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Ketamine Pharmacology

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On this episode, I discuss ketamine pharmacology.

Ketamine is primarily broken down by CYP2B6 which fortunately does not have a lot of common medications that can interfere with its action.

Ketamine can cause psychiatric type adverse effects such as hallucinations, nightmares, and vivid dreams.

At lower to moderate dosages, ketamine does have some mild sympathetic activity which can raise blood pressure and heart rate.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Escitalopram Pharmacology

escitalopram pharmacology

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On this episode of the Real Life Pharmacology Podcast, I discuss escitalopram pharmacology.

Escitalopram is an SSRI and can be used to manage depression, anxiety, OCD, PTSD, and other psychiatric disorders.

If you consider fluoxetine the most activation SSRI and paroxetine the most sedating, escitalopram probably falls somewhere in the middle.

Sexual dysfunction is a potential adverse effect with escitalopram. I discuss it further on this episode.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Ziprasidone Pharmacology

ziprasidone pharmacology

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On this episode of the Real Life Pharmacology Podcast, I cover ziprasidone pharmacology.

Ziprasidone has dopamine blocking activity and is classified as a second generation antipsychotic.

Ziprasidone tends to have lower metabolic syndrome risks compared to other antipsychotics like clozapine and olanzapine.

QTc prolongation is a significant risk with ziprasidone and be aware of drug interactions and electrolyte imbalances that may increase this risk.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Diphenhydramine (Benadryl) Pharmacology

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Diphenhydramine is a first generation antihistamine that is highly anticholinergic.

When using medications like diphenhydramine, be sure to watch for side effects like dry eyes, dry mouth, constipation, urinary retention, and CNS changes.

Sedation is a primary effect of diphenhydramine. It can be advantageous in certain situations, and detrimental in others.

Drugs like donepezil, memantine, laxatives, tamsulosin, and artificial tears can be indicators of anticholinergic side effects from diphenhydramine.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Omeprazole Pharmacology

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Omeprazole is a proton pump inhibitor that can be commonly used for GERD, PUD, and GI prophylaxis.

Omeprazole can inhibit CYP2C19 which can cause concentrations of drugs like escitalopram and citalopram to rise.

Hypomagnesemia, low B12, osteoporosis, and an increase in C. Diff risk are potential complications with longer term PPI use.

PPI’s like omeprazole are best given 30-60 minutes before meals. This is something that patients often forget.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Conjugated Estrogens Pharmacology

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Conjugated estrogens (Premarin) are most often used in the management of menopausal symptoms.

Estrogen therapy can increase the risk for breast cancer and the risk should be assessed before beginning therapy.

Blood clots are a potential consequence from the use of Premarin. Premarin can oppose the benefit of anticoagulation.

Conjugated estrogens are broken down by CYP3A4. Inhibitors may increase concentrations while inducers may reduce concentrations.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Paroxetine Pharmacology

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Paroxetine (Paxil) is an SSRI that can be used in the management of depression. I discuss more on paroxetine pharmacology in this episode.

Because paroxetine has some modest anticholinergic effects, it does show up on the Beers list as a potentially inappropriate medication.

By inhibiting CYP2D6, paroxetine can have numerous drug interactions. Drugs like atomoxetine, aripiprazole, and metoclopramide can all have their concentrations increased.

Tamoxifen is activated by CYP2D6 and paroxetine can ultimately reduce the effectiveness of the medication.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Citalopram Pharmacology

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Citalopram is an SSRI used in the management of depression, anxiety, OCD, and PTSD.

How do you manage the risk of citalopram causing QTc prolongation? I discuss it further in the podcast.

Omeprazole can inhibit CYP2C19 which affects the metabolism of citalopram. I discuss the clinical impacts of this interaction in the podcast.

Geriatric dosing with citalopram is recommended to be lower than traditional adult dosing. I discuss this further in the podcast.

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

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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Calcium Acetate Pharmacology

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Calcium Acetate (PhosLo) is used in the management of hyperphosphatemia associated with CKD.

Important monitoring parameters for calcium acetate include phosphorus, calcium, PTH, and renal function.

There are numerous binding interactions with calcium acetate. It can reduce concentrations of some HIV drugs, antibiotics, and thyroid supplements. I discuss more examples in the podcast.

Thiazide diuretic in combination with calcium acetate may increase the risk for hypercalcemia.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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

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Nortriptyline Pharmacology

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Nortriptyline is a TCA that can be used for depression and various pain syndromes. I discuss other less common diagnoses in this podcast episode as well.

There are a lot of drug interactions with nortriptyline. It is metabolized by CYP2D6, can have additive anticholinergic effects and has been associated with QTc prolongation.

Nortriptyline is very anticholinergic and can blunt the effects of dementia medications.

Dry mouth, dry eyes, sedation, urinary retention, and constipation are a few of the more common adverse effects of nortriptyline.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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