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.

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Richard Senyszyn MD
ADHD Medication Management Plan
Date: __________________________________________ To the family of __________________________________________ , please refer to this plan between visits if you have questions about care. If you are stil unsure, cal us at _______________________ for assistance. Patient _____________________________________ 's doctor is ________________________________________ Pager # __________________________________ Parent/Guardian ______________________________________________ Relationship _____________________ Contact Number(s) ____________________________________________________________________________ School Name _________________________________________________________________________________ School Phone # __________________________ Fax # __________________________ Key Teacher Contact Name _________________________________________________ Grade _______________ Teacher's E-mail Address ________________________________________________________________________ Goals What improvements would you most like to see? Specific behavior you would like to see improve:
1. __________________________________________________________________________________________ 2. __________________________________________________________________________________________ 3. __________________________________________________________________________________________ Plans to reach these goals:
1. __________________________________________________________________________________________ 2. __________________________________________________________________________________________ 3. __________________________________________________________________________________________ Richard Senyszyn MD

Medication
1. _______________________ Time __________ am/pm Time __________am/pm
2. _______________________ Time __________ am/pm Time __________am/pm
☐ Medication to be given on nonschool days
☐ School authorization signed by parent and MD
☐ Side effects explained/information given
☐ Medication given for _______ number of days
☐ RX written for duplicate bottle for administration at school
Common Side Effects: Decreased appetite, sleep problems, transient stomachache, transient headache, behavioral rebound;
atomoxetine (Strattera): sediation or insomnia, stomach upset, slight increase in blood pressure; alpha-2 agonists (lntuniv,
Kapray): sedation or drowsiness, dry mouth, decreased appetite, rebound hypertension
Call your doctor Immediately If any Infrequent side effects occur: Weight loss, increased heart rate and/or blood pressure,
dizziness, growth suppression, hallucinations/mania, exacerbation of tics and Tourette syndrome (rare); atomoxetine
(Strattera): liver failure (rare), suicidal thoughts Further Evaluation
☐ School testing scheduled
Date _______________________________________________________ Completed __________________________________________________ Additional Resources and Treatment Strategies
☐ Follow-up Parent Vanderbilt given
Completed __________________________________________________ ☐ Follow-up Teacher Vanderbilt given to parent ☐ Follow-up Teacher Vanderbilt faxed to school Completed _______ ☐ Behavioral modification counseling referral to ______________________________________________________ ☐ Parenting tips sheet given ☐ CHADD phone number given: 800/233-4050 ☐ Community resources/referrals: _________________________________________________________________ __________________________________________________________________________________________ Next Follow-up Visit: ___________________________________________________________________________

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