Olmesartan Pharmacology

On this episode, I discuss olmesartan (Benicar) pharmacology, adverse effects, drug interactions, and pharmacokinetics.

Olmesartan can cause a unique GI adverse effect called enteropathy. I discuss this on this podcast episode.

Important monitoring parameters for olmesartan include potassium, renal function, and blood pressure.

Olmesartan has a longer half-life than losartan. I discuss how this might be advantageous in clinical practice.

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Bisoprolol (Zebeta) Pharmacology

On this episode, I discuss bisoprolol (Zebeta) pharmacology, adverse effects, drug interactions, and other important clinical pearls.

Bisoprolol is a beta-1 selective antagonist that can be used for atrial fibrillation, angina, and other cardiovascular indications.

It is important to remember that bisoprolol and other beta-blockers are not considered first-line agents for hypertension alone.

Beta-receptor selectivity does start to disappear with bisoprolol as you get to higher dosages. I discuss this further in the podcast.

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Chlorthalidone Pharmacology

On this episode I discuss chlorthalidone pharmacology, adverse effects, and recent literature regarding cardiovascular disease reduction. Our friends at Pyrls.com are offering a free diagram of the nephron including the mechanism of action AND a summary of diuretic effects that I discussed on the podcast – Go sign up and get these for free and support this awesome sponsor!

Chlorthalidone is a thiazide diuretic that uniquely raises blood calcium levels compared to loop diuretics which lower calcium levels.

There was a recent piece of literature (2020) comparing chlorthalidone versus hydrochlorothiazide. It found that chlorthalidone was no more effective than HCTZ.

Remember that chlorthalidone can raise uric acid and increase the risk of gout flares.

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Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

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Verapamil Pharmacology Podcast

On this episode, I discuss verapamil pharmacology, adverse effects, and important drug interactions.

There are numerous drug interactions to be aware of with verapamil as it inhibits the enzyme CYP3A4.

Verapamil is a calcium channel blocker (non-dihydropyridine) that blocks calcium channels in the heart and vessels.

In addition to hypotension and bradycardia, verapamil can cause constipation which may be more prominent in our geriatric patients.

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Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

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Drug Interactions In Primary Care (Amazing Resource for Practicing Clinicians)

Perils of Polypharmacy (Great Resource for Those Who Work in Geriatrics)

Carvedilol (Coreg) Pharmacology

On this episode of the Real Life Pharmacology podcast, I discuss carvedilol pharmacology, drug interactions, and adverse effects.

Carvedilol is one of the few beta-blockers that has alpha-blocking activity.

Carvedilol is almost exclusively metabolized by various CYP enzymes so renal function changes typically don’t change drug concentrations to a significant extent.

Beta-blockers like carvedilol are well known to cause the adverse effects of fatigue and sexual dysfunction.

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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Drug Interactions In Primary Care (Amazing Resource for Practicing Clinicians)

Perils of Polypharmacy (Great Resource for Those Who Work in Geriatrics)

Losartan Pharmacology

On this episode, I discuss losartan pharmacology, adverse effects, drug interactions, and appropriate monitoring.

Losartan is an ARB and can increase potassium levels. Keep an eye out for medications like spironolactone and trimethoprim which can increase this risk further.

Losartan has been shown to lower uric acid levels which could potentially be helpful in patients with gout.

Monitoring renal function is very important with losartan. The risk of ARF goes significantly higher when used with NSAIDs or diuretics.

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)

Diltiazem Pharmacology

Diltiazem is a non-dihydropyridine calcium channel blocker that can be used in atrial fibrillation as well as hypertension.

One big downside to diltiazem is that it does have a few drug interactions via CYP3A4.

Aripiprazole, apixaban, and certain statins are all examples of medication that can have concentrations increased by adding diltiazem to a patient’s regimen.

Diltiazem works a little differently from dihydropyridine calcium channel blockers (like amlodipine) as it works on the heart AND the vessels.

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Hydralazine Pharmacology

Hydralazine Pharmacology

Hydralazine Pharmacology

Hydralazine works as a direct vasodilator. It primarily works on the arterioles versus the venous system.

Hydralazine can cause a unique adverse reaction. It can cause a Lupus type syndrome that can result in fever, myopathy and symptoms that mimic arthritis.

I discuss drug interactions with hydralazine and how you need to be aware of certain medications that can have additive effects and also those that can oppose the effects of the drug.

One of the downsides to using hydralazine is that patients don’t like to take it as often as it requires. It is typically dosed three to four times per day.

Orthostasis is a risk with any drug that reduces blood pressure and hydralazine is no different.

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Clonidine Pharmacology

Clonidine is classified as an antihypertensive. Clonidine pharmacology involves having agonist activity at central alpha 2 receptors. This leads to lower sympathetic outflow and a reduction in blood pressure.

Clonidine has numerous reported uses in addition to its antihypertensive effect. It can potentially be used for ADHD, menopausal type symptoms, and opioid withdrawal.

Clonidine has historically been on the Beers’ list of drugs as it can cause some CNS side effects like sedation, dizziness, and rarely delirium.

Clonidine is unique in the antihypertensive class as it does have a patch formulation.

Because of the blood pressure lowering effect of clonidine, we have to be aware of patients who report dizziness. Monitoring is critical.

Clonidine can also lower heart rate and contribute to dry mouth. Keep an eye out for drugs that can have a cumulative effect on these symptoms.

Drugs like beta-blockers, non-DHP CCB’s, and digoxin can all have a cumulative effect with clonidine and lower pulses. Monitoring is important.

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