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8 Things You Should Know Before Using an Online Pharmacy

Prescription costs are on the rise in the U.S. and many consumers are scrambling to save money on their medications. Americans spent more than $374 billion on prescription drugs in 2014, according to the IMS Institute, a company that tracks medical spending. That’s up 13% from drug spending in 2013.

In an effort to manage rising drug costs, many Americans order their prescriptions from online pharmacies. This isn’t always legal or safe, but there are trustworthy online pharmacies — you just have to know how to find them. Here’s what to know to do just that.

Online pharmacies are Internet-based vendors of prescription drugs. Because they can serve a large clientele from one central location — and avoid the cost of operating brick-and-mortar branches — they can sell medications more cheaply than traditional pharmacies.

In many cases, foreign online pharmacies can sell drugs for even less than domestic ones. Price caps that many countries place on drugs help drive down the costs.

1. What an online pharmacy is

Online pharmacies are Internet-based vendors of prescription drugs. Because they can serve a large clientele from one central location — and avoid the cost of operating brick-and-mortar branches — they can sell medications more cheaply than traditional pharmacies.

In many cases, foreign online pharmacies can sell drugs for even less than domestic ones. Price caps that many countries place on drugs help drive down the costs.

There are thousands of online pharmacies. Many are legal and legitimate, but many aren’t.

In many cases, illegitimate pharmacies don’t operate in compliance with U.S. rules and regulations. These pharmacies are considered fraudulent, and most of them are based in other countries, or claim to be. For example, many popular pharmacies operate out of Mexico and India, where medications are particularly inexpensive, but these countries don’t have medication quality and security guidelines as stringent as in the U.S. and Canada.

Fraudulent pharmacies have multiple ways of deceiving consumers. Some might send a non-U.S. version of your drug, an incorrect dosage or a generic when your doctor has prescribed a brand name. In other cases, you might receive the incorrect medication or a sugar pill without any active ingredients. You might also receive a medication with an incomplete or missing label, making it difficult to tell drugs apart or how to take them.

2. Not every online pharmacy is the same

There are thousands of online pharmacies. Many are legal and legitimate, but many aren’t.

In many cases, illegitimate pharmacies don’t operate in compliance with U.S. rules and regulations. These pharmacies are considered fraudulent, and most of them are based in other countries, or claim to be. For example, many popular pharmacies operate out of Mexico and India, where medications are particularly inexpensive, but these countries don’t have medication quality and security guidelines as stringent as in the U.S. and Canada.

Fraudulent pharmacies have multiple ways of deceiving consumers. Some might send a non-U.S. version of your drug, an incorrect dosage or a generic when your doctor has prescribed a brand name. In other cases, you might receive the incorrect medication or a sugar pill without any active ingredients. You might also receive a medication with an incomplete or missing label, making it difficult to tell drugs apart or how to take them.

No law explicitly forbids importing prescription drugs from other countries, so long as they aren’t controlled substances and are purchased with the approval of a licensed physician. Even so, the FDA recommends against buying drugs from other countries because consumers can’t confirm their safety and have no recourse against the manufacturers.

3. What the FDA says about foreign online pharmacies

No law explicitly forbids importing prescription drugs from other countries, so long as they aren’t controlled substances and are purchased with the approval of a licensed physician. Even so, the FDA recommends against buying drugs from other countries because consumers can’t confirm their safety and have no recourse against the manufacturers.

It’s definitely legal to purchase drugs through a U.S.-based online pharmacy that has been certified by the National Association of Boards of Pharmacy. The association is a professional organization that supports state pharmacy boards and is recognized by the FDA as the nation’s leading pharmacy authority.

Some online pharmacies aren’t verified by the association, but are verified by independently owned LegitScript. LegitScript approves only U.S.-based online pharmacies, and is acknowledged by the boards of pharmacy association for recognizing safe practices and complying with federal law. Unlike the association, however, LegitScript doesn’t require a fee or application from pharmacies for verification.

4. What is definitely legal

It’s definitely legal to purchase drugs through a U.S.-based online pharmacy that has been certified by the National Association of Boards of Pharmacy. The association is a professional organization that supports state pharmacy boards and is recognized by the FDA as the nation’s leading pharmacy authority.

Some online pharmacies aren’t verified by the association, but are verified by independently owned LegitScript. LegitScript approves only U.S.-based online pharmacies, and is acknowledged by the boards of pharmacy association for recognizing safe practices and complying with federal law. Unlike the association, however, LegitScript doesn’t require a fee or application from pharmacies for verification.

It is illegal to do the following:

  • Purchase controlled substances without a prescription written by a licensed doctor. This includes all prescription narcotic painkillers, sedatives, stimulants and anabolic steroids.
  • Purchase prescription drugs that aren’t FDA approved, even if they’re legal in the country from which you purchase them.

If you can want to buy from a foreign pharmacy, you’ll also be held to that country’s laws. In order to legally purchase a controlled medicine from a Mexican online pharmacy, for example, you’ll need a prescription from a licensed Mexican physician in addition to the prescription from your local doctor.

5. What is definitely illegal

It is illegal to do the following:

  • Purchase controlled substances without a prescription written by a licensed doctor. This includes all prescription narcotic painkillers, sedatives, stimulants and anabolic steroids.
  • Purchase prescription drugs that aren’t FDA approved, even if they’re legal in the country from which you purchase them.

If you can want to buy from a foreign pharmacy, you’ll also be held to that country’s laws. In order to legally purchase a controlled medicine from a Mexican online pharmacy, for example, you’ll need a prescription from a licensed Mexican physician in addition to the prescription from your local doctor.

Canadian pharmacy practices and standards are similar to those in the U.S. Legitimate Canadian pharmacies don’t require a separate Canadian prescription and avoid selling controlled substances to U.S. patients in order to comply with our laws. However, the FDA reports that many online pharmacies that appear Canadian are actually operating out of other countries.

True Canadian pharmacies are certified by the Canadian International Pharmacy Association, but they can’t be verified by U.S. pharmacy bodies. Even though research has shown that legitimate Canadian pharmacies sell legitimate drugs at cheaper prices, the FDA still advises against these purchases.

6. How Canadian online pharmacies are different

Canadian pharmacy practices and standards are similar to those in the U.S. Legitimate Canadian pharmacies don’t require a separate Canadian prescription and avoid selling controlled substances to U.S. patients in order to comply with our laws. However, the FDA reports that many online pharmacies that appear Canadian are actually operating out of other countries.

True Canadian pharmacies are certified by the Canadian International Pharmacy Association, but they can’t be verified by U.S. pharmacy bodies. Even though research has shown that legitimate Canadian pharmacies sell legitimate drugs at cheaper prices, the FDA still advises against these purchases.

Two major studies have assessed online pharmacies. The most recent, conducted by the boards of pharmacy association in September 2013, found that 96.7% of online pharmacies selling to U.S. citizens were “rogue,” meaning that they didn’t comply with U.S. laws and regulations. The report covered 10,642 pharmacies, and determined that only 90 were legitimate, while another 258 were classified as potentially legitimate.

The National Bureau of Economic Research did a more comprehensive study in 2012. To assess drug cost and integrity, researchers acquired samples of the most popular dosages of five common brand name prescription drugs — Lipitor, Viagra, Celebrex, Nexium and Zoloft — from a variety of online pharmacies. Researchers concluded that:

  • All of the U.S. pharmacies required a process that ensures the prescription is authentic, compared with 90% of Canadian pharmacies and 67% of foreign pharmacies.
  • 10% of the drugs provided were incorrect, or generic when a name brand was prescribed.
  • Although there are many rogue pharmacies online, a blanket ban against certified Canadian pharmacies is unjustified and would prevent considerable savings for consumers, since Canadian drugs are 49% cheaper than those bought in the U.S.

7. What the research says about online pharmacies

Two major studies have assessed online pharmacies. The most recent, conducted by the boards of pharmacy association in September 2013, found that 96.7% of online pharmacies selling to U.S. citizens were “rogue,” meaning that they didn’t comply with U.S. laws and regulations. The report covered 10,642 pharmacies, and determined that only 90 were legitimate, while another 258 were classified as potentially legitimate.

The National Bureau of Economic Research did a more comprehensive study in 2012. To assess drug cost and integrity, researchers acquired samples of the most popular dosages of five common brand name prescription drugs — Lipitor, Viagra, Celebrex, Nexium and Zoloft — from a variety of online pharmacies. Researchers concluded that:

  • All of the U.S. pharmacies required a process that ensures the prescription is authentic, compared with 90% of Canadian pharmacies and 67% of foreign pharmacies.
  • 10% of the drugs provided were incorrect, or generic when a name brand was prescribed.
  • Although there are many rogue pharmacies online, a blanket ban against certified Canadian pharmacies is unjustified and would prevent considerable savings for consumers, since Canadian drugs are 49% cheaper than those bought in the U.S.

