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.

Microsoft word - als checklist11012006.doc

Company __________________________ Unit # ___________ Multi-County Ambulance Advanced Life Support Checklist:

Ventilation Equipment:
Patient Assessment Equipment:
__ Chest Decompression: Commercial__ Self Kit__ Monitor/Defibrillator Operational Check: Angiocath: 10g ___ Other: ___________________ Make and Model: ________________________ __ Cricothyrotomy Tray: Commercial__or Self-Kit__ Monitor Serial No. _______________________ ________________________________________ Defibrillator Serial No. ____________________ __ Laryngoscope and Blades, straight and/or curved sizes: Straight: 0, 1, 2, 3, 4, Curved: 0, 1, 2, 3, 4 Uncuffed: __ 2.5 __ 3 __ 3.5 __ 4 __ 4.5 __ 5 __ 5.5 Cuffed: __6 __6.5__ 7__ 7.5__ 8__ 8.5__ 9__ __ End Tidal CO2 detector or alternative device, FDA approved to determine endotracheal tube placemnt Date of last service: _______________________ __ Nasogastric Tube (optional) Size 16 __ Size 18 __ IV Fluids and Equipment:
__ Soluset __________________________________ Medications:
Miscellaneous Equipment:
__ Medical Director selected and approved list (optional) _____________________________ __ Pediatric “length-based” device for sizing drug __ Denver Metro Paramedic Protocols, Section VI dosage calculation and sizing equipment Type:________________date:_____________ Other Comments: _______________________________________________________________________________ ______________________________________________________________________________________________ ‰ Approved ALS
‰ Not Approved. Re-inspection required.
‰ Approved BLS with ALS capabilities
Inspection Expires:
Date of Re-inspection:
Please print Ambulance Service Representative’s Name:
Ambulance Service Representative’s Signature Stanley Howell, Multi-County Ambulance Inspector Denver Metro Paramedic Protocols, Section VI.
DRUG PROTOCOLS
Drug Protocols
Page Number
__ Epinephrine __ 1:1 AMP __ 1:1 MDV __ 1:10 M __ Mark I Nerve Agent Antidote Kit _______________ __ Naloxone Hydrochloride (Narcan) _______________ __ Racemic Epinephrine (Vaponephrine) _______________ Other: _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ Medical Director: ___________________________________________ Medical Facility: _______________________________________________________________________________ M:/adm/clerical/ambulance/forms/ALS inspection checklist

Source: http://www.dcsheriff.net/emergencymanagement/documents/advancedlifesupportchecklist.pdf