Real Life Examples: Polypharmacy and the Prescribing Cascade Part 1 of 2

Polypharmacy isn’t just about medication count—it’s about cumulative risk and unintended consequences. One of the biggest drivers is the prescribing cascade, where a drug side effect is mistaken for a new condition, and another medication gets added instead of addressing the root cause.

You see this all the time in practice. A patient starts amlodipine and develops edema, then gets placed on furosemide. Or donepezil leads to urinary symptoms, and oxybutynin is added—potentially worsening cognition. These patterns add risk quickly.

In this episode, I’ll break down common examples that I have recently encountered in practice.

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Diabetes Medications Section 4.3 – Free Nursing Pharmacology Review Course

This podcast episode provides nurses with a clear, practical overview of non-insulin diabetes medications, focusing on how to safely and effectively manage patients with type 2 diabetes. It reviews key drug classes such as metformin, glipizide, empagliflozin, and semaglutide, emphasizing mechanisms of action, common side effects, and important monitoring parameters. Nurses will learn how to recognize risks like hypoglycemia with sulfonylureas, genitourinary infections with SGLT2 inhibitors, and gastrointestinal effects with GLP-1 agents, along with key patient counseling points. The episode also connects medication selection to real-world considerations such as weight impact, cardiovascular benefit, and kidney function, helping nurses feel more confident in supporting individualized diabetes care.

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Heart Failure Medications – Loops, SGLT2s, and ARNI – Test Prep and Practice Pearls

If you’re managing patients with heart failure, you already know the medication landscape has evolved quickly over the past decade. From traditional volume management with furosemide to newer, guideline-driven therapies like sacubitril/valsartan and empagliflozin, staying up to date is essential—but not always easy.

In this episode, we break down three cornerstone medication classes you’ll encounter every day in practice: loop diuretics, ARNI therapy, and SGLT2 inhibitors. We start with the fundamentals of loop diuretics—how they work, when to use them, and key monitoring parameters—before shifting into the mortality-reducing benefits of ARNI therapy. Finally, we explore the rapidly expanding role of SGLT2 inhibitors, which have transformed both heart failure and chronic kidney disease management.

Whether you’re a pharmacist, nurse, or student, this episode focuses on practical, real-world application. We highlight clinical pearls, common pitfalls, and monitoring strategies to help you feel more confident when optimizing therapy.

Tune in to sharpen your understanding of these essential therapies and walk away with actionable insights you can use right away in patient care.

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Diabetes Compelling Indications Section 4.2 – Free Nursing Pharmacology Review Course

This podcast episode breaks down diabetes “compelling indications” in a way that’s highly practical for nurses managing complex patients. It explains how comorbid conditions like cardiovascular disease, heart failure, and chronic kidney disease influence medication selection beyond just lowering A1c.

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

Medication Errors – Real Life Examples and Definitions – Part 2

In this section, I cover the most important medication errors you’ll see in practice. I got a good start in Part 1, so go back and listen to that for some great real-life information. In this section, I talk about a few types of medication errors that have led to serious complications and life-threatening situations for our patients. Wrong patient errors are one of the highest risk errors that a healthcare professional can make, and I cover that in this podcast episode.

I hope you find this episode on medication errors helpful, and if you do, I’d greatly appreciate a rating and review on iTunes or whatever platform you listen on – Thanks!

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Addison’s and Cushing’s Disease Section 4.1 – Nursing Pharmacology Review Course

This podcast episode provides nurses with a practical, clinically focused overview of Addison’s disease and Cushing’s disease, highlighting key differences in pathophysiology, presentation, and management. Listeners will learn how adrenal insufficiency in Addison’s leads to symptoms like fatigue, hypotension, and hyperpigmentation, while excess cortisol in Cushing’s presents with weight gain, hypertension, and glucose intolerance. The episode emphasizes important nursing considerations such as recognizing adrenal crisis, monitoring electrolytes and blood pressure, patient education on steroid adherence, and identifying medication-related causes of Cushing’s.

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Medication Errors – Real Life Examples and Definitions – Part 1

In this 2 part series, I cover important medication errors, including examples I’ve seen in real life. Some of the error types covered in section 1 include:

  • Prescribing errors
  • Omission errors
  • Monitoring errors
  • Dispensing errors

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Respiratory Failure Section 3.3 – Free Nursing Pharmacology Review Course

Respiratory failure is a serious clinical condition that nurses frequently encounter in critical care, emergency, and acute care settings. While supportive therapies such as oxygen and mechanical ventilation are often required, medications also play an important role in stabilizing patients and addressing the underlying causes. In this episode, we’ll review the general pharmacologic strategies used in the management of respiratory failure and highlight key considerations for nursing practice.

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Aminoglycosides Podcast – Pharmacology, Kinetics, Monitoring, and Adverse Effect

Aminoglycosides are antibiotics used to treat serious Gram-negative infections, but they also come with important safety concerns and unique pharmacokinetic properties that healthcare professionals must understand. In this episode, we’re going to break down the essential clinical pearls surrounding aminoglycosides and how pharmacists and clinicians can use them effectively while minimizing toxicity.

We’ll review the most common agents in this class, including Gentamicin, Tobramycin, and Amikacin, and discuss when these medications are typically used in clinical practice. From severe Gram-negative infections to synergy dosing in conditions like infective endocarditis, aminoglycosides still play a role in antimicrobial therapy.

Another key focus of this episode will be the pharmacology that makes these drugs unique. Aminoglycosides demonstrate concentration-dependent killing and a post-antibiotic effect, which is why strategies like extended-interval dosing and tools such as the Hartford Nomogram are commonly used to guide therapy.

We’ll also cover the major adverse effects, including nephrotoxicity and ototoxicity, and highlight practical monitoring strategies to help reduce these risks. By the end of this episode, you’ll have a clearer understanding of how aminoglycosides work, when they should be used, and the key dosing and monitoring principles that every clinician should know.

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COPD Section 3.2 – Free Nursing Pharmacology Review Course

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory condition that nurses encounter frequently in both inpatient and outpatient settings. Effective pharmacologic management plays a major role in controlling symptoms, preventing exacerbations, and improving quality of life for patients living with COPD. In this episode, we’ll review the key medication classes used to manage COPD and highlight practical clinical considerations nurses should know when caring for these patients.

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