This episode is sponsored by Freed – Freed is an amazing time saver for busy healthcare professionals! It listens, transcribes, and writes medical notes for you! Go check them out and support our sponsor! Pantoprazole (Protonix) is a PPI that can be used for GERD and peptic ulcer disease. I differentiate why this medication is different from the commonly used omeprazole. Dicyclomine (Bentyl) is an anticholinergic medication that may be used to help reduce pain and spasms associated with irritable bowel syndrome. Sumatriptan (Imitrex) is a selective 5HT1 receptor agonist, which potentially helps with vasoconstriction that contributes to migraine symptoms. Chlorhexidine (Peridex) is an antibiotic oral rinse that can be used for gingivitis. Metoprolol (Lopressor, Toprol XL) is a beta-blocker that may be used for atrial fibrillation, angina prevention, and hypertension. It is not a first-line medication for hypertension.

This episode is sponsored by Freed - Freed is an amazing time saver for busy healthcare professionals! It listens, transcribes, and writes medical notes for you! Go check them out and support our sponsor! In this episode, we highlight some of the most important clinical pearls (and highly testable pearls) on the following medications; Suboxone, lisdexamfetamine, nortriptyline, insulin lispro, and valproic acid. Suboxone is a combination of buprenorphine and naloxone used for opioid use disorder. Lisdexamfetamine is a stimulant medication that can be used to manage ADHD. Common side effects include weight loss, insomnia, hypertension, and tachycardia. Nortriptyline is a TCA medication known for its ability to cause anticholinergic side effects like constipation, dry eyes, dry mouth, urinary retention, and confusion. Insulin lispro is a rapid-acting insulin medication that is most often used to bring down post-prandial blood sugar. Valproic acid is an antiepileptic medication that can also be used for migraines.

This episode is sponsored by Freed - Freed is an amazing time saver for busy healthcare professionals! It listens, transcribes, and writes medical notes for you! Go check them out and support our sponsor! In this episode, we highlight some of the most important clinical pearls on the following medications; nitrofurantoin, fentanyl patches, isosorbide mononitrate, fluoxetine, and triamcinolone. Nitrofurantoin is an antibiotic used for UTIs. We need to be careful with this medication in patients with CKD. Fentanyl is an opioid. There are many clinical quirks with fentanyl patches. For a full rundown, check out this previous podcast episode. Isosorbide mononitrate is a nitrate medication so we need to be careful with the use of PDE-5 inhibitors. Fluoxetine is an SSRI. It has a longer half-life than most SSRIs. I discuss what that means in this episode. Triamcinolone (topical) is most frequently used for redness, itching, and skin irritation.

On this episode of the Real Life Pharmacology podcast, I cover medications 51-55. They are eszopiclone, celecoxib, estrogen, moxifloxacin, and donepezil. Eszopiclone is a "Z" drug used for insomnia. Its adverse effect profile is very similar to benzodiazepines. Celecoxib is a COX-2 Inhibitor used for pain and inflammation. I discuss how this medication differs from traditional NSAIDs. Estrogen therapy is used for menopausal symptoms but carries a risk of cancer and blood clots. Moxifloxacin is a quinolone antibiotic. Binding drug interactions, boxed warnings, and QTc prolongation are potential concerns. Donepezil is a medication used for dementia. I discuss its mechanism of action and common adverse effects.

On this episode, we continue with the Top 200 Drugs podcast. We cover the basics of the following drugs: tizanidine, risperidone, ramipril, pravastatin, and terazosin. Tizanidine is a skeletal muscle relaxant that has drug interactions via CYP2D6 Risperidone is a 2nd generation antipsychotic. Be on the lookout for EPS, hyperprolactinemia, sedation, and metabolic syndrome. Ramipril is an antihypertensive agent that is an ACE Inhibitor. Cough and hyperkalemia are two important adverse effects. Pravastatin is an HMG-CoA reductase inhibitor that lowers LDL levels. It isn't as potent as other statins and I discuss this on the podcast episode. Terazosin is a non-selective alpha-blocker that may be used for BPH and hypertension.

