that enhances the activity of GABA which is an inhibitory neurotransmitter in the central nervous system.

It is important to try to avoid using benzodiazepines like clonazepam with opioids as it can increase the risk of respiratory depression and death.

Clonazepam is an intermediate-acting benzodiazepine that is only commercially available as an oral dosage form.

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Phentermine Pharmacology Podcast

blue tape measuring on clear glass square weighing scale

In this podcast episode, I break down the pharmacology, adverse effects, pharmacokinetics, and drug interactions of phentermine.

Phentermine has some CNS stimulant activity so adverse effects like insomnia, hypertension, and tachycardia are possible.

Pay attention to drugs that can oppose the effects of phentermine and cause weight gain such as mirtazapine and sulfonylureas.

Phentermine is a controlled substance so the risk of addiction and dependence is possible.

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Glimepiride Pharmacology Podcast

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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