Real Life Pharmacology - Pharmacology Education for Health Care Professionals Podcast Por Eric Christianson PharmD; Pharmacology Expert and Clinical Pharmacist arte de portada

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

De: Eric Christianson PharmD; Pharmacology Expert and Clinical Pharmacist
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Episodios
  • Midodrine Pharmacology Podcast

    Midodrine Pharmacology Podcast
    Oct 2 2025
    Midodrine is an oral alpha-1 agonist most commonly used for the treatment of symptomatic orthostatic hypotension. Its mechanism of action is through peripheral vasoconstriction, which helps increase blood pressure. Because of its short duration of action, it is typically dosed three times daily, with the last dose recommended in the late afternoon to reduce the risk of hypertension at night. Clinically, midodrine is often considered when non-pharmacologic strategies for orthostatic hypotension (such as increased salt/fluid intake, compression stockings, or physical counter-maneuvers) are not enough. Pharmacists should also be aware of prescribing cascades—such as urinary retention leading to tamsulosin initiation—that can arise when midodrine is used. Midodrine is generally not metabolized through cytochrome P450 pathways, so significant drug–drug interactions are less common. However, caution should be exercised with other agents that can raise blood pressure (like decongestants) or slow the heart rate (such as beta-blockers). Monitoring parameters include blood pressure, pulse, symptoms of urinary retention, and the patient’s overall response to therapy.
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    12 m
  • Piperacillin/Tazobactam Pharmacology

    Piperacillin/Tazobactam Pharmacology
    Sep 25 2025
    Zosyn (piperacillin/tazobactam) is a broad-spectrum β-lactam/β-lactamase inhibitor combination used widely in hospitals. Piperacillin covers gram-positive, gram-negative, and anaerobic bacteria, while tazobactam helps protect against β-lactamase breakdown. It is commonly used for pneumonia, intra-abdominal infections, skin and soft tissue infections, and febrile neutropenia. An important pharmacology pearl for exams is understanding that Pseudomonas, but it doesn't cover MRSA. The drug is renally eliminated, so dosing adjustments are needed in kidney impairment. Many institutions use extended or prolonged infusions to maximize time above the MIC, which can improve efficacy. Standard dosing is 3.375 g to 4.5 g every 6–8 hours, with modifications for dialysis patients. Adverse effects include hypersensitivity, gastrointestinal upset, electrolyte imbalances like hypokalemia, and blood count changes with prolonged therapy. A key clinical concern is nephrotoxicity risk, especially when used with vancomycin. Monitoring renal function and electrolytes are important. Methotrexate and probenecid are two medications that can interact with Zosyn. Concentrations of Zosyn can be increased when these medications are used in combination.
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    13 m
  • Senna Pharmacology

    Senna Pharmacology
    Sep 18 2025
    Senna is a stimulant laxative. Its pharmacological activity comes from natural compounds called sennosides. Metabolites act locally in the colon to stimulate peristalsis, thereby accelerating bowel movements. While osmotic laxatives are generally considered first-line laxative agents, this makes senna a useful alternative for the short-term treatment of constipation. The pharmacokinetics of senna are unique in that its onset of action typically takes 6 to 12 hours after oral administration, reflecting the time required for colonic bacteria to metabolize sennosides into active compounds. This delayed onset makes senna better suited for bedtime dosing when overnight relief is desired. Although senna is effective, its use carries potential adverse effects. Common side effects include abdominal cramping, diarrhea, and, rarely, electrolyte disturbances such as hypokalemia. Chronic or excessive use can lead to dependency and possibly melanosis coli, a benign but visible pigmentation of the colon lining. Drug interactions may occur, particularly with medications affected by potassium levels, such as digoxin or diuretics. For these reasons, senna is generally recommended for short-term use, with emphasis on evaluating underlying causes of constipation before long-term therapy is considered.
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    14 m
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