Paroxetine Pharmacology

Paroxetine (Paxil) is an SSRI that can be used in the management of depression. I discuss more on paroxetine pharmacology in this episode.

Because paroxetine has some modest anticholinergic effects, it does show up on the Beers list as a potentially inappropriate medication.

By inhibiting CYP2D6, paroxetine can have numerous drug interactions. Drugs like atomoxetine, aripiprazole, and metoclopramide can all have their concentrations increased.

Tamoxifen is activated by CYP2D6 and paroxetine can ultimately reduce the effectiveness of the medication.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

Olanzapine Pharmacology

Olanzapine is a 2nd generation antipsychotic that blocks dopamine-2 receptors.

Olanzapine Relprevv (long acting injectable) needs to be closely monitored after the injection is given due to risks of sedation and delirium.

Sedation is a common occurance with the use of olanzapine. It is one of the more sedating second generation antipsychotics.

Weight gain, hyperlipidemia, and hyperglycemia are all potential adverse effects with olanzapine.

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

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

Sertraline Pharmacology

Sertraline is an SSRI. It has the highest potential to cause diarrhea of any SSRI.

Sertraline is often called “Squirtraline” because of its potential to cause diarrhea.

Sertraline has a much shorter half-life than fluoxetine. I discuss why that may be important in this podcast episode.

I discuss the role of serotonin in platelet aggregation and how sertraline may affect this.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

Citalopram Pharmacology

Citalopram is an SSRI used in the management of depression, anxiety, OCD, and PTSD.

How do you manage the risk of citalopram causing QTc prolongation? I discuss it further in the podcast.

Omeprazole can inhibit CYP2C19 which affects the metabolism of citalopram. I discuss the clinical impacts of this interaction in the podcast.

Geriatric dosing with citalopram is recommended to be lower than traditional adult dosing. I discuss this further in the podcast.

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

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

Nortriptyline Pharmacology

Nortriptyline is a TCA that can be used for depression and various pain syndromes. I discuss other less common diagnoses in this podcast episode as well.

There are a lot of drug interactions with nortriptyline. It is metabolized by CYP2D6, can have additive anticholinergic effects and has been associated with QTc prolongation.

Nortriptyline is very anticholinergic and can blunt the effects of dementia medications.

Dry mouth, dry eyes, sedation, urinary retention, and constipation are a few of the more common adverse effects of nortriptyline.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

Doxepin Pharmacology

Doxepin is under the class of tricyclic antidepressants. It can inhibit the reuptake of serotonin and norepinephrine.

In addition to the serotonin and norepinephrine reuptake inhibition mechanism, doxepin also has antihistamine type effects.

Because of the anticholinergic activity of doxepin, it is recommended to avoid this medication in the elderly, particularly at high doses.

Be aware that anticholinergics like doxepin can reduce the benefit of dementia medications.

CYP2D6 is an important enzyme in the metabolism of doxepin and drugs like bupropion that inhibit CYP2D6 can increase the concentrations of doxepin.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

Atomoxetine Pharmacology

Atomoxetine is a norepinephrine reuptake inhibitor that can be used in the management of ADHD.

Atomoxetine is a non-controlled substance option for patients seeking this alternative to traditional stimulants.

CYP2D6 is an important enzyme in the breakdown of atomoxetine.

CYP2D6 inhibition or poor metabolizers via CYP2D6 can lead to higher concentrations of atomoxetine and put our patients at greater risk for adverse effects.

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

Fluoxetine Pharmacology

Fluoxetine is an SSRI used in the management of depression, anxiety, OCD, PTSD, and other psychiatric conditions.

Fluoxetine has a very long half-life which can impact clinical management. I discuss how this matters in this podcast episode.

Fluoxetine inhibits CYP2D6 which can alter the concentrations of many drugs.

Prodrugs like codeine and tamoxifen can have their effects reduced because of fluoxetine. I explain this further in the episode.

By inhibiting CYP2D6 concentrations of many drugs can be raised by the use of fluoxetine.

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

Methylphenidate Pharmacology

Methylphenidate has an FDA approved indication for ADHD. In this podcast episode, I cover the pharmacology, adverse effects, kinetics, and drug interaction.

Because methylphenidate has stimulant type effects, it can raise blood pressure and heart rate.

Weight, blood pressure, and pulse are important monitoring parameters in patients taking a stimulant type medication like methylphenidate.

There are numerous dosage forms of methylphenidate which can help accommodate many different patients’ needs.

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

Benzodiazepine Pharmacology

Benzodiazepines act by enhancing the effect of GABA, an inhibitory neurotransmitter.

Benzodiazepines can cause confusion, sedation, and respiratory depression.

There are many potential indications for benzodiazepines. They can be used in anxiety, status epilepticus, insomnia, and alcohol withdrawal amongst other things.

There is a boxed warning for the use of opioids with benzodiazepines. The primary risk of the combination is respiratory depression.