Use these guidelines to ensure your safety and the security of your personal information when buying medications online:

  • Look for pharmacies that are certified by the U.S. or Canadian pharmacy association, indicating that they follow stringent safety and quality standards.
  • Cross-check your pharmacy’s certification against the associations’ websites.
  • Don’t buy from websites that sell drugs without a prescription, or that offer to prescribe the drug for you.
  • Make sure your online pharmacy’s privacy and security policies are easy to understand. Illegal pharmacies will often sell your personal information.
  • Check your pharmacy’s website for a physical address and a phone number you can call to talk to a pharmacist.
  • Ask for your pharmacist’s license information. If he or she is U.S.-based, you can verify this information online.

Use the links below for more specific information.

  • The National Association of Boards of Pharmacy has a listing of recommended sites here .
  • The association’s not recommended sites are here .
  • LegitScript’s recommended sites are here .
  • If you’re looking into Canadian pharmacies, verify Canadian International Pharmacy Association certification here .
  • To find a site recommended by the Canadian association, go here .
  • PharmacyChecker’s reviews are here .

8. Guidelines for safely purchasing drugs online

Use these guidelines to ensure your safety and the security of your personal information when buying medications online:

  • Look for pharmacies that are certified by the U.S. or Canadian pharmacy association, indicating that they follow stringent safety and quality standards.
  • Cross-check your pharmacy’s certification against the associations’ websites.
  • Don’t buy from websites that sell drugs without a prescription, or that offer to prescribe the drug for you.
  • Make sure your online pharmacy’s privacy and security policies are easy to understand. Illegal pharmacies will often sell your personal information.
  • Check your pharmacy’s website for a physical address and a phone number you can call to talk to a pharmacist.
  • Ask for your pharmacist’s license information. If he or she is U.S.-based, you can verify this information online.

Use the links below for more specific information.

  • The National Association of Boards of Pharmacy has a listing of recommended sites here .
  • The association’s not recommended sites are here .
  • LegitScript’s recommended sites are here .
  • If you’re looking into Canadian pharmacies, verify Canadian International Pharmacy Association certification here .
  • To find a site recommended by the Canadian association, go here .
  • PharmacyChecker’s reviews are here .

This article was updated on December 15, 2015.

Woman researching online pharmaciesimage via Shutterstock.

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Tesco to sell ‘cut-price’ Viagra

The supermarket Tesco says it is to start selling Viagra over the counter at the ‘cheapest price’.

From next Monday, men with erectile dysfunction (ED) who don’t have a GP prescription will be able to request the drug at 300 of its UK stores.

As the first supermarket to offer such a service, Tesco will charge ВЈ52 for eight of the blue pills. Boots pharmacy currently charges ВЈ55 for four.

Tesco stressed a pharmacist would make the sale and customers will be vetted.

Extra checks

The service is only available to men aged between 40 and 65 years.

They will have to complete a questionnaire and have their blood pressure and cholesterol measured, as well as undergo a test for diabetes.

Shona Scott, commercial manager for Tesco pharmacy services, said: “Provided that the men are suitable we will discuss their options and sell them an effective treatment.”

Dr Nick Tomlinson of the Sexual Advice Association said offering over-the-counter treatments for erectile dysfunction could be a good idea.

“Men can be very embarrassed about going to their GP for help with things like this,” he said

He added some men resorted to buying the drug over the internet, which could be risky because they might be sold fake Viagra.

Dr Tomlinson said it was essential that men seeking drugs for ED had thorough medical checks for underlying health problems.

“It’s now realised that for a great many men, ED is a warning sign of cardiovascular problems that need checking out. Something like a third of men with ED go on to develop some sort of cardiovascular problem within five years.”

He said men who see and get a prescription from their GP could purchase the drugs for even less – around ВЈ48 for eight tablets from some dispensaries.

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The Insurance Pay Viagra family has a long tradition of entertaining locals and summer visitors in the Beaver Dam section of Berwick. Samuel’s weekly barn dances at the “Forget Me Not” were a favorite pastime during the early decades of the 1900’s. His son Lewis, a local and state Grange Master, was also a master of many musical instruments. He had a passion for starting bands and performing in Beaver Dam and across the state of Maine. His son Carleton organized several theatre groups, first at the Beaver Dam grange, and then at his barn now called Hackmatack Playhouse.

Every year thousands of people gather outside the Playhouse with tickets to the summer’s productions. Every year talented actors audition for their chance to perform at Hackmatack Playhouse, and to experience the history and excitement of being part of Hackmatack’s family. The farm and its building have many stories to tell. Perhaps 200 years from now Insurance Pay Viagra great, great grandchildren will be telling this story to aspiring actors nervously waiting for their audition slot, and to friendly crowds waiting to take their seats; of how the barn became home for the Hackmatack Playhouse.

After the death of the founder in 1995, the S Carleton Insurance Pay Viagra Memorial Fund was established to preserve and improve our historical buildings. The fund also is dedicated to advancements of dramatic arts, both for the participant and the community, and to the commitment of providing quality family entertainment and drama at a reasonable price. Contributions are always welcomed. We thank you in advance for helping us secure the future of Hackmatack Playhouse for potential Hackmatackers.

Hackmatack exists because of the generosity of it’s patrons, friends and those that appreciate the theater’s contribution to local culture and community. It is committed to the advancement of dramatic arts and to providing quality family entertainment at a reasonable price.

We ask that you would consider a donation, and thank you in advance.

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ВїViagra o Cialis?

La principal ventaja de Cialis respecto de la Viagra es la duraciГіn. La Viagra funciona durante 4 horas, y por lo tanto siempre debe ser tomada antes del sexo. Cialis estГЎ activo durante 36 horas. La nueva versiГіn de Cialis, Cialis Once a Day. se toma diariamente. Esto permite que el usuario tenga una experiencia sexual espontГЎnea en cualquier momento.

Cialis funciona mГЎs rГЎpido que la Viagra

Cialis trabaja mГЎs rГЎpido que la Viagra. Un cuarto de hora despuГ©s de tomar la pГ­ldora, una persona con problemas de erecciГіn puede estar sexualmente activa. El efecto de Cialis dura mГЎs tiempo que la Viagra. Una persona con disfunciГіn erГ©ctil podrГ­a tener una vida sexual activa de un dГ­a, un promedio de 36 horas despuГ©s de la ingestiГіn. Se le da al paciente una ventaja Гєnica sobre la Viagra. PodrГЎ disfrutar de una renovada y mejorada vida sexual en un perГ­odo de tiempo mГЎs corto.

Funcionamiento de la Viagra y de Cialis

Cuando un hombre es sexualmente excitado, ciertos tejidos en el pene se relajan. Esto provoca una corriente natural de sangre hacia el pene y la erecciГіn se produce. La Viagra ayuda al paciente con la disfunciГіn erГ©ctil al incrementar la liberaciГіn de quГ­micos que causan la relajaciГіn de los tejidos del pene y sus alrededores.

Cialis funciona quГ­micamente casi de la misma manera, pero el paciente usa una dosis menor y obtiene una erecciГіn mГЎs rГЎpida. La duraciГіn del efecto de Cialis es aproximadamente diez veces mГЎs que el de la Viagra. La espontaneidad de la experiencia sexual es mayor. Esto es tan importante para el hombre como para la mujer.

Peligros de Viagra y Cialis

Tanto la Viagra como Cialis tienen un peligroso efecto cuando son tomadas por personas que tienen un tratamiento con una medicaciГіn a base de nitratos. Entre estos medicamentos se incluyen las pastillas del corazГіn que son suministradas como un tratamiento para el dolor torГЎcico. TambiГ©n ciertos medicamentos que aumentan la libido incluyen la misma soluciГіn de nitratos. La Viagra no debe ser nunca tomada por pacientes que usen nitratos. Cialis tiene un efecto potenciador similar en estos medicamentos y no es apropiado para estos pacientes.

A pesar de que Cialis. Levitra y Viagra tienen otros ingredientes, estos activos, inhibidores del PDE-5, no son todavГ­a apropiados para pacientes que busquen un tratamiento para sus corazones, hГ­gado o riГ±ones. Aunque no ha sido estudiado, hay razones teГіricas que hacen esperar la interacciГіn con los inhibidores de la proteasa. Los inhibidores de la proteasa se espera que incrementen el nivel de sangre de Cialis. El resultado puede causar mГЎs efectos secundarios de Cialis, ademГЎs de una mayor actividad. La dosis debe ser adaptada adecuadamente. Esto es tambiГ©n aplicable para la Viagra.

Impotencia

DisfunciГіn erectil

La impotencia -cuyo tГ©rmino mГ©dico es el de “disfunciГіn erГ©ctil (DE)”- es la incapacidad de lograr o mantener una erecciГіn suficiente para una actividad sexual satisfactoria.

La disfunciГіn erectil (DE) es una situaciГіn muy frecuente; se ha calculado que afecta en mayor o menor grado a la mitad de los hombres entre los 40 y los 70 aГ±os. Pero no es un tema que se trate abiertamente. Mitos y expectativas culturales de la sexualidad masculina han impedido a muchos hombres buscar ayuda para un trastorno que puede, en la mayorГ­a de los casos, beneficiarse de un tratamiento mГ©dico.

