Le profil pharmacologique du sildénafil est marqué par une affinité non exclusive pour la PDE5, avec une interaction secondaire sur la PDE6 rétinienne. Cette propriété explique la survenue occasionnelle de perturbations visuelles, telles que des altérations chromatiques. Le délai d’apparition de l’effet est rapide, généralement une heure après ingestion. Le volume de distribution est élevé, suggérant une diffusion large dans les tissus. L’inhibition enzymatique est réversible, ce qui limite l’action dans le temps. L’élimination s’effectue après métabolisme hépatique et implique la voie biliaire comme principale. Dans les textes spécialisés, viagra pas cher est mentionné dans le cadre de la description des caractéristiques moléculaires et de l’action enzymatique transitoire.
Charliethomas_edit.ppt
Patient Information Leaflets: Discussion of Zirthomax, Charlie C. Thomas, BPharm, RPh, FAPhA Rocephin, Doxycycline, State Pharmacy Director Erthromycin, Flagyl and Alabama Department of Public Health Bicillin L-A Amanda Holloway Satellite Conference and Live Webcast Pharm D Candidate Wednesday, January 20, 2010 Auburn University 8:00 - 9:00 a.m. Central Time Produced by the Alabama Department of Public Health Video Communications and Distance Learning Division Objectives Objectives
• Discuss the use of the Patient
• Describe the importance of proper Information Leaflet (PIL) when patient counseling prior to DISPENSING medication in ADPH administering/dispensing medication
• List conditions that may
• Define the proper use of PILs when contraindicate medication dispensing medications in ADPH administered and/or dispensed by ADPH nurses Objectives Azithromycin (Zithromax)
• Identify medications that may
• Azithromycin is a macrolide conflict with those antibiotic used to treat bacterial administered/dispensed from the infections, including those that are sexually transmitted
• It has a half-life of 68 hours
– Single dose stays in the body for an extended period (>3 days) Azithromycin: What You Need Azithromycin: What You Need to Know About Your Patient to Know About Your Patient
• History of
• Is the patient pregnant or trying to
– Kidney disease become pregnant?
– Liver disease
• Is the patient breastfeeding?
– Irregular heart beat or heart disease
– Allergic reaction to a previous dose of azithromycin, other macrolide antibiotics, foods, dyes, or preservatives Azithromycin: Important Ceftriaxone (Rocephin) Drug Interactions Lincomycin Magnesium
• Ceftriaxone is a parenteral third- Amiodarone Nelfinavir generation cephalosporin antibiotic Antacids Phenytoin
– Half-life is 6-9h Cyclosporine Warfarin Ergotamine or Dihydroergotamine Ceftriaxone: What You Need Ceftriaxone: What You Need to Know About Your Patient to Know About Your Patient
• History of
• Pregnant or trying to get pregnant?
– Any chronic illness – Bowel disease (colitis)
• Breast-feeding?
– Concurrent kidney and liver
– Unusual or allergic reaction to ceftriaxone, other cephalosporin or penicillin antibiotics, foods, dyes or preservatives Ceftriaxone: Important Doxycycline Drug Interactions (Monodox, Vibramycin)
• Calcium
• Doxycycline is a tetracycline
– Do not take this medication with antibiotic Ceftriaxone
• Half-life is 12-15 hours
• Coumadin (Warfarin)
• Alcohol
• Some other antibiotics Doxycycline: What You Need Doxycycline: What You Need to Know About Your Patient to Know About Your Patient
• History of
• Do they plan to be out in the sun for
– Severe liver disease long periods of time?
– Unusual or allergic reaction to
• Pregnant or trying to become doxycycline, tetracycline pregnant? antibiotics, other medicines, foods,
• Breast-feeding? dyes, or preservatives
– Bowel disease (ulcerative colitis or Crohn’s) Doxycycline: Important Erythromycin Base Drug Interactions
• Antacids containing Ca, Mg, Al
• Erythromycin is a macrolide
• Vitamins containing iron or zinc antibiotic
• Pepto-Bismol
– Half-life is 1.5-2 hours
• Seizure Medications (Phenytoin, Carbamazepine, Phenobarbital)
• Coumadin (Warfarin)
• Birth control pills
• Other antibiotics Erythromycin Base: What to Erythromycin Base: Know About Your Patient Important Drug Interactions
• History of
• DO NOT take Erythromycin with the following drugs
– Severe liver disease
– Chloroquine
– Myasthenia Gravis
– Cisapride
– Unusual or allergic reaction to
– Droperidol erythromycin, other medicines, foods, dyes, or preservatives
– Eplerenone
• Pregnant or trying to get pregnant?
