pharmacy by asim

29/06/2025

🧪 Metformin + Topiramate Drug Interaction 🧪

-Topiramate can increase metformin toxicity by inducing non-anion gap, hyperchloremic metabolic acidosis through decreased serum bicarbonate.
- Combined use heightens the risk of metabolic acidosis.
- Close monitoring of renal function, acid-base balance, and bicarbonate levels is recommended.

🎯 𝗬𝗼𝘂 𝗰𝗮𝗻 𝘃𝗶𝘀𝗶𝘁 𝗺𝘆 𝗬𝗼𝘂𝗧𝘂𝗯𝗲 𝗰𝗵𝗮𝗻𝗻𝗲𝗹 𝗳𝗼𝗿 𝗮𝗺𝗮𝘇𝗶𝗻𝗴 𝗰𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗽𝗵𝗮𝗿𝗺𝗮𝗰𝗼𝗹𝗼𝗴𝘆 𝘃𝗶𝗱𝗲𝗼𝘀: https://youtube.com/

27/06/2025

💊 𝗛𝘆𝗱𝗿𝗼𝘅𝘆𝘂𝗿𝗲𝗮 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗣𝗲𝗮𝗿𝗹𝘀 💊

- Hydroxyurea is an oral antimetabolite primarily used for chronic myeloid leukemia (CML), sickle cell anemia, and essential thrombocythemia.
- It works by inhibiting ribonucleotide reductase, blocking DNA synthesis in rapidly dividing cells.
- Benefits include reducing sickle cell crises by boosting fetal hemoglobin (HbF).
- Common side effects are myelosuppression (anemia, leukopenia), GI upset, and skin ulcers.
- Dosing varies by condition (e.g., 15–35 mg/kg/day for sickle cell, 500–1500 mg/day for CML).
- Requires regular blood monitoring due to toxicity risks.
- Contraindicated in severe bone marrow suppression.

🎯 𝗬𝗼𝘂 𝗰𝗮𝗻 𝘃𝗶𝘀𝗶𝘁 𝗺𝘆 𝗬𝗼𝘂𝗧𝘂𝗯𝗲 𝗰𝗵𝗮𝗻𝗻𝗲𝗹 𝗳𝗼𝗿 𝗮𝗺𝗮𝘇𝗶𝗻𝗴 𝗰𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗽𝗵𝗮𝗿𝗺𝗮𝗰𝗼𝗹𝗼𝗴𝘆 𝘃𝗶𝗱𝗲𝗼𝘀: https://youtube.com/

26/06/2025

💊 Repaglinide Clinical Pearls 💊

- Repaglinide is a short-acting meglitinide that stimulates rapid, glucose-dependent insulin secretion by targeting pancreatic β-cell Kₐₜₚ channels.
- Used for Type 2 diabetes, it’s taken 15–30 minutes before meals, offering flexible dosing.
- It has a quick onset (~15–30 min) and short duration (~3–4 hours), reducing hypoglycemia risk compared to sulfonylureas.
- Common side effects include hypoglycemia, GI upset, and weight gain.
- Avoid with CYP3A4/CYP2C8 inhibitors (e.g., gemfibrozil).
- Ideal for postprandial hyperglycemia but requires multiple daily doses.
- Monitor in renal/hepatic impairment.

🎯 check out my detailed video about CLINICAL PHARMACOLOGY of REPAGLINIDE: https://youtu.be/T8R3Pvvjw8A?si=0auSLXhQ7MbxCp2P

repaglinide pharmacology, novonorm pharmacology, antidiabetic drugs pharmacology, pharmacology made easy💊 Repaglinide is a short-acting meglitinide that sti...

25/06/2025

💊 Aspirin has dose-dependent effects 💊

⬇️ At low doses (75–100 mg/day)
- it works as an antiplatelet by irreversibly inhibiting COX-1, which reduces thromboxane A2 and prevents platelet aggregation.

⬆️ At high doses (≥ 3 grams/day)
- it has anti-inflammatory effects by significantly reducing peripheral prostaglandin synthesis.

🎯 𝗬𝗼𝘂 𝗰𝗮𝗻 𝘃𝗶𝘀𝗶𝘁 𝗺𝘆 𝗬𝗼𝘂𝗧𝘂𝗯𝗲 𝗰𝗵𝗮𝗻𝗻𝗲𝗹 𝗳𝗼𝗿 𝗮𝗺𝗮𝘇𝗶𝗻𝗴 𝗰𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗽𝗵𝗮𝗿𝗺𝗮𝗰𝗼𝗹𝗼𝗴𝘆 𝘃𝗶𝗱𝗲𝗼𝘀: https://youtube.com/

24/06/2025

💊 Nebivolol's Unique Features 💊

- β₁-Selective with vasodilatory effect
- Neutral effects on glucose/lipids
- May improve endothelial dysfunction

📍 Combines β₁-blockade + NO-mediated vasodilation → preferred in HTN, especially in metabolic syndrome.

