Tag: hypertension

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June 5, 2025May 29, 2025

Nifedipine Pharmacology

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Nifedipine is a dihydropyridine calcium channel blocker that selectively inhibits L-type calcium channels in vascular smooth muscle, leading to vasodilation and reduced peripheral vascular resistance.

The extended-release formulation of nifedipine provides more stable plasma concentrations and is preferred for chronic management of hypertension and angina.

Common adverse effects include headache, flushing, peripheral edema, and dizziness, all related to its vasodilatory action.

Nifedipine undergoes extensive first-pass metabolism in the liver, primarily via CYP3A4 enzymes, which significantly influences its bioavailability and potential drug interactions.

CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, grapefruit juice) can increase plasma levels of nifedipine, raising the risk of hypotension and adverse effects.

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May 22, 2025May 14, 2025

Irbesartan Pharmacology

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Irbesartan is an angiotensin II receptor blocker (ARB) used primarily for the management of hypertension and diabetic nephropathy in type 2 diabetes.

It selectively inhibits the binding of angiotensin II to the AT1 receptor found in vascular smooth muscle and the adrenal gland. This blockade results in vasodilation, reduced aldosterone secretion, decreased sodium and water retention, and ultimately lower blood pressure.

Irbesartan is administered orally, with a typical starting dose of 150 mg once daily, which may be increased to 300 mg depending on the patient’s clinical response and tolerability.

Adverse effects of irbesartan are generally mild but can include hyperkalemia and dizziness. Hypotension may occur, especially in volume-depleted individuals or those on diuretics.

Routine monitoring of renal function and serum potassium is recommended, especially in patients with underlying kidney disease or those taking potassium-sparing agents or supplements.

Irbesartan is contraindicated in pregnancy due to the risk of fetal toxicity and should be discontinued as soon as pregnancy is detected.

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May 1, 2025May 1, 2025

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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April 3, 2025March 19, 2025

Amphetamine/Dextroamphetamine (Adderall) Pharmacology Podcast

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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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March 27, 2025March 17, 2025

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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February 6, 2025February 1, 2025

Top 200 Drugs – Medications 176-180

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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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July 18, 2024July 5, 2024

Top 200 Drugs Podcast – Drugs 31-35

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On this episode of the Real Life Pharmacology podcast, I discuss drugs 31-35 of the top 200 drugs.

Ethinyl estradiol/drospirenone is a combined oral contraceptive used for birth control purposes.

Hydralazine is a direct vasodilatory that can be used for hypertension and heart failure.

Benztropine is an older anticholinergic medication originally indicated for Parkinson’s disease but most commonly used to manage EPS symptoms from dopamine-blocking agents such as antipsychotics.

Tussionex is a combination medication of chlorpheniramine and hydrocodone. It is used to help alleviate cough.

Paroxetine is an SSRI used for the treatment of depression, anxiety, and other psychiatric disorders.

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July 4, 2024June 29, 2024

Top 200 Drugs Podcast – Drugs 21-25

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Lamotrigine is an antiseizure medication and also may be used for bipolar disorder. A rash is a major side effect to remember with this medication.

Valganciclovir is an antiviral medication that can be used to prevent cytomegalovirus (CMV) in patients with a suppressed immune system.

Fluconazole is an azole antifungal that can be used to treat candidiasis, blastomycosis, and tinea infections. Drug interactions, QTc prolongation, and hepatotoxicity are potential risks.

Atenolol is a beta-blocker used to treat atrial fibrillation and hypertension. It is relatively selective for beta-1 receptors meaning that it doesn’t affect the lungs as much as non-selective agents.

Montelukast is a medication that blocks the actions of leukotrienes. This can be beneficial for the management of allergies and asthma.

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May 30, 2024May 27, 2024

Timolol Pharmacology Podcast

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

Timolol is a non-selective beta-blocker so it blocks both beta-1 and beta-2 receptors.

Since timolol blocks beta-2 receptors, it can blunt the effect of respiratory medications that have beta-agonist action.

Beta-blockers are notorious for causing bradycardia and pulse is an important monitoring parameter for timolol.

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