Aunque puede decirse con seguridad que todo hombre experimenta una disfunciГіn erГ©ctil de vez en cuando, la impotencia se define en tГ©rminos mГ©dicos como la incapacidad para mantener una erecciГіn suficiente para el coito en al menos 25% de los intentos.

Cuando no hay estimulaciГіn sexual, el flujo de sangre dentro del pene es muy bajo, lo que lo mantiene en estado flГЎcido o no erecto. Cuando un hombre es estimulado sexualmente, las arterias del pene se relajan y dilatan, y el flujo sanguГ­neo hacia el pene aumenta mucho. A medida que el pene se expande, las venas del pene -que tendrГ­an que devolver la sangre del pene hacia la circulaciГіn de retorno- se comprimen, y la sangre no puede salir. Con mГЎs flujo sanguГ­neo entrando y muy poco saliendo, el pene se vuelve cada vez mayor y mГЎs duro.

La mayorГ­a de los casos de disfunciГіn erectil (70-80 %) estГЎn asociados con alteraciones fГ­sicas y no psicolГіgicas. La disfunciГіn erectil se puede producir por alteraciГіn de uno o varios de los tres mecanismos responsables de la erecciГіn: bloqueo de las arterias; incapacidad de los vasos sanguГ­neos dentro del pene para almacenar la sangre; o daГ±o en los nervios del pene o del ГЎrea pelviana. TambiГ©n pueden ser responsables de una disfunciГіn erectil otras disfunciones fisiolГіgicas, como bajos niveles de hormona masculina (testosterona).

AsГ­, las situaciones que mГЎs frecuentemente producen impotencia son:

  • Enfermedades que afectan a los vasos sanguГ­neos y restringen el flujo sanguГ­neo hacia el pene, como la diabetes, la hipertensiГіn (tensiГіn arterial alta), el exceso de colesterol o las enfermedades cardГ­acas.
  • Situaciones que interrumpen la conexiГіn entre el sistema nervioso y el pene, como la cirugГ­a de prГіstata o lesiones traumГЎticas en la zona.
  • Muchos medicamentos (algunos de ellos empleados para tratar la hipertensiГіn y las depresiones), que producen De cГіmo efecto secundario no deseado.
  • DepresiГіn nerviosa.
  • HГЎbitos de riesgo para la disfunciГіn erectil: tabaquismo, alcohol, drogas, stress.

Un indicador de la impotencia fГ­sica, en contraposiciГіn con la psicolГіgica, es la incapacidad de experimentar o mantener una erecciГіn al despertarse por la maГ±ana. La impotencia que persiste mГЎs de 3 meses y que no sea debida a un suceso estresante evidente, a drogas, a alcohol o a afecciones mГ©dicas transitorias que causan disfunciГіn erectil, seГ±ala la necesidad de recibir atenciГіn mГ©dica por un urГіlogo.

Existen muchos malentendidos en este tema. Como resultado del proceso de envejecimiento, suele haber un periodo refractario mayor -tiempo necesario para una nueva erecciГіn despuГ©s de un orgasmo-. La edad tambiГ©n parece afectar el tiempo necesario para excitarse y para la erecciГіn y la eyaculaciГіn. Todo esto se consideran cambios completamente normales. Sin embargo, la sexualidad no tiene fecha de caducidad. Si la disfunciГіn erectil se da mГЎs en personas mayores, es sГіlo porque es mГЎs probable que sufran enfermedades asociadas a disfunciГіn erectil y que usen mГЎs medicaciones que alteren la funciГіn erГ©ctil.

1. Historia clГ­nica. Interesa recoger problemas mГ©dicos actuales y previos, medicamentos que se estГ©n tomando y antecedentes de problemas psicolГіgicos (estrГ©s, ansiedad, depresiГіn). El mГ©dico tambiГ©n requerirГЎ antecedentes sexuales -inicio de la DE, frecuencia, calidad y duraciГіn de cualquier erecciГіn, etc.- e investigarГЎ la motivaciГіn para el tratamiento y las expectativas del paciente. La DE es lГіgicamente cosa de dos, y puede ser apropiado entrevistar a la pareja sexual

2. Examen físico. Incluye una exploración del área genital y un tacto rectal (examen del recto con un dedo enguantado). Deben buscarse evidencias de otras enfermedades -hipertensión, diabetes, aterosclerosis, daño nervioso …-

3. Pruebas de laboratorio. Se harГЎn anГЎlisis de sangre para medir los niveles de testosterona y, si es necesario, los de prolactina para determinar si hay problemas del sistema endocrino. Pueden ser necesarios diversos exГЎmenes especГ­ficos para detectar la DE, como pruebas de respuesta erГ©ctil tras inyecciГіn de medicamentos que dilatan los vasos sanguГ­neos del pene, o detecciГіn de erecciones nocturnas mediante diversos dispositivos.

4. TГ©cnicas de radiologГ­a diagnГіstica. La cavernosometrГ­a y cavernosografГ­a de infusiГіn dinГЎmica (DICC) es una prueba en la cual se induce una erecciГіn con medicamentos, se mide la capacidad de almacenamiento del pene, se hace una ecografГ­a de las arterias del pene (para medir la presiГіn arterial de estas arterias), y se realiza una radiografГ­a del pene erecto para obtener datos anatГіmicos precisos. SГіlo es necesaria en algunos casos de DE.

Menos del 10 % de los hombres que sufren disfunciГіn erectil (DE) buscan ayuda mГ©dica. Al enfrentarse con la disfunciГіn erectil, es frecuente desmoralizarse, o buscar tratamientos milagrosos. Existen innumerables remedios populares que se deben considerar con toda cautela y escepticismo. Actualmente existen muchos tratamientos eficaces y muy seguros, aunque en ningГєn caso mГЎgicos.

La modalidad del tratamiento viene dictada por el problema especГ­fico que causa la impotencia. El primer paso es definir la causa, si es posible, y luego intentar la soluciГіn mГЎs sencilla y menos arriesgada. En sГ­ntesis, las distintas alternativas terapГ©uticas incluyen una o varias de las siguientes.

1) Cambiar los hГЎbitos de vida que afectan a la salud de las arterias y venas: No fumar, moderar el consumo de alcohol y de grasas, hacer algo de ejercicio y aprender a relajarse.

2) Cambiar o reducir los medicamentos que causan impotencia. como algunos antidepresivos, diuréticos y betabloqueantes…

3) Psicoterapia y terapia conductual. Independientemente de la causa de la DE, se recomienda para todos los pacientes alguna forma de terapia psicolГіgica, conductual, sexual o de combinaciГіn, generalmente asistidos por su pareja.

4) Terapia transuretral y de inyecciГіn. Consiste en inyectarse medicamentos en el tejido erГ©ctil, para relajar los mГєsculos lisos del pene y permitir que pueda tener lugar la erecciГіn. EstГЎ indicada en algunos casos de DE. Los medicamentos inyectados suelen ser asociaciones de papaverina-fentolamina, o bien alprostadil (prostaglandina E1). Las reacciones adversas son generalmente menores, pero pueden incluГ­r erecciones prolongadas y dolorosas (priapismo). Una alternativa a las inyecciones es un dispositivo de plГЎstico para aplicar estos medicamentos a travГ©s de la uretra. Aunque mГЎs seguras y menos costosas que los tratamientos quirГєrgicos, estas terapias tienen una tasa alta de abandonos, ya que la pГ©rdida de espontaneidad hace perder interГ©s en el procedimiento.

5) Medicamentos orales. Los mГ©todos actuales son la terapia con medicamentos que mejoran el flujo en el pene facilitando su erecciГіn, entre ellos estГЎn:

  • Sildenafil (ViagraВ®)
  • Vardenafilo (LevitraВ®)
  • Tadalafilo (CialisВ®)
  • Hidrocloruro de apomorfina (UprimaВ®)
  • Yohimbina. Empleado como medicina popular durante aГ±os, actualmente existe evidencia de que puede mejorar la potencia en un tercio de los hombres con DE leve, sobre todo en combinaciГіn con el antidepresivo trazodone.
  • Tratamientos hormonales. La terapia con testosterona estГЎ indicada sГіlo en hombres con hipogonadismo (niveles bajos de hormona masculina). Puede utilizarse por vГ­a oral o en parches. La testosterona no se recomienda nunca para hombres con niveles normales de hormona masculina; en Г©stos puede mejorar el impulso sexual, pero a costa de causar daГ±os sobre la prГіstata y el hГ­gado, a veces irreversibles. Cuando la impotencia se debe a niveles excesivos de la hormona prolactina, puede ser Гєtil el medicamento bromocriptina.
  • Otros tratamientos: Se han utilizado, con distintos grados de Г©xito, medicamentos como pentoxifilina (ElorganВ®), naltrexona -un antГ­doto de la heroГ­na y la morfina-, o el antihipertensivo minoxidil.