22/06/2025

💊 Ethambutol is known to cause optic neuritis (leading to blurred vision, color blindness, or vision loss) as a dose-dependent side effect.

💊 Patients on ethambutol should undergo baseline and periodic vision monitoring.

19/06/2025

- Thrombolytics (e.g., alteplase, tenecteplase) dissolve clots by activating plasmin.
- Used in STEMI, stroke (tPA

16/06/2025

💊 𝗕𝗲𝘁𝗮 𝗯𝗹𝗼𝗰𝗸𝗲𝗿𝘀 𝗮𝗻𝗱 𝗦𝗹𝗲𝗲𝗽 𝗱𝗶𝘀𝘁𝘂𝗿𝗯𝗮𝗻𝗰𝗲 💊

- Beta-blockers like propranolol can cause vivid, strange, or disturbing dreams by affecting REM sleep and adrenaline receptors.
- Lipophilic types (e.g., propranolol, metoprolol) are more likely to disrupt dreams.
- Managing side effects includes taking doses earlier, improving sleep hygiene, or switching medications.
- Not everyone experiences this, but consult a doctor if dreams become severely disruptive.

14/06/2025

💊 Levofloxacin injection should be administered for adult and pediatric patients by slow IV infusion over 60 minutes_(250 to 500 mg) and over 90 minutes (for 750 mg).
🚨 Due to an increased risk of hypotension , bolus or rapid IV administration should be avoided.

🔎 In addition, the infusion should not use a solution containing multivalent cations. Adequate hydration is essential to prevent crystalluria.

11/06/2025

🎯 PPIs may diminish the therapeutic effect of CLOPIDOGREL, do not use OMEPrazole and ESOMEPrazole while taking clopidogrel.

🪀 inhibit enzyme CYP2C19 ---> converts clopidogrel into active form (antiplatelet effect).

🧊 RABEprazole or PANToprazole have less risk.

🎯 𝗬𝗼𝘂 𝗰𝗮𝗻 𝘃𝗶𝘀𝗶𝘁 𝗺𝘆 𝗬𝗼𝘂𝗧𝘂𝗯𝗲 𝗰𝗵𝗮𝗻𝗻𝗲𝗹 𝗳𝗼𝗿 𝗮𝗺𝗮𝘇𝗶𝗻𝗴 𝗰𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗽𝗵𝗮𝗿𝗺𝗮𝗰𝗼𝗹𝗼𝗴𝘆 𝘃𝗶𝗱𝗲𝗼𝘀: https://youtube.com/

08/06/2025

💊 𝗡𝗶𝗮𝗰𝗶𝗻’𝘀 𝗜𝗺𝗽𝗮𝗰𝘁 𝗼𝗻 𝗟𝗶𝗽𝗶𝗱𝘀 💊

✅ Niacin + HMG-CoA Reductase Inhibitors (Statins) → ⬇️ LDL (additive effect)
✅ Niacin + Omega-3 Fatty Acids → ⬇️ Triglycerides (synergistic reduction)
✅ Niacin Alone → ⬆️ HDL (best pharmacologic HDL booster)

🚨 𝗞𝗲𝘆 𝗡𝗼𝘁𝗲𝘀:
- HDL Increase: Niacin raises HDL by 15–35% (highest among drugs).

- LDL/Triglycerides: Works well in combo therapy but not first-line due to side effects (flushing, hepatotoxicity, hyperglycemia).

- 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗨𝘀𝗲: Mostly reserved for statin-intolerant patients or severe mixed dyslipidemia.

🎯 𝗬𝗼𝘂 𝗰𝗮𝗻 𝘃𝗶𝘀𝗶𝘁 𝗺𝘆 𝗬𝗼𝘂𝗧𝘂𝗯𝗲 𝗰𝗵𝗮𝗻𝗻𝗲𝗹 𝗳𝗼𝗿 𝗮𝗺𝗮𝘇𝗶𝗻𝗴 𝗰𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗽𝗵𝗮𝗿𝗺𝗮𝗰𝗼𝗹𝗼𝗴𝘆 𝘃𝗶𝗱𝗲𝗼𝘀: https://youtube.com/

05/06/2025

💊 Proton pump inhibitors (PPIs) are prodrugs activated by stomach acid in parietal cells. They are mainly metabolized by the liver enzyme CYP2C19, though other P450 enzymes also play a role.

🔎Metabolic differences explain why PPI effectiveness varies:
- Asians often have higher PPI bioavailability and may need lower doses.
- Elderly patients also experience increased bioavailability, requiring dose adjustments.

✅ PPIs are the most potent acid-reducing drugs, though other medications can also decrease stomach acid. Understanding their metabolism helps optimize dosing for different populations.