On this episode of the Real Life Pharmacology podcast, I continue my education on the top 200 drugs. Raloxifene, prednisone, phenytoin, fish oil, and ezetimibe are covered in this podcast episode. Prednisone is a corticosteroid that may cause hyperglycemia, insomnia, GI upset, osteoporosis, HPA suppression, and hypertension as primary adverse effects. Raloxifene is classified as a SERM and can be used for osteoporosis and breast cancer. DVT and hot flashes are significant adverse effect concerns. Fish oil (Lovaza) is used to reduce triglycerides. Elevated triglycerides can increase the risk of pancreatitis. Ezetimibe inhibits the absorption of cholesterol through the gut. It lowers LDL but not to the extent of statins. Phenytoin is a narrow therapeutic index medication (NTI) that is used as an anticonvulsant. Ataxia, confusion, GI upset, and vertical nystagmus are potential signs of toxicity.

On this episode of the Real Life Pharmacology podcast, I continue my coverage with the Top 200 Drugs Podcast. Here's the list of medications we will cover. Lorazepam (Ativan) is a benzodiazepine well known for its anxiolytic and anti-seizure properties. Phenazopyridine (Pyridium) is a urinary analgesic that can change the color of the urine to a reddish/orange color as one of its adverse effects. Hydroxychloroquine (Plaquenil) is a DMARD used in rheumatoid arthritis and Lupus. One highly testable and unique nugget to remember is that it can cause retinopathy. Lidocaine patch (Lidoderm) is used topically to help with various types of pain including neuropathy and postherpetic neuralgia. Diclofenac (Cataflam) is an NSAID used as an analgesic and anti-inflammatory. It can increase the risk of GI bleed, edema, renal failure, and thrombosis.

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.

On this episode of the Top 200 Drugs pharmacology podcast, I cover fluticasone nasal spray, allopurinol, alendronate, famotidine, and cefdinir. Fluticasone is a corticosteroid that can be used nasally for the treatment of allergic rhinitis. Allopurinol is a xanthine oxidase inhibitor used to reduce uric acid and prevent gout flares. Alendronate is a bisphosphonate that inhibits the action of osteoclasts. This action helps treat osteoporosis. Famotidine is a histamine-2 receptor antagonist that helps reduce gastric acid secretion and alleviate heartburn symptoms. Cefdinir is a third-generation cephalosporin that is often used as an alternative for those who cannot take penicillin antibiotics. There is a small risk for cross-reactivity that a clinician has to consider.

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.

In this episode of the Real Life Pharmacology podcast, I cover drugs 16-20 of the top 200 drugs. This podcast includes information about clozapine, furosemide, heparin, tetracycline, and vardenafil. Clozapine has five boxed warnings and these are all items that you may see on your pharmacology and board exams! I've also blogged about these in the past at meded101. Furosemide is a loop diuretic and a common indicator of the prescribing cascade. I discuss this in this podcast episode. Heparin can cause thrombocytopenia. I discuss what HIT (heparin-induced thrombocytopenia) may look like.

Metformin is a medication used in the management of diabetes. It can cause significant diarrhea, B12 deficiency, and in rare cases, lactic acidosis. Atorvastatin (Lipitor) is a statin medication used for cholesterol management. It lowers LDL and is associated with myopathy. Omeprazole is a PPI used for GERD and has drug interactions with citalopram and clopidogrel. Ciprofloxacin is a quinolone antibiotic used to treat gram-negative infections and UTIs. It carries numerous risks such as tendon rupture. Ondansetron is an antiemetic medication used in the management of nausea and vomiting. I discuss the prescribing cascade in relation to this medication.