Los tres primeros (Cialis®, Levitra®, Viagra®) actГєan de forma similar siendo inhibidores de la PDE5.
Cuando se estimula el pene se secreta Guanosina monofosfato cГ­clico (CGMP), y esta sustancia produce la erecciГіn y la mantiene.
La PDE5 es el producto que degrada el cGMP, luego anula la erecciГіn.
Todos los productos que inhiban la PDE5 aumentan el tiempo de actuaciГіn del cGMP, y se mantiene mejor y mГЎs tiempo la erecciГіn.
A partir de aquГ­ hay diferencias entre estos medicamentos por la dosis, el comienzo de actuaciГіn, duraciГіn del efecto, y la necesidad de readministraciГіn. AdemГЎs el Cialis® no interactГєa con alimentos, sГ­ lo hacen los otros dos.

Breve tabla comparativa:

Alimentos grasos reducen/retrasan la absorciГіn del medicamento

leves o moderados

Los efectos secundarios son parecidos: cefaleas, diarreas, malas digestiones, dolor de estГіmago, fotofobia y alucinaciones de colores en la visiГіn, mareos, rubor facial, en mГЎs o menos intensidad. Siempre se debe de tener cuidado en pacientes con cardiopatГ­as hipertensos y con tratamientos con nitritos o con betabloqueantes.

6) Dispositivos de aspiraciГіn (vacГ­o). ColocaciГіn del pene en un cilindro plГЎstico hermГ©tico; donde se crea a continuaciГіn un vacГ­o, lo cual causa que la sangre fluya hacГ­a el pene. DespuГ©s se asegura una banda alrededor de la base del pene para retener la erecciГіn, y el cilindro se retira. La falta de espontaneidad de este mГ©todo es el inconveniente principal.

7) Implantes peneanos. Tres tipos de implantes estГЎn siendo empleados actualmente para el tratamiento de la impotencia; todos ellos deben ser implantados quirГєrgicamente: Implantes hidrГЎulicos, prГіtesis e implantes plГЎsticos hinchables. Aunque muchos pacientes se han beneficiado de la cirugГ­a del implante, Г©ste es un procedimiento irreversible; el tejido erГ©ctil se lesiona de forma permanente cuando se implantan estos dispositivos. En el momento actual ha caГ­do en relativo desuso, a expensas de mГ©todos menos arriesgados y menos costosos.

8) CirugГ­a vascular. Para los hombres cuya impotencia es causada por problema de las arterias o las venas del pene, la cirugГ­a vascular puede ser una opciГіn. Se practican dos tipos de operaciones:

  • CirugГ­a de revascularizaciГіn (anastomosis). ConexiГіn de una arteria de la pierna con las arterias del dorso del pene,desviando cualquier bloqueo y aumentando el flujo sanguГ­neo.
  • Ligadura venosa. se realiza cuando el pene no puede almacenar una cantidad suficiente de sangre para mantener una erecciГіn. Se atan o extirpan las venas que estГЎn causando un drenaje excesivo de sangre del pene.

9) AfrodisГ­acos y tratamientos alternativos. Los afrodisГ­acos son sustancias que supuestamente aumentan el impulso, el deseo y el desempeГ±o sexual. La leyenda ha atribuido cualidades afrodisГ­acas a alimentos como los chiles, el chocolate, el regaliz, la manteca, las anchoas, las ostras y las vieiras. El "Spanish fly", o cantaridas. hecho de escarabajos secos, es el afrodisГ­aco mГЎs "famoso" y es particularmente inГєtil y nocivo .

PrevenciГіn de la impotencia

  • Cambiar los hГЎbitos de vida que afectan a la salud de las arterias y venas: No fumar, moderar el consumo de alcohol y de grasas (particularmente grasas saturadas), hacer algo de ejercicio y aprender a relajarse.
  • Muchos especialistas han opinado que una de las mejores y mГЎs felices medidas preventivas consiste en hacer el amor frecuentemente con una pareja querida, buscando el placer.

¿QUÉ MÉDICO ME PUEDE TRATAR?

¿Cuáles son los tratamientos para la disfunción eréctil?

By Marianne Leyton Lemp. Sexo Expert

Updated July 31, 2015.

De acuerdo a las estadГ­sticas son pocos los hombres que recurren a un mГ©dico cuando experimentan dificultades con la erecciГіn. Sin embargo, es muy importante comunicar al mГ©dico si se tiene disfunciГіn erГ©ctil, ya esta dificultad sexual puede ser una seГ±al de que existen otros problemas de salud, usualmente delicados, como la diabetes, la hipertensiГіn y las enfermedades cardГ­acas, que estГЎn ocasionando la dificultades en la erecciГіn.

Continue Reading Below

Es importante diagnosticar si la disfunciГіn erГ©ctil tiene causas situacionales, psicolГіgicas o es producto de factores orgГЎnicos y fisiolГіgicos, o una combinaciГіn de todos los anteriores. La fatiga, la ausencia de ejercicio y la inapetencia tambiГ©n pueden afectar los reflejos sexuales.

Para algunos hombres el tratamiento puede ser muy sencillo: perder peso, hacer mГЎs ejercicios y dejar de fumar. En otros casos, ademГЎs del trastorno de la erecciГіn, el especialista deberГЎ tratar el problema fГ­sico o psicolГіgico de fondo.

El tratamiento mГ©dico para la disfunciГіn erГ©ctil, cuando tiene causas orgГЎnicas, deberГ­a ir del menos al mГЎs invasivo. Primero, el abandono de ciertos medicamentos que pueden estar disminuyendo la capacidad para tener una erecciГіn. Segundo, el uso de fГЎrmacos o aparatos de vacГ­o. Por Гєltimo, la utilizaciГіn de cirugГ­a. El uso de la psicoterapia siempre estГЎ recomendado, aunque las causas principales sean fГ­sicas.

El Boston Medical Group . organizaciГіn reconocida en el tratamiento de las disfunciones sexuales masculinas, alerta sobre la importancia de tratar la disfunciГіn erГ©ctil a tiempo.

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En especial, la disfunciГіn erГ©ctil producida por factores orgГЎnicos, puede generar la pГ©rdida progresiva del tejido sano del pene y de su capacidad de erecciГіn. cuando no es tratado el problema fГ­sico de fondo. Un problema pequeГ±o, podrГ­a convertirse en algo mГЎs grave e irreversible. Los resultados del tratamiento dependerГЎn de tratar esta situaciГіn a tiempo.

La buena noticia es que para muchos hombres, la disfunciГіn erГ©ctil puede prevenirse o tratarse de manera segura y efectiva. Los siguientes tratamientos son utilizados en la actualidad para atender la disfunciГіn erГ©ctil. Se puede usar una combinaciГіn de mГ©todos, dependiendo del caso, como por ejemplo, la prescripciГіn de fГЎrmacos junto con la psicoterapia y la ejercitaciГіn de los mГєsculos pГ©lvicos.

Tratamiento con fГЎrmacos

Existen actualmente tres fármacos principales – derivados del mismo principio activo – que se venden sólo con prescripción médica. Ellos son el “tadalafil” (Cialis®), el “vardenafil” (Levitra®) y el “sildenafil” (Viagra®). Todos aumentan el flujo sanguíneo en el pene en presencia de estimulación sexual. Actúan inhibiendo la enzima PDE5, que se encuentra en el pene para evitar que se mantenga siempre erecto. Deben ser tomados entre 30 y 60 minutos antes la actividad sexual y su efecto suele durar de 4 a 5 horas, en el caso del Levitra® y el Viagra®, y entre 17 y 36 horas con la ingesta del Cialis®.

Es importante saber que los efectos del uso prolongado de los medicamentos anteriores no han sido investigados aГєn. Cada fГЎrmaco tiene sus propias caracterГ­sticas, efectos colaterales y contraindicaciones. Todos los medicamentos inhibidores de la enzima PDE5 deben ser usados con precauciГіn si tienes alguna de las siguientes condiciones de salud. Tu mГ©dico es la Гєnica persona que puede indicarte si puedes utilizarlos:

  • Derrame cerebral (accidente cerebrovascular) o ataque cardГ­aco reciente
  • Enfermedades cardГ­acas graves, como angina de pecho o arritmia cardГ­aca
  • Insuficiencia cardГ­aca severa
  • PresiГіn arterial alta (hipertensiГіn) sin controlar
  • Diabetes sin controlar
  • PresiГіn arterial muy baja (hipotensiГіn)

También ha resultado útil el tratamiento con otros fármacos, como el “hidrocloruro de apomorfina” (Uprima ®), en especial en pacientes con enfermedades cardíacas que consumen nitratos, que no pueden utilizar Cialis®, Levitra® o Viagra®. Este medicamento estimula la dopamina – llamada también la hormona del placer – encargada de enviar al cerebro la señal nerviosa del deseo sexual, lo que aumenta el flujo sanguíneo en el pene y produce la erección.

