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.
Voiding symptoms questionnaire
Address: Telephone Number: Date of Birth: Social Security Number: Marital Status: Mother’s First Name: Father’s First Name:
Medical History Questionnaire 1. Do you have any of the following heart problems?
 heart murmur  chest pain  heart attack  rheumatic fever
 irregular heart beat  shortness of breath  high blood pressure
 mitral valve prolapse  coronary artery disease  Other__________________________________________ COMMENTS:
2. Do you have any of the following lung problems?
 emphysema  cough  shortness of breath
3. Have you ever had any of the following blood problems?
4. Have you ever been treated for or do you have any of the following?
 thyroid disease  hepatitis  glaucoma  frequent fevers  frequent vomiting  frequent diarrhea
 vision problems  problems with hearing
5. Do you have any of the following psychiatric problems?
 extreme nervousness  extreme anxiety
6. Have you ever had any of the following nervous, muscular or neurologic problems?  YES  NO  insulin dependent diabetes
 noninsulin dependent diabetes  dizziness
 spinal bifida  spinal stenosis  other_____________
Do you have neurologic symptoms?
What symptoms do you have and for how long?
If you have a spinal cord injury, what ZONE level is the injury? Cervical
7. Please check the boxes that apply to your kidney and bladder problems.
8. Have you had any of the following urologic or gynecologic surgery?  YES  NO What surgery did you have and when was the procedure?
 Other___________________________ ______
9. Have you had any other surgery?
10. Have you ever been hospitalized for anything else or do you have any other medical problem to report?  YES
11. Do you take medications regularly?
12. Has anyone in your family been treated for cancer?  YES  NO COMMENTS:
13. Are you a smoker?
14. Do you drink alcohol?  YES  NO
15. Do you drink any of the following?
16. Are you allergic to any medications?  YES  NO Please give the names of the medications.
If female: 17. How many children have you had?
 none  one  two  three  four  five  six  seven
18. What is your menstrual status?  post-menopausal
 irregular menstruation  regular menstruation
 partial hysterectomy  total hysterectomy Name:
I have read and answered all of the questions in their entirety and the information is accurate and true to the best of my knowledge.
Voiding Symptoms Questionnaire 1. What are your most troublesome urinary complaints?  Frequency ( Urinating Often)  Urgency
 Stress Incontinence (loss or leakage of urine when coughing, sneezing, etc.)  Urge Incontinence (can’t hold urine with an urge)  Pain
2. How long have you had your bladder or urinary problems? Select Time Number:1 2 3 4 5 6 7 8 9 10 11 12 Time Unit:
3. How often do you urinate during the daytime?
Average Time Interval: 1 2 3 4 5 6 7 8 9 10 15 20 25 30 90
Maximum Time Interval: 1 2 3 4 5 6 7 8 9 10 15 20 25 3090
Minimum Time Interval: 1 2 3 4 5 6 7 8 9 10 15 20 25 30 90
4. Why do you urinate as often as you do?  normal urge
5. How many times do you get up to urinate at night? 1
6. Why do you get up to urinate at night?  awakened by urge to urinate  you're already up  afraid you might wet the bed  habit  N/A 7. How often is there a sense of urgency?  never
 a few times a month  once a month
 a few times a week  once a week  once a day  a few times a day
8. When you get the urge to urinate, is the urge controllable?  YES How long can you hold it or control it before you lose control?
Time Interval: 1 2 3 4 5 6 7 8 9 10 15 20 25 3090 Time Unit:
9. How often do you lose control of urination because you feel a strong urge and cannot control it?  never
 a few times a month  once a month
 a few times a week  once a week  once a day  a few times a day
10. Do you leak urine or lose control of urination? 11. Do you wear pads or other form of protection because of wetting?  YES
12. About how many pads do you use a day? 1 13. How wet are they when you change them?  dry
14. Do you know what happens or do you just find yourself wet?  know what happens
15. How often do you lose control when you cough or sneeze?  never
 a few times a month  once a month
 a few times a week  once a week  once a day  a few times a day
16. How often do you lose control when you engage in physical activity such as running or jogging?  never
 a few times a month  once a month
 a few times a week  once a week  once a day  a few times a day
17. How often do you lose control when you raise yourself from a sitting to a standing position?  never
 a few times a month  once a month
 a few times a week  once a week  once a day  a few times a day
18. What method do you use to start urinating?  none  straining  crede  tapping  catheterize 19. Does it take a while before you start urinating?
20. How long does it take to start urinating? Time Interval: 1 2 3 4 5 6 7 8 9 10 15 20 25 3090 Time Unit: 21. How would you describe the usual force of the stream?  strong  weak
 interrupted  intermittent  variable  not as strong as it used to be
22. How often do you feel that you have not emptied your bladder after urinating?  never
 a few times a month  once a month
 a few times a week  once a week  once a day  a few times a day
23. Have you ever been unable to urinate and required a catheter in order to empty your bladder?
24. Do you use condom catheters or indwelling catheters?
25. Do you use intermittent catheterization to empty your bladder? How often? qD BID TID QID q 1-2 hours q 3-4 hours q 5-6 hours q 7-8 hours  q 9-10 hours  q 11-12 hours
26. Have you ever had, or been told, you had blood in your urine?
27. Do you have pain during urination?  YES What type of pain do you have? What location do you feel pain?
28. If Female, do you think that you have a dropped bladder or a bulge in the vagina?
29. Have you taken any medications for your bladder condition in the past?  YES  NO COMMENTS: Please Check Off Urologic Medications That You Are Taking
30a. Any anticholinergics?
30b. Any antispasmotics?
30c. Any anticonvulsants?  YES  NO 30d. Any alpha-blockers?  YES  NO  Cardura (Doxazosin)
30e. Any antiandrogens?
30f. Any alpha agonists?
30g. Any diuretics?
31h. Any antihistamines?
30i. Any other bladder medications?
AUA Symptom Score
have you had as sensation of not emptying your bladder completely after urinating?
have you had the urge to urinate again less than two hours after you finished urinating?
have you found you stopped and started again several times when you urinated?
have you found it difficult to postpone urination?
have you had to push or strain to begin urination?
did you most typically get up to urinate
from the time you went to bed at night until the time you got up in the morning?
AUA Symptom Score = sum of questions 1-7
REZA FARID HOSSEYNI, MD, DTCT, FAAAAI 55 Nastran Ave. Nasteran 8 Mashhad, Iran [email protected] Home: 0098 511 761 15 80 Cell: 0098 915 111 13 80 Fax: 0098 511 761 06 81 Intrested Research : HTLV-1 , Allergic disease Adjunct Professor of Allergy Health Promotion Sciences Adjunct Professor of Immunology College of Medicine . The University Of Arizona Mel and Enid Zuckerman College of Public
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