Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

A Meded101.com Production

  1. 1D AGO

    Ezetimibe and PCSK-9 Inhibitors – Cholesterol Test Prep and Practice Pearls

    In this pharmacology podcast episode, we focus on two key non-statin cholesterol-lowering therapies: ezetimibe and PCSK9 inhibitors (Click here to listen to the statin podcast episode). These agents play a role in lipid management, particularly for patients who are unable to reach LDL cholesterol goals with statins alone or who have statin intolerance. Ezetimibe works by inhibiting the absorption of dietary and biliary cholesterol at the brush border of the small intestine. By reducing the amount of cholesterol delivered to the liver, ezetimibe lowers circulating LDL cholesterol by approximately 15 to 25 percent. It is taken orally once daily and is commonly used as add-on therapy to statins in patients with established atherosclerotic cardiovascular disease or high baseline LDL levels. Ezetimibe is generally well tolerated, with a favorable safety profile and minimal systemic exposure, making it an attractive option in older adults and patients with multiple comorbidities. PCSK9 inhibitors, including alirocumab and evolocumab, offer a much more potent LDL-lowering effect. These monoclonal antibodies work by blocking PCSK9, a protein that promotes degradation of LDL receptors in the liver. By preserving LDL receptors, PCSK9 inhibitors enhance clearance of LDL cholesterol from the bloodstream, often reducing LDL levels by 50 to 60 percent. They are administered via subcutaneous injection every two to four weeks and are most commonly used in patients with familial hypercholesterolemia, established cardiovascular disease, or persistently elevated LDL despite maximally tolerated statin and ezetimibe therapy. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE! Support The Podcast and Check Out These Amazing Resources! NAPLEX Study Materials BCPS Study Materials BCACP Study Materials BCGP Study Materials BCMTMS Study Materials Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated) Guide to Drug Food Interactions (Amazon Best Seller) Pharmacy Technician Study Guide by Meded101

    14 min
  2. FEB 5

    Fibrates – Test Prep and Practice Pearls

    Fibrate derivatives are lipid-lowering medications that primarily target triglycerides rather than LDL cholesterol. Common agents include gemfibrozil, fenofibrate, and fenofibric acid. While their use has declined with the widespread adoption of statins, fibrates remain an important option for patients with severe hypertriglyceridemia, particularly to reduce the risk of acute pancreatitis rather than for routine cardiovascular risk reduction. Fibrates work by activating PPAR-alpha, which increases lipoprotein lipase activity and enhances the clearance of triglyceride-rich lipoproteins. This leads to significant reductions in triglycerides, modest increases in HDL cholesterol, and variable effects on LDL cholesterol. Because they are not strong LDL-lowering agents, fibrates should not replace statins in patients who require LDL reduction, but they can be effective in select clinical scenarios when triglycerides are the primary concern. From a safety standpoint, fibrates are generally well tolerated but require careful monitoring. Common concerns include gastrointestinal side effects, liver enzyme elevations, gallstone risk, and muscle toxicity, especially when combined with statins. Gemfibrozil carries a higher risk of drug interactions, while fenofibrate is usually preferred if combination therapy is necessary. Appropriate patient selection, lab monitoring, and lifestyle counseling are essential to maximize benefit and minimize harm when using fibrate derivatives. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE! Support The Podcast and Check Out These Amazing Resources! NAPLEX Study Materials BCPS Study Materials BCACP Study Materials BCGP Study Materials BCMTMS Study Materials Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated) Guide to Drug Food Interactions (Amazon Best Seller) Pharmacy Technician Study Guide by Meded101

    13 min
  3. JAN 29

    Statin Test Prep and Practice Pearls

    On this podcast episode, I discuss important practice pearls and important test prep information about statins. Statins are cornerstone agents for ASCVD risk reduction, so test questions often focus on indication, intensity, and monitoring. Health care professionals should quickly identify statin intensity: high-intensity therapy (atorvastatin 40–80 mg, rosuvastatin 20–40 mg) lowers LDL by ~50% and is indicated for patients with clinical ASCVD, LDL ≥190 mg/dL, or high-risk diabetes patients age 40–75. Moderate-intensity statins (e.g., atorvastatin 10–20 mg, simvastatin 20–40 mg) are commonly tested for primary prevention. Statin-associated muscle symptoms range from myalgias (most common, normal CK) to rare but serious rhabdomyolysis (marked CK elevation and AKI). Risk factors include high doses, advanced age, hypothyroidism, drug interactions, and renal impairment. If muscle symptoms occur, stopping the statin, ruling out secondary causes (like hypothyroidism), and rechallenging with a lower dose or different statin is often the correct clinical approach. Drug interactions and statin selection frequently separate good from great test-takers. Lipophilic statins (simvastatin, atorvastatin, lovastatin) are more prone to muscle effects and CYP3A4 interactions, while hydrophilic statins (pravastatin, rosuvastatin) are preferred in patients with prior intolerance or complex drug regimens. Grapefruit juice, strong CYP3A4 inhibitors, and certain calcium channel blockers raise simvastatin levels—often prompting dose limits or avoidance on exams. If LDL goals aren’t met, adding ezetimibe or a PCSK9 inhibitor is the next evidence-based step. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE! Support The Podcast and Check Out These Amazing Resources! NAPLEX Study Materials BCPS Study Materials BCACP Study Materials BCGP Study Materials BCMTMS Study Materials Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated) Guide to Drug Food Interactions (Amazon Best Seller) Pharmacy Technician Study Guide by Meded101

    17 min
4.9
out of 5
724 Ratings

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A Meded101.com Production

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