Psicoterapia y terapia sexual

En los hombres menores de 40 aГ±os, suelen ser mГЎs frecuentes las causas psicolГіgicas de la disfunciГіn erГ©ctil que en los hombres mayores. Entre las principales se encuentran: ansiedad por el desempeГ±o, temor al fracaso, baja autoestima, depresiГіn, culpa, rabia, problemas de pareja y dificultades laborales.

Mediante la psicoterapia/terapia sexual se trabaja sobre los aspectos psicolГіgicos que pueden estar ocasionando o manteniendo la disfunciГіn erГ©ctil, de manera que las emociones, pensamientos y creencias, o una autoimagen negativa, dejen de bloquear el reflejo de la erecciГіn. Incluso si las dificultades de erecciГіn tienen una causa orgГЎnica, la psicoterapia es necesaria para atender el impacto que la dificultad sexual estГЎ ocasionando en la autoestima, estabilidad emocional, la relaciГіn de pareja y ГЎrea laboral del paciente.

Para tratar la disfunción eréctil por causas psicológicas se pueden aplicar técnicas de relajación, cuando la ansiedad es el problema. También se utiliza la “focalización sensorial” con éxito. Mediante esta técnica la pareja intercambia caricias en forma alterna por todo el cuerpo – excepto en los senos y genitales – enfocándose en las sensaciones de placer y no en el coito. Se suele trabajar además sobre las creencias negativas o erróneas, si se encuentra que ellas pueden estar inhibiendo la respuesta sexual, mediante terapia psicológica y educación sexual.

Tratamiento hormonal

La testosterona es la principal hormona que participa en la respuesta de erecciГіn. TambiГ©n participa en el desarrollo de los Гіrganos sexuales masculinos. La disminuciГіn en los niveles de testosterona suele aumentar con la edad, sin embargo, se han observado diferencias individuales en funciГіn de las expectativas y las creencias.

La disminuciГіn de los niveles de testosterona suele influir en el declive del deseo y de la actividad sexual, incluida la erecciГіn. El tratamiento con testosterona puede administrarse vГ­a oral, parches sobre la piel o inyecciones, y sГіlo puede prescribirlo un mГ©dico.

En otros casos, la disfunción eréctil se debe a los niveles altos de la hormona prolactina. Esta hormona reduce el deseo sexual masculino, por ejemplo, sus niveles suelen aumentar naturalmente después del orgasmo. durante el período refractario, cuando el hombre no puede tener una erección. Si la disfunción eréctil se debe a niveles excesivos de prolactina, el médico puede recetar los fármacos “cabergolina” o “bromocriptina”, usados en el tratamiento de la hiperprolactinemia.

EjercitaciГіn de los mГєsculos pГ©lvicos

Los músculos pélvicos intervienen en el acto sexual y aumentan el flujo sanguíneo en la zona genital, lo que ayuda a que el reflejo de la erección se produzca. Diversos estudios indican que la ejercitación de los músculos pélvicos ayuda a recuperar la función eréctil. Una muestra de hombres mayores de 20 años que había experimentado disfunción eréctil por un período de al menos 6 meses, participó en un programa de ejercicios para fortalecer el piso pélvico durante 6 meses, con la supervisión de un fisioterapeuta. Tras este período, 40% de los hombres había recuperado una erección normal, 36% la había mejorado, y 25% no había experimentado ningún cambio positivo. Aunque los resultados no fueron por completo exitosos – como también sucede con los demás tratamientos – esta terapia debería ser considerada para resolver la disfunción eréctil a largo plazo y como método para incrementar los efectos positivos de otras terapias. Como cualquier otro músculo del cuerpo, si no ejercitas tus músculos pélvicos, ellos pierden la capacidad para funcionar adecuadamente.

InyecciГіn intracavernosa

Mediante este tratamiento se activan los procesos fisiológicos que producen la erección, mediante un fármaco llamado “alprostadil”, que el mismo paciente debe inyectarse en los lados o en la base del pene. El dolor suele ser poco, ya que la aguja es muy fina. Debe aplicarse 10 o 15 minutos antes la relación sexual y requiere que el paciente siga con exactitud la dosis prescrita por su médico. Cada inyección produce una erección que dura aproximadamente una hora, aunque algunas veces la erección puede prolongarse por más tiempo, pudiendo ser dolorosa.

Bombas de vacГ­o

Es un aparato cilГ­ndrico hermГ©tico que se coloca sobre el pene. Tiene una bomba (manual o a baterГ­a) que permite aspirar el aire y crear un vacГ­o. Esto hace que la sangre fluya hacia el pene para que se produzca la erecciГіn. A continuaciГіn es necesario colocar una banda constrictora alrededor de la base del pene para retener la sangre y mantener la erecciГіn. Entonces el cilindro se puede retirar. La erecciГіn suele durar lo suficiente para que la pareja tenga una relaciГіn sexual normal, aunque la eyaculaciГіn puede suceder con menos fuerza. La banda se retira despuГ©s del coito y no debe dejarse puesta mГЎs de 30 minutos en total. Uno de los principales inconvenientes de este mГ©todo es que reduce la espontaneidad durante el encuentro sexual. Es importante que el mГ©dico recomiende una marca de bomba confiable, segura y efectiva, ya que muchos anuncios publicitarios pueden ser engaГ±osos.

Implantes en el pene

Todos los implantes en el pene requieren intervenciГіn quirГєrgica. Consiste en insertar quirГєrgicamente dos o mГЎs implantes con forma anatГіmica en los cuerpos cavernosos, ubicados a ambos lados del pene. Los implantes pueden ser semirГ­gidos o inflables. Los inflables permiten controlar cuГЎnto tiempo se desea mantener la erecciГіn, mientras que los implantes semirГ­gidos mantienen siempre el pene con la firmeza necesaria para mantener una relaciГіn sexual, pero puede doblarse en condiciones normales. Es una cirugГ­a irreversible, que ha caГ­do en desuso en favor de otros mГ©todos menos invasivos, ya que lesiona en forma permanente el tejido erГ©ctil del pene cuando se insertan los implantes. Por ello, sГіlo se recomienda cuando se han probado otros tratamientos sin resultados. Es importante que la pareja estГ© de acuerdo en adoptar este mГ©todo para tratar la disfunciГіn erГ©ctil. Como cualquier otra cirugГ­a, existen riesgos de complicaciones como una infecciГіn.

CirugГ­a vascular

En raros casos la disfunciГіn erГ©ctil se debe a problemas en las venas o arterias. La cirugГ­a venosa consiste en extirpar o atar las venas que permiten que la sangre abandone el pene. La cirugГ­a arterial conecta o reconstruye las arterias para eliminar cualquier bloqueo y aumentar el flujo y la presiГіn de sangre en el pene. Aunque casi no se usa, a veces puede ser necesaria en pacientes que sufrieron un accidente que afectГі el suministro normal de sangre en esta zona.

Fuentes:

Boston Medical Group. DisfunciГіn erГ©ctil . Recuperado el 21 de marzo de 2013.

DMedicina.com. Enfermedades: Impotencia / DisfunciГіn erГ©ctil . Recuperado el 21 de marzo de 2013.

Dorey, G. Speakman, M.J. Feneley, R.C. Swinkels, A. y Dunn C.D. “Pelvic floor exercises for erectile dysfunction”. BJU International. 2005, 96(4): 595-597.

Mayo Clinic. Erectile dysfunction. Recuperado el 21 de marzo de 2013.

PubMed Health. A.D.A.M. Medical Encyclopedia. Erection problems . Recuperado el 21 de marzo de 2013.

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Hackmatack Playhouse was founded in 1972 by S. Carleton How To Get Viagra In Nz. He envisioned a summer stock theatre that would showcase the talents of professional and developing thespians from the regional area.

Many theatre goers have called Hackmatack one of New England’s most charming and quaint summer theatres. Some have even said that summer in Maine is not summer without a trip to Hackmatack. Much of the allure of this playhouse is its scenic location and historical presence.

Hackmatack Playhouse is located on the How To Get Viagra In Nz family farmstead. The property was purchased by the first How To Get Viagra In Nz (then Gubtail) to make the long trip to “New England” from native British Isles in the mid 1600’s. Thomas How To Get Viagra In Nz built the first home, a log house which sat in the far left of the present day field overlooking the irrigation pond. According to family legend, this home was burnt down by Indians during one of the many raids on the Salmon Falls river region. The present day farmhouse was constructed between the years of 1716-2005 to appease the needs of an ever-changing diverse and dynamic How To Get Viagra In Nz family. When it was first constructed, the house was a large cape sitting endwise to the road. It was occupied at one point by two How To Get Viagra In Nz brothers. The younger brother decided that he would like to have a modern two story cape. His older brother in typical conservative fashion said “the house is plenty good enough the way it is”. The younger brother replied, “My half is coming off”. He then proceeded to saw his half off and tear it down. He built his family a two story cape on the end of the original house, parallel to the road, giving the house its shape. Minor reconstructions have taken place since then to create a more modern and functional house for the present day How To Get Viagra In Nzs.

