Ticagrelor Pharmacology

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

Ticagrelor has a warning with regards to the use of aspirin. Higher doses of aspirin can impair the effectiveness of ticagrelor and I discuss this further on this episode.

Bleeding is the major adverse effect from ticagrelor and naturally, hematocrit and hemoglobin are important monitoring parameters.

I discuss CYP3A4 drug interactions on this episode and how it may affect ticagrelor.

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Prednisolone Pharmacology

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On this episode, I discuss prednisolone (Orapred, Pediapred) pharmacology, adverse effects, practice pearls, and drug interactions.

Prednisolone is a systemic corticosteroid that can cause insomnia, elevations in blood sugars, and numerous effects if used long-term.

CYP3A4 is an important enzyme in the breakdown of prednisolone. Inhibitors or inducers may raise or lower drug levels respectively.

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Ropinirole Pharmacology

Ropinirole (Requip) is a dopamine agonist that can be used in Parkinson’s disease and Restless Legs Syndrome.

Dopamine agonists like ropinirole can worsen psychiatric symptoms in some patients by causing hallucinations, and obsessive/compulsive symptoms.

Nausea, vomiting, hypotension, and fatigue are the most common adverse effects of ropinirole.

Ropinirole has drug interactions with antipsychotics and CYP1A2 inhibitors. I discuss these in greater detail in this podcast episode.

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Canagliflozin Pharmacology

Canagliflozin is an SGLT2 inhibitor. I discuss the pharmacology, dosing, adverse effects, and drug interactions of this medication.

Canagliflozin reduces blood sugar, by facilitating its exit through the urine. This can increase the risk of genitourinary infections.

A diuresis type effect can happen due to canagliflozin and this effect may be exacerbated by the use of thiazide and loop diuretics.

Hyperkalemia has been reported with the use of canagliflozin; the risk for this is increased with the use of medications like ACE inhibitors, ARBs, and aldosterone antagonists.

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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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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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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.

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