Insulin Aspart (Novolog) Pharmacology Podcast Episode 312

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

Insulin apart is a rapid acting insulin product meant to bring down blood sugars quickly (most often after meals).

It is important to remember a couple of medications that may counteract the effects of insulin and apart and raise blood sugar. I talk about corticosteroids and thiazide diuretics in the drug interaction section.

Fiasp is a slightly modified insulin aspart molecule that allows for quicker absorption. This quicker absorption will allow for blood sugars to come down sooner than the Novolog formulation.

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Insulin Lispro (Humalog) Pharmacology Podcast

On this podcast episode, I discuss the pharmacology, adverse effects, and drug interactions of insulin lispro (Humalog).

I spend some time on this podcast episode discussing carb ratios and sliding scale insulin when using insulin lispro.

Potassium is critical to monitor in diabetic ketoacidosis as insulin therapy can cause significant hypokalemia.

Sliding-scale insulin lispro is discouraged in the overwhelming majority of situations. Ideally, we should be more proactive about insulin administration to reduce the risk of hyperglycemia spikes.

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Bexagliflozin Pharmacology Podcast

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

I wasn’t wowed by the A1C reduction of this medication. I get into the specifics on bexagliflozin in the podcast episode.

SGLT2 inhibitors like bexagliflozin increase the glucose in the urine which can facilitate the growth of bacteria and fungi in the genitourinary tract.

Limb amputation and euglycemic DKA are two rare, reported adverse effects to be aware of with the use of bexagliflozin.

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Exenatide Pharmacology Podcast

On this podcast episode, I discuss exenatide pharmacology, adverse effects, drug interactions, and much more!

Exenatide has an immediate release formulation (Byetta) and a long acting formulation (Bydureon). I discuss the differences in this podcast episode.

Byetta use has fallen out of favor due to frequent dosing, patient inconvenience and needing to time the dose 60 minutes prior to meals.

I discuss the risk of pancreatitis related to GLP-1 agonists like exenatide in this podcast episode.

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Tirzepatide (Mounjaro) Pharmacology Podcast

On this episode I discuss the pharmacology of tirzepatide. I’m appreciative of Derek Borkowski who operates Pyrls for providing a free PDF of the 2023 ADA Diabetes Guidelines when you subscribe for an account at Pyrls.com/rlp – Tirzepatide makes its first appearance in the diabetes guidelines for its ability to promote weight loss.

Tirzepatide is a combination GIP and GLP-1 agonist that is currently indicated for diabetes with reductions of A1C in the range of about 2 points.

Much like GLP-1 agonists, tirzepatide can cause GI upset and other gastrointestinal adverse effects like diarrhea.

Tirzepatide doesn’t have a large number of drug interactions which is nice. Corticosteroids can counteract its blood sugar-lowering effects while sulfonylureas and insulin may significantly increase the risk for hypoglycemia.

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Methimazole Pharmacology Podcast

On this episode of the Real Life Pharmacology podcast, I cover methimazole adverse effects, mechanism of action, drug interactions, and much more!

Methimazole and propylthiouracil are from the same class of medications and are used for hyperthyroidism. I go over some of the differences between these agents in this podcast episode.

Methimazole is dosed once daily but can be split if the patient experiences significant GI adverse effects.

T3 plays an important role in hyperthyroidism. I discuss the physiologic of T3 production and how methimazole creates its effects to lower thyroid hormone levels.

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Semaglutide (subQ) Pharmacology Podcast

On this podcast episode, I discuss the pharmacology, adverse effects, and drug interactions of semaglutide.

Semaglutide has two primary uses: Type 2 diabetes and Weight Management – the dosing varies depending upon the indication.

When using semaglutide, pay attention to GI adverse effects. Nausea, diarrhea, and vomiting are the most common ADRs and are dose-dependent.

Pay attention to corticosteroid bursts. They can cause substantial hyperglycemia and counteract the effects of diabetes medications like semaglutide.

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Propylthiouracil Pharmacology Podcast

In this podcast episode, I cover propylthiouracil pharmacology, adverse effect, drug interaction, and much more!

Propylthiouracil carries a boxed warning for hepatotoxicity which is a significant downside compared to the other agent in its class (methimazole).

What about dosing? I discuss why this medication has to be dosed multiple times per day.

Drug interactions aren’t incredibly common with propylthiouracil but it can affect warfarin differently than most drug interactions. I discuss it further in this episode.

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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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Phentermine Pharmacology Podcast

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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