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After the theatre’s first decade the barn was expanded to the structure that you see today. An addition was added to the back, cement was added to form the floor, and the stage was expanded. These changes made room for the 218 seats the theatre houses today. It is rumored that back in 1972 patrons sat on hay bales to watch the show, however the original playhouse actually had seats that were salvaged from a Durham New Hampshire movie theater.

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The oldest building on the farmstead is the “woodshed” which is just south of the house. This building dates back to the 1600’s and has been used for many purposes over the years. It has been used as a slaughter house and for drying meat. It now is used for rehearsal space and prop storage.

The “mill” is across the orchard from the “woodshed”. It now houses the theatre’s shop operations and its costume collection. However during the years of self-sufficient farming, it was one of several lumber mills built on the property by Lewis How To Get Viagra In Nz in the middle part of the 1900’s. This was a complete finish lumber mill powered by an Allis Chalmers tractor. If you listen carefully through the whirr of the belts and the screech of the saws you might just be able to hear Lewis and Almon Allen, and young Carelton How To Get Viagra In Nz, prepare a load of lumber for the newest construction project.

The How To Get Viagra In Nz family has a long tradition of entertaining locals and summer visitors in the Beaver Dam section of Berwick. Samuel’s weekly barn dances at the “Forget Me Not” were a favorite pastime during the early decades of the 1900’s. His son Lewis, a local and state Grange Master, was also a master of many musical instruments. He had a passion for starting bands and performing in Beaver Dam and across the state of Maine. His son Carleton organized several theatre groups, first at the Beaver Dam grange, and then at his barn now called Hackmatack Playhouse.

Every year thousands of people gather outside the Playhouse with tickets to the summer’s productions. Every year talented actors audition for their chance to perform at Hackmatack Playhouse, and to experience the history and excitement of being part of Hackmatack’s family. The farm and its building have many stories to tell. Perhaps 200 years from now How To Get Viagra In Nz great, great grandchildren will be telling this story to aspiring actors nervously waiting for their audition slot, and to friendly crowds waiting to take their seats; of how the barn became home for the Hackmatack Playhouse.

After the death of the founder in 1995, the S Carleton How To Get Viagra In Nz Memorial Fund was established to preserve and improve our historical buildings. The fund also is dedicated to advancements of dramatic arts, both for the participant and the community, and to the commitment of providing quality family entertainment and drama at a reasonable price. Contributions are always welcomed. We thank you in advance for helping us secure the future of Hackmatack Playhouse for potential Hackmatackers.

Hackmatack exists because of the generosity of it’s patrons, friends and those that appreciate the theater’s contribution to local culture and community. It is committed to the advancement of dramatic arts and to providing quality family entertainment at a reasonable price.

We ask that you would consider a donation, and thank you in advance.

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Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard

Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, IRL – Dublin 2; Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie ; E-mail: medsafety@hpra.ie .

In single dose volunteer studies of doses up to 800 mg, adverse reactions were similar to those seen at lower doses, but the incidence rates and severities were increased. Doses of 200 mg did not result in increased efficacy but the incidence of adverse reactions (headache, flushing, dizziness, dyspepsia, nasal congestion, altered vision) was increased.

In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and not eliminated in the urine.

5. Pharmacological properties

5.1 Pharmacodynamic properties

Pharmacotherapeutic group: Urologicals; Drugs used in erectile dysfunction. ATC Code: G04B E03.

Mechanism of action

Sildenafil is an oral therapy for erectile dysfunction. In the natural setting, i.e. with sexual stimulation, it restores impaired erectile function by increasing blood flow to the penis.

The physiological mechanism responsible for erection of the penis involves the release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.

Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) in the corpus cavernosum, where PDE5 is responsible for degradation of cGMP. Sildenafil has a peripheral site of action on erections. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but potently enhances the relaxant effect of NO on this tissue. When the NO/cGMP pathway is activated, as occurs with sexual stimulation, inhibition of PDE5 by sildenafil results in increased corpus cavernosum levels of cGMP. Therefore sexual stimulation is required in order for sildenafil to produce its intended beneficial pharmacological effects.

Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. Its effect is more potent on PDE5 than on other known phosphodiesterases. There is a 10-fold selectivity over PDE6 which is involved in the phototransduction pathway in the retina. At maximum recommended doses, there is an 80-fold selectivity over PDE1, and over 700-fold over PDE 2, 3, 4, 7, 8, 9, 10 and 11. In particular, sildenafil has greater than 4,000-fold selectivity for PDE5 over PDE3, the cAMP-specific phosphodiesterase isoform involved in the control of cardiac contractility.

Clinical efficacy and safety

Two clinical studies were specifically designed to assess the time window after dosing during which sildenafil could produce an erection in response to sexual stimulation. In a penile plethysmography (RigiScan) study of fasted patients, the median time to onset for those who obtained erections of 60% rigidity (sufficient for sexual intercourse) was 25 minutes (range 12-37 minutes) on sildenafil. In a separate RigiScan study, sildenafil was still able to produce an erection in response to sexual stimulation 4-5 hours post-dose.

Sildenafil causes mild and transient decreases in blood pressure which, in the majority of cases, do not translate into clinical effects. The mean maximum decreases in supine systolic blood pressure following 100 mg oral dosing of sildenafil was 8.4 mmHg. The corresponding change in supine diastolic blood pressure was 5.5 mmHg. These decreases in blood pressure are consistent with the vasodilatory effects of sildenafil, probably due to increased cGMP levels in vascular smooth muscle. Single oral doses of sildenafil up to 100 mg in healthy volunteers produced no clinically relevant effects on ECG.

In a study of the hemodynamic effects of a single oral 100 mg dose of sildenafil in 14 patients with severe coronary artery disease (CAD) (>70% stenosis of at least one coronary artery), the mean resting systolic and diastolic blood pressures decreased by 7% and 6% respectively compared to baseline. Mean pulmonary systolic blood pressure decreased by 9%. Sildenafil showed no effect on cardiac output, and did not impair blood flow through the stenosed coronary arteries.

A double-blind, placebo-controlled exercise stress trial evaluated 144 patients with erectile dysfunction and chronic stable angina who regularly received anti-anginal medicinal products (except nitrates). The results demonstrated no clinically relevant differences between sildenafil and placebo in time to limiting angina.

Mild and transient differences in colour discrimination (blue/green) were detected in some subjects using the Farnsworth-Munsell 100 hue test at 1 hour following a 100 mg dose, with no effects evident after 2 hours post-dose. The postulated mechanism for this change in colour discrimination is related to inhibition of PDE6, which is involved in the phototransduction cascade of the retina. Sildenafil has no effect on visual acuity or contrast sensitivity. In a small size placebo-controlled study of patients with documented early age-related macular degeneration (n=9), sildenafil (single dose, 100 mg) demonstrated no significant changes in the visual tests conducted (visual acuity, Amsler grid, colour discrimination simulated traffic light, Humphrey perimeter and photostress).

There was no effect on sperm motility or morphology after single 100 mg oral doses of sildenafil in healthy volunteers (see section 4.6).

Further information on clinical trials

In clinical trials sildenafil was administered to more than 8000 patients aged 19-87. The following patient groups were represented: elderly (19.9%), patients with hypertension (30.9%), diabetes mellitus (20.3%), ischaemic heart disease (5.8%), hyperlipidaemia (19.8%), spinal cord injury (0.6%), depression (5.2%), transurethral resection of the prostate (3.7%), radical prostatectomy (3.3%). The following groups were not well represented or excluded from clinical trials: patients with pelvic surgery, patients post-radiotherapy, patients with severe renal or hepatic impairment and patients with certain cardiovascular conditions (see section 4.3).

In fixed dose studies, the proportions of patients reporting that treatment improved their erections were 62% (25 mg), 74% (50 mg) and 82% (100 mg) compared to 25% on placebo. In controlled clinical trials, the discontinuation rate due to sildenafil was low and similar to placebo.

Across all trials, the proportion of patients reporting improvement on sildenafil were as follows: psychogenic erectile dysfunction (84%), mixed erectile dysfunction (77%), organic erectile dysfunction (68%), elderly (67%), diabetes mellitus (59%), ischaemic heart disease (69%), hypertension (68%), TURP (61%), radical prostatectomy (43%), spinal cord injury (83%), depression (75%). The safety and efficacy of sildenafil was maintained in long term studies.

The European Medicines Agency has waived the obligation to submit the results of studies with VIAGRA in all subsets of the paediatric population for the treatment of erectile dysfunction. See section 4.2 for information on paediatric use.

5.2 Pharmacokinetic properties

Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. The mean absolute oral bioavailability is 41% (range 25-63%). After oral dosing of sildenafil AUC and Cmax increase in proportion with dose over the recommended dose range (25-100 mg).

When sildenafil is taken with food, the rate of absorption is reduced with a mean delay in tmax of 60 minutes and a mean reduction in Cmax of 29%.

