Bempedoic acid, also known as Nexletol, is a once-daily medication used in lipid management. I discuss its pharmacology, side effects, and much more on this podcast episode.
Bempedoic is a once-daily medication that doesn’t need to be titrated. Standard dosing is 180mg once daily which can be taken with or without food.
What are the most common side effects of bempedoic acid? One of the most notable adverse effects is hyperuricemia. This is usually seen within the first 4 weeks of being on the medication but could happen throughout the treatment.
Tendon problems can happen as well, especially in patients who are greater than 60 years old, on fluoroquinolones, have renal failure, or are taking corticosteroids.
If Bempedoic acid is taken along with Simvastatin, it is recommended to avoid doses greater than 20mg. This is partly because Bempedoic Acid 180mg along with 40mg of Simvastatin was found to increase Simvastatin AUC by 2-fold. The mechanism of this interaction has yet to be reported. Pravastatin doses greater than 40mg are to be avoided as well due to an increased risk of myopathy. Atorvastatin and Rosuvastatin didn’t have any maximum dose considerations.
I discuss Pyridostigmine Pharmacology in this podcast episode in addition to adverse effects, drug interactions, and much more!
Pyridostigmine is an acetylcholinesterase inhibitor that can be used for myasthenia gravis or orthostasis.
Pyridostigmine can blunt the effect of neuromuscular blocking agents so patients undergoing surgery should be sure to have a game plan with their surgery team.
Similar to donepezil, pyridostigmine can cause diarrhea and bradycardia.
On this podcast episode, I discuss simethicone pharmacology, adverse effects, drug interactions, and much more!
Simethicone is primarily used for anti-gas purposes. It is most often used on an as needed basis for relief of flatulence and bloating associated with gas.
Systemic absorption is minimal with simethicone so the occurrence of any systemic-type side effects at therapeutic doses is low.
Simethicone may interfere with levothyroxine absorption. Timing levothyroxine at least a few hours prior to simethicone should help reduce the significance of this interaction.
On this episode of the Real Life Pharmacology podcast, I discuss haloperidol pharmacology, adverse effects, drug interactions and much more.
Haloperidol comes in multiple dosage forms. Be very careful with the use of injectable haloperidol as there is an immediate and extended release formulation.
Haloperidol is a dopamine antagonist which means that EPS adverse effects are going to be concerning.
In hospice patients, haloperidol is frequently used for its antiemetic properties as well as its potential to help end-of-life restlessness and agitation.
In this episode, I discuss loperamide (Imodium) pharmacology, adverse effects, and drug interactions.
Loperamide has opioid-type activity in the gut but has extremely low oral bioavailability. This allows it to be used for diarrhea but at lower doses won’t cause systemic opioid-like effects.
Loperamide abuse has been reported. Excessive dosages can increase the risk of cardiac arrest and other cardiovascular concerns.
Medication causes of diarrhea should be ruled out prior to starting a medication like loperamide. I discuss numerous medications that can cause diarrhea in this podcast.
I discuss calcium carbonate pharmacology, adverse effects, drug interactions, and more in this podcast episode.
Calcium tends to have a constipating effect and the higher the dose, the more likely patients are to experience this adverse effect.
Binding interactions are a major problem with oral calcium carbonate. I lay out numerous examples of this on the podcast.
There are a few medications that can increase calcium levels in the blood. Thiazide diuretics are a commonly used antihypertensive that may contribute to hypercalcemia.
