Polyethylene Glycol (Miralax) Pharmacology

On this episode of the Real Life Pharmacology podcast, I discuss Miralax (polyethylene glycol) pharmacology, adverse effects, and much more.

MiraLAX is an osmotic laxative commonly used to treat occasional constipation by retaining water in the stool to increase stool frequency and soften consistency.

The standard adult dose of MiraLAX is 17 grams (approximately one heaping tablespoon) dissolved in 4 to 8 ounces of liquid once daily.

Electrolyte imbalances are rare but possible with prolonged or excessive use of Miralax, particularly in elderly or renal-impaired patients.

Advise patients to maintain adequate hydration while using MiraLAX to support its mechanism and reduce side effects.

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Minoxidil Pharmacology

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On this episode of the Real Life Pharmacology Podcast, we cover minoxidil pharmacology, adverse effects, drug interactions, and much more.

Minoxidil is a potent arterial vasodilator used in the treatment of hypertension and androgenetic alopecia.

The route of administration greatly impacts the drug’s safety profile. Oral minoxidil is typically reserved for refractory hypertension due to its strong systemic effects and associated risks.

Topical formulations (2% or 5%) are widely used for hair regrowth, offering local benefits with minimal systemic absorption.

Systemic minoxidil can result in fluid retention, tachycardia, and even pericardial effusion, often requiring co-administration with a diuretic and beta-blocker.

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Prednisone Pharmacology

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Prednisone is a commonly used medication for its antiinflammatory and immunosuppressive action. On this episode I discuss prednisone pharmacology, ADRs, and much more.

In the episode, I discuss how prednisone affects the HPA system in the body. Cortisol production can be greatly impacted by long term use of prednisone.

GI adverse effects can be problematic with oral prednisone which is why we often give this medication with food or milk.

Hyperglycemia is a complication from the use of prednisone. I’ve commonly seen blood sugar spike by 50-100+ mg/dL due to this medication.

Osteoporosis is a long term risk with the use of prednisone. Prednisone can also impact the benefits of vaccination. I discuss this in greater depth in the drug interactions portion of the podcast.

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Amphetamine/Dextroamphetamine (Adderall) Pharmacology Podcast

In this episode, I discuss amphetamine/dextroamphetamine pharmacology, adverse effects, drug interactions, and much more.

Stimulants like Adderall are well known to cause insomnia. This adverse effect can be affected by the timing of the dose.

Lack of growth and poor appetite are two important things to monitor in pediatric patients taking Adderall.

Changes in the pH of the stomach/gut can alter the absorption of Adderall. I discuss this in greater detail in this podcast episode.

Cardiovascular monitoring is essential with the use of stimulants like Adderall. Pulse and heart rate are two important vital signs to assess.

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Benazepril Pharmacology Podcast

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Benazepril is an ACE inhibitor used to treat hypertension by blocking the conversion of angiotensin I to angiotensin II, reducing vasoconstriction.

Combining benazepril with potassium-sparing diuretics or potassium supplements increases the risk of hyperkalemia due to aldosterone suppression.

Common side effects of benazepril include dry cough, hyperkalemia, and hypotension due to its effect on the renin-angiotensin-aldosterone system.

Benazepril can be prescribed alone or in combination with other antihypertensive agents, such as diuretics or calcium channel blockers, to enhance blood pressure control.

Benazepril has a long duration of action, allowing for once-daily dosing, which improves patient adherence and convenience in hypertension management.

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Loratadine Pharmacology Podcasst

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On this podcast episode, I cover loratadine pharmacology, adverse effects, drug interactions, and much more.

Loratatdine is a second generation antihistamine. It has a lower incidence of central nervous system adverse effects compared to first-generation antihistamines like diphenhydramine.

Loratadine dosing varies in pediatric patients and those with renal impairment. I get into the details on this podcast episode.

Drug interactions aren’t common with loratadine but I discuss a few that may be clinically significant.

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Modafinil Pharmacology Podcast

Modafinil (Provigil) is a CNS stimulant medication. I cover modafinil pharmacology, adverse effects, drug interactions, and much more on this podcast episode.

You should be aware that modafinil is a Schedule 4 controlled substance so it does carry a risk of dependence and addiction.

Modafinil can cause CYP3A4 induction and lead to lowering the concentrations of many medications. This includes antiepileptic agents and oral contraceptives.

The most common adverse effects of modafinil include ramping up the body and causing symptoms such as anxiety and insomnia.

Cardiovascular changes are a risk with modafinil as this medication can contribute to hypertension and tachycardia.

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Top 200 Drugs – Medications 181-185

On this Real Life Pharmacology Podcast episode, we cover medications 181-185.

Proscar is the brand name for finasteride. This medication can be helpful in shrinking the size of the prostate but it does typically take a while to work (months).

Sinemet is a combination of carbidopa and levodopa. Levodopa is converted in the central nervous system to dopamine to help alleviate a shortage of dopamine in the brain.

Risedronate is a bisphosphonate medication that can be used in the treatment of osteoporosis.

Albuterol (Ventolin) is a short-acting beta-agonist that is used to relieve symptoms of acute respiratory distress most often associated with an asthma exacerbation.

Tramadol is classified as an opioid analgesic. It also has activity similar to SNRIs as it has the ability to increase serotonin and norepinephrine in the brain.

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Top 200 Drugs – Medications 176-180

Prednisolone is a corticosteroid that is often used in pediatrics. Hyperglycemia, insomnia, and GI upset are relatively common adverse effects.

Ibuprofen is a commonly used OTC pain reliever. It is classified as an NSAID and can increase GI bleed risk and exacerbate heart failure.

Aceon is the brand name for perindopril. ACE inhibitors are well known to cause drug induced cough and will cause hyperkalemia.

Trazodone is classified as an antidepressant but is frequently used to treat insomnia because of its sedative properties.

Pioglitazone is an oral anti-diabetes medication that should be avoided in patients with heart failure.

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Top 200 Drugs Podcast – Medications 171-175

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On this episode of the Top 200 drugs podcast, we are going to cover these 5 medications: Cyclosporine, insulin glargine, tadalafil, amitriptyline, and gemfibrozil.

Cyclosporine is a calcineurin inhibitor that suppresses the immune system. This is useful in patients who have had an organ transplant.

Insulin glargine is a long-acting insulin product that can be used in type 1 and type 2 diabetes. I discuss adverse effects, dosing, and much more.

Tadalafil is a PDE-5 inhibitor that can be used to treat sexual dysfunction. The nitrate drug interaction is one of the most highly tested drug interactions in school.

Amitriptyline is a TCA. It is highly anticholinergic and because of this is not a great medication to utilize in elderly patients.

Gemfibrozil is primarily used to lower triglyceride levels. This medication can significantly increase the risk for rhabdomyolysis in patients taking statin medications.

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