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.
Mpho.org
INHALED CONTROLLER MEDICATIONS Medication Name Medication Class Recommendation Doses-Strengths ♦Pricing Comments Aerobid (flunisolide) CFC $88.38/250mcg
No shaking required; 3 primes to start and reprime after
Alvesco (ciclesonide) HFA
Inhaled Corticosteroid (ICS) 12 and older
$155.98/160 mcg
10 days without use. Dose indicator in increments of 10
$105.99/110mcg $130.06/220mcg
Breath actuated device with dose counter; may be given
Asmanex (mometasone) DPI*
Inhaled Corticosteroid (ICS) 4-11, 12 and older
$140.91/60 metered doses
once daily in PM (110 dose FDA approved for 4-11 yrs)
$186.43/120 metered doses
Shake 5 sec.; 2 primes to start; reprime after 3 days
Azmacort (triamcinolone) HFA $152.36/75mcg
Diskus device like Advair, but without serevent; comes in
Flovent (fluticasone) DPI* $99.75/50mcg
only one strengthShake 5 sec.; 4 primes to start; after 7 days without use,
44mcg, 110mcg, 220mcg per $100.74/44mcg
or if dropped, reprime once; Inhaler, often used with
Flovent (fluticasone) HFA $131.73/110mcg
spacer (44-88mcg BID FDA approved for 4-11 yrs); has
$214.24/220mcg Pulmicort (budesonide) DPI* $103.84/90mcg
New Flexhaler (breath actuated device); has dose counter;
Flexhaler $137.65/180mcg
twist to prime in upright position; two primes to start
$191.12/0.25mg
Deliver with closed system mask if < 3 yrs; mask with
Pulmicort (budesonide) Respules Inhaled Corticosteroid (ICS) 8 years of age $224.76/0.5mg
Does not require shaking; 2 primes to start, reprime after
40mcg or 80mcg per actuation $75.59/40mcg QVAR (beclomethasone) HFA
10 days. Inhaler, recommended to be used without spacer
$92.87/80mcg $175.99/100-50mcg Advair (fluticasone and
No priming; don't tip once loaded; twice daily dosage (only
$209.98/250-50mcg salmeterol) DPI* $271.97/500-50mcg
45/21mcg,115/21, 230/21 per $178.76/45-21mcg Advair (fluticasone and
Shake 5 sec.; 4 primes to start; if dropped, or 4 weeks
$208.95/115-21mcg salmeterol) HFA
without use, 2 test sprays; twice daily dosage
$269.91/230-21mcg Symbicort (budesonide and $171.99/80-4.5mcg
Shake 5 sec.; 2 primes to start, again after 7 days without
formoterol) HFA $202.37/160-4.5mcg Serevent (salmeterol) DPI* $161.30/50mcg Not be used for quick relief or without ICS in asthma Foradil (formoterol) DPI* $161.20/12mcg Not be used for quick relief or without ICS in asthma Brovana (arformoterol) nebulized Long-acting beta2-agonist $56.25/5- 18mcg Spiriva (tiotropium)*
Once daily; should avoid use with Combivent or Duoneb
$197.16/30- 18mcg * Contains lactose INHALED QUICK RELIEF MEDICATIONS Medication Name Medication Class Recommendation Doses-Strengths ♦Pricing Comments AccuNeb (albuterol for $49.13/0.63mg/3ml nebulization) $50.99/1.25mg/3ml
Shake 5 sec.; 4 primes to start; reprime after 4 weeks
Albuterol CFC $15.99/2mg tablets Albuterol Nebulized 0.083% $18.99/0.083% Albuterol Nebulized 0.5% $15.99/0.5%
Shake 5 sec.; 2 primes to start; 2 primes after 2 days
Maxair (pirbuterol) CFC $115.99/200mcg
Shake 5 sec.; 3 primes to start; reprime after 14 days
ProAir (albuterol sulfate) HFA $41.84/90mcg
Shake 5 sec.; 4 primes to start; reprime after 2 weeks
Proventil (albuterol sulfate) HFA $52.02/90mcg
Shake 5 sec.; 4 primes to start; reprime if dropped or after
Ventolin (albuterol sulfate) HFA $37.99/90mcg
Shake 5 sec.; 4 primes to start; 4 primes after 3 days
Xopenex (levalbuterol) HFA $53.84/45mcg $100.11/0.31mg/3ml Xopenex Nebulized (levalbuterol) Short-acting beta2-agonist $102.78/0.63mg/3ml
Unit dose for nebulization; needs no mixing
$101.59/1.25mg/3ml Atrovent (ipratropium) HFA $117.62/17mcg
2 primes to start; 2 primes after 3 days without use
Combivent (ipratropium and $127.03/103-18mcg
Shake 10 sec.; 3 primes to start; 3 primes after 24 hours
albuterol) CFC Duoneb (ipratropium and $40.00/0.5-2.5mg/3ml albuterol)
♦Pricing Source: Prices noted are from April 2009, www.drugstore.com. Actual prices will vary by retail pharmacy and likely change over time. Not all prices for doses listed above are available.
Source: medication package insertThis document is intended to comprise most frequently used medication in the MaineHealth system.
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C V ( S H O R T ) H E N N I N G B E C K - N I E L S E N Professor Henning Beck-Nielsen, MD, DMSc Odense University Hospital, Department of Endocrinology, Kloevervaenget 6, 4th floor, 5000 Odense C, Denmark28 June 1945 Henning Beck-Nielsen (HBN) is Professor of Endocrinology at the University of Southern Denmark and Consultant and Head of research at Odense University Hospital. He has b