Simvastatin use has declined over time due to more potent statins being available and due to numerous drug interactions.



Grapefruit juice can inhibit CYP3A4 which will increase the concentrations of simvastatin.



Genetic variations in SLCO1B1 can lead to patients being more susceptible to simvastatin toxicity. 



Simvastatin is a lipophilic statin. I discuss why this is important and how it might impact clinical decisions.

Simvastatin Pharmacology

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On this special episode, I provide some real-life examples and layout 5 of my 10 commandments of polypharmacy. 



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



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.

Top 10 Anticoagulant Drug Interactions

Today's sponsor of the Top 10 SSRI 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



In this podcast episode, I discuss how to navigate SSRI drug interactions and identify some of the most common medications that have additive serotonergic activity. 



SSRIs have antiplatelet activity. I discuss how to navigate using other medications that may increase bleed risk in combination with SSRIs. 



Paroxetine and fluoxetine inhibit CYP2D6 I discuss how this can affect the benefits of tamoxifen therapy. 



Fluvoxamine is a nasty medication with regard to the number of and significance of drug interactions. I outline important fluvoxamine interactions in this podcast episode.

Top 10 SSRI Drug Interactions Podcast

On this episode, I discuss travoprost pharmacology, adverse effects, administration, and much more on this podcast episode. 



Travoprost is used to reduce intraocular pressure in the management of glaucoma. I discuss the mechanism of action and adverse effects. 



Travoprost is a prostaglandin analog that can help reduce intraocular pressure and reduce the risk of the potential complication of blindness. 



Growth of eyelashes is a unique adverse effect associated with travoprost.

Travoprost Pharmacology

On this podcast episode, I finish up my breakdown of the Beers Criteria. 



I cover the use of sliding-scale insulin and sulfonylureas in geriatric patients. Hypoglycemia is a major concern with both of these diabetes management strategies. 



PPIs show up on the Beers criteria list as they can increase the risk of C. diff, pneumonia, fractures, and GI malignancies. 



Metoclopramide has dopamine antagonist activity and can increase the risk of EPS and tardive dyskinesia.

Simvastatin Pharmacology

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