Lactulose is an osmotic laxative but it is rarely used for this purpose. I discuss lactulose pharmacology in this episode. 



Elevated ammonia levels are an issue in hepatic encephalopathy. Lactulose can help manage this issue. 



Lactulose is dosed to 2-3 soft stools per day when used to reduce ammonia levels. 



Lactulose can increase the effect of warfarin and raise INR; I discuss this further on this episode.

Lactulose Pharmacology

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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.

Food and Supplement Drug Interactions

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.

Vonoprazan Pharmacology – New Esophagitis Medication Class! Episode 326

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

10 Commandments of Polypharmacy Part 2 of 2

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

Ten Commandments of Polypharmacy – Part 1

Today’s sponsor of the Top 10 Anticoagulant Drug Interactions 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



Apixaban is one of the most commonly used anticoagulants and there are some drug interactions you need to be aware of. Take a listen and find out!



Warfarin concentrations can substantially be elevated by drugs that inhibit CYP2C9. I cover a few of them in my top 10 anticoagulant drug interactions.

Lactulose Pharmacology

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