On this podcast episode, I discuss Clotrimazole pharmacology, adverse effects, indications, administration, and much more.

Clotrimazole is an imidazole antifungal that exerts its pharmacological effect by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes. This inhibition compromises membrane integrity, leading to leakage of cellular contents and ultimately fungal cell death.

Clotrimazole is primarily used topically due to poor systemic absorption when administered via the skin or mucous membranes, which limits systemic side effects.

When clotrimazole is used intravaginally or orally in lozenge form, localized concentrations are sufficient to treat mucocutaneous infections without significant systemic exposure.

Pay attention when clotrimazole is used frequently to treat Candida infections as corticosteroids, immunosuppression, and antibiotics may increase the risk of this type of infection.

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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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On this episode, I discuss benzonatate pharmacology, adverse reactions, and much more.

Tessalon Pearls (benzonatate) are a non-narcotic antitussive commonly prescribed to relieve dry, non-productive coughs.

Benzonatate acts by numbing stretch receptors in the respiratory tract, lungs, and pleura, which helps suppress the cough reflex at its source. Unlike opioid-based cough suppressants, it doesn’t work in the brain’s cough center.

The usual adult dose is 100 to 200 mg taken orally three times a day as needed, with a maximum daily dose of 600 mg.

One of the most critical points is that the capsules must be swallowed whole. Chewing, sucking, or crushing them can cause numbness in the mouth and throat, leading to a risk of choking or aspiration.

There are no major drug interactions associated with benzonatate.

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

Linagliptin is a DPP-4 inhibitor used to help control blood sugar levels in adults with type 2 diabetes. It works by increasing the levels of incretin hormones, which stimulate insulin release and decrease glucagon levels in the blood.

Linagliptin is usually taken once daily and can be used alone or in combination with other diabetes medications.

Unlike some other diabetes drugs, linagliptin does not usually cause weight gain or low blood sugar (hypoglycemia) when used alone.

Linagliptin should not be used with GLP-1 agonists as it works on a similar pathway as that medication class.

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Meclizine is classified as a first-generation antihistamine. I discuss meclizine pharmacology, adverse effects, drug interactions, and much more.

Meclizine is included on the Beers list due to its highly anticholinergic activity. Anticholinergic effects include constipation, dry eyes, dry mouth, urinary retention, and confusion.

Sedation is an important adverse effect of meclizine. This adverse effect can be increased when used with other sedating medications such as opioids and benzodiazepines.

Meclizine is primarily used for vertigo and motion sickness in clinical practice. The usual starting dose ranges between 12.5 to 25 mg.

Meclizine is partially broken down by CYP2D6 so medications like bupropion can inhibit the breakdown of meclizine and lead to higher concentrations.

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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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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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