Category: Neurology and Musculoskeletal Medications

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NSAIDs Part 2 – Test Prep and Practice Pearls for Aspirin, Ibuprofen, Naproxen, and Celecoxib

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Aspirin, ibuprofen, naproxen, and celecoxib are some of the most commonly used NSAIDs, but they are not interchangeable when it comes to safety, indications, and patient-specific risks. In this episode of Real Life Pharmacology, we compare these four medications and highlight the key differences pharmacists and other healthcare professionals need to know.

We’ll review how NSAIDs work, including COX-1 and COX-2 inhibition, and discuss their effects on pain, inflammation, platelets, the gastrointestinal system, kidneys, cardiovascular system, and fluid balance. We’ll also compare the GI, cardiovascular, renal, and heart failure risks of aspirin, ibuprofen, naproxen, and celecoxib.

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NSAIDs Part 1 – Test Prep and Practice Pearls

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On this podcast episode, I cover the basics of NSAIDs, including how they work, what they are used for, significant drug interactions, and what adverse effects are important to monitor. I’ll educate about some of the major risks associated with NSAIDs and what I look out for as a practicing pharmacist.

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Opioids Part 5 – Tramadol, Tapentadol, and Meperidine

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In this episode of Real Life Pharmacology, we’re taking a closer look at three unique opioids: tramadol, tapentadol, and meperidine. These medications have some important differences in their mechanisms, clinical uses, drug interactions, and safety concerns. We’ll review the key pharmacology and practical clinical pearls you should know when using these opioids in real-world practice.

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Opioids Part 4 – Methadone and Buprenorphine

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In this episode of Real Life Pharmacology, we’re taking a closer look at two unique opioids: methadone and buprenorphine. Both medications have important roles in pain management and opioid use disorder, but their pharmacology, dosing, drug interactions, and safety considerations are quite different. We’ll review the key clinical pearls you need to know when using these medications in real-world practice.

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Opioids Part 3 – Test Prep and Practice Pearls – Codeine and Fentanyl

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On this podcast episode, we will explore the most important practice pearls of codeine and fentanyl. Both medications are opioids, but codeine is frequently found in combination with acetaminophen. Fentanyl has numerous unique dosage forms, including the transdermal formulation which is a source of frequent test questions. I break these two medications down in this podcast episode.

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Opioids Part 2 – Test Prep and Practice Pearls

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In Part 2 of my series on opioids, I cover hydromorphone, oxycodone, and oxymorphone. Hydromorphone and oxycodone are two opioids that are used frequently in clinical practice, and I will discuss what makes them unique, in addition to numerous other practice pearls and test prep nuggets. Enjoy the podcast and be sure to share it with friends, colleagues, and students!

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Opioids Part 1 – Test Prep and Practice Pearls

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On part 1 of opioids, I’ll discuss morphine, morphine equivalents, conversion, and hydrocodone. The pharmacokinetic differences will be important between opioids, as well as the dosage forms. I hope you enjoy this podcast episode and share it with your friends!

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Skeletal Muscle Relaxants – Test Prep and Practice Pearls

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On this episode of the Real Life Pharmacology podcast, I’m going to cover important practice pearls on skeletal muscle relaxants. Important medications that will be covered in this podcast include baclofen, cyclobenzaprine, tizanidine, and diazepam.

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Suzetrigine Pharmacology

Suzetrigine is a relatively newer analgesic offering a novel approach to treating acute pain without acting as an opioid. By selectively blocking the Nav1.8 sodium channel found in peripheral pain-sensing nerves, suzetrigine helps reduce pain transmission while minimizing many of the risks associated with traditional opioid therapy. In this episode of the Real Life Pharmacology podcast, we’ll review how suzetrigine works, its FDA-approved indication, common adverse effects, and where it may fit into clinical practice. Whether you’re a pharmacist, pharmacy student, nurse, or other healthcare professional, this episode will provide practical insights to help you better understand this analgesic.

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Glycopyrrolate Pharmacology

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Glycopyrrolate is an anticholinergic medication commonly used to reduce excessive secretions, particularly in palliative care, postoperative settings, and certain neurologic conditions. It works by blocking acetylcholine at muscarinic receptors, which decreases salivary and respiratory secretions. Clinically, glycopyrrolate is often used to manage terminal respiratory secretions (“death rattle”).

Adverse effects of glycopyrrolate are primarily related to its anticholinergic properties. These may include dry mouth, constipation, urinary retention, blurred vision, tachycardia, and decreased sweating. While it has fewer central effects than agents like scopolamine, caution is still warranted in patients with glaucoma, gastrointestinal obstruction, or significant urinary retention risk. Monitoring hydration and bowel function is important, especially in elderly or frail patients.

Dosing strategies depend on the clinical need. In palliative care, low doses may be given subcutaneously or intravenously every 4–6 hours as needed, while oral dosing is common for chronic sialorrhea.

Clinicians should consider the patient’s overall medication burden, as cumulative anticholinergic load can worsen cognitive impairment and contribute to falls or constipation. I discuss drug interactions and other commonly used medications that may contribute to anticholinergic burden.

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