Loop Diuretics Pharmacology

On this episode, I cover common loop diuretics. They include furosemide, torsemide, and bumetanide.

Loop diuretics are potent agents that can help in the management of heart failure and ascites.

Loops diuretics help promote the loss of excessive fluid through the urine.

A common patient complaint from loop diuretics is that they can cause frequent urination. Because of this, we typically dose these drugs earlier in the day.

Kidney function and electrolyte monitoring is critical with the use of loop diuretics.

Enjoy the episode!

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Methotrexate Pharmacology

On this episode of the Real Life Pharmacology Podcast, I cover the pharmacology of methotrexate.

Methotrexate has a few different indications. It can be used for treatment of cancer. These doses are typically going to be much higher than standard low doses for other conditions.

Lower dose methotrexate is often used for autoimmune type conditions like rheumatoid arthritis and psoriasis.

Folic acid should be supplemented with use of methotrexate to help reduce the risk of adverse effects.

Liver toxicity and immune system suppression are two important factors to monitor in a patient taking chronic methotrexate.

I also talk about important cumulative drug interactions with methotrexate such as immunosuppressives and other agents that may impact liver function.

Be sure to listen to the end as I talk about the potential impact of methotrexate on some vaccines!

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Cyclobenzaprine Pharmacology

On this episode, I discuss cyclobenzaprine pharmacology. Cyclobenzaprine is an older skeletal muscle relaxant.

Cyclobenzaprine can have a significant number of anticholinergic side effects.

The anticholinergic side effects of cyclobenzaprine can include sedation, dry eyes, dry mouth, urinary retention, and confusion.

Cyclobenzaprine is not well tolerated in the elderly and cause more problems in that patient population.

Cyclobenzaprine has a similar structure to the Tricyclic antidepressants.

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Lithium Pharmacology

Lithium is a drug that has a ton of clinical pearls.  On this episode, I talk about the pharmacology, side effects, drug interactions, and critical practice pearls.

Kidney function is very important to monitor in our patients taking lithium.  Lithium can accumulate in renal impairment.

Thyroid function can be altered by lithium.  Be sure to regularly monitor TSH in a patient on chronic lithium.

Over-the-counter NSAID can interact and raise lithium levels.  This is something you need to watch out for as patients can begin taking these medications on their own without supervision.

Be sure to assess lithium levels.  Signs of toxicity can include GI upset, tremor, motor movement issues, sedation, and CNS changes.

Pseudoephedrine Pharmacology

Pseudoephedrine is commonly used to help relieve nasal congestion.

There are some adverse effects you need to be aware of with pseudoephedrine. Insomnia, increase in blood pressure, and urinary retention are all possible.

When I assess a patient using pseudoephedrine, I like to investigate blood pressure, history of urinary problems and insomnia history.

Pseudoephedrine can cause the prescribing cascade.  I lay out examples in the podcast.

Pseudoephedrine should not be utilized with MAOI’s if possible – I discuss the reason for this in the podcast.

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Fentanyl Pharmacology

On this episode, I discuss fentanyl pharmacology.

I address important considerations that you must remember with fentanyl patches.

Those considerations include how pharmacokinetics can impact our patients.

I also break down common side effects of opioids as well as potential common drug interactions.

Drug diversion and illicit use is an important consideration when using fentanyl.  I also touch on this topic.

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Quinolone Antibiotic Pharmacology

Quinolones are a class of antibiotics that can be used for various infections. I discuss the pharmacology, adverse effects, drug interactions and other items on this podcast episode.

On this episode, I talk about the warnings associated with quinolones.

Quinolone use has subsided over time, not due to the fact that they are ineffective, but to rising concerns and warnings about adverse effects.

Quinolones can interact with quite a few medications.  I’ve seen a case of amiodarone and levofloxacin contributing to QTc prolongation which I discuss on this episode.

It is critical to remember the binding interactions associated with quinolones as these can potentially lead to treatment failure.

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Potassium Supplement Pharmacology

On this episode I discuss why we may need to use potassium supplements.

I also talk about a medication error situation involving potassium that lead to a death.

It is important to remember other medications that can raise potassium levels.

I also talk about a dosage form of potassium that might make patients ask some questions.

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Apixaban Pharmacology

On this episode, I talk about apixaban (Eliquis) pharmacology.

I also cover adverse effects like bleeding and what to monitor.

Drug interactions are a concern with apixaban and I discuss a few items that you may want to look out for.

It is important to remember that apixaban does require dose adjustments in certain situations as well.

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Metoclopramide (Reglan) Pharmacology

Metoclopramide Pharmacology

Metoclopramide can block dopamine receptors as part of it’s mechanism of action.  I discuss the clinical implications from this in the podcast.

Metoclopramide can exacerbate Parkison’s disorder so you need to be careful in that type of patient.

Metoclopramide is dosed frequently, which can potentially be a downside as far as patient adherence goes.

Metoclopramide has a few potential interactions that you should be aware of.  I talk about those in this episode.

Be sure to check out The Thrill of the Case on Amazon as I do have a clinical scenario about Reglan (metoclopramide) in that 200+ page book.

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