Podcasts about Pharmacology

"Because the premise of immune checkpoint blockade centers around elevating the immune function, we should always take a great deal of caution around those patients who have high immune risks. Those include patients with autoimmune disorders. That's one of our biggest questions that we ask, usually every consult that we're seeing with solid tumor. 'Do you have any history of autoimmune disorders? Tell me a little bit more about it. Is it being treated? What are your symptoms like?' And then also patients who have undergone organ transplants. Now, interestingly, this does include stem cell transplants," Kelsey Finch, PharmD, BCOP, oncology pharmacist practitioner at Columbus Regional Health in Indiana, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about checkpoint inhibitors. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 20, 2027. Kelsey Finch has disclosed a speakers bureau relationship with AstraZeneca. This financial relationship has been mitigated. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to checkpoint inhibitors in the treatment of cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 273: Updates in Chemotherapy and Immunotherapy Episode 174: Administer Pembrolizumab Immunotherapy With Confidence Episode 139: How CAR and Other T Cells Are Revolutionizing Cancer Treatment ONS Voice articles: Here's Why Oncology Nurses Are Pivotal in Managing Immune-Related Adverse Events Make Subcutaneous Administration More Comfortable for Your Patients Nursing Considerations for ICI-Related Myocarditis Oncology Nurses Navigate the Changing Landscape of Immuno-Oncology Postdischarge ICI Patient Education Eliminates Hospital Readmissions Shorter Administration Times Still Require High-Acuity Care ONS Voice oncology drug reference sheets: Dostarlimab-Gxly Nivolumab and Hyaluronidase-Nvhy Nivolumab and Relatlimab-Rmbw Pembrolizumab and Berahyaluronidase Alfa-Pmph Retifanlimab-Dlwr Toripalimab-Tpzi ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Guide to Cancer Immunotherapy (second edition) ONS course: ONS/ONCC® Chemotherapy Immunotherapy Certificate™ Clinical Journal of Oncology Nursing articles: Immune Checkpoint Inhibitor–Related Myocarditis: Recognition, Surveillance, and Management Immune Checkpoint Inhibitor Therapy: Key Principles When Educating Patients Triple M Syndrome: Implications for Hematology-Oncology Advanced Practice Providers ONS Huddle Cards: Checkpoint Inhibitors Immunotherapy ONS Learning Libraries: Genomics and Precision Oncology Learning Library Immuno-Oncology Learning Library Drugs@FDA package inserts National Comprehensive Cancer Network homepage OncoLink: All About Immunotherapy To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Before immune checkpoint blockade, the two-year overall survival rate in metastatic melanoma was hovering around 10%. After these agents came to market, depending on the trial and the agents used, that number actually increased to about 50%–65%. So, five times the amount of patients were actually living at the two-year mark. Not surprisingly, studies then exploded across several tumor types, leading to approvals in all sorts of cancers, mostly in the solid tumor. But there are a couple hematologic as well. Lung cancer, kidney cancer, head and neck, Hodgkin lymphoma, hepatocellular, the list goes on. So, it's really just transforming the stage IV setting across all tumors, specifically from uniformly fatal prognosis to one where durable responses and long-term survival is also possible." TS 3:03 "There are four different mechanisms officially being used in therapies that are approved by the U.S. Food and Drug Administration (FDA). Those are cytotoxic T-lymphocyte–associated protein 4, programmed cell death protein 1, and programmed cell death ligand 1, which I'm counting as two different mechanisms, even though they somewhat work together. And lymphocyte-activation gene 3 is the fourth one that's in there. So, all these mechanisms impact the T cell in our immune system. The T cell is traditionally responsible for protecting our body from harmful things like bacteria, viruses, and cancer. When the tumor binds to cytotoxic T-lymphocyte–associated protein 4 receptors, that happens on the T cell itself. And that inhibits the activation of the T cells, essentially allowing that tumor to then live. So when developing medications that block this receptor, they noted an added benefit that it actually increased the T-cell proliferation as well as keeping that T cell active. So not only are we not blocking the T cells, we're making them more productive." TS 5:38  "If you have a chance of any sort of tissue rejection, specifically with allogeneic stem cell transplants or where we see that focusing on it, there's a little bit of controversy, mixed bag on opinions as far as autologous stem cell transplants. But it's best to at least exercise a little bit of caution. If they have a chance of organ rejection, is that worth the risk of the therapy that we're looking to give? And then, patients with HIV, any sort of immunologic concerns at baseline that we could potentially worsen." TS 14:37 "As a rule of thumb, with immune checkpoint blockade, regardless of what mechanism you're looking at, if something in your body can get inflamed, that can wind up as an adverse event. So, whenever I talk to my patients, the key word is anything ending in '-itis.' ... The most common adverse events that we end up seeing are dermatitis and hypothyroidism. Immune checkpoint blockade can cause both hyper- and hypothyroidism. Very often, we actually start in the hyper- and then end up, for lack of better words, burning out the thyroid, ultimately leading to a sustained hypothyroidism." TS 18:34 "The half-life of immune checkpoint inhibitors is usually around 30 days, meaning that once these agents are given, the drug will be in the patient's system for up to five months. Specifically, it will probably build month to month, so often we don't even see a lot of our adverse events until month three or four. Usually, when we're that far into treatment, we're not looking for new adverse events in things like chemotherapy. But these drugs do build over time." TS 24:28 "As far as safe handling is concerned, these agents are not chemotherapy. That makes drug compounding and administration pretty straightforward. When looking at the follow-up care, the most important thing, in my opinion, is to engage in meaningful dialogue with your patients. A lot of the side effects can be nonspecific. So, really listening to the patient and evaluating changes in their lifestyle, I think it'll get you far. We usually hark in on the new, worsening, or persistent whenever we're talking to patients because they'll be looking for things as well. So, just having a dialogue of how their life has changed can certainly help." TS 26:17

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP]In this episode:One-week launch countdown plus a behind-the-scenes tour of the new Atomic Anesthesia platform.Overview of current features: 150+ lessons, quiz builder with 2,000+ questions, and gamified learning with avatars, gems, and leaderboards.Breakdown of seven core pharmacology concepts to make drug questions predictable instead of pure memorization.Clinical-style thinking tips: using receptor logic, dose–response, onset, redistribution, protein binding, and context-sensitive half-time to anticipate drug behavior.

Managing cholesterol is a key part of preventing cardiovascular disease, and nurses are on the front lines of patient care. In this episode, we explore the main cholesterol-lowering medications, including statins, ezetimibe, PCSK9 inhibitors, fibrates, and more. You'll learn how each medication works, important side effects, lab monitoring, and nursing considerations for safe administration. We'll also cover strategies for educating patients and supporting long-term adherence. By the end of this episode, you'll have practical tools to confidently recognize, monitor, and teach about cholesterol medications in everyday nursing practice. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Autonomic medications are some of the most commonly used — and commonly tested — drugs in nursing practice. In this episode, we break down the sympathetic and parasympathetic nervous systems in a clear, practical way so you can connect receptors to real-world patient care. We'll review key drug classes like beta blockers, alpha agonists, anticholinergics, and cholinergic agents, focusing on mechanisms, common indications, and high-yield adverse effects nurses must recognize. You'll learn how to anticipate vital sign changes, monitor for safety concerns, and avoid common medication errors. Whether you're preparing for exams or strengthening bedside confidence, this episode will simplify autonomic pharmacology and give you practical pearls you can apply immediately in clinical practice. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Hypertension medications are a cornerstone of nursing practice, and understanding how they work can dramatically improve patient safety and outcomes. In this episode, we break down the major antihypertensive drug classes, including ACE inhibitors, ARBs, beta blockers, calcium channel blockers, and diuretics, in a practical and easy-to-understand way. You'll learn how each class lowers blood pressure, key monitoring parameters, common side effects, and important nursing considerations. We'll also cover when to hold medications, what lab values matter most, and how to educate patients to improve adherence. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Antiplatelet medications play a critical role in preventing heart attacks and strokes, and nurses are often on the front lines of monitoring their safety and effectiveness. In this episode, we break down key agents like aspirin, P2Y12 inhibitors such as clopidogrel, and other commonly used therapies in a clear, practical way. You'll learn how these medications work, when they're indicated, and the most important bleeding risks to watch for. We'll also review monitoring parameters, perioperative considerations, and patient education pearls that can help prevent complications. By the end of this episode, you'll feel more confident recognizing adverse effects, educating patients, and safely supporting antiplatelet therapy in everyday practice. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Hypertension is one of the most common conditions nurses manage, yet small details can make a big difference in patient outcomes. In this episode, we break down essential hypertension pearls every nurse should know. Whether you're preparing for exams or caring for patients at the bedside, this episode delivers concise, high-yield strategies to help you manage hypertension with confidence and clarity. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Heart failure management has evolved dramatically, and nurses are central to optimizing outcomes and preventing hospital readmissions. In this episode, we break down the core medication classes used in heart failure, including ACE inhibitors, ARBs, beta blockers, mineralocorticoid receptor antagonists, diuretics, and newer agents like ARNIs and SGLT2 inhibitors. You'll learn how these medications improve symptoms and survival, key monitoring parameters such as blood pressure, potassium, and renal function, and common adverse effects to watch for. We'll also review practical bedside considerations and patient education pearls that improve adherence and safety. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Heparin medications are commonly used in hospitals, and nurses play a critical role in ensuring they're given safely. In this episode, we break down unfractionated heparin and low molecular weight heparins in a practical, easy-to-understand way. We'll also review dosing considerations, signs of bleeding, and the importance of recognizing heparin-induced thrombocytopenia early. Plus, we'll cover reversal with protamine and essential patient safety tips. Whether you're preparing for exams or managing anticoagulation at the bedside, this episode will help you confidently navigate heparin therapy in clinical practice. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Anticoagulation therapy can feel complex, but nurses play a vital role in keeping patients safe. In this episode, we break down the key differences between warfarin and direct oral anticoagulants (DOACs), including how they work, when they're used, and what makes each unique. You'll review important monitoring parameters like INR for warfarin, renal function considerations for DOACs, major drug and food interactions, and bleeding risk assessment. We'll also cover reversal strategies and practical patient education pearls. Whether you're preparing for exams or managing patients on anticoagulation, this episode will simplify the essentials and strengthen your confidence in safely caring for patients on warfarin and DOAC therapy. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Atrial fibrillation is one of the most common cardiac arrhythmias nurses encounter, and understanding its management is essential for safe patient care. In this episode, we break down what atrial fibrillation is, why it increases stroke risk, and how treatment strategies focus on rate control, rhythm control, and anticoagulation. We'll review common medications, monitoring priorities, and key assessment findings you should never ignore. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Four years after our original antibiotic myth-busting episode (Ep 60), we're back with Dr Riati Scarborough to talk antibiotic prescribing habits. This time we're joined by fellow stewardship expert Dr Laura Hardefeldt, and this time we're asking the harder question: Have we actually changed?The good news? Some prescribing habits are shifting. We're seeing shorter courses and less ‘just in case antibiotic usage. But let's not pat ourselves on the back too quickly. Because some of our most entrenched habits are still alive and well, like how we treat skin disease, and our ongoing love affair with amoxiclav.This episode is a practical, clinically grounded update on what the evidence says in 2026 - and how to make realistic changes without compromising patient care.We cover:Why skin disease remains the single biggest driver of antimicrobial resistance in small animal practice, and what to do about itAmoxicillin vs amoxiclav: when de-escalation is not just safe, but smarterWhy convenience (you know the brand we're talking about right…) is not a clinical indicationTrimethoprim-sulphonamide and the real story on KCS riskDentals, heart murmurs, and what prophylaxis actually looks like in 2026Simple in-clinic stewardship strategies that genuinely shift prescribing behaviourThis isn't about perfection. It's about progress.If you'd like effective antibiotics to still exist in five to ten years…This episode is essential listening.Find out how we can support you in your vet career at ⁠⁠⁠⁠⁠⁠⁠thevetvault.com⁠⁠⁠⁠⁠⁠⁠.⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠for Hubert's favourite clinical and non-clinical learnings from the week.Grab one last handful of spots in the Maldives for our surf/dive vet conference with ⁠Vets On Tour⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Tips and Timestamps3:03 Progress in prescribing habits including UTI durations and surgical prophylaxis4:55 Skin disease as the biggest problem area in small animal practice7:01 Topical therapy versus systemic antibiotics for skin conditions9:28 Deep pyoderma and the new consensus statement11:00 Gut bacteria as a source of resistant infections12:41 Rise of MRSP, methicillin-resistant Staphylococcus pseudintermedius14:00 Amoxicillin-clavulanate overuse16:47 Vets on Tour conferences advertisement18:08 Pharmacology refresher on amoxicillin, amoxicillin-clavulanate, and cefovecin19:45 Why cefovecin is classified as high importance, vs the convenience argument for cefovecin in cats22:56 Long-acting amoxicillin injections as an alternative24:00 Getting amoxicillin back on the shelf24:53 Communicating antibiotic choices to clients29:32 Dental antibiotics and debunking the heart murmur myth34:07 Subclinical bacteriuria and stopping cultures in asymptomatic patients38:30 Reassessing the dry eye risk of trimethoprim-sulfonamide41:43 Antimicrobial stewardship trial using colour-coded pharmacy shelves

