drug interactions – Real Life Pharmacology

October 24, 2019October 22, 2019

Mirabegron Pharmacology

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Mirabegron is a beta-3 agonist that can help relax bladder smooth muscle and manage symptoms of overactive bladder.

Mirabegron inhibits CYP2D6 which can negatively impact the effectiveness of tamoxifen. I discuss this in greater detail in the podcast.

Tramadol and codeine effectiveness can be impacted by mirabegron. Be aware of this when using this medication.

By inhibiting CYP2D6, mirabegron can increase the concentrations of many psychotropic medications such as fluoxetine, aripiprazole, clozapine, and paroxetine. I discuss this further in this episode of the podcast.

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

July 11, 2019July 2, 2019

Cimetidine Pharmacology

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Cimetidine blocks histamine 2 receptors which can suppress acid production and reduce symptoms of heartburn.

One of the major downsides to cimetidine is that it has a ton of drug interactions. I discuss many of the common ones in this episode.

Cimetidine is one of a few drugs that has the potential to cause gynecomastia. I discuss the mechanism of this adverse effect in this episode.

Phenytoin concentrations can rise due to the use of cimetidine. I discuss this in the drug interactions section of this episode.

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

May 23, 2019May 17, 2019

Clozapine Pharmacology

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On this episode, I discuss clozapine pharmacology. This drug has multiple mechanisms of action: Dopamine blockade, anticholinergic activity, and alpha blocking activity all contribute to the complexity of this drug.

Smoking cessation can significantly increase the concentrations of clozapine. This is because smoking can induce CYP1A2. Listen to the podcast for more details on how this can impact our patients clinically.

Clozapine has 5 boxed warnings. I discuss them all in this podcast. The most well-known boxed warning is for agranulocytosis.

Because clozapine has alpha blocking activity, it can cause orthostasis. We need to monitor for this.

Clozapine can cause QTc prolongation. Keep an eye out for other medications that the patient may be taking that can also cause this. Examples include: amiodarone, ondansetron, quinolones, and macrolides

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

May 16, 2019August 25, 2019

Carbamazepine Pharmacology

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On this episode, I discuss carbamazepine pharmacology. This drug is most commonly used for seizures, bipolar disorder, or trigeminal neuralgia.

Carbamazepine is an autoinducer and can reduce the concentrations of numerous drugs. Some examples include apixaban, warfarin, rivaroxaban, diltiazem, verapamil, and many more!

Carbamazepine has the potential to cause Steven Johnson’s Syndrome. This has a much greater chance of happening in patients with certain genetics.

Carbamazepine can contribute to SIADH and cause significant hyponatremia.

Carbamazepine has boxed warning for numerous potential events like aplastic anemia, agranulocytosis, and the above-mentioned SJS.

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

January 31, 2019January 29, 2019

Trazodone Pharmacology

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Trazodone pharmacology is complex. It can inhibit serotonin reuptake, block histamine receptors, and possibly have alpha-blocking activity.

Side effects of trazodone include sedation, dizziness, and dry mouth. Rarely, priapism may occur. I’ve seen this nugget come up on pharmacology exams!

While trazodone is classified as antidepressant, it is often used to help manage insomnia.

Trazodone can possibly prolong the QT interval. Risk of other medications and patient specific parameters should be considered.

Trazodone concentrations can be increased with the use of CYP3A4 inhibitors and reduced with 3A4 inducers.

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