Cabergoline Pharmacology

Cabergoline is a dopamine agonist. I discuss the pharmacology, adverse effects, and drug interactions in this podcast episode.

Be on the lookout for drugs that could oppose the effects of cabergoline such as antipsychotics and metoclopramide.

Cabergoline can be used for hyperprolactinemia management and may cause adverse effects like hypotension and GI upset.

Cabergoline has a very long half-life so it is most often only dosed 1-2 times per week.

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Venlafaxine Pharmacology

In this episode, I discuss venlafaxine pharmacology, adverse effect, dose conversion of IR to ER, and drug interactions.

Venlafaxine is notorious for producing withdrawal symptoms when discontinued abruptly. I discuss these in detail on the podcast.

How significant is the interaction of venlafaxine with antiplatelet agents? I discuss that in this episode.

The onset of action is a critical education point that patients must be aware of as it takes some time for venlafaxine to work.

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Chlorthalidone Pharmacology

On this episode I discuss chlorthalidone pharmacology, adverse effects, and recent literature regarding cardiovascular disease reduction. Our friends at Pyrls.com are offering a free diagram of the nephron including the mechanism of action AND a summary of diuretic effects that I discussed on the podcast – Go sign up and get these for free and support this awesome sponsor!

Chlorthalidone is a thiazide diuretic that uniquely raises blood calcium levels compared to loop diuretics which lower calcium levels.

There was a recent piece of literature (2020) comparing chlorthalidone versus hydrochlorothiazide. It found that chlorthalidone was no more effective than HCTZ.

Remember that chlorthalidone can raise uric acid and increase the risk of gout flares.

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Verapamil Pharmacology Podcast

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

There are numerous drug interactions to be aware of with verapamil as it inhibits the enzyme CYP3A4.

Verapamil is a calcium channel blocker (non-dihydropyridine) that blocks calcium channels in the heart and vessels.

In addition to hypotension and bradycardia, verapamil can cause constipation which may be more prominent in our geriatric patients.

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Salmeterol (Serevent) Pharmacology

In this episode, I cover salmeterol (Serevent) pharmacology, adverse effects, drug interactions and special warnings with this medication.

Salmeterol is a long acting beta agonist that can be used in combination with inhaled corticosteroids for management of asthma.

Salmeterol can be used as monotherapy in COPD and should not be used as monotherapy in asthma.

Elevations in pulse and blood pressure can happen with a beta agonist like salmeterol.

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Esomeprazole (Nexium) Pharmacology

On this episode, I discuss esomeprazole (Nexium) pharmacology, adverse effects, tapering, kinetics, and drug interactions.

I spend a good amount of time discussing the esomeprazole and clopidogrel interaction in this podcast episode.

Esomeprazole inhibits CYP2C19. This can cause an increase in citalopram concentrations and raise the potential for QTc prolongation.

It is critical to reassess the length of therapy and the dose of PPIs like esomeprazole.

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Carvedilol (Coreg) Pharmacology

On this episode of the Real Life Pharmacology podcast, I discuss carvedilol pharmacology, drug interactions, and adverse effects.

Carvedilol is one of the few beta-blockers that has alpha-blocking activity.

Carvedilol is almost exclusively metabolized by various CYP enzymes so renal function changes typically don’t change drug concentrations to a significant extent.

Beta-blockers like carvedilol are well known to cause the adverse effects of fatigue and sexual dysfunction.

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Umeclidinium Pharmacology

On this episode, I discuss umeclidinium pharmacology, adverse effects, patient education pearls, and drug interactions.

Umeclidinium is used in the management of COPD. Below is an excellent quick overview of the COPD guidelines from pyrls.com – You can get the full PDF by signing up for a free account at pryls.com/rlp

Umeclidinium is a long-acting anticholinergic (anti-muscarinic) LAMA and as you can see from the figure above drugs from this class are frequently used in COPD management.

The brand name of umeclidinium is Incruse Ellipta. Ellipta refers to the device and not the drug umeclidinium.

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Denosumab (Prolia) Pharmacology

On this episode, I discuss denosumab pharmacology, adverse effects, clinical pearls, and drug interactions.

Whenever I see an osteoporosis medication like denosumab used, I review the medications to ensure that we avoid medications that can cause osteoporosis.

Denosumab is often used as a potential alternative in osteoporosis management for those that cannot tolerate bisphosphonates.

We need to monitor calcium levels when using denosumab as levels can be dangerously low, especially when used in combination with other calcium lowering drugs.

Loop diuretics and cinacalcet can have additive hypocalcemia effects when used in combination with denosumab.

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Roflumilast (Daliresp) Pharmacology

On this episode I discuss roflumilast (Daliresp) pharmacology, adverse effects, and important drug interactions.

Roflumilast is indicated to reduce the incidence of COPD exacerbations.

Roflumilast is significantly broken down by CYP3A4 so there are numerous drug interactions that we have to take into account.

Psychiatric issues, GI upset, and weight loss are all potential adverse effects due to roflumilast.

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

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