Tag: diabetes

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Teplizumab For Diabetes Episode 315 – Real Life Pharmacology Podcast

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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.

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Insulin Aspart (Novolog) Pharmacology Podcast Episode 312

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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.

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Insulin Lispro (Humalog) Pharmacology Podcast

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On this podcast episode, I discuss the pharmacology, adverse effects, and drug interactions of insulin lispro (Humalog).

I spend some time on this podcast episode discussing carb ratios and sliding scale insulin when using insulin lispro.

Potassium is critical to monitor in diabetic ketoacidosis as insulin therapy can cause significant hypokalemia.

Sliding-scale insulin lispro is discouraged in the overwhelming majority of situations. Ideally, we should be more proactive about insulin administration to reduce the risk of hyperglycemia spikes.

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Bexagliflozin Pharmacology Podcast

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

I wasn’t wowed by the A1C reduction of this medication. I get into the specifics on bexagliflozin in the podcast episode.

SGLT2 inhibitors like bexagliflozin increase the glucose in the urine which can facilitate the growth of bacteria and fungi in the genitourinary tract.

Limb amputation and euglycemic DKA are two rare, reported adverse effects to be aware of with the use of bexagliflozin.

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Exenatide Pharmacology Podcast

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

Exenatide has an immediate release formulation (Byetta) and a long acting formulation (Bydureon). I discuss the differences in this podcast episode.

Byetta use has fallen out of favor due to frequent dosing, patient inconvenience and needing to time the dose 60 minutes prior to meals.

I discuss the risk of pancreatitis related to GLP-1 agonists like exenatide in this podcast episode.

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Tirzepatide (Mounjaro) Pharmacology Podcast

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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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Semaglutide (subQ) Pharmacology Podcast

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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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Sitagliptin Pharmacology Podcast

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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.

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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Glimepiride Pharmacology Podcast

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On this podcast episode, I discuss glimepiride pharmacology, adverse effects, hypoglycemia symptoms, and drug interactions.

CYP2C9 is an important enzyme in the breakdown of glimepiride. I discuss a few drugs that can cause interactions via this enzyme.

Renal function is important to consider with glimepiride. The active metabolites are cleared by the kidney and can accumulate in CKD.

Hypoglycemia and weight gain are problematic adverse effects of this medication and are the primary reasons it has fallen out of favor.

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)

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Prednisolone Pharmacology

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I mentioned prednisolone to prednisone conversion in this podcast. Please go check out Pyrls.com for a free steroid conversion downloadable PDF with a free account!

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.

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)