Brexpiprazole (Rexulti) Pharmacology Podcast

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 8 December 2022

⏱️ 16 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Brexpiprazole (Rexulti) is a second generation antipsychotic. I discuss its pharmacology, adverse effects, drug interactions, and more in this podcast episode.

I like to associate brexpiprazole with aripiprazole. They have a lot of overlapping characteristics, particularly in relation to the adverse effect profile.

Brexpiprazole tends to have a low incidence of metabolic adverse effects which makes it a nice selection for patients who have diabetes, hypercholesterolemia, or who are overweight.

CYP3A4 and CYP2D6 are the two primary enzymes that break down brexpiprazole. I discuss the pharmacogenomic considerations associated with this medication.

Transcript

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0:00.0	Hey all, welcome back to the Real Life Pharmacology podcast. I'm your host pharmacist, Derek Christensen.
0:05.7	Thank you so much for listening today. Head on over to real life pharmacology.com. We've got that
0:12.1	free 31 page PDF. It is a study guide on the top 200 drugs. No-brainer, just simply an email. We will get you access to that. Great if you're taking
0:24.0	board exams or going through pharmacology classes or just want a refresher and you're out in clinical
0:29.2	practice. So again, go check that out. RealLife Pharmacology.com. If you subscribe there with simply an
0:35.8	email, you'll get access to that free resource.
0:40.1	All right, let's get into the drug of the day today, and this is by request.
0:45.7	The drug is Brexpiprosol.
0:48.9	Brand name of this medication is Rexalti, and this medication is a second generation antipsychotic so from a mechanism of action
1:00.1	standpoint understand that antipsychotics will have action on dopamine receptors and specifically
1:08.5	dopamine two receptors.
1:12.0	Now, Brexprizol varies a little bit compared to most traditional antipsychotics in its mechanism of action.
1:21.7	So it is a partial agonist or has partial agonist activity for serotonin 1A receptors.
1:33.2	In addition, it's got partial agonist activity to those D2 receptors.
1:39.7	So again, this is agonist activity.
1:42.1	So partial agonist activity means so partial agonist activity,
1:48.1	means it stimulates that receptor to a certain extent, but also prevents or can help reduce the action of full agonist on those dopamine receptors.
2:00.0	So it can kind of limit the activity in being a partial agonist.
2:06.1	It also has some antagonist activity at 5HT2A receptors.
2:12.6	Again, 5HT stands for serotonin.
2:16.8	Just kind of another way to abbreviate that.
2:19.5	So if you see that in the literature, that's what that's referring to.
	...

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