Category: Cardiovascular Medications

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June 5, 2025May 29, 2025

Nifedipine Pharmacology

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Nifedipine is a dihydropyridine calcium channel blocker that selectively inhibits L-type calcium channels in vascular smooth muscle, leading to vasodilation and reduced peripheral vascular resistance.

The extended-release formulation of nifedipine provides more stable plasma concentrations and is preferred for chronic management of hypertension and angina.

Common adverse effects include headache, flushing, peripheral edema, and dizziness, all related to its vasodilatory action.

Nifedipine undergoes extensive first-pass metabolism in the liver, primarily via CYP3A4 enzymes, which significantly influences its bioavailability and potential drug interactions.

CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, grapefruit juice) can increase plasma levels of nifedipine, raising the risk of hypotension and adverse effects.

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May 22, 2025May 14, 2025

Irbesartan Pharmacology

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Irbesartan is an angiotensin II receptor blocker (ARB) used primarily for the management of hypertension and diabetic nephropathy in type 2 diabetes.

It selectively inhibits the binding of angiotensin II to the AT1 receptor found in vascular smooth muscle and the adrenal gland. This blockade results in vasodilation, reduced aldosterone secretion, decreased sodium and water retention, and ultimately lower blood pressure.

Irbesartan is administered orally, with a typical starting dose of 150 mg once daily, which may be increased to 300 mg depending on the patient’s clinical response and tolerability.

Adverse effects of irbesartan are generally mild but can include hyperkalemia and dizziness. Hypotension may occur, especially in volume-depleted individuals or those on diuretics.

Routine monitoring of renal function and serum potassium is recommended, especially in patients with underlying kidney disease or those taking potassium-sparing agents or supplements.

Irbesartan is contraindicated in pregnancy due to the risk of fetal toxicity and should be discontinued as soon as pregnancy is detected.

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May 1, 2025May 1, 2025

Minoxidil Pharmacology

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On this episode of the Real Life Pharmacology Podcast, we cover minoxidil pharmacology, adverse effects, drug interactions, and much more.

Minoxidil is a potent arterial vasodilator used in the treatment of hypertension and androgenetic alopecia.

The route of administration greatly impacts the drug’s safety profile. Oral minoxidil is typically reserved for refractory hypertension due to its strong systemic effects and associated risks.

Topical formulations (2% or 5%) are widely used for hair regrowth, offering local benefits with minimal systemic absorption.

Systemic minoxidil can result in fluid retention, tachycardia, and even pericardial effusion, often requiring co-administration with a diuretic and beta-blocker.

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March 27, 2025March 17, 2025

Benazepril Pharmacology Podcast

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Benazepril is an ACE inhibitor used to treat hypertension by blocking the conversion of angiotensin I to angiotensin II, reducing vasoconstriction.

Combining benazepril with potassium-sparing diuretics or potassium supplements increases the risk of hyperkalemia due to aldosterone suppression.

Common side effects of benazepril include dry cough, hyperkalemia, and hypotension due to its effect on the renin-angiotensin-aldosterone system.

Benazepril can be prescribed alone or in combination with other antihypertensive agents, such as diuretics or calcium channel blockers, to enhance blood pressure control.

Benazepril has a long duration of action, allowing for once-daily dosing, which improves patient adherence and convenience in hypertension management.

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May 30, 2024May 27, 2024

Timolol Pharmacology Podcast

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

Timolol is a non-selective beta-blocker so it blocks both beta-1 and beta-2 receptors.

Since timolol blocks beta-2 receptors, it can blunt the effect of respiratory medications that have beta-agonist action.

Beta-blockers are notorious for causing bradycardia and pulse is an important monitoring parameter for timolol.

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April 18, 2024April 18, 2024

Top 10 Anticoagulant Drug Interactions

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Apixaban is one of the most commonly used anticoagulants and there are some drug interactions you need to be aware of. Take a listen and find out!

Warfarin concentrations can substantially be elevated by drugs that inhibit CYP2C9. I cover a few of them in my top 10 anticoagulant drug interactions.

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March 21, 2024March 25, 2024

Beers Criteria Podcast Part 1 or 2

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In this podcast episode, I break down some of the most common medications that show up on the Beers criteria list.

I discuss cardiovascular medications in this podcast episode, including rivaroxaban and warfarin, and why they show up on the Beers list.

Alpha-blockers who up on the Beers list as these medications are inappropriate to use for the management of hypertension.

The Beers criteria addresses the use of aspirin in primary prevention. I break down what the criteria state and why it should be avoided in general.

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March 14, 2024March 11, 2024

Navigating QTc Prolongation and Drug Interactions

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On this episode, I discuss the pharmacology surrounding QTc prolongation and drug interactions.

I discuss which medications are more likely to cause QTc prolongation and which patient populations we should be more concerned about.

Antiarrhythmics are a common class of medication that can exacerbate QTc prolongation when used with other interacting medications.

500 ms is a common value utilized to help identify patients at risk for QTc prolongation and ultimately torsades de pointes.

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