Pharmacology For Babies by Amanda Mullins https://www.amazon.com/Pharmacology-Babies-Amanda-Mullins/dp/B0BM3DD9LM Understanding basic pharmacology is important for the safe use of medicines. Receptors, agonists, and antagonists are all important parts of how medicines work in our bodies. Pharmacists go to school to learn about medicines and how they interact and change our body’s processes.

Send us a textThe brain's mysterious claustrum region, its role in cognitive flexibility, and how substances like alcohol and psychedelics affect neural circuits and behavior. Not medical advice.TOPICS DISCUSSED:Cerebral cortex structure: Described as a six-layered structure with pyramidal neurons and inhibitory interneurons; information flows between layers and regions to process sensory input and enable complex behaviors.Claustrum anatomy & connectivity: A sheet-like subcortical structure embedded in white matter, bidirectionally connected to cortical areas, especially prefrontal regions in rodents, with broader connections in primates and humans suggesting an integrative role.Claustrum function in cognition: Experiments show claustrum activation during task switches from easy to demanding modes, synchronizing cortical networks via inhibition and rebound excitation, potentially enabling flexible behavior.Mouse models in neuroscience: Mice are used for genetic tractability to manipulate and monitor specific circuits, revealing claustrum's role in vigilance tasks but not simple ones.Alcohol's effects on brain circuits: Chronic alcohol promotes inflexible behaviors by altering striatal interneurons and inhibitory inputs, leading to compulsive drinking despite aversive consequences.Psychedelics & brain networks: Psilocybin disrupts default mode and other networks, inhibits claustrum via serotonin 1B receptors, with effects persisting 24 hours, possibly contributing to therapeutic benefits.Evolution of claustrum: Connectivity expands from rodents to humans, shifting from cognitive-specific to broader network control, including anti-correlated states like default mode versus task-engaged.Integration of claustrum & basal ganglia: Claustrum funnels prefrontal signals to basal ganglia for action selection; alcohol may impair this, exacerbating inflexibility in addiction.ABOUT THE GUEST: Brian, PhD is a professor in the Department of Pharmacology and Physiology at the University of Maryland School of Medicine, where he leads a neuroscience lab studying brain circuits underlying flexible and inflexible behaviors using mouse models, with a focus on alcohol use disorder.Support the showHealth Products by M&M Partners: SporesMD: Premium mushrooms products (gourmet mushrooms, nootropics, research). Use code 'nickjikomes' for 20% off. Lumen device: Optimize your metabolism for weight loss or athletic performance. MINDMATTER gets you 15% off. AquaTru: Water filtration devices that remove microplastics, metals, bacteria, and more from your drinking water. Through link, $100 off AquaTru Carafe, Classic & Under Sink Units; $300 off Freestanding models. Seed Oil Scout: Find restaurants with seed oil-free options, scan food products to see what they're hiding, with this easy-to-use mobile app. KetoCitra—Ketone body BHB + electrolytes formulated for kidney health. Use code MIND20 for 20% off any subscription (cancel anytime) For all the ways you can support my efforts

Today, we're diving into an increasingly urgent and complex area of frontline medicine: novel psychoactive substances and synthetic drugs. Over the past decade, the drug landscape has shifted dramatically. Potent synthetics, unpredictable chemical variants, and rapidly evolving supply chains are creating new clinical challenges for ambulance crews, HEMS teams, and frontline responders. These substances don't play by traditional rules; presentations can be extreme, toxidromes atypical, and responses to treatment unpredictable. To help us understand this shifting landscape, I'm joined byDr Caroline Copeland, Senior Lecturer in Pharmacology and Toxicology at King's College London and Director of the National Programme on Substance Use Mortality. Caroline is one of the UK's leading experts in drug-related harms, combining pharmacology, epidemiology, and innovative data science to better understand emerging substances and their real-world impact. She advises national bodies, contributes to the ACMD's Novel Psychoactive Substances Committee, and leads national surveillance programmes shaping policy and practice. Today, she helps us unpack what clinicians need to know, what's changing, and how we can better protect patients in a rapidly evolving drug landscape. Caroline's work and publications can be found here: https://www.kcl.ac.uk/people/caroline-copelandThis episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

"You also want to deal with patient preferences. We do want to get their disease under control. We want to make them live a long, good quality of life. But do they want to come to the clinic once a week? Is it a far distance? Is geography a problem? Do they prefer not taking oral chemotherapies at home? We have to think about what the patient's preferences are to some degree and kind of incorporate that in our decision-making plan for treatments for relapsed and refractory myeloma," Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University Medical Center in Neptune, NJ, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about multiple myeloma treatment considerations. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 6, 2027. Ann McNeill has disclosed a speakers bureau relationship with Pfizer. This financial relationship has been mitigated. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the treatment of multiple myeloma. Episode Notes  Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 398: An Overview of Multiple Myeloma for Oncology Nurses Episode 395: Pharmacology 101: Monoclonal Antibodies Episode 372: Pharmacology 101: Proteasome Inhibitors ONS Voice articles: Effective Care Transitions Are Essential for New Multiple Myeloma Treatments New Multiple Myeloma Treatments Present New Challenges in Side Effect Management Reduce Racial Barriers and Care Inequities for Black and African American Patients With Multiple Myeloma ONS Voice FDA approval alerts ONS Voice oncology drug reference sheets: Belantamab mafodotin-blmf Daratumumab Motixafortide Selinexor Clinical Journal of Oncology Nursing articles: Journey of a Patient With Multiple Myeloma Undergoing Autologous Stem Cell Transplantation Optimizing Transitions of Care in Multiple Myeloma Immunotherapy: Nurse Roles Oncology Nursing Forum article: Facilitators of Multiple Myeloma Treatment: A Qualitative Study ONS books: Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition) Multiple Myeloma: A Textbook for Nurses (third edition) ONS course: ONS Hematopoietic Stem Cell Transplantation™ ONS Huddle Cards: Financial Toxicity Hematopoietic Stem Cell Transplantation (HSCT) Monoclonal Antibodies ONS Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library American Society of Clinical Oncology (ASCO)–Ontario Health: Treatment of Multiple Myeloma Living Guideline International Myeloma Foundation: Clinical Trials Fact Sheets Clinical Trial Support Resource Library Multiple Myeloma Research Foundation resource: Treatments for Multiple Myeloma To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Typically for our first-line therapies, we use certain classes of drugs and some of them are proteasome inhibitors like bortezomib and carfilzomib. We also have IMiDs or immunomodulatory agents like thalidomide, lenalidomide, and pomalidomide. We have monoclonal antibodies, anti-CD38 monoclonal antibodies. Of course, we can never talk about treatment for myeloma without mentioning dexamethasone. It is an integral part of our treatment regimen. Most of our frontline therapies now are not just a single agent. They're not even doublets anymore. Typically, they're triplet therapies. And now in 2026, it's leaning more toward quadruplet therapies. By that, I mean you're taking a proteasome inhibitor, an immunomodulatory drug, dexamethasone, and an anti-CD38 monoclonal antibody all together to present patients with a good chance their induction therapy will lead to a good chance of them responding to treatment." TS 4:25 "[With] myeloma labs, there should be some indication after each cycle of therapy that the treatment is working. So, you don't have to do a whole myeloma panel, but maybe getting a monoclonal protein spike, maybe getting a free light chain assay, or maybe an immunoglobulin G or immunoglobulin A level, just to see if the treatment is working. So, those labs are crucial to determine whether the therapies are working. And again, the lab improvements usually correlate with the clinical presentation of the patient." TS 11:01 "There are active clinical trials ongoing with drugs like cell mods. Cell mods are the new oral anticancer agents for myeloma that have shown great promise with efficacy and safety profiles. And then there are other combinations that are showing a lot of promise. So, drugs that are already approved by the U.S. Food and Drug Administration (FDA). And I'm talking about pairing anti-CD38 monoclonal antibodies with bispecific T-cell engagers. If you do that, there has been some evidence that these combinations are very efficacious and responses are durable. And there are ongoing clinical trials and studies being done right now to see if these can be FDA-approved to pinpoint where they are as far as in comparison to other treatments." TS 20:10 "I always tell patients to try to participate in safe, and I want to stress safe, physical activity. So, I tell patients, the more you sit on the couch or you sit in the chair for most of the day, that unfortunately will make your pain worse. So, trying to get up and about and doing some physical activity, such as getting a physical therapy evaluation and a treatment program, no matter how passive or mild or gentle it is, can really help these patients with bone pain." TS 26:10 "I think it's important to realize that myeloma has had amazing advances in science, research and treatments. I think that all of these things coming together, all the science and clinical trials and everything like that, has led to a significant increase in overall survival of our patients, which ultimately is a great thing. We want patients to live longer and they're living longer with a very good quality of life. So, I think it's important to realize that myeloma is very well studied, very well researched, and it's still ongoing with many, many clinical trials." TS 36:04