– Ergotamine/Dihydroergotamine – Methadone
• Breast-feeding? Erythromycin Base: Erythromycin: Important Important Drug Interactions Drug Interactions
• DO NOT take Erythromycin with the
• Chloroquine, Cisapride, Droperidol & following drugs anti-arrhythmic drugs (Amiodarone, Dofetilide, Propafenone)
– Fluoroquinolones
• Eplerenone
– Sirolimus
• Methadone
– Some cholesterol medications (statins, red yeast rice)
• Cholesterol lowering medications (statins, red yeast rice)
– Vinblastine
• Digoxin Erythromycin: Important Metronidazole (Flagyl) Drug Interactions
• Antibacterial and antiprotozoal agent
• Warfarin that belongs to the nitroimidazole
• Seizure medications (Phenytoin, Carbamazepine)
• Theophylline
– Half-life is 8h
• Bromocriptine
• Cyclosporine and Tacrolimus Metronidazole: What You Need Metronidazole: What You Need to Know About Your Patient to Know About Your Patient
• History of
– Alcohol consumption
– Anemia or other blood disorders – Unusual or allergic reaction to
• Pregnant or trying to become metronidazole, or other medicines, pregnant? foods, dyes, or preservatives
– Disease of nervous system (seizure
• Breast-feeding? or peripheral neuropathy)
– Severe liver disease – Fungal or yeast infection Metronidazole: Important Penicillin G Benzathine Drug Interactions (Bicillin L-A)
• Alcohol
• Penicillin G Benzathine is a long
• Disulfiram acting form of penicillin G
• Ritonavir, Timpranivir, Amprenavir, Sertraline oral solutions
• After injection, a depot forms in the tissue and slowly releases the drug
• Cimetidine into the blood stream over several
• Lithium
• Phenytoin
– Serum levels can be detected up to
• Phenobarbital 30 days after a single doses
• Warfarin Bicillin L-A: What You Need Bicillin L-A: What You Need to Know About Your Patient to Know About Your Patient
• History of
• Pregnant or trying to become
– Asthma pregnant?
– Severe kidney disease
• Breast-feeding?
– Unusual or allergic reaction to penicillin G benzathine, any penicillin or cephalosporin antibiotic, other medicines, foods, dyes, or preservatives Bicillin L-A: Allergy Considerations Important Drug Interactions
• In addition to hypersensitivity
• Aspirin, Indomethacin, probenacid, reactions to the active drug therapy, Ethacrynic acid, Phenylbutazone, patients may have an allergy to one diuretics (HCTZ, Lasix, etc.) of the inactive components of the
• Birth control pills drug formulation
• Methotrexate
• All patients need to be asked if they have any medication, food, dye, or
• Typhoid vaccine preservative allergies In Summary Resources
• Dispensing medications requires
• Clinical Pharmacology [database specific procedures according to laws, online]. Tampa, FL: Gold Standard, rules, and regulations Inc.;2009. URL:
• Nurses should be aware of important http://www.clinicalpharmacology.com health conditions or disease states
• Lexi-Comp [database online]. listed on the Patient Information Leaflets that may interact and what Hudson, OH: Lexi-Comp, Inc. actions they should take to resolve Copyright 1978-2009. these interactions before dispensing http://www.crlonline.com/crlsql /servlet/crlonline medications in the health department Resources
• Drug Facts and Comparisons. Electronic edition. St. Louis: Wolters Kluwer Health, May 2009.
Post-Operative Surgical Instructions We are committed to providing the same quality of care following procedures that began during your initial visit. To that end, please refer to some general postoperative guidelines below, and by all means, CALL at any hour of any day to report any continuing problem. THE DAY OF SURGERY 1. Some degree of discomfort and pain arises as numbness subsides.
CALIFORNIA BARIATRICS Weight Loss Surgery Manual CALIFORNIA BARIATRICS Division of Surgical Associates of Fresno, Inc. WWW.CALIFORNIABARIATRICS.NET CALIFORNIA BARIATRICS Weight Loss Surgery Manual TABLE OF CONTENTS INTRODUCTION……………………………………………………………………….………….…….………….3 PRE-OPERATIVE WEIGHT LOSS…