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Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

By: Eric Christianson PharmD; Pharmacology Expert and Clinical Pharmacist
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 A Meded101.com Production Hygiene & Healthy Living Physical Illness & Disease
Episodes
  • Glycopyrrolate Pharmacology

    Glycopyrrolate Pharmacology
    Nov 20 2025
    Glycopyrrolate is an anticholinergic medication commonly used to reduce excessive secretions, particularly in palliative care, postoperative settings, and certain neurologic conditions. It works by blocking acetylcholine at muscarinic receptors, which decreases salivary and respiratory secretions. Clinically, glycopyrrolate is often used to manage terminal respiratory secretions (“death rattle”). Adverse effects of glycopyrrolate are primarily related to its anticholinergic properties. These may include dry mouth, constipation, urinary retention, blurred vision, tachycardia, and decreased sweating. While it has fewer central effects than agents like scopolamine, caution is still warranted in patients with glaucoma, gastrointestinal obstruction, or significant urinary retention risk. Monitoring hydration and bowel function is important, especially in elderly or frail patients. Dosing strategies depend on the clinical need. In palliative care, low doses may be given subcutaneously or intravenously every 4–6 hours as needed, while oral dosing is common for chronic sialorrhea. Clinicians should consider the patient’s overall medication burden, as cumulative anticholinergic load can worsen cognitive impairment and contribute to falls or constipation. I discuss drug interactions and other commonly used medications that may contribute to anticholinergic burden.
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    12 mins
  • Bisacodyl (Dulcolax) Pharmacology

    Bisacodyl (Dulcolax) Pharmacology
    Nov 13 2025
    Bisacodyl, commonly known by the brand name Dulcolax, is a stimulant laxative widely used for short-term relief of constipation and bowel preparation before procedures. It works by directly stimulating the enteric nerves in the colon, increasing peristalsis, and promoting bowel evacuation. Mechanism of Action:Bisacodyl acts primarily on the large intestine. It stimulates intestinal smooth muscle and alters water and electrolyte transport, increasing fluid accumulation in the bowel and triggering defecation. The result is a bowel movement typically within 6–12 hours orally or within 15–60 minutes when given rectally. Dosage Forms and Dosing:Bisacodyl is available as oral tablets (5 mg) and rectal suppositories (10 mg). Typical adult dosing is 5–15 mg by mouth once daily or 10 mg rectally as needed. It’s often used for acute constipation, bowel prep, or to prevent straining in specific medical situations. Adverse Effects:Common side effects include abdominal cramping, diarrhea, and nausea. Chronic or excessive use may lead to electrolyte imbalances, dehydration, and laxative dependence. Drug Interactions and Monitoring:Concurrent use with antacids, proton pump inhibitors, or milk may cause premature dissolution of enteric-coated tablets, leading to gastric irritation. Monitoring for bowel regularity, hydration status, and signs of electrolyte imbalance is important—especially in elderly or debilitated patients.
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    16 mins
  • Fludrocortisone (Florinef) Pharmacology

    Fludrocortisone (Florinef) Pharmacology
    Nov 6 2025
    On this podcast episode, I cover fludrocortisone. Fludrocortisone is a synthetic corticosteroid with potent mineralocorticoid activity and minimal glucocorticoid effects. It works primarily by promoting sodium reabsorption and potassium excretion in the distal renal tubules, leading to increased water retention and expansion of extracellular fluid volume. This pharmacologic action helps maintain blood pressure and electrolyte balance. Fludrocortisone is most commonly indicated for the treatment of adrenocortical insufficiency, such as Addison’s disease, and for managing orthostatic hypotension by enhancing vascular tone and volume status. Adverse effects are typically related to its mineralocorticoid potency and may include hypertension, edema, hypokalemia, and weight gain. Long-term use can also lead to complications such as heart failure exacerbation, osteoporosis, and mood changes. Because of its sodium-retaining effects, careful monitoring of blood pressure, electrolytes, and signs of fluid overload is recommended during therapy.
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    15 mins
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