Real Life Pharmacology - Pharmacology Education for Health Care Professionals

On this episode, I discuss clozapine pharmacology. This drug has multiple mechanisms of action: Dopamine blockade, anticholinergic activity, and alpha blocking activity all contribute to the complexity of this drug.

Smoking cessation can significantly increase the concentrations of clozapine. This is because smoking can induce CYP1A2. Listen to the podcast for more details on how this can impact our patients clinically.

Clozapine has 5 boxed warnings. I discuss them all in this podcast. The most well-known boxed warning is for agranulocytosis.

Because clozapine has alpha blocking activity, it can cause orthostasis. We need to monitor for this.

Clozapine can cause QTc prolongation. Keep an eye out for other medications that the patient may be taking that can also cause this. Examples include: amiodarone, ondansetron, quinolones, and macrolides

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On this episode, I discuss carbamazepine pharmacology. This drug is most commonly used for seizures, bipolar disorder, or trigeminal neuralgia.

Carbamazepine is an autoinducer and can reduce the concentrations of numerous drugs. Some examples include apixaban, warfarin, rivaroxaban, diltiazem, verapamil, and many more!

Carbamazepine has the potential to cause Steven Johnson’s Syndrome. This has a much greater chance of happening in patients with certain genetics.

Carbamazepine can contribute to SIADH and cause significant hyponatremia.

Carbamazepine has boxed warning for numerous potential events like aplastic anemia, agranulocytosis, and the above-mentioned SJS.

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

On this episode, I discuss the pharmacology of commonly used stimulant laxatives like sennosides and bisacodyl.

Stimulant laxatives “stimulate” the GI tract smooth muscle which helps propel fecal material out of the body and thus helping to relieve constipation.

Patients who are having diarrhea and are unsure of what medications they are taking should have their regimen assessed for these medications.

Chronic opioid therapy is a situation where chronic stimulant laxative therapy may be used.

Stimulant laxatives have very few drug interactions. However, bisacodyl effectiveness can be reduced by the use of antacids like calcium carbonate.

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

On this episode, I discuss ezetimibe pharmacology. Ezetimibe works by inhibiting Niemann-Pick C1-Like1 (NPC1L1) transporter. This transporter aids in cholesterol absorption so by blocking it, we can reduce cholesterol levels (and LDL) in the bloodstream.

Ezetimibe is usually very well tolerated. Diarrhea, myopathy, and elevations in LFT’s are adverse effects that have been reported but do not occur at high rates.

Ezetimibe is dosed at 10 mg once daily. This is a nice advantage because this is a starting dose and the usual treatment dose.

With the most recent cholesterol guideline updates, I do expect ezetimibe to be utilized a little more than it used to be. They place more emphasis on a target LDL and getting patients to goal.

Statins are going to be used first line for cholesterol and ezetimibe will be an add on therapy to consider. They don’t, unfortunately, lower cholesterol as much as high-intensity statins do.

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

On this episode, I cover azithromycin pharmacology. This drug primarily acts by inhibiting protein synthesis. It binds to the 50s ribosomal subunit.

GI adverse effects like nausea and diarrhea are going to be the most common with azithromycin.

Azithromycin has been associated with prolonging the QT interval. Drugs like amiodarone, ondansetron, citalopram, antipsychotics, and quinolone antibiotics can also prolong the QT interval.

One major advantage that azithromycin has over other antibiotics is that it has a long half life which allows for once daily dosing.

Azithromycin has numerous uses like pneumonia, MAC, alternative for ear infections in patients with a beta-lactam allergy, certain STD’s, and also is rarely used in long term COPD exacerbation prevention.

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