Tadalafil gehört zur Gruppe der PDE5-Hemmer und wirkt über eine hochselektive Blockade des Enzyms Phosphodiesterase Typ 5. Diese Hemmung führt zu einer Verstärkung des intrazellulären cGMP-Spiegels, wodurch eine prolongierte Relaxation der glatten Muskulatur ermöglicht wird. Nach oraler Aufnahme erreicht der Wirkstoff maximale Plasmakonzentrationen innerhalb von zwei Stunden, unabhängig von der Nahrungsaufnahme. Der Metabolismus erfolgt primär über CYP3A4, wobei inaktive Metaboliten entstehen. Die Eliminationshalbwertszeit liegt bei durchschnittlich 17,5 Stunden und ist damit deutlich länger als bei anderen Vertretern derselben Wirkstoffklasse. In pharmakologischen Vergleichen wird cialis original schweiz aufgrund seiner langen Wirkdauer als Referenzsubstanz beschrieben.
Microsoft word - colon_osmo-prep.080111.doc
DIGESTIVE ASSOCIATES OF HOUSTON, PA
Isaac Raijman, MD Dang M Nguyen, MD H. Chami Amaratunge, MD
COLONOSCOPY PREPARATION WITH OSMO-PREP ® TABLETS
The following are the instructions that you will need to follow prior to your colonoscopy. Please try to follow them as closely as possible to ensure a successful procedure. It is possible that you may feel abdominal cramping, rectal discomfort, some rectal bleeding, tiredness, and headaches during the preparation. Should any of these symptoms be significant or you have concerns about them, please do not hesitate to contact us at 713-795-4444. Failure to take this preparation as indicated below may result in a poorly cleansed colon and possible cancellation of the procedure. You will need: - Prescription for 32 tablets of Osmo-Prep®
- 4 tablets of Dulcolax ® (bisacodyl) - available over-the-counter at any drug/grocery store.
At least 5 days ahead, stop the following medications. You may take Tylenol if it is necessary. - NSAIDS: Aspirin, Advil/ Ibuprofen/Motrin, Aleve/Anaprox/Naproxe/Naprelan, Celebrex. - Blood thinners: Coumadin/Warfarin, Heparin, Plavix/Clopidogrel, Ticlid/Ticlopidine, Lovenox/Enoxaparin. - Any iron or multi-vitamins (with iron) products. ONE DAY before your procedure: * Start on a CLEAR liquid diet and continue clear liquids throughout the day. Solid foods, milk, or milk product are NOT allowed!!! * Clear Liquids include (not the red or purple kind): Water, Jell-O, Gatorade, apple juice, white grape juice, clear broth, soda (any, but NO cream sodas), bouillon, coffee without cream (sugar is OK), tea, popsicles, NO alcohol!!
THE DAY before your procedure: Follow this regimen: At 4 PM, start taking Osmo-Prep ® tablets EVERY 15 MINUTES with at least 8 ounces of any clear liquid.
==========================================
9:45 p.m.: 4 tablets of Dulcolax (generic: Bisacodyl) with 8 ounces of any clear liquid
• Medications: You may take important medications (such as heart, blood pressure, thyroid or a seizure
disorder etc.) with a small sip of water on the morning of your procedure. If you are a diabetic, DO
NOT take your diabetic medications on the morning of
your procedure. Routine medications with the
exception of blood thinning medications may be taken when you get home. Insulin should not be taken
• Transportation: Since a colonoscopy involves some anesthesia/sedation, you MUST have someone drive
you home and stay with you during the following 4-6 hours (NO TAXI DRIVERS). They should also remain in the facility during your procedure so the physician may speak with them once you are in recovery.
Results: The medical assistant will notify you in the mail regarding your biopsy result (if taken) within 10 business days. We appreciate your efforts in helping us to help you. All of us at Digestive Associates of Houston, P.A. thank you and wish you well.
Wyeth v. Levine : What Does It Mean for Risk Management and Risk Communication? Geoffrey Levitt Chief Regulatory Counsel Wyeth n Summary of Levine n The “Newly Acquired Information” Standard n FDA Interactions n CBE/sNDA Practices The Levine Decision: Summary of Key Elements n Patient received IV push injection of phenergan to treat nausea