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 - pregnancy discomforts.doc

• Calcium and magnesium imbalance, sodium deficiency • Pressure from enlarged uterus on leg nerves, slower circulation Self-help
• Magnesium supplementation (especial y in the 2nd trimester), Mag Phos cel salts • Regular, appropriate exercise routine (calf flexing, foot circles) • Avoid tea, coffee and chocolate, which interfere with calcium absorption
Back Pain
• Posture and centre of gravity changes due to increasing size of baby • Relaxing of ligaments and joints due to hormonal output Self-help
• Massage • Focus on maintaining good posture • Exercise and stretching (yoga or pilates), pelvic rocking on al fours • Support lower back (e.g. pil ows under bel y and between knees when sleeping) • Consult physiotherapist
Heartburn
• Softening effect of progesterone on the digestive tract causes relaxation of the sphincter muscle between stomach and oesophagus al owing reflux of digestive acids • Relaxation of smooth muscle of the colon leads to increased transit time, which gives rise to • Often associated with dietary stresses (i.e. food intolerance and food combining) Self-help
• Eat frequent smal meals, eat slowly in an upright position and chew wel • Reduce intake of foods containing yeast (e.g. bread) • Use digestive aid after meals (e.g. peppermint, spearmint, fennel, lemon balm, chamomile or aniseed teas, papaya digestive enzyme supplement) • Slippery elm powder or capsules help soothe the digestive tract • Before going to bed, slowly sip a glass of warm milk or a smal amount of natural unsweetened • Sleep with the upper body slightly elevated
Indigestion/Flatulence
Self-help
• Avoid spicy or oily foods • Avoid large meals, especial y before going to bed • Avoid alcohol • Chamomile or peppermint tea can be setting and soothing • Warm water rather than cold with meals
Insomnia
Self-help
• If uncomfortable, try sleeping on your side with the upper knee drawn up and supported by a • Try a warm (not hot) bath before bed • Sleep-time herbal tea (e.g. chamomile, passionflower) • Warm milk with honey before going to bed • Relaxation CDs
Bleeding Gums
Self-help
• Use a soft toothbrush, brush gently • Diet rich in iron, vitamin C and bioflavonoid
Constipation
• Progesterone effect • Compression of intestine and bowel by growing uterus Self-help
• Eat a high-fibre diet (i.e. wholemeal and wholegrain breads and cereals, fruit and vegetables) • Drink lots of fluids • Exercise • Try hot prune juice or lemon juice in hot water half and hour before breakfast
Haemorrhoids
• Growing uterus exerts pressure on bowel, causing constipation • Uterus compresses veins, interfering with venous circulation • Progesterone effect Self-help
• Avoid constipation by increasing fibre in diet and fluid intake • Epsom salts bath • Cold compresses on affected area
Varicose Veins
• Progesterone effect – softening of vein valves makes them less effective at propel ing blood back • Compounded by greatly increased blood volume for the circulatory system to deal with Self-help
• Sit or lie with legs elevated for periods throughout the day • Ankle rotations while sitting or lying • Swimming and walking are good exercises for the circulatory system • Avoid wearing tight knee-high socks or underwear with tight elastic • Use support stockings (put stockings on before you get out of bed in the morning, and always take them off before going to sleep at night) • Elevating the foot of the bed or mattress can help
Oedema (swelling)
• Some degree of swel ing during pregnancy is normal due to fluid retention (in pregnancy your body’s fluid requirements almost double) • Consult with your LMC if you are concerned about the degree of swel ing you are experiencing Self-help
• Continue moderate exercise such as swimming or yoga • Do not reduce fluid intake • Elevate your legs and feet whenever you sit • Iron deficiency • Low blood sugar • Low fluid Self-help
• Iron supplementation (after consultation with LMC or GP). There are herbal alternatives – consult • Eating little and often, avoiding sugar-rich foods • Drink plenty of water • Rest
Breast Changes
• Hormone-induced growth of the secretory ductal system in preparation for breastfeeding • Increased blood flow causes greater nerve sensitivity in the breasts Self-help
• Wear a supportive bra, ensuring you change to soft-cup (i.e. no underwire) bras during the 3rd

Source: http://www.umatter.co.nz/uploads/90408/files/229664/Pregnancy_Discomforts.pdf