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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Glimepiride Pharmacology Podcast

On this podcast episode, I discuss glimepiride pharmacology, adverse effects, hypoglycemia symptoms, and drug interactions.

CYP2C9 is an important enzyme in the breakdown of glimepiride. I discuss a few drugs that can cause interactions via this enzyme.

Renal function is important to consider with glimepiride. The active metabolites are cleared by the kidney and can accumulate in CKD.

Hypoglycemia and weight gain are problematic adverse effects of this medication and are the primary reasons it has fallen out of favor.

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Canagliflozin Pharmacology

Canagliflozin is an SGLT2 inhibitor. I discuss the pharmacology, dosing, adverse effects, and drug interactions of this medication.

Canagliflozin reduces blood sugar, by facilitating its exit through the urine. This can increase the risk of genitourinary infections.

A diuresis type effect can happen due to canagliflozin and this effect may be exacerbated by the use of thiazide and loop diuretics.

Hyperkalemia has been reported with the use of canagliflozin; the risk for this is increased with the use of medications like ACE inhibitors, ARBs, and aldosterone antagonists.

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Perils of Polypharmacy (Great Resource for Those Who Work in Geriatrics)

Liraglutide Pharmacology

On this episode, I discuss liraglutide pharmacology, drug interactions, and adverse effects.

Liraglutide is well known to cause nausea. It is important to assess the severity of nausea as it may subside in some patients as they gain tolerability to the medication.

We mentioned the 2022 Diabetes Guideline Cheat Sheet in the podcast – you can get that for free at pyrls.com/rlp

Liraglutide has a fairly low risk of hypoglycemia when used alone, but this risk increases when it is used with insulin or sulfonylureas.

Saxenda is the weight loss formulation of liraglutide and dosing is higher for weight management than it is for diabetes management.

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

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Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

Drug Interactions In Primary Care (Amazing Resource for Practicing Clinicians)

Perils of Polypharmacy (Great Resource for Those Who Work in Geriatrics)

Glyburide Pharmacology

On this episode, I will discuss glyburide pharmacology.

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Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

Drug Interactions In Primary Care (Amazing Resource for Practicing Clinicians)

Perils of Polypharmacy (Great Resource for Those Who Work in Geriatrics)