Real Life Pharmacology - Pharmacology Education for Health Care Professionals

In this episode, we explore four unique antidepressants that do not fit neatly into the traditional SSRI or SNRI categories: trazodone, nefazodone, vilazodone, and vortioxetine. Trazodone and nefazodone are classified as serotonin antagonist and reuptake inhibitors (SARIs), working primarily through blockade of 5-HT2 receptors while also inhibiting serotonin reuptake. Trazodone’s strong antihistamine and alpha-1 blocking properties make it highly sedating and commonly used off-label for insomnia, whereas nefazodone causes less sedation but is rarely prescribed today because of its association with severe and potentially fatal liver toxicity. Both agents are notable for producing less sexual dysfunction than many traditional SSRIs.

We also discuss two newer multimodal antidepressants: vilazodone (Viibryd) and vortioxetine (Trintellix). Vilazodone combines serotonin reuptake inhibition with partial agonism at the 5-HT1A receptor, a mechanism often compared to combining an SSRI with buspirone. Vortioxetine has an even more complex pharmacology, acting as a serotonin reuptake inhibitor while modulating multiple serotonin receptor subtypes through agonist, partial agonist, and antagonist actions. This multimodal activity may contribute to benefits in cognitive symptoms associated with major depressive disorder. Throughout the episode, we compare receptor pharmacology, clinical applications, adverse effect profiles, and the unique characteristics that distinguish these medications from more commonly prescribed antidepressants.

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

In this section, I educate about the most common ICU sedation medications.

You can find the full 16+ hour nursing pharmacology review course, including PDF handouts, cheat sheets, practice questions, and on-demand videos at meded101.com!

Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressants that increase serotonin and norepinephrine levels in the brain. Common agents include venlafaxine (Effexor XR), desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and milnacipran (Savella). In addition to treating depression and anxiety disorders, several SNRIs have important pain indications, making them especially useful in patients with neuropathy, fibromyalgia, or chronic musculoskeletal pain. Common adverse effects include nausea, sweating, insomnia, sexual dysfunction, and elevated blood pressure. Clinicians should also remember the significant discontinuation risk associated with shorter half-life agents like venlafaxine and desvenlafaxine.

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

Human Immunodeficiency Virus, or HIV, remains one of the most important infectious diseases in modern healthcare, but advances in antiretroviral therapy have transformed it from a fatal diagnosis into a manageable chronic condition for many patients. In this episode, we’ll break down the major medication classes used to treat HIV, discuss how these drugs work, review key adverse effects and drug interactions, and highlight practical nursing considerations that impact patient safety and adherence. Whether you work in acute care, outpatient practice, long-term care, or public health, understanding HIV pharmacology is essential to providing compassionate, evidence-based care for patients living with HIV and AIDS.

You can find the full 16+ hour nursing pharmacology review course, including PDF handouts, cheat sheets, practice questions, and on-demand videos at meded101.com!

Mirtazapine is a unique antidepressant often chosen when depression occurs alongside insomnia or poor appetite. Its antihistamine activity makes it sedating, particularly at lower doses, and it commonly increases appetite and weight. Unlike many SSRIs, mirtazapine has a lower risk of sexual dysfunction and gastrointestinal side effects because it blocks 5-HT2 and 5-HT3 receptors. It is frequently dosed at bedtime and can be especially useful in older adults or medically ill patients who need both mood improvement and help with sleep or weight gain.

Bupropion is an activating antidepressant that works by increasing norepinephrine and dopamine activity rather than serotonin. It is often preferred in patients with fatigue, low motivation, hypersomnia, or concerns about sexual dysfunction and weight gain. Bupropion is also approved for smoking cessation. Common adverse effects include insomnia, anxiety, dry mouth, and headache. A major clinical pearl is its dose-related seizure risk, making it contraindicated in patients with seizure disorders or eating disorders such as anorexia nervosa or bulimia.

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