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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Minocycline Pharmacology Podcast

Minocycline is a tetracycline antibiotic. I discuss pharmacology, adverse effects, and drug interactions.

Minocycline can cause sun sensitivity. Be sure to educate patients about this risk.

Metal cations like iron, zinc, calcium, and magnesium can bind minocycline and reduce the oral absorption of the medication.

Tooth discoloration is a possible adverse effect if minocycline is given to pediatric patients. I discuss it further in this episode.

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

Brexpiprazole (Rexulti) Pharmacology Podcast

Brexpiprazole (Rexulti) is a second generation antipsychotic. I discuss its pharmacology, adverse effects, drug interactions, and more in this podcast episode.

I like to associate brexpiprazole with aripiprazole. They have a lot of overlapping characteristics, particularly in relation to the adverse effect profile.

Brexpiprazole tends to have a low incidence of metabolic adverse effects which makes it a nice selection for patients who have diabetes, hypercholesterolemia, or who are overweight.

CYP3A4 and CYP2D6 are the two primary enzymes that break down brexpiprazole. I discuss the pharmacogenomic considerations associated with this medication.

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Indapamide (Lozol) Pharmacology Podcast

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

I discuss how indapamide differs from other thiazide diuretics. Particularly, I discuss indapamide compared to hydrochlorothiazide.

Frequent urination, hypokalemia, and dehydration are all possible risks with indapamide.

Pay attention to medications that can increase the risk for acute renal failure when added to indapamide. NSAIDs, ACEIs, ARBs, and other diuretics can increase this risk.

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

Tadalafil (Cialis) Pharmacology Podcast

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

Tadalafil has a significantly longer half-life than sildenafil. I discuss how this is going to impact a patient that may need a nitrate.

PDE-5 inhibitors like tadalafil are most commonly used for erectile dysfunction but I talk about other unique indications in the podcast.

Daily use or as-needed use of tadalafil are both acceptable options but there are some quirks you need to know with these two methods of use.

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

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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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)

Gabapentin (Neurontin) Pharmacology Podcast

On this podcast episode, I discuss gabapentin (Neurontin) pharmacology, adverse effects, drug interactions, and much more!

Gabapentin’s GI absorption is a little wacky. I discuss on the podcast the clinical effects that this may have on our patients.

Renal elimination is critical to gabapentin. Worsening renal function will significantly impact the action of the drug.

CNS sedation can be a problem with gabapentin, especially in combination with other CNS depressants. I discuss this further on the podcast.

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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)