Food and Supplement Drug Interactions

Metformin is a medication used in the management of diabetes. It can cause significant diarrhea, B12 deficiency, and in rare cases, lactic acidosis. Atorvastatin (Lipitor) is a statin medication used for cholesterol management. It lowers LDL and is associated with myopathy. Omeprazole is a PPI used for GERD and has drug interactions with citalopram and clopidogrel. Ciprofloxacin is a quinolone antibiotic used to treat gram-negative infections and UTIs. It carries numerous risks such as tendon rupture. Ondansetron is an antiemetic medication used in the management of nausea and vomiting. I discuss the prescribing cascade in relation to this medication.

On this episode of the Real Life Pharmacology podcast, I discuss drugs 6-10 of the top 200 drugs. Included in this podcast episode are two antibiotics that are frequently used in pediatrics. Those two antibiotics are azithromycin and amoxicillin. Alprazolam is a benzodiazepine. It is a controlled substance that is used for the acute relief of anxiety. It is not well tolerated in the elderly. Hydrochlorothiaizde is a thiazide diuretic used primarily for hypertension. It can exacerbate gout and cause frequent urination. Amlodipine is a dihydropyridine calcium channel blocker. The most important adverse effect to remember with this medication is edema.

On this episode of the Real Life Pharmacology Podcast, I start my journey on summarizing the most highly testable pearls with the top 200 medications. I'm going through the top 200 medications, 5 drugs at a time, and sharing my experience and clinically relevant information about these medications. Escitalopram is an SSRI that can cause serotonin syndrome, sexual dysfunction, and SIADH. Simvastatin is a cholesterol medication that can cause myopathy and rhabdomyolysis. Levothyroxine is a thyroid hormone replacement medication that has numerous binding drug interactions. Vicodin is a brand name combination of hydrocodone and acetaminophen. It is an opioid combined with and OTC analgesic. Lisinopril is an ACE inhibitor used for hypertension that can cause a chronic dry cough and hyperkalemia.

On this episode, I discuss timolol pharmacology, adverse effects, drug interactions, and much more. Timolol is a non-selective beta-blocker so it blocks both beta-1 and beta-2 receptors. Since timolol blocks beta-2 receptors, it can blunt the effect of respiratory medications that have beta-agonist action. Beta-blockers are notorious for causing bradycardia and pulse is an important monitoring parameter for timolol.

Continuous Glucose Monitors (CGMs) are becoming an important tool in the management of diabetes. I break down some of the most common clinical practice pearls you should know.

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.

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.

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

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

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.