On this episode of the Real Life Pharmacology podcast, I discuss drugs 6-10 of the top 200 drugs. Included in this podcast episode are two antibiotics that are frequently used in pediatrics. Those two antibiotics are azithromycin and amoxicillin. Alprazolam is a benzodiazepine. It is a controlled substance that is used for the acute relief of anxiety. It is not well tolerated in the elderly. Hydrochlorothiaizde is a thiazide diuretic used primarily for hypertension. It can exacerbate gout and cause frequent urination. Amlodipine is a dihydropyridine calcium channel blocker. The most important adverse effect to remember with this medication is edema.

On this episode of the Real Life Pharmacology Podcast, I start my journey on summarizing the most highly testable pearls with the top 200 medications. I'm going through the top 200 medications, 5 drugs at a time, and sharing my experience and clinically relevant information about these medications. Escitalopram is an SSRI that can cause serotonin syndrome, sexual dysfunction, and SIADH. Simvastatin is a cholesterol medication that can cause myopathy and rhabdomyolysis. Levothyroxine is a thyroid hormone replacement medication that has numerous binding drug interactions. Vicodin is a brand name combination of hydrocodone and acetaminophen. It is an opioid combined with and OTC analgesic. Lisinopril is an ACE inhibitor used for hypertension that can cause a chronic dry cough and hyperkalemia.

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.

Continuous Glucose Monitors (CGMs) are becoming an important tool in the management of diabetes. I break down some of the most common clinical practice pearls you should know.

On this episode of the Real Life Pharmacology Podcast, I cover some of the most common food and supplement drug interactions. The 3 G's can potentially increase the risk of bleeding in patients on anticoagulants and antiplatelets. I discuss what supplements these are. There are some vitamins that can cause drug interactions. Vitamin C is a supplement that can alter the absorption of some medications. Metal cations like iron can bind certain medications and reduce absorption. I discuss which medications are most likely to be affected.

On this episode, I discuss the new medication vonoprazan and where it will likely be used in practice. Vonoprazan is from a brand new class of medication called "PCAB". I discuss this medication and its pharmacology in this podcast episode. Drug interactions and cost are the two major downsides of this medication that will likely limit its use compared to the PPIs. CYP3A4 inducers like rifampin, carbamazepine, and phenytoin should not be used with vonoprazan. They will reduce the effectiveness of vonoprazan.

Today’s sponsor of the 10 Commandments of Polypharmacy podcast is FreedAI. Freed listens, transcribes, and writes medical documentation for you. FreedAI is offering a discount exclusive to RLP listeners! Users will get $50 off their first month with Freed! Use the discount code: RLPPOD Here is part 2 of 2 on the final 5 of the 10 commandments of polypharmacy. 6. Thou shalt identify limits for medications not intended for chronic use as well as not continue a medication indefinitely for symptoms that have an expected short duration 7. Thou shalt not start a medication from a similar medication class without appropriate rationale 8. Thou shalt not initiate a medication without considering medications that may treat duplicate conditions – Kill two birds with one stone 9. Thou shalt consider eliminating or reducing medications at every medication review 10. Thou shalt be willing to accept risk in discontinuing a medication if they were willing to accept the risk of initiating a medication

On this special episode, I provide some real-life examples and layout 5 of my 10 commandments of polypharmacy. Today’s sponsor of the 10 Commandments of Polypharmacy podcast is FreedAI. Freed listens, transcribes, and writes medical documentation for you. FreedAI is offering a discount exclusive to RLP listeners! Users will get $50 off their first month with Freed! Use the discount code: RLPPOD Here are the first 5 commandments that are addressed in the podcast. 1. Thou shalt not start, ask for, dispense, or administer medication without reviewing a medication list that is accurate, up to date, and complete with over-the-counter medications and supplements 2. Thou shalt consider utilizing non-drug approaches and interventions to solve patient problems before initiating medication 3. Thou shalt assess if a medication is effective before adding a new medication for the same condition 4. Thou shalt consider any new symptom is an adverse effect of another medication until proved otherwise 5. Thou shalt not start a medication without an appropriate indication and assessing appropriate lab work