Author: Eric Christianson

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

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Polypharmacy is one of the most common—and often overlooked—challenges in modern healthcare, especially in older adults. It’s not just about the number of medications a patient is taking, but whether each one still has a clear indication, is providing benefit, and isn’t causing harm. As medication lists grow, so does the risk of adverse effects, drug interactions, and something we see all the time in practice: the prescribing cascade.

A prescribing cascade happens when a medication causes a side effect that is misinterpreted as a new medical condition, leading to the addition of another drug. Over time, this can snowball into unnecessary complexity and increased risk for patients.

In part 2 of this podcast, we outline 5 more examples that I’ve encountered in my geriatric pharmacist practice.

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Insulin Therapy Section 4.4 – Free Nursing Pharmacology Review Course

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This podcast episode gives nurses a practical, bedside-focused guide to insulin therapy, helping simplify one of the most important—and often confusing—areas of diabetes management. It reviews key insulin types, including rapid-acting insulin lispro, long-acting insulin glargine, and intermediate options like NPH insulin, highlighting onset, peak, and duration differences that drive dosing decisions. Nurses will learn how to safely administer insulin, adjust for meals and blood glucose trends, and recognize and treat hypoglycemia quickly. Real-world clinical tips are included to help nurses feel confident managing insulin in both inpatient and outpatient settings.

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

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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.

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

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Diabetes Medications Section 4.3 – Free Nursing Pharmacology Review Course

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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.

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

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

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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.

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

Support The Podcast and Check Out These Amazing Resources!

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Diabetes Compelling Indications Section 4.2 – Free Nursing Pharmacology Review Course

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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!

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Medication Errors – Real Life Examples and Definitions – Part 2

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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!

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

Support The Podcast and Check Out These Amazing Resources!

NAPLEX Study Materials

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Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

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Pharmacy Technician Study Guide by Meded101

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

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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.

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

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Medication Errors – Real Life Examples and Definitions – Part 1

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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

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

Support The Podcast and Check Out These Amazing Resources!

NAPLEX Study Materials

BCPS Study Materials

BCACP Study Materials

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BCMTMS Study Materials

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

Pharmacy Technician Study Guide by Meded101

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Respiratory Failure Section 3.3 – Free Nursing Pharmacology Review Course

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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.

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