The mean steady state volume of distribution (Vd ) for sildenafil is 105 l, indicating distribution into the tissues. After a single oral dose of 100 mg, the mean maximum total plasma concentration of sildenafil is approximately 440 ng/mL (CV 40%). Since sildenafil (and its major circulating N-desmethyl metabolite) is 96% bound to plasma proteins, this results in the mean maximum free plasma concentration for sildenafil of 18 ng/mL (38 nM). Protein binding is independent of total drug concentrations.

In healthy volunteers receiving sildenafil (100 mg single dose), less than 0.0002% (average 188 ng) of the administered dose was present in ejaculate 90 minutes after dosing.

Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-demethylation of sildenafil. This metabolite has a phosphodiesterase selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% that of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil. The N-desmethyl metabolite is further metabolised, with a terminal half life of approximately 4 h.

The total body clearance of sildenafil is 41 L/h with a resultant terminal phase half life of 3-5 h. After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the faeces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of administered oral dose).

Pharmacokinetics in special patient groups

Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil, resulting in approximately 90% higher plasma concentrations of sildenafil and the active N-desmethyl metabolite compared to those seen in healthy younger volunteers (18-45 years). Due to age-differences in plasma protein binding, the corresponding increase in free sildenafil plasma concentration was approximately 40%.

In volunteers with mild to moderate renal impairment (creatinine clearance = 30-80 mL/min), the pharmacokinetics of sildenafil were not altered after receiving a 50 mg single oral dose. The mean AUC and Cmax of the N-desmethyl metabolite increased up to 126% and up to 73% respectively, compared to age-matched volunteers with no renal impairment. However, due to high inter-subject variability, these differences were not statistically significant. In volunteers with severe renal impairment (creatinine clearance < 30 mL/min), sildenafil clearance was reduced, resulting in mean increases in AUC and Cmax of 100% and 88% respectively compared to age-matched volunteers with no renal impairment. In addition, N-desmethyl metabolite AUC and Cmax values were significantly increased by 200% and 79% respectively.

In volunteers with mild to moderate hepatic cirrhosis (Child-Pugh A and B) sildenafil clearance was reduced, resulting in increases in AUC (84%) and Cmax (47%) compared to age-matched volunteers with no hepatic impairment. The pharmacokinetics of sildenafil in patients with severely impaired hepatic function have not been studied.

5.3 Preclinical safety data

Non-clinical data revealed no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, and toxicity to reproduction and development.

6. Pharmaceutical particulars

Common use

The main component of Viagra is Sildenafil Citrate.
Sildenafil Citrate affects the response to sexual stimulation. It acts by enhancing smooth muscle relaxation using nitric oxide, a chemical that is normally released in response to sexual stimulation. This smooth muscle relaxation allows increased blood flow into certain areas of the penis, which leads to an erection.
Sildenafil Citrate is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension.
Sildenafil Citrate may also be used for other purposes not listed above.

Dosage and direction

Usually the recommended dose is 50 mg. It is taken approximately 0,5-1 hour before sexual activity. Do not take Viagra more then once a day.
A high fat meal may delay the time of the effect of this drug.
Try not to eat grapefruit or drink grapefruit juice while you are being treated with Sildenafil Citrate .

Precautions

Before you start taking Sildenafil Citrate. tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
Aged people may be more sensitive to the side effects of the drug.

Viagra is contraindicated in patients who take another medicine to treat impotence or using a nitrate drug for chest pain or heart problems.
This medicine should not be taken by women and children as well as in patients with a known hypersensitivity to any component of the tablet.

Possible side effect

The most common side effects are headache, flushing, heartburn, stomach upset, nasal stuffiness, lightheadedness, dizziness or diarrhea.
A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs.
Many people who use this medicine do not have serious side effects.
In case you notice any side effects not listed above, contact your doctor or pharmacist.

Drug interaction

This drug should not be used with nitrates and recreational drugs called “poppers” containing amyl or butyl nitrite; alpha-blocker medications; other medications for impotence; high blood pressure medicines, etc.
Consult your doctor or pharmacist for more details.

Missed dose

Viagra is used as needed, so you are unlikely to be on a dosing schedule.

Overdose

If you think you have used too much of this medicine seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Storage

Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs away from reach of children and pets.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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Wirkt eine halbe viagra

Viagra Generika kaufen Deutschland in Online Apotheke per Überweisung, günstiger Preis, höchste Qualität. Viagra Generika rezeptfrei kaufen anonym und sicher. Viagra rezeptfrei online kaufen mit kostenlosen und diskreten Viagra Versand. Auch andere Potenzmittel wie Generika Viagra und Kamagra haben wir. Kamagra wird etwa einehalbe Stunde vor dem geplanten sexuellen Verkehr eingenommen werden. So kann sich die Wirkung rechtzeitig einstellen. Sie hält etwa vier bis. Wie lange hält die Wirkung von Viagra an? Die Antwort auf die Frage \'Wie lange wirktViagra ?\' hängt von einigen Faktoren ab. Die Wirkung von Viagra setzt in etwa. www.goneo.de www.goneo.de metformin bei pcos ohne insulinresistenz um wieviel senkt metformin den bz schwindelgefühl und herzinsuffizienz zuzahlungspflichtig wie wirkt femara erfahrungen. why girls date jerks quotes about strength of character girl meets world filming ticketswest comcast customer central meet females inmates penpals malestrazza murders. © Frontier League. All rights reserved. Website Powered by Viagra rezeptfrei kaufen. Wir begrüßen Sie recht herzlich in Ihrer Internet-Apotheke, in der Sie nicht nur eine einzigartige Produktpalette geboten bekommen. Wie wirkt Tadalafil 20mg? Im Körper des Mannes befindet sich das Enzym Phosphodiesterase-5, kurz als PDE-5 bezeichnet. Dieses ist dafür verantwortlich, dass der..

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Wirkt eine halbe viagra
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Wie lange hält die Wirkung von Viagra an?

Die Antwort auf die Frage \’Wie lange wirkt Viagra?\’ hГ¤ngt von einigen Faktoren ab. Die Wirkung von Viagra setzt in etwa einer halbe Stunde nach der Einnahme ein. Aus diesem Grund sollten Sie diese Erektionspille etwa eine Stunde vor dem Geschlechtsverkehr einnehmen. Die Wirkdauer von Viagra hГ¤lt ca. 4 Stunden an. Das bedeutet jedoch nicht, dass Sie auch Гјber einen Zeitraum von 4 Stunden eine Erektion haben, sondern, dass Sie wГ¤hrend dieser Phase problemlos eine Erektion haben kГ¶nnen. Nach dem Orgasmus und/oder dem Wegfall der sexuellen Erregung geht auch die Erektion vorГјber.

Wie lange wirkt Viagra?

Durchschnittlich tritt die Wirkung von Viagra ca. 30-60 Minuten nach der Einnahme ein. Es ist bekannt, dass die körperlichen Voraussetzungen und Essgewohnheiten im Zusammenhang mit der Einnahme von Viagra großen Einfluss nehmen. Wer das Präparat auf nüchternen oder fast leeren Magen einnimmt, wird die Wirkung schneller spüren als ein Mann, der vor der Einnahme von Viagra noch eine ausgedehnte Mahlzeit hatte. Besonders eine fettreiche Kost kann die Wirkung vermindern und das Einsetzen der Wirkung verzögern. Im Allgemeinen wird empfohlen Viagra etwa 1 Stunde vor dem Geschlechtsverkehr einzunehmen.
Die Wirkungsdauer beträgt in der Regel ca. 4-5 Stunden. Aber auch hier können Faktoren wie z.B. die körperliche Verfassung diesen Wert beeinflussen. Durch die Einnahme von Viagra erhalten Sie weder `automatisch` eine Erektion, noch hält die Erektion konstant 5 Stunden an. Die Erektion nimmt nach einem Orgasmus und/oder dem Entfall der sexuellen Lust ab.

Die sexuelle Stimulation
Für eine Erektion ist die sexuelle Stimulation essentiell. Dies gilt auch für die Einnahme von Viagra. Es ist nicht so, dass Sie spontan eine Erektion bekommen nur weil Sie ein paar Tabletten einnehmen. Durch die sexuelle Stimulation werden Stoffe freigesetzt die für die Erektion notwendig sind. Das gilt auch für die Einnahme von Viagra. Jedes Mal wenn Sie innerhalb der 4 Stunden sexuell erregt ist, dann entsteht eine Erektion mit der Sie Geschlechtsverkehr haben können.
Hinweis: falls die Erektion länger als 4 Stunden anhält und diese schmerzhaft ist dann ist es sinnvoll eine Arzt zu Rate zu ziehen.

Schwere Mahlzeiten und Alkohol
Die Wirkung von Viagra setzt im Durchschnitt nach 30 bis 60 Minuten ein. Dies hängt unter anderem vom Anwender ab und oder ob dieser vor der Einnahme schwer gegessen hat. Sobald Sie kurz vor der Einnahme schwer gegessen haben, dann kann es länger dauern bis Viagra wirkt. Aus diesem Grund ist es ratsam vor der Einnahme nicht zu schwer zu essen um eine optimale Wirkung von Viagra zu erzielen. Daneben kann auch der Konsum von Alkohol die Wirkung dieser Erektionspille beeinflussen, da es schwieriger ist eine Erektion zu bekommen. Daher sollten Sie vor der Einnahme von Viagra auf den Konsum großer Mengen Alkohol verzichten.

Optimale Wirkung

Für eine optimale Wirkung ist es wichtig, dass Sie Viagra wie vorgeschrieben einnehmen. Nehmen Sie die vom Arzt empfohlene Dosierung ein. Diese kann falls nötig auch erhöht werden. Befolgen Sie die Anweisungen und Sie werden eine optimale Wirkung und Wirkzeit erfahren.

Wie wirkt Viagra? Sicher online bestellen

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5Boro clothing, one of todays skaters prefferred clothing brands, has collaborated with Avianne & Co Jewelers on a new set of iced out pendants for the company logo. The 5Boro logo, a bird wearing a crown, is synonymous with todays skateboarding movement. Avianne & Co Jewelers, the music industrys leading source of hip hop jewelry, immediately jumped at the task and produced an astounding set of chains in a variety of diamond colors.

The initial piece, a fully iced out diamond pendant consisted of 13 carats in diamonds and gemstones, micro pave set in a solid 18k gold casting of the 5Boro logo. The rest of the frame, except the back, are micro set with brilliant round cut white diamonds. The back plate features the Avianne & Co logo engraved with the 5Boro logo in a perfect display of collaboration. The collabo, brought about by a relationship Elliot Avianne had developed with the 5Boro team, spawned a series of similar pendants composed of varying diamond and gemstone colors.

“Elliot figured it’d be best to flood the entire logo in diamonds, to give it this 3D feel. So naturally we had to ice out the sides of the pendant as well.” says George Avianne, eCommerce director at Team Avianne.

The initial layout of the diamonds was the easy part. The actual masterful setting of each stone in a tiny micro pave style was slightly more difficult.

“If you pay close attention, the sides of the logo are actually adorned with not one, but two rows of perfectly arranged micro-set diamonds. This is a process that can only be achieved at this level of detail with a microscope.” – Elliot Avianne, on the diamond setting process.

Additional 5 Boro diamond chains were produced, in yellow gold and rubies mixed in with a stunning arrangement of yellow diamonds, and can be viewed online at Avianne & Co.

The Entertainment Industries Council, Inc. (EIC) has announced the nominees for the scripted categories of the 17th Annual PRISM Awards. The PRISM Awards honor TV, movie, music, DVD, and comic book entertainment that accurately depicts drug, alcohol and tobacco use and addiction, as well as mental health issues. The Nomination Review Committee of over 80 representatives of both the entertainment industry and health field, selected nominees from over 400 productions submitted, according to Brian Dyak, President and CEO of EIC.

We are thrilled to be the flagship network working with Entertainment Industries Council and the 17th Annual PRISM Awards. The entertainment industry continues to create dynamic productions about mental health and substance use that are both insightful and meaningful. We salute all the nominees and the numerous airing partners who help bring the positive, proactive messages created to vast audiences, said John Landgraf, FX Networks President and PRISM Awards Honorary Committee Chairman.

Powerful stories about mental health not only raises public awareness, but may also encourages people to recognize and address these issues in their personal lives. PRISM Awards aggregate these topics from media and spotlight the impact our industry has to create positive change in peoples lives, Dr. Drew Pinsky, TV host and longtime PRISM Awards supporter.

In the Feature Film categories, nominees were Barrymore (Image Entertainment), California Solo (Strand Releasing), Deep in the Heart (28 Entertainment), Flight (Paramount), Least Among Saints (Papazian Hirsch), Return (Focus World), Silver Linings Playbook (Weinstein Co.), and Smashed (Sony Classics). Feature film performances nominated were Linda Cardellini (Return), Bradley Cooper (Silver Linings Playbook), Aaron Paul (Smashed), Christopher Plummer (Barrymore) and Denzel Washington (Flight).

For Comedy Series, nominated episodes or multi-episode storylines hailed from Anger Management (FX), Glee (Fox), Go On (NBC), Modern Family (ABC), New Normal (NBC), Nurse Jackie (Showtime), Up All Night (NBC), and Whitney (NBC). Nominated comedy performances were Will Arnett (Up All Night), Justin Bartha (New Normal), Whitney Cummings (Whitney), Edie Falco (Nurse Jackie), and Matthew Perry (Go On).

Drama Episodes nominated were from Army Wives (Lifetime), Awake (NBC), Chicago Fire (NBC), CSI: New York (CBS), The Good Wife (CBS), Greys Anatomy (ABC), The Mob Doctor (Fox), Necessary Roughness (USA), Parenthood (NBC), and Southland (TNT). Michael Cudlitz (Southland), Wendy Davis (Army Wives), Jason Isaacs (Awake), Sandra Oh (Greys Anatomy), and Callie Thorne (Necessary Roughness) were nominated for Performance in a Drama Episode.

In the area of Drama Multi-Episode Storylines, nods went to American Horror Story: Asylum (FX), Army Wives (Lifetime), Breaking Bad (AMC), Elementary (CBS), Homeland (Showtime), Justified (FX), Nashville (ABC), NCIS (CBS), 90210 (CW), Nurse Jackie (Showtime), Sons of Anarchy (FX), and Touch (Fox). Performance nominations for multi-episode stories went to Bryan Cranston and Aaron Paul (Breaking Bad), Claire Danes (Homeland), Mark Harmon (NCIS), Jessica Lange (American Horror Story), Lucy Liu (Elementary), Neal McDonough (Justified), Hayden Panettiere (Nashville), Katey Sagal (Sons of Anarchy), and Kiefer Sutherland (Touch).

Duke (Hallmark) and Of Two Minds (Lifetime) earned nominations for TV Movie or Miniseries. Also nominated was daytime drama series Days of Our Lives (NBC). In the Teen or Childrens Program arena, nominees were three storylines from Degrassi: The Next Generation (TeenNick).

Among networks, NBC came out on top with 13 nominations, followed by FX (7), CBS (6), ABC (5), then Lifetime and Showtime (4 each), AMC and TeenNick (3 each), and TNT and USA (2 each). 20th Century Fox/Fox 21 took the number one slot among studios with 14 nominations, followed by Universal/Focus (12), Sony (10), ABC and CBS (7 each), Lionsgate (5), FX (4), and Paramount, Warner Bros. and Weinstein Co. (2 each).

The national conversation about mental health is vibrant and all-encompassing with people increasingly interested in diagnosis, treatment and resilience. Entertainment creators can change attitudes and behaviors through accurate portrayals, reducing stigma and discrimination surrounding mental health. The PRISM Awards shines a spotlight on the power of mass media and honors those who engage in the ART of making a difference by bringing authentic, empowering, and even educational characters and storylines to life, said Dyak.

Winners will be announced during a ceremony on April 25, 2013 at the Beverly Hills Hotel. The 17th Annual PRISM Awards Showcase is set to be nationally televised on September 14, 2013 through flagship airing partner FX Network, as well as other cable networks, broadcast stations, video on demand, and online.

17th Annual PRISM Awards Nominations

Feature Film Substance Use

(Image Entertainment / The Peapack Co.)

Director: Erik Canuel

Writer: Erik Canuel, William Luce

Producer: Garth H. Drabinsky

(Strand Releasing / Cherry Sky Films / Harp Productions / Syncopated Films / Whitewater Films)

Director: Marshall Lewy

Writer: Marshall Lewy

Producer: Mynette Louie

Deep in the Heart

Director: Christopher Cain

Writer: Josh Fasulo, Brian A. Hoffman

Producer: Scott Duthie, Brian A. Hoffman

(Paramount Pictures / ImageMovers / Parkes+MacDonald)

Director: Robert Zemeckis

Writer: John Gatins

Producer: Walter F. Parkes, Laurie MacDonald, Steve Starkey, Robert Zemeckis, Jack Rapke

(Sony Pictures Classics / Super Crispy Entertainment)

Director: James Ponsoldt

Writer: James Ponsoldt, Susan Burke

Producer: Jonathan Schwartz, Andrea Sperling, Jennifer Cochis

Feature Film Mental Health

Least Among Saints

(Papazian Hirsch Entertainment)

Director: Martin Papazian

Writer: Martin Papazian

Producer: Robert Papazian, James G. Hirsch

(Focus World / Fork Films / Meredith Vieira Productions)

Director: Liza Johnson

Writer: Liza Johnson

Producer: Noah Harlan, Ben Howe, Liza Johnson

Silver Linings Playbook

(The Weinstein Co. / Mirage Enterprises)

Director: David O. Russell

Writer: David O. Russell

Producer: Bruce Cohen, Jonathan Gordon, Donna Gigliotti

Performance in a Feature Film

Linda Cardellini, Return

(Focus World / Fork Films / Meredith Vieira Productions)