Send us a textPharmacology & neurobiology of psychedelics & MDMA, focusing on isomers, sex-specific effects, and mechanisms in animal models. Not medical advice.TOPICS DISCUSSED:Biased agonism: Different drugs activate the same receptor (e.g., 5-HT2A) but trigger varied intracellular pathways, explaining why LSD is psychedelic while similar lisuride is not.Enantiomers & isomers: Mirror-image versions of drugs like MDMA (S and R forms) and LSD (four isomers) often produce distinct effects; only one LSD isomer is psychedelic, for example.MDMA isomer effects: S-MDMA induces stronger head twitches (psychedelic proxy) via serotonin release, and increases dendritic spines in male mice but not females; R-MDMA has somewhat different effects.Sex-specific drug responses: In mice, females show stronger psychedelic effects (head twitches) from psilocybin and DOI at the same dose, but males exhibit greater post-acute benefits like reduced opioid withdrawal.Psilocybin in opioid addiction models: A single dose reduces place preference for oxycodone and withdrawal symptoms in male mice more than females, with opposite spine density effects in reward-related brain areas.Mechanisms beyond 5-HT2A: Psychedelics involve other receptors like metabotropic glutamate receptors, forming dimers with 5-HT2A to enable dual signaling pathways; effects in subcortical regions like nucleus accumbens are 5-HT2A-independent.Clinical implications: Street MDMA may vary in S/R ratios, affecting experiences; clinical trials often use racemic mixtures without weight-adjusted dosing, potentially missing sex differences.ABOUT THE GUEST: Javier Gonzalez-Maeso, PhD is a professor of pharmacology and toxicology at Virginia Commonwealth University, with a PhD in medicine from Spain focused on G-protein coupled receptors and human brain studies in depression and addiction.RELATED EPISODE:M&M 230 | Psilocybin & MDMA: Inflammation, Stress & Brain-Body Communication | Michael WheelerSupport the showHealth Products by M&M Partners: SporesMD: Premium mushrooms products (gourmet mushrooms, nootropics, research). Use code 'nickjikomes' for 20% off. Lumen device: Optimize your metabolism for weight loss or athletic performance. MINDMATTER gets you 15% off. AquaTru: Water filtration devices that remove microplastics, metals, bacteria, and more from your drinking water. Through link, $100 off AquaTru Carafe, Classic & Under Sink Units; $300 off Freestanding models. Seed Oil Scout: Find restaurants with seed oil-free options, scan food products to see what they're hiding, with this easy-to-use mobile app. KetoCitra—Ketone body BHB + electrolytes formulated for kidney health. Use code MIND20 for 20% off any subscription (cancel anytime) For all the ways you can support my efforts

In this episode, Julia speaks with Ebisan about trust — and why it begins not with others, but with learning to trust ourselves. Ebisan reflects on how she approaches relationships with openness, but also with hesitation — not as fear, but as discernment. She talks about trusting the signals we feel in our bodies, and how gut instinct often tells us when something feels right, or when something feels off, long before we can explain it. The conversation explores how trust is built in layers, through consistency, accountability, and paying attention to behaviour over time. Ebisan shares how trust looks different across cultures, generations, and contexts — and why what feels trustworthy in one situation may not translate directly into another. Ebisan and Julia also speak candidly about disappointment — what happens when trust is broken, why we often feel more disappointed in ourselves than in others, and how ignoring early signals can leave us feeling foolish rather than angry. This episode is a reminder that trusting others starts with self-trust — listening carefully, questioning our instincts when needed, and learning to hold openness and hesitation in balance as we navigate relationships. About the Guest: Ebisan Akisanya, Chairman, WIMBIZ Board of Trustees, is a seasoned development professional with nearly 30 years of experience driving social impact across corporate and nonprofit sectors. Her passion for inclusive growth is reflected in her active service on several not-for-profit boards, where she contributes to initiatives that address systemic social inequities and uplift vulnerable populations. She currently serves as coordinator, Corporate Responsibility and National Programs at Chevron Nigeria, where she leads initiatives that drive sustainable impact. Ebisan holds a Bachelor of Science in Pharmacology and a Master's degree in Public Administration from the University of Lagos. Beyond her corporate role, Ebisan is also an active member of the African Philanthropy Forum (APF), a dynamic network of social investors committed to advancing development across the continent.

It's a new medicine made of old medicines! Jody reviews the mechanism of this new (?) option for treatment of major depressive disorder in adults.References:1) Auvelity Package Insert2) Auvelity Review Article (Annals of Medicine & Surgery)3) Auvelity Overview (OpenEvidence)4) Physiology of NMDA Receptor (PubMed)5) Pharmacology of Sigma-1 Receptor (PubMed)6) Mucinex DM Label Information

Episode: 1516 In which we must save the lore as well as the plants.  Today, we have to save more than the endangered plants.

"Radioimmunoconjugates work through a dual mechanism that combines immunologic targeting with localized radiation delivery. The monoclonal antibody components bind to specific tumor-associated antigens such as CD20, expressed on malignant B cells. Once found, the attached radioisotope delivers beta radiation directly to the tumor, causing DNA damage and cell death," Sabrina Enoch, MSN, RN, OCN®, CNMT, NMTCB (CT), theranostics clinical specialist at Highlands Oncology in Rogers, AR, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radioimmunoconjugates. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 30, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge in the history of, the mechanism of action of, and the use of radioimmunoconjugates in the treatment of cancer. Episode Notes  Complete this evaluation for free NCPD. ONS Podcast™ episodes: Pharmacology 101 series Episode 377: Creating and Implementing Radiopharmaceutical Policies and Procedures Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 298: Radiation Oncology: Nursing's Essential Roles ONS Voice articles: Interprofessional Collaboration Reduces Time to Neutropenia Antibiotic Administration Radiopharmaceuticals and Theranostics Offer New Options for Oncology Nurses to Transform Cancer Care Radiopharmaceuticals Pack a One-Two Punch Against Cancer Safety Is Key in Use of Radiopharmaceuticals Telehealth Has Value During Radiotherapy, Patients Say ONS Voice oncology drug reference sheets: Lutetium Lu 177 dotatate Lutetium Lu 177 vipivotide tetraxetan Radium 223 dichloride Sodium iodide-131 Strontium chloride Sr-89 ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS/ONCC® Chemotherapy Immunotherapy Certificate™ ONS/ONCC® Radiation Therapy Certificate™ Clinical Journal of Oncology Nursing articles: Radiopharmaceutical Safety: Making It Easy Targeted Radionuclide Therapy: A Theranostic Approach to Cancer Therapy ONS Huddle Cards: Radiobiology Radiopharmaceuticals ONS Learning Libraries: Immuno-Oncology Radiation ONS Symptom Interventions for Prevention of Bleeding Drugs@FDA package inserts To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Radioimmunoconjugates are a specialized subset of radiopharmaceuticals designed to combine the specificity of monoclonal antibodies with the cytotoxic power of radiation. ... Early development focused on B-cell malignancies, particularly non-Hodgkin lymphoma." TS 1:51  "An important concept for nurses to understand is the crossfire effect, where radiation can affect nearby tumor cells, even though not every cell expressed has the target antigen. This helps explain why these agents can be effective even in heterogeneous tumors." TS 3:40 "At present, 90 Y-ibritumomab tiuxetan is the only radioimmunoconjugate approved by the U.S. Food and Drug Administration (FDA) in clinical use. Historically, iodine-131 tositumomab played a major role in establishing these therapy classes, but it's also useful to contrast radioimmunoconjugates with other radiopharmaceuticals, such as iodine-131 therapies, which a lot of places do at this time, used for thyroid diseases, or radium 223, used for metastatic prostate cancer. Unlike those agents, radioimmunoconjugates rely on antibody-mediated targeted rather than physiologic uptake or bone affinity." TS 4:55 "I just try to explain to [patients] that radiation exposure is like being next to a flame. The further you are away, the less heat you get, the less exposure you get. These patients can be radioactive for three days, seven days—it just depends on how fast they excrete it through their bodies with half-life exposure." TS 9:33 "While only one agent is currently approved, the principles established by radioimmunoconjugates continue to guide development for newer targeted radiopharmaceuticals. Emerging agents aim to improve targeting, reduce toxicity, and expand indications beyond hematologic malignancies. This evolution underscores the importance of nursing education in this rapidly changing field." TS 10:41 "Radioimmunoconjugates represent an important bridge between traditional oncology treatments and the future of targeted therapies. Oncology nurses play a vital role in ensuring safe delivery, patient understanding, and collaboration between multidisciplinary teams. So, it's very important to educate and also stay up to date on evidence-based practices." TS 13:12

Medication calculations are a foundational nursing skill—and one of the most critical for patient safety. From weight-based dosing and IV drip rates to unit conversions and dose adjustments, small calculation errors can have serious consequences. In this episode, we'll break down medication calculations in nursing pharmacology with a clear, practical approach focused on real clinical scenarios. Whether you're building confidence, brushing up for exams, or double-checking bedside math, this discussion reinforces why accuracy, consistency, and critical thinking matter every time a medication is calculated. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

The route of administration can change everything about how a medication works—from how fast it takes effect to how safe and effective it is for a specific patient. For nurses, choosing and administering the correct route is a critical clinical responsibility that directly affects outcomes. In this episode, we'll explore common routes of administration in nursing pharmacology, including oral, IV, subcutaneous, topical, and inhaled therapies. We'll discuss when and why certain routes are preferred, common pitfalls to avoid, and how nursing judgment plays a key role in safe medication delivery. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Dosage forms are more than just pills and injections—they directly impact how medications work, how quickly they act, and how safely they're used. For nurses, understanding the differences between tablets, liquids, injectables, patches, and modified-release products is critical to proper administration and patient education. In this episode, we'll explore common dosage forms in nursing pharmacology, why they matter, and how choosing—or administering—the wrong form can lead to errors or reduced effectiveness. This discussion connects dosage form basics to real bedside decisions nurses make every day. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Pharmacokinetics explains what the body does to a medication—and for nurses, it's essential to understanding how and why drugs work differently from one patient to the next. Absorption, distribution, metabolism, and excretion all influence onset, duration, and safety of therapy at the bedside. In this episode, we'll break down pharmacokinetics with a nursing lens, tying key concepts to real-world scenarios like renal impairment, IV versus oral dosing, and timing of medication administration. The goal is to make pharmacokinetics practical, approachable, and directly relevant to everyday nursing care. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

This is section 1.3 of the nearly 20-hour Nursing Pharmacology Review Course from Meded101! Enjoy! Pharmacodynamics is the “why” behind what medications do in the body—and for nurses, understanding it is key to safe and effective patient care. From receptor binding and dose–response relationships to therapeutic effects and adverse reactions, pharmacodynamics helps explain how medications produce both benefit and harm. In this episode, we'll break down pharmacodynamics in a practical, nurse-focused way, connecting core concepts to real bedside decisions. Whether you're titrating a medication, monitoring for side effects, or educating patients, this discussion will help you see how pharmacodynamics guides everyday nursing practice. Find access to the review course at meded101.com/nurse

This is section 1.2 of the Nursing Pharmacology Review Course From Meded101. Every medication decision carries ethical weight, and nurses are often at the center of those moments. From advocating for patient autonomy and informed consent to navigating high-risk medications, resource limitations, and end-of-life care, nurses face ethical challenges in pharmacology every day. In this episode, we'll explore the ethical considerations that shape nursing pharmacology practice, including safety, accountability, equity, and professional judgment. Find access to the review course at meded101.com/nurse

This is section 1.1 of the Nursing Pharmacology Review Course From Meded101. Medication management is one of the most powerful ways nurses influence patient outcomes—often in ways that go unseen. From administering medications at the bedside to identifying adverse effects, preventing errors, and advocating for safer therapy, nurses are the final safeguard in the medication-use process. In this episode, we'll explore the critical role nurses play in medication management, including how clinical judgment, patient education, and interprofessional communication come together to improve safety and effectiveness. Whether you're a bedside nurse, nurse leader, or student, this conversation highlights why nursing insight is essential to getting medications right. Find access to the review course at meded101.com/nurse

Support the Institute today. https://givenow.nova.edu/the-institute-for-neuro-immune-medicine-inim-2025   In this episode, Haylie Pomroy speaks with Dr. Theoharis Theoharides about multiple chemical sensitivity (MCS). He explains the immunological responses occurring within the body, the symptoms and daily experiences reported by patients, and the connection between MCS and mast cell activation. Dr. Theoharides also offers expert guidance on managing MCS, explains the diagnostic codes associated with mast cell activation, and emphasizes why blocking mast cells is critical to the healing process. He further discusses how stress can trigger mast cell reactivation, the role of vitamin D3, and why measuring chemical exposures and mycotoxins does not always indicate the absence of ongoing immune reactivation.   Dr. Theoharis Theoharides is a Professor, Vice Chair of Clinical Immunology, and Director at the Institute for Neuro-Immune Medicine-Clearwater, an Adjunct Professor of Immunology at Tufts School of Medicine, where he was a Professor of Pharmacology and Internal Medicine, and also the  Director of Molecular Immunopharmacology & Drug Discovery, and Clinical Pharmacologist at the Massachusetts Drug Formulary Commission (1983-2022). He received his BA, MS, MPhil, PhD, and MD degrees and the Winternitz Price in Pathology from Yale University and received a Certificate in Global Leadership from Tufts Fletcher School of Law and Diplomacy and a Fellowship at Harvard Kennedy  School of Government. He trained in internal medicine at New England Medical Center, which awarded him the Oliver Smith Award, "recognizing excellence, compassion, and service." Dr. Theoharides has 485 publications (46,491 citations; h-index 106), placing him in the world's top 2% of most cited authors, and he was rated the worldwide expert on mast cells by Expertscape. He was inducted into the Alpha Omega Alpha National Medical Honor Society, the Rare Diseases Hall of Fame, and the World Academy of Sciences. Website: https://www.drtheoharides.com LinkedIn: linkedin.com/in/theoharis-theoharides-ms-phd-md-faaaai-67123735 Instagram: https://www.instagram.com/dr.theoharides/   Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.   Learn more about Haylie Pomroy's approach to wellness through her website: https://hayliepomroy.com   Instagram: https://www.instagram.com/hayliepomroy  Facebook: https://www.facebook.com/hayliepomroy  YouTube: https://www.youtube.com/@hayliepomroy/videos  LinkedIn: https://www.linkedin.com/in/hayliepomroy/  X: https://x.com/hayliepomroy    Sign up today for our newsletter. https://nova.us4.list-manage.com/subscribe?u=419072c88a85f355f15ab1257&id=5e03a4de7d    This podcast is brought to you by the Institute for Neuro-Immune Medicine. Learn more about us here.   Website: https://www.nova.edu/nim/ Facebook: https://www.facebook.com/InstituteForNeuroImmuneMedicine Instagram: https://www.instagram.com/NSU_INIM/ Twitter: https://www.twitter.com/NSU_INIM

Estima-se que em torno de 15% da população mundial sofra de enxaqueca, com maior prevalência nas mulheres - e muitos sintomas, tais como aura, além de hipersensibilidade à luz, ao som e ao cheiro... Afinal, o que a ciência tem a dizer sobre o tema?Confira o papo entre o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.>> OUÇA (60min 43s)Convidado: Dr. Fabiano Moulin de MoraesMédico neurologista pela Escola Paulista de Medicina da UNIFESP, onde é preceptor da residência em Neurologia. Membro titular da Academia Brasileira de Neurologia, Professor da Casa do Saber e Especialista em neurologia da cognição e do comportamento. Participou do Naruhodo Entrevista 48.* Naruhodo! é o podcast pra quem tem fome de aprender. Ciência, senso comum, curiosidades, desafios e muito mais. Com o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.Edição: Reginaldo Cursino.http://naruhodo.b9.com.br*APOIO: INSIDERIlustríssima ouvinte, ilustríssimo ouvinte do Naruhodo, janeiro é tempo de recomeços - e o recomeço mais importante é o momento em que acordamos, todos os dias.Afinal, a escolha da manhã muda tudo:- Vestir a roupa de treino assim que acorda — mesmo treinando só à tarde — aumenta a chance de cumprir a meta.- Colocar uma peça inteligente para trabalhar ou criar conteúdo te coloca instantaneamente em modo produtivo e confiante.- Mesmo para ficar em casa, trocar o pijama por um look confortável e bonito muda o humor, a energia e a presença.Ou seja: a Insider entra no seu ritual matinal e acompanha sua rotina com naturalidade.Então use o endereço a seguir pra já ter o cupom NARUHODO aplicado ao seu carrinho de compras: são 10% de desconto, ou 15% de desconto caso seja sua primeira compra.>>> creators.insiderstore.com.br/NARUHODOOu clique no link que está na descrição deste episódio.E bons recomeços pra você!INSIDER: inteligência em cada escolha.#InsiderStore*REFERÊNCIASMigraine Triggers: An Overview of the Pharmacology, Biochemistry, Atmospherics, and Their Effects on Neural Networkshttps://pmc.ncbi.nlm.nih.gov/articles/PMC8088284/Migraine and cognitive dysfunction: a narrative reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11657937/Structural and Functional Brain Changes in Migrainehttps://pmc.ncbi.nlm.nih.gov/articles/PMC8119592/Migraine: Multiple Processes, Complex Pathophysiologyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC4412887/Migraine management: Non-pharmacological points for patients and health care professionalshttps://www.degruyterbrill.com/document/doi/10.1515/med-2022-0598/htmlIs there a causal relationship between stress and migraine? Current evidence and implications for managementhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8685490/The Global Burden of Migraine: A 30-Year Trend Review and Future Projections by Age, Sex, Country, and Regionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11751287/Practical issues in the management of sleep, anxiety, and mood disorders in primary headacheshttps://pmc.ncbi.nlm.nih.gov/articles/PMC12221693/Differentiating Visual Symptoms in Retinal Migraine and Migraine With Aura: A Systematic Review of Shared Features, Distinctions, and Clinical Implicationshttps://pmc.ncbi.nlm.nih.gov/articles/PMC12380025/Current Trends in Pediatric Migraine: Clinical Insights and Therapeutic Strategieshttps://pmc.ncbi.nlm.nih.gov/articles/PMC11940401/Migrainehttps://www.nejm.org/doi/10.1056/NEJMra1915327Pratice guideline update summary: Acute treatment of migraine in children and adolescentshttps://www.neurology.org/doi/10.1212/WNL.0000000000008095Migraine aura as an artistic resource https://nah.sen.es/vmfiles/vol13/NAHV13N22025102_115EN.pdfMigraine aura as artistic inspiration.https://pmc.ncbi.nlm.nih.gov/articles/PMC1838881/Migraine as a source of artistic inspirationhttps://neuro.org.br/pdfs/RBN-59/RBN-594-DEZEMBRO/RBN-594-DEZEMBRO.pdf#page=44Migraine and risk of all-cause mortality and specific cause mortality: a systematic review and meta-analysishttps://pmc.ncbi.nlm.nih.gov/articles/PMC12534955/Comparative effects of drug interventions for the acute management of migraine episodes in adults: systematic review and network meta-analysishttps://pmc.ncbi.nlm.nih.gov/articles/PMC11409395/The impacts of migraine on functioning: Results from two qualitative studies of people living with migrainehttps://pmc.ncbi.nlm.nih.gov/articles/PMC10922598/Exploring the Hereditary Nature of Migrainehttps://pmc.ncbi.nlm.nih.gov/articles/PMC8075356/Transient receptor potential melastatin 8 (TRPM8) is required for nitroglycerin and calcitonin gene-related peptide induced migraine-like pain behaviors in micehttps://pmc.ncbi.nlm.nih.gov/articles/PMC9519811/Association between weather conditions and migraine: a systematic review and meta-analysishttps://link.springer.com/article/10.1007/s00415-025-13078-0Evaluation of Green Light Exposure on Headache Frequency and Quality of Life in Migraine Patients: A Preliminary One-way Cross-over Clinical Trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8034831/CGRP — The Next Frontier for Migrainehttps://www.nvvg.nl/files/3306/CGRP%20—%20The%20Next%20Frontier%20for%20Migraine.pdfDigital Media Use in Adolescents with Migraine: A Topical Reviewhttps://link.springer.com/article/10.1007/s11916-025-01444-6Placebo Response in Acute and Prophylactic Treatment of Migrainehttps://www.neurologic.theclinics.com/article/S0733-8619(25)00068-4/abstractCalcitonin Gene–Related Peptide Inhibitors and Cardiovascular Events in Patients With Migrainehttps://www.neurology.org/doi/abs/10.1212/WNL.0000000000214479?casa_token=WccpvEByt0MAAAAA:LKbxQClihNe2WsrHRKBmteHftcUECeozPKYcnSQPjsBA0hlEvKExc2DvBgn-J5WwWyudd3QV1nluWwInsights from triggers and prodromal symptoms on how migraine attacks start: The threshold hypothesishttps://journals.sagepub.com/doi/10.1177/03331024241287224Elucidating the susceptibility genes between insomnia and migraine by integrating genetic data and transcriptomeshttps://link.springer.com/article/10.1186/s10194-025-02249-zThe experience of neck pain in people with migraine: A qualitative studyhttps://www.sciencedirect.com/science/article/pii/S1413355525003922?casa_token=9ct7RuiXWIgAAAAA:Sxlqh2wKO3-2l4ig9hzuXb92eJtttlM1Mdd3EId-5BfNQ2J8kpTn2iCd3tr6a0l58kyqDTDR7wThe impact of pain on memory: a study in chronic low back pain and migraine patients https://academic.oup.com/braincomms/article/8/1/fcaf486/8376909Migraine as a dynamic continuum during the life coursehttps://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00441-7/abstractNaruhodo #447 - O que é AVC e como evitá-lo? #TodosPeloPirullahttps://www.youtube.com/watch?v=vRu9cet1TWMNaruhodo #236 - Por que temos dor de cabeça?https://www.youtube.com/watch?v=q8FtXVlSz1INaruhodo #345 - Por que às vezes sentimos as dores dos outros?https://www.youtube.com/watch?v=mKdMBCqy6XANaruhodo #145 - Por que a cabeça dói quando tomamos gelado?https://www.youtube.com/watch?v=qjq2Ds6YB-cNaruhodo #165 - Quando tomo antidepressivos continuo sendo eu mesmo?https://www.youtube.com/watch?v=dWyfUyHUiA4Naruhodo #62 - Existem doenças psicossomáticas?https://www.youtube.com/watch?v=etuFYdCAKe4Naruhodo #288 - Por que existe a menopausa?https://www.youtube.com/watch?v=3Ewwdi2guWgNaruhodo #339 - Por que as coisas parecem girar quando estamos bêbados?https://www.youtube.com/watch?v=YmK1Yq0mwW8Naruhodo #398 - Jejum intermitente funciona?https://www.youtube.com/watch?v=lTkWGFFkOLo*APOIE O NARUHODO!O Altay e eu temos duas mensagens pra você.A primeira é: muito, muito obrigado pela sua audiência. Sem ela, o Naruhodo sequer teria sentido de existir. Você nos ajuda demais não só quando ouve, mas também quando espalha episódios para familiares, amigos - e, por que não?, inimigos.A segunda mensagem é: existe uma outra forma de apoiar o Naruhodo, a ciência e o pensamento científico - apoiando financeiramente o nosso projeto de podcast semanal independente, que só descansa no recesso do fim de ano.Manter o Naruhodo tem custos e despesas: servidores, domínio, pesquisa, produção, edição, atendimento, tempo... Enfim, muitas coisas para cobrir - e, algumas delas, em dólar.A gente sabe que nem todo mundo pode apoiar financeiramente. E tá tudo bem. Tente mandar um episódio para alguém que você conhece e acha que vai gostar.A gente sabe que alguns podem, mas não mensalmente. E tá tudo bem também. Você pode apoiar quando puder e cancelar quando quiser. O apoio mínimo é de 15 reais e pode ser feito pela plataforma ORELO ou pela plataforma APOIA-SE. Para quem está fora do Brasil, temos até a plataforma PATREON.É isso, gente. Estamos enfrentando um momento importante e você pode ajudar a combater o negacionismo e manter a chama da ciência acesa. Então, fica aqui o nosso convite: apóie o Naruhodo como puder.bit.ly/naruhodo-no-orelo

Improving outcomes for those with the deadliest cancers is ongoing. Trudy G. Oliver, professor in the department of pharmacology and cancer biology at the Duke University School of Medicine, examines a possible new step forward. Trudy G. Oliver, PhD, is a Professor of Pharmacology & Cancer Biology at Duke University and a Duke Science & […]

Paediatric seizures are common, time-critical events and they're something most of us will deal with, whether that's pre-hospital, in the emergency department, or on the ward. They make up around 1–2% of ED attendances, and about 1 in 20 children will have a seizure at some point. Most seizures self-terminate, but the longer they go on the harder they are to stop, and the higher the risk of harm. In paediatric seizures, time really matters. In this episode we take a step-by-step look at how to assess and manage a child who's seizing. We start with the fundamentals; how seizures are defined and classified, what status epilepticus actually means in practice, and why recognising it early makes such a difference. We then dig into the physiology behind seizures, exploring why early benzodiazepines work well and why delayed treatment often doesn't. Understanding what's happening at a receptor level helps make sense of when to escalate treatment and why different drugs work at different stages of a prolonged seizure. Pharmacology is a big part of this episode. We talk through first- and second-line anti-seizure medications, routes of administration, and how effective they really are. We cover the EcLiPSE and ConSEPT trials comparing levetiracetam and phenytoin, and look at newer evidence from the Ket-Mid study and what that might mean for managing refractory status and thinking about RSI. We also work through the approach to cases, pre-hospital management and in-hospital care aligned with UK and European recommendations. There's a clear focus on febrile seizures too, separating simple from complex presentations and helping you decide who needs investigating, admitting, or reassuring and discharging. As ever, the aim is to turn guidelines and evidence into something usable on the shop floor. Paediatric seizures are stressful, but with a structured approach, early treatment, and good airway management, they're absolutely manageable and we can make a real difference on outcomes. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP]Topics included in this episode:Hemodynamic goals and risks during induction in severe aortic stenosis​Limitations and hypotensive effects of propofol in aortic stenosis patients​Pharmacology and potential advantages of cipepofol (ciprofol) as a propofol derivative​Key findings of the JAMA Surgery randomized trial comparing cipepofol vs propofol in severe AS​Practical induction strategies and future implications for managing severe AS patients under anesthesiaARTICLE: Hemodynamic Impact of Cipepofol vs Propofol During Anesthesia Induction in Patients With Severe Aortic Stenosis

Alprazolam is a short-acting benzodiazepine that enhances the inhibitory effects of gamma-aminobutyric acid (GABA) at the GABA-A receptor. Clinically, this results in anxiolytic, sedative, muscle-relaxant, and anticonvulsant effects. After oral administration, alprazolam is rapidly absorbed, with onset of action typically within 30–60 minutes. It undergoes extensive hepatic metabolism primarily via CYP3A4 to inactive metabolites, and has an elimination half-life of approximately 11 hours, which may be prolonged in elderly patients or those with hepatic impairment. Common adverse effects include sedation, dizziness, impaired coordination, and cognitive slowing. More serious risks include respiratory depression, especially when combined with opioids, alcohol, or other CNS depressants. Clinically, alprazolam should be used at the lowest effective dose for the shortest possible duration. Abrupt discontinuation should be avoided; gradual tapering is essential to reduce withdrawal risk. It is a controlled substance that carries the risk of addiction and dependence. 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

On this, our 308th Evolutionary Lens livestream, we discuss glyphosate, Roundup, Monsanto, and how science and the law are done. A benchmark scientific review paper from 2000, which established the safety of glyphosate for humans, has been retracted by the publisher, on the basis that a) the paper did not actually review the available evidence, b) the stated authors did not actually write (much of) the paper, and c) employees of Monsanto, which makes Roundup, cryptically contributed substantively to the paper. This paper never should have been published, and its retraction should prompt the EPA to revamp guidelines for the use of glyphosate. Also: peer review and scientific culture are widely gamed. And: punitive damages to injured plaintiffs, awarded by juries against corporations, are being reduced by appellate courts due to a misapplication of the 14th Amendment.*****Our sponsors:Xlear: Xylitol nasal spray that acts as prophylaxis against respiratory illnesses by reducing the stickiness of bacteria and viruses. Find Xlear online, or at your local pharmacy, grocery store, or natural products store.ARMRA Colostrum is an ancient bioactive whole food that can strengthen your immune system. Go to http://www.tryarmra.com/DARKHORSE to get 30% off your first order.Caraway: Non-toxic, highly functional & beautiful cookware and bakeware. Save with Caraway's cookware set, and visit http://Carawayhome.com/DH10 to for an additional 10% off your next purchase.*****Join us on Locals! Get access to our Discord server, exclusive live streams, live chats for all streams, and early access to many podcasts: https://darkhorse.locals.comHeather's newsletter, Natural Selections (subscribe to get free weekly essays in your inbox): https://naturalselections.substack.comOur book, A Hunter-Gatherer's Guide to the 21st Century, is available everywhere books are sold, including from Amazon: https://amzn.to/3AGANGg (commission earned)Check out our store! Epic tabby, digital book burning, saddle up the dire wolves, and more: https://darkhorsestore.org*****Mentioned in this episode:NYT on glyphosate article retraction: https://www.nytimes.com/2026/01/02/climate/glyphosate-roundup-retracted-study.htmlWilliams, Kroes, and Munro 2000. Safety evaluation and risk assessment of the herbicide Roundup and its active ingredient, glyphosate, for humans. Regulatory Toxicology and Pharmacology, 31(2), pp.117-165:https://www.cbs17.com/wp-content/uploads/sites/29/2019/06/Safety-Evaluation-and-Risk-Assessment-of-the-Herbicide-Roundup-and-its-Active-Ingredient-Glyphosate-for-Humans.pdfRetraction: https://www.sciencedirect.com/science/article/pii/S0273230025002387Journal Aims and Scope: https://www.sciencedirect.com/journal/regulatory-toxicology-and-pharmacology/about/aims-and-scopeJohnson v Monsanto (2018): https://www.wisnerbaum.com/toxic-tort-law/monsanto-roundup-lawsuit/johnson-trial-2018/Support the show

Use code ATCornerStudent to get 10% off your monthly subscription price of ATStudyBuddy, an online BOC exam prep platform built by athletic trainers for athletic training students. ATStudy Buddy gives you realistic practice tests, instant feedback, and over 250 study guides and games—online, affordable, and proven to help you pass. Start your journey today at ⁠ATStudyBuddy.com⁠.Studying for the BOC or just wanting a review of athletic training topics? Tune in as we compare what the book says to real life stories from athletic trainers.--Whether it's using Tums to treat muscle cramps or battling a rash from tape with hydrocortisone, ATs must now the ins and outs of pharmacology. In this BOC IRL episode, ATs share their stories of pharmacology in their practice and how this relates to the textbook.Featuring stories from Emily M, Sarah Y, Kjersten M, Megan M, Maddie E, & many more!AT CORNER FACEBOOK GROUP: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/groups/atcornerpodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram, Website, YouTube, and other links: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠atcornerds.wixsite.com/home/links⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠EMAIL US: atcornerds@gmail.comSAVE on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbridge⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠: Use code ATCORNER to get $101 off your subscriptionWant to host a podcast like ours? Use our link to sign up for Zencastr, the service we use to record our interviews: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://zencastr.com/?via=atcorner⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Music: Jahzzar (betterwithmusic.com) CC BY-SA---Sandy & Randy

Dr. Randy Blakely is a Professor of Biomedical Science at Florida Atlantic University and Executive Director of the Florida Atlantic University Brain Institute. Randy is examining how neurons control neurotransmitter signaling, as well as how medicinal drugs and drugs of abuse impact neurotransmitters. He is interested in how normal neurotransmitter regulation and changes in neurotransmission due to drugs ultimately impact behavior. Randy lives in beautiful South Florida near the Everglades, and he likes to spend is free time enjoying nature and observing the local wildlife. While commuting between campuses, Randy listens to a variety of audiobooks, and he is also a big fan of Americana and folk music. He received his B.A. in Philosophy from Emory University and his Ph.D. in Neuroscience from the Johns Hopkins School of Medicine. He next conducted postdoctoral research at the Yale/Howard Hughes Medical Institute Center for Molecular Neuroscience. Randy was an investigator and faculty member at Emory University and Vanderbilt University before accepting his current position at Florida Atlantic University. Randy is the recipient of numerous awards and honors for his research and mentorship. He was awarded the Daniel Efron Award from the American College of Neuropsychopharmacology, two Distinguished Investigator Awards from the Brain and Behavioral Research Foundation, a MERIT Award from the National Institute of Mental Health, a Zenith Award from the Alzheimer's Association, the Delores C. Shockley Partnership Award in recognition of minority trainee mentorship, as well as the Astellas Award in Translational Pharmacology and the Julius Axelrod Award both from the American Society for Pharmacology and Experimental Therapeutics. In addition, he is a Fellow of the American Academy for the Advancement of Science. Randy joins us in this episode to talk more about his life and science.

"We proposed a concept to the American Society of Clinical Oncology (ASCO), recognizing that extravasation management requires significant interdisciplinary collaboration and rapid action. There can occasionally be uncertainty or lack of clear guidance when an extravasation event occurs, and our objective was to look at this evidence with the expert panel to create a resource to support oncology teams overall. We hope that the guideline can help mitigate harm and improve patient outcomes," Caroline Clark, MSN, APRN, AGCNS-BC, OCN®, EBP-C, director of guidelines and quality at ONS, told Chelsea Backler, MSN, APRN, AGCNS-BC, AOCNS®, VA-BC, oncology clinical specialist at ONS, during a conversation about the ONS/ASCO Guideline on the Management of Antineoplastic Extravasation. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 2, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the management of antineoplastic extravasation. Episode Notes  Complete this evaluation for free NCPD. ONS/ASCO Guideline on the Management of Antineoplastic Extravasation ONS Podcast™ episodes: Episode 391: Pharmacology 101: Antibody–Drug Conjugates Episode 335: Ultrasound-Guided IV Placement in the Oncology Setting Episode 145: Administer Taxane Chemotherapies With Confidence Episode 127: Reduce and Manage Extravasations When Administering Cancer Treatments ONS Voice articles: Access Devices and Central Lines: New Evidence and Innovations Are Changing Practice, but Individual Patient Needs Always Come First New Extravasation Guidelines Provide Recommendations for Protecting Patients and Standardizing Care Standardizing Venous Access Assessment and Validating Safe Chemo Administration Drastically Lowers Rates of Adverse Venous Events This Organization's Program Trains Non-Oncology Nurses to Deliver Antineoplastic Agents Safely ONS books: Access Device Guidelines: Recommendations for Nursing Practice and Education (fourth edition) Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) ONS courses: Complications of Vascular Access Devices (VAD) and IV Therapy ONS Fundamentals of Chemotherapy and Immunotherapy Administration™ ONS Oncology Treatment Modalities Clinical Journal of Oncology Nursing articles: Chemotherapy Extravasation: Incidence of and Factors Associated With Events in a Community Cancer Center Standardized Venous Access Assessment and Safe Chemotherapy Administration to Reduce Adverse Venous Events Oncology Nursing Forum article: Management of Extravasation of Antineoplastic Agents in Patients Undergoing Treatment for Cancer: A Systematic Review ONS huddle cards: Antineoplastic Administration Chemotherapy Immunotherapy Implanted Venous Port ONS position statements: Administration (Infusion and Injection) of Antineoplastic Therapies in the Home Education of the Nurse Who Administers and Cares for the Individual Receiving Antineoplastic Therapies ONS Guidelines™ for Extravasation Management ONS Oncologic Emergencies Learning Library ONS/ASCO Algorithm on the Management of Antineoplastic Extravasation of Vesicant or Irritant With Vesicant Properties in Adults American Society of Clinical Oncology (ASCO) Podcast: Management of Antineoplastic Extravasation: ONS-ASCO Guideline To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "The focus of this guideline was specifically on intravenous antineoplastic extravasation or when a vesicant or an irritant with vesicant properties leaks out of the vascular space. This can cause an injury to the patient that's influenced by several factors including the specific drug that was involved in the extravasation, whether it was DNA binding, how much extravasated, the affected area, and individual patient characteristics." TS 1:48 "The panel identified and ranked outcomes that mattered most with extravasation. Not surprising, one of the first was tissue necrosis. Like, 'How are we going to prevent tissue necrosis and preserve tissue?' The next were pain, quality of life, delays in cancer treatment: How is an extravasation going to delay cancer treatment that's vital to the patient? Is an extravasation also going to result in hospitalization or additional surgical interventions that would be burdensome to the patient? ... We had a systematic review team that then went in and summarized the data, and the panel applied the grading of recommendations, assessment, development, and evaluation (GRADE) criteria, grading quality of evidence and weighing factors like patient preferences, cost, and feasibility of an intervention. From there, they developed their recommendations." TS 7:35 "The panel, from the onset, wanted to make sure we had something visual for our readers to reference. They combined evidence from the systematic review, other scholarly sources, and their real-world clinical experience to make this one-page supplementary algorithm. They wanted it to be comprehensive and easy to follow, and they included not only those acute management steps but also guidance on 'How do I document this and what are the objective and subjective assessment factors to look at? What am I going to tell the patient?' In practice, for use of that, I would compare it to your current processes and identify any gaps to inform policies in your individual organizations." TS 16:34 "The guidelines don't take place of clinician expertise; they're not intended to cover every situation, but a situation that keeps coming up that we should talk about as a limitation, is we're seeing these case reports of tissue injury with antibody–drug conjugate extravasation. There's still not enough evidence to inform care around the use of antidotes with those agents, so this still needs to be addressed on a case-by-case basis. We still need publication of those case studies, what was done, and outcomes to help inform direction." TS 19:24 "Beyond the acute management is to ensure thorough documentation regarding extravasation. Whether you're on electronic documentation or on paper, are the prompts there for the nurse to capture all of the factors that should be captured regarding that extravasation? The size, the measurement, the patient's complaints. Is there redness? Things like that. And then within the teams, everyone should know where to find that initial extravasation assessment so that later on, if they're in a different clinic, they have something to go by to see how the extravasation is healing or progressing. ... I think there's an importance here, too, to our novice oncology nurses and their preceptors. This could be anxiety-provoking for the whole team and the patient, so we want to increase confidence in management. So, I think using these resources for onboarding novice oncology nurses is important." TS 22:34

Pimavanserin is an atypical antipsychotic approved for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis. Unlike traditional antipsychotics, it does not block dopamine receptors, making it a unique option for patients with Parkinson’s disease who are highly sensitive to dopamine antagonism. Mechanism of Action Pimavanserin works primarily as a selective serotonin 5-HT2A inverse agonist and antagonist, with minor activity at 5-HT2C receptors. This dopamine-sparing effect is the key reason it does not worsen motor symptoms in Parkinson’s disease. Adverse Effects The most commonly reported side effects include peripheral edema, nausea, confusion, and hallucinations. QT interval prolongation is a clinically important concern, especially in patients with existing cardiac risk factors. Somnolence may occur but is generally less prominent compared with dopamine-blocking antipsychotics. Warnings and Precautions Pimavanserin carries a boxed warning for increased mortality in elderly patients with dementia-related psychosis, consistent with other antipsychotics. It should not be used in patients with known QT prolongation, a history of ventricular arrhythmias, or in combination with other QT-prolonging agents when possible. Drug Interactions Strong CYP3A4 inhibitors, such as ketoconazole or clarithromycin, can significantly increase pimavanserin concentrations and require dose reduction. Strong CYP3A4 inducers, such as rifampin or carbamazepine, may reduce efficacy and should generally be avoided. Additive QT prolongation may occur when combined with other QT-prolonging medications, including certain antiarrhythmics, fluoroquinolones, and macrolide antibiotics. 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

We bring back our prior pharmacology discussion because it's so incredibly important for the conversations that are on the horizon over the next few weeks. In this continuation of our myeloma series, we begin our discussion about treatment options for multiple myeloma, focusing first on pharmacology. We are so thrilled to have a special guest, Kathryn Maples, PharmD, BCOP who is a clinical pharmacy specialist in Multiple Myeloma at the Winship Cancer Institute of Emory Healthcare in Atlanta, Georgia!Content:- What are common drugs we use in "triplet regimens"? "quadruple therapy"? - What considerations must we take into account when prescribing commonly used medications in myeloma? - How should we counsel our patients? - What about supportive care?- How and when do we make dose adjustments? - This episode is SO eye-opening about the "behind the scenes" of myeloma care that physicians do not seeWant to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

References Nature Neuroscience 2009.volume 12, pages 988–995 The Journal of Pharmacology and Experimental Therapeutics 2023. Volume 385, Supplement 3, June: 343 Alcohol Clin Exp Res. 2016 Sep 1;40(10):2030–2042. PNAS 2013. vol. 110 no. 45 November 5,Rom J Morphol Embryol .2021 Apr-Jun;62(2):553-561Alcohol, 2017-12-01, Volume 65, Pages 51-62Cells 2022, 11(11), 1773;Journal of Neuroscience 17 April 2024, 44 (16) e0918232024;Paige/Plant 1971. Stairway to Heavenhttps://open.spotify.com/track/5CQ30WqJwcep0pYcV4AMNc?si=2c35ff68c11e464fWinwood, S. 1968. Dear Mr. Fantasy Traffichttps://open.spotify.com/track/2pKGqD3UQBAdi0dCLNYR7a?si=dcfb9f099f9d40c0Seeger, P. 1965 Turn Turn Turn. Byrdshttps://open.spotify.com/track/5qBqBdfTEIWJwAS0Jm2F5R?si=ae25a0be1e474d96

"They [monoclonal antibodies] are able to cause tumor cell death by binding to and blocking to necessary growth factor signaling pathways for tumor cell survival. That's going to be dependent on the target of the antibody, but I'll give an example of epidermal growth factor, or EGFR. This is overexpressed in several different kinds of cancers where activation of this growth factor increases the amount of proliferation and migration of cancer cells. So, if we bind to it and block to it, then that would help halt these pathways and stop cancer cell growth," Carissa Ganihong, PharmD, BCOP, oncology and bone marrow transplantation clinical pharmacist at Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about monoclonal antibodies. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD) (including 45 minutes of pharmacotherapeutic content) by listening to the full recording and completing an evaluation at courses.ons.org by December 26, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge in the history of, the mechanism of action of, and the use of monoclonal antibodies in the treatment of cancer.  Episode Notes  Complete this evaluation for free NCPD. ONS Podcast™ episodes: Pharmacology 101 series Episode 391: Pharmacology 101: Antibody–Drug Conjugates Episode 383: Pharmacology 101: Bispecific Antibodies Episode 375: Pharmacology 101: VEGF Inhibitors Episode 338: High-Volume Subcutaneous Injections: The Oncology Nurse's Role Episode 283: Desensitization Strategies to Reintroduce Treatment After an Infusion-Related Reaction Episode 275: Bispecific Monoclonal Antibodies in Hematologic Cancers and Solid Tumors ONS Voice articles: An Oncology Nursing Overview of Biosimilars Make Subcutaneous Administration More Comfortable for Your Patients Oncology Nurses' Role in Translating Biomarker Testing Results Reduce Chair Time by as Much as 16 Minutes by Priming IVs With Drug Shorter Administration Times Still Require High-Acuity Care The Names of Targeted Therapies Give Clues to How They Work ONS Voice drug reference sheets: Datopotamab deruxtecan-dlnk Enfortumab vedotin Margetuximab-cmkb Mirvetuximab soravtansine-gynx Nivolumab and hyaluronidase-nvhy Nivolumab and relatlimab-rmbw Pembrolizumab and berahyaluronidase alfa-pmph Retifanlimab-dlwr ONS book: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) ONS course: ONS Fundamentals of Chemotherapy and Immunotherapy Administration™ Clinical Journal of Oncology Nursing articles: Bolusing IV Administration Sets With Monoclonal Antibodies Reduces Cost and Chair Time: A Randomized Controlled Trial Management of Immunotherapy Infusion Reactions Nurse-Led Grading of Antineoplastic Infusion-Related Reactions: A Call to Action Safety and Adverse Event Management of VEGFR-TKIs in Patients With Metastatic Renal Cell Carcinoma Oncology Nursing Forum articles: Administration of Subcutaneous Monoclonal Antibodies in Patients With Cancer Depressive Symptoms and Quality of Life Associated With the Use of Monoclonal Antibodies in Breast Cancer Treatment ONS huddle cards: Bispecifics Checkpoint Inhibitors Monoclonal Antibodies Other ONS resources: Biomarker Database Bispecific Antibodies video Patient Education Sheets Antibodies article: A Comprehensive Review About the Use of Monoclonal Antibodies in Cancer Therapy Cureus article:  A Comprehensive Review of Monoclonal Antibodies in Modern Medicine: Tracing the Evolution of a Revolutionary Therapeutic Approach Association of Cancer Care Centers (ACCC) homepage Cancer Immunology, Immunotherapy article: Therapeutic Antibodies in Oncology: An Immunopharmacological Overview Drugs@FDA package inserts Future Oncology article: Biosimilars: What the Oncologist Should Know Hematology/Oncology Pharmacy Association homepage National Comprehensive Cancer Network homepage Network for Collaborative Oncology Development and Advancement (NCODA) subcutaneous therapy article Oncolink: Side Effects of Immunotherapy World Health Organization: New International Nonproprietary Names (INN) Monoclonal Antibody Nomenclature Scheme To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Prior to monoclonal antibodies, all we really had were these toxic chemotherapies or toxic radiation, so it was recognized how great it would be if we could have a treatment that was much more specific to the tumor cells and have agents that have less toxicities. These advancements in monoclonal antibody production began in the 1980s. ... Eventually, we had the first monoclonal antibody that was approved by the U.S. Food and Drug Administration (FDA) for an oncologic indication, rituximab." TS 4:14  "Nowadays, we do have treatments that are also considered tumor-agnostic. This is when a patient has a certain biomarker, then that treatment can be given and FDA approval was given, regardless what type of tumor the patient has. We typically see these kinds of tumor-agnostic therapies more so in patients who have recurrent or advanced diseases in solid tumors. One monoclonal antibody example that comes to mind is dostarlimab. That's a checkpoint inhibitor that's approved for patients who are deficient in mismatch repair mechanism." TS 23:48 "Our immune system constantly has this surveillance system and it's able to recognize foreign pathogens, abnormal cells, and even precancerous cells. And they're able to eliminate them before they become cancerous. But on the flip side, one of the regulatory mechanisms that we have so our immune system doesn't attack itself is the presence of checkpoints. When these checkpoints bind to their ligands, this can then act as an off switch so that, again, our immune system is not going to attack itself. But then the tumor cells can take advantage of this and actually use this mechanism to evade the immune system. So, when we're giving a checkpoint inhibitor, now we're removing that off switch. As a consequence, common adverse effects can include things like immune mediated adverse events. These most commonly affect the skin, gastrointestinal tract, and liver. Essentially, this can cause any '-itis' you can think of." TS 26:36 "Looking at strategies to prevent infusion reactions, one example is the use of premedication. If premedication is recommended, this typically includes any combination of antipyretics, which is typically acetaminophen. Antihistamine, which is typically an H1 antagonist like diphenhydramine. Although, there could be cases where we want to substitute this agent because maybe the patient has been tolerating therapy okay, and they're having a lot of side effects. So, we might use a second-generation antihistamine in some cases. The premedication may be given with or without some kind of steroid, whether that's methylprednisolone, hydrocortisone, or dexamethasone." TS 29:53 "We tend to think of monoclonal antibody usage to be primary oncology, but that's not really the case. The first monoclonal antibodies that were developed were not for oncologic indications, they were for transplant indication for cardiac indication. So, they're really diversely utilized across all specialties and medicines. We have monoclonal antibodies for hyperlipidemia, for neurology, for rheumatology, so the uses are so very expansive across all specialties." TS 41:01

We bring back our prior pharmacology discussion because it's so incredibly important for the conversations that are on the horizon over the next few weeks. In this continuation of our myeloma series, we begin our discussion about treatment options for multiple myeloma, focusing first on pharmacology. We are so thrilled to have a special guest, Kathryn Maples, PharmD, BCOP who is a clinical pharmacy specialist in Multiple Myeloma at the Winship Cancer Institute of Emory Healthcare in Atlanta, Georgia!Content:- What are common drugs we use in "triplet regimens"? "quadruple therapy"? - What considerations must we take into account when prescribing commonly used medications in myeloma? - How should we counsel our patients? - What about supportive care?- How and when do we make dose adjustments? - This episode is SO eye-opening about the "behind the scenes" of myeloma care that physicians do not seeWant to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Support the Institute today: https://givenow.nova.edu/the-institute-for-neuro-immune-medicine-inim-2025   In this episode, Haylie Pomroy speaks with Dr. Theoharis Theoharides about the scientific foundations of brain fog. Together, they clarify its definition, physiological mechanisms, and how it presents across various illnesses and cognitive disorders. Dr. Theoharides further examines the relationship between brain fog and inflammation, explains how viral infections can contribute to the development of chronic illness, and discusses the role of microglia in neuroinflammation. He also reviews supplements that may help inhibit microglial activation, explains alpha-gal syndrome, and outlines relevant laboratory testing that can assist individuals experiencing brain fog in gaining clearer insight into their current health status. Dr. Theoharis Theoharides is a Professor, Vice Chair of Clinical Immunology, and Director at the Institute for Neuro-Immune Medicine-Clearwater, an Adjunct Professor of Immunology at Tufts School of Medicine, where he was a Professor of Pharmacology and Internal Medicine, and also the  Director of Molecular Immunopharmacology & Drug Discovery, and Clinical Pharmacologist at the Massachusetts Drug Formulary Commission (1983-2022). He received his BA, MS, MPhil, PhD, and MD degrees and the Winternitz Price in Pathology from Yale University and received a Certificate in Global Leadership from Tufts Fletcher School of Law and Diplomacy and a Fellowship at Harvard Kennedy  School of Government. He trained in internal medicine at New England Medical Center, which awarded him the Oliver Smith Award, "recognizing excellence, compassion, and service." Dr. Theoharides has 485 publications (46,491 citations; h-index 106), placing him in the world's top 2% of most cited authors, and he was rated the worldwide expert on mast cells by Expertscape. He was inducted into the Alpha Omega Alpha National Medical Honor Society, the Rare Diseases Hall of Fame, and the World Academy of Sciences. Website: https://www.drtheoharides.com LinkedIn: linkedin.com/in/theoharis-theoharides-ms-phd-md-faaaai-67123735 Instagram: https://www.instagram.com/dr.theoharides/   Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.   Learn more about Haylie Pomroy's approach to wellness through her website: https://hayliepomroy.com   Instagram: https://www.instagram.com/hayliepomroy  Facebook: https://www.facebook.com/hayliepomroy  YouTube: https://www.youtube.com/@hayliepomroy/videos  LinkedIn: https://www.linkedin.com/in/hayliepomroy/  X: https://x.com/hayliepomroy    Enjoy our show? Please leave us a 5-star review on the following platforms so we can bring hope and help to others.   Apple Podcasts: https://podcasts.apple.com/us/podcast/hope-and-help-for-fatigue-chronic-illness/id1724900423 Spotify: https://open.spotify.com/show/154isuc02GnkPEPlWfdXMT   Sign up today for our newsletter. https://nova.us4.list-manage.com/subscribe?u=419072c88a85f355f15ab1257&id=5e03a4de7d   Enjoy our show? Please leave us a 5-star review on the following platforms so we can bring hope and help to others.   Apple Podcasts: https://podcasts.apple.com/us/podcast/hope-and-help-for-fatigue-chronic-illness/id1724900423   Spotify: https://open.spotify.com/show/154isuc02GnkPEPlWfdXMT   Sign up today for our newsletter. https://nova.us4.list-manage.com/subscribe?u=419072c88a85f355f15ab1257&id=5e03a4de7d   This podcast is brought to you by the Institute for Neuro-Immune Medicine. Learn more about us here.   Website: https://www.nova.edu/nim/ Facebook: https://www.facebook.com/InstituteForNeuroImmuneMedicine Instagram: https://www.instagram.com/NSU_INIM/ Twitter: https://www.twitter.com/NSU_INIM

In this special edition on Adherence to Medications our host, Dr. Neil Skolnik will discuss medication adherence and the role of clinicians, pharmacies and pharmacists in helping with medication adherence. This special episode is supported by an independent educational grant from Amazon. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Susan Kuchera, M.D. - Clinical Assistant Professor of Family and Community Medicine at the Sidney Kimmel Medical College of Thomas Jefferson University and Program Director of the Family Medicine Residency at Jefferson Health Abington. Tess Carey, PharmD, Clinical Advisor for Amazon Pharmacy  Selected references: Better Medications Adherence Lowers Cardiovascular Events, Stroke, and All-Cause Mortality Risk: A Dose-Response Meta-Analysis. Journal of Cardiovascular Development and Disease. 2021, 8, 146. Adherence to antihypertensive medications for secondary prevention of cardiovascular disease events: a dose-response meta-analysis. Public Health 196 (2021) 179e185 Medication nonadherence - definition, measurement, prevalence, and causes: reflecting on the past 20 years and looking forwards. Frontiers in Pharmacology, March 2025. DOI 10.3389/fphar.2025.1465059  

"I'll go back to the backpack analogy. When your kids come home with a backpack, all of a sudden their homework is not on the desk where it's supposed to be. It's in the kitchen; it kind of spreads all over the place, but it's still in the house. When we give antibody–drug conjugates (ADCs), the chemotherapy does go in, but then it can kind of permeate out of the cell membrane and something right next to it—another cancer cell that might not look exactly like the cancer cell that the chemotherapy was delivered into—is affected and the chemotherapy goes over to that cancer cell and kills it," ONS member Marisha Pasteris, OCN®, office practice nurse in the breast medicine service at Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about ADCs in metastatic breast cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  This podcast is sponsored by Gilead and is not eligible for NCPD contact hours. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications.  Episode Notes  This episode is not eligible for NCPD. ONS Podcast™ episodes: Episode 391: Pharmacology 101: Antibody–Drug Conjugates Episode 378: Considerations for Adolescent and Young Adult Patients With Metastatic Breast Cancer Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer Episode 350: Breast Cancer Treatment Considerations for Nurses Episode 303: Cancer Symptom Management Basics: Ocular Toxicities ONS Voice articles: An Oncology Nurse's Guide to Cancer-Related Ocular Toxicities Black Patients With Metastatic Breast Cancer Are Less Informed About Their Clinical Trial Options Communication Case Study: Talking to Patients About Progressive Metastatic Breast Cancer What Is HER2-Low Breast Cancer? ONS Voice drug reference sheets: Belantamab mafodotin-blmf Datopotamab deruxtecan-dlnk Enfortumab vedotin-ejfv Fam-trastuzumab deruxtecan-nxki ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Guide to Breast Care for Oncology Nurses Guide to Cancer Immunotherapy (second edition) ONS courses: ONS Fundamentals of Chemotherapy and Immunotherapy Administration™ ONS/ONCC® Chemotherapy Immunotherapy Certificate™ Clinical Journal of Oncology Nursing article: Antibody–Drug Conjugates and Ocular Toxicity: Nursing, Patient, and Organizational Implications for Care The Association Between Hormone Receptor Status and End-of-Life Care Among Patients With Metastatic Breast Cancer Oncology Nursing Forum article: Impact of Race and Area Deprivation on Triple-Negative Metastatic Breast Cancer Outcomes ONS huddle cards: Altered Body Image Huddle Card Chemotherapy Huddle Card Targeted Therapy Huddle Card Foundations of Antibody–Drug Conjugate Use in Metastatic Breast Cancer: A Case Study ONS Biomarker Database (refine by breast cancer) ONS Breast Cancer Learning Library American Society of Clinical Oncology (ASCO) homepage Drugs@FDA package inserts National Comprehensive Cancer Network homepage Susan G. Komen metastatic breast cancer page To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "What an ADC is doing is taking the antibody and linking it to a cytotoxic chemotherapy with the idea of delivering it directly into the cell. How I explain this to new nurses or patients is a backpack analogy. If we think of it as a HER2 molecule wearing a chemo backpack, it's going to find the HER2 receptor attached to it and then drop the chemotherapy into the cell via the backpack. Similar to how we come home from work, we open the key to our door, we're carrying all of our items, and then we drop our own personal items in our house." TS 2:30 "The reason that so many patients with metastatic breast cancer are able to receive ADC therapy is because they are targeting two very common antibodies that we see in breast cancer. One is HER2 and the other is trophoblast cell surface antigen 2 (TROP2). These are seen across the board. We see these on triple-negative breast cancers, hormone receptor–positive cancers, and HER2-positive breast cancers. And now we have a new way to talk about HER2, which is a HER2-low. ... Recently, we have found that patients who express low levels of HER2 are able to receive ADC therapy, specifically fam-trastuzumab deruxtecan." TS 4:21 "Another [ADC] that has just been approved is datopotamab deruxtecan. This is another ADC that targets the TROP2 receptor on a cancer cell. This one carries a lot of side effects. I mentioned earlier that you need an ophthalmology clearance because there is a lot of ocular toxicity around this one. We see a lot of blepharitis, conjunctivitis, there can be blurred vision. Another thing we monitor on this one is mucositis. In the package insert, there's a recommendation for using ice chips while receiving the treatment. ... Then in the HER2-positive and HER2-low space is the big one, which is fam-trastuzumab deruxtecan. This was approved in 2019 for the HER2-positive patients, then more recently in the HER2-low [patients]. The big [side effect] with this one is interstitial lung disease." TS 10:11 "Interstitial lung disease is an inflammation or a little bit of fibrosis within the lung that causes an impaired exchange between the oxygen and carbon dioxide. This was seen in the clinical trials, specifically around fam-trastuzumab deruxtecan. During the trials, they had a very small percentage, I think it was 1%, that died due to interstitial lung disease. So, this is a very important side effect for us as nurses to be aware of. It typically presents in patients like a dyspnea. A lot of times, it's like, 'Well, I used to be able to walk my kid to the bus stop, but now when I walk there, I feel really short of breath.' Or 'I've had this dry cough for the past couple weeks and I've tried medications, but haven't had that relieved.' So, we really need to be aware of that because early intervention in interstitial lung disease is key." TS 12:57 "ADCs are toxic drugs. They have the benefit of being targeted, but we know that they carry a lot of side effects. ... Their specificity makes them so wonderful and we've seen amazing responses to these drugs. But also, we want patients to be safe. We want to give these drugs safely. So, we have to assess our patients and make sure that this is an appropriate patient to give this therapy to. I think that's an open conversation that clinicians need to have with patients regarding these drugs." TS 18:08

Moxifloxacin is a fourth-generation fluoroquinolone that works by inhibiting bacterial DNA gyrase and topoisomerase IV—two enzymes essential for DNA replication, repair, and transcription. By blocking both targets, it provides broad-spectrum activity against gram-positive, gram-negative, and atypical pathogens. Its enhanced gram-positive coverage, especially against Streptococcus pneumoniae, distinguishes it from earlier fluoroquinolones like ciprofloxacin. Pharmacokinetically, moxifloxacin has excellent oral bioavailability, meaning the PO and IV doses are essentially interchangeable. It distributes well into tissues like the lungs and sinuses, making it a frequent choice for respiratory infections. With a long half-life of about 12 hours, once-daily dosing is standard. Adverse effects are similar to the fluoroquinolone class, with concerns including tendonitis and tendon rupture, QT interval prolongation, CNS effects like confusion or agitation—particularly in older adults—and the risk of peripheral neuropathy. Moxifloxacin is especially notable for a higher propensity toward QT prolongation compared with some of its peers, making it important to avoid in patients with existing QT issues or those taking other QT-prolonging medications. 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

On this episode of the Real Life Pharmacology Podcast, I cover albuterol pharmacology, adverse effects, and a rare indication for this classic respiratory medication. Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that works by stimulating beta-2 receptors in the bronchial smooth muscle. This stimulation activates adenylate cyclase, increases cyclic AMP, and leads to relaxation of airway smooth muscle. The end result is rapid bronchodilation, making albuterol effective for quick relief of acute bronchospasm in conditions such as asthma and COPD. Common adverse effects occur due to both beta-2 and some unintended beta-1 receptor stimulation. Patients may experience tremors, nervousness, headache, or tachycardia. Higher doses or frequent use can lead to hypokalemia because beta-2 stimulation drives potassium into cells. Some individuals may also report palpitations or feelings of anxiety. These effects are generally mild and transient but can be more pronounced in older adults, those with cardiovascular disease, or when albuterol is used excessively. Albuterol has several clinically relevant drug interactions. Concomitant use with non-selective beta-blockers (such as propranolol) can blunt its bronchodilatory effect and may precipitate bronchospasm in susceptible individuals. Using albuterol with other sympathomimetics can enhance cardiovascular stimulation, increasing the risk of tachycardia or hypertension. Diuretics, especially loop or thiazide types, may compound albuterol-induced hypokalemia. Additionally, monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants can potentiate the effects of albuterol and increase the risk of cardiovascular adverse reactions. 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

When you're preparing for your NP certification exam, pharmacology questions can feel overwhelming with all the drug names, interactions, and clinical scenarios to remember.   In this episode, our content guru Courtney and I tackle this challenge head-on with a rapid-fire pharmacology Q&A session that mirrors the fast-paced nature of the actual exam. The format gives you a chance to quiz yourself alongside Courtney, building confidence through repetition of key concepts.    Get full show notes, transcript, and more information here: https://blog.npreviews.com/np-exam-pharmacology-lightning-session-courtney-h    Follow us on Instagram: instagram.com/smnpreviewsofficial

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.