10 Commandments of Polypharmacy Part 2 of 2

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Here is part 2 of 2 on the final 5 of the 10 commandments of polypharmacy.

6. Thou shalt identify limits for medications not intended for chronic use as well as not continue a medication indefinitely for symptoms that have an expected short duration

7. Thou shalt not start a medication from a similar medication class without appropriate rationale

8. Thou shalt not initiate a medication without considering medications that may treat duplicate conditions – Kill two birds with one stone

9. Thou shalt consider eliminating or reducing medications at every medication review

10. Thou shalt be willing to accept risk in discontinuing a medication if they were willing to accept the risk of initiating a medication

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

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

Beers Criteria Podcast Part 2 or 2

On this podcast episode, I finish up my breakdown of the Beers Criteria.

I cover the use of sliding-scale insulin and sulfonylureas in geriatric patients. Hypoglycemia is a major concern with both of these diabetes management strategies.

PPIs show up on the Beers criteria list as they can increase the risk of C. diff, pneumonia, fractures, and GI malignancies.

Metoclopramide has dopamine antagonist activity and can increase the risk of EPS and tardive dyskinesia.

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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)

Beers Criteria Podcast Part 1 or 2

In this podcast episode, I break down some of the most common medications that show up on the Beers criteria list.

I discuss cardiovascular medications in this podcast episode, including rivaroxaban and warfarin, and why they show up on the Beers list.

Alpha-blockers who up on the Beers list as these medications are inappropriate to use for the management of hypertension.

The Beers criteria addresses the use of aspirin in primary prevention. I break down what the criteria state and why it should be avoided in general.

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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)

Navigating QTc Prolongation and Drug Interactions

On this episode, I discuss the pharmacology surrounding QTc prolongation and drug interactions.

I discuss which medications are more likely to cause QTc prolongation and which patient populations we should be more concerned about.

Antiarrhythmics are a common class of medication that can exacerbate QTc prolongation when used with other interacting medications.

500 ms is a common value utilized to help identify patients at risk for QTc prolongation and ultimately torsades de pointes.

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Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

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

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

Risedronate Pharmacology Podcast

On this podcast episode, I cover risedronate pharmacology, adverse effects, drug interactions, and much more.

There is a strict administration procedure with risedronate which is designed to reduce adverse effects and enhance absorption. I discuss this in the podcast.

Many medications may cause osteoporosis and may precipitate treatment with risedronate. Corticosteroids and excessive thyroid hormone replacement are two examples.

Patients should remain upright (sitting or standing) for at least 30 minutes following administration to reduce the risk of esophagitis and ulceration.

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)

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

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

Teplizumab For Diabetes Episode 315 – Real Life Pharmacology Podcast

Teplizumab is a relatively new agent that helps delay the progression of type 1 diabetes. It slows the rate of beta-cell destruction in the pancreas.

Teplizumab is associated with cytokine release syndrome which can result in flu-like symptoms of fever, aches, and headache.

Cytokine release syndrome due to teplizumab can be reduced by using appropriate pretreatment medications. Those medications can include analgesics, antihistamines, and/or antiemetics.

Teplizumab is associated with suppressing the immune system so it is ideal to get vaccinations completed before using this medication. I go over the specific recommendations in the podcast episode.

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)

Captopril Pharmacology Podcast – Episode 314

On this podcast episode, I discuss captopril pharmacology, kinetics, interactions, and much more!

Captopril is an ACE Inhibitor. It can cause hyperkalemia, cough, and renal impairment.

One of the notable issues with captopril is its relatively short half-life which requires it to be dose frequently throughout the day.

Lithium is an important drug interaction and the use of captopril with this medication may increase concentrations and the chance for toxicity.

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)

Insulin Aspart (Novolog) Pharmacology Podcast Episode 312

On this podcast episode, I discuss insulin aspart pharmacology, adverse effects, drug interactions, and much more.

Insulin apart is a rapid acting insulin product meant to bring down blood sugars quickly (most often after meals).

It is important to remember a couple of medications that may counteract the effects of insulin and apart and raise blood sugar. I talk about corticosteroids and thiazide diuretics in the drug interaction section.

Fiasp is a slightly modified insulin aspart molecule that allows for quicker absorption. This quicker absorption will allow for blood sugars to come down sooner than the Novolog formulation.

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)

Gentamicin Pharmacology Podcast Episode 311

On this podcast episode, I discuss gentamicin pharmacology, adverse effects, monitoring, drug interactions and much more!

Drug monitoring is critical with gentamicin. Trough and peak concentrations can guide therapy and identify someone at risk of toxicity.

Nephrotoxicity is a major concern with gentamicin. There are numerous nephrotoxic agents that can increase this risk. I discuss them on the podcast.

Ototoxicity is another risk associated with gentamicin. Loop diuretics like furosemide can increase this risk. Learn more on this podcast episode.

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)

Fenofibrate Pharmacology Podcast Episode 310

On this podcast episode, I discuss fenofibrate pharmacology, adverse effects, kinetics, drug interactions, and much more!

Fenofibrate is typically only used for hypertriglyceridemia. The primary risk of hypertriglyceridemia is pancreatitis so we treat these levels because of this risk.

LFTs elevation has been associated with fenofibrate use as well as myopathy. In the presence of myopathy, checking CPK may be considered.

Fenofibrate is a weak CYP2C9 inhibitor. Warfarin and phenytoin are two important medications that may be affected by the use of fenofibrate.

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

Support The Podcast and Check Out These Amazing Resources!

Flippin’ Pharmacology Flash Cards

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BCMTMS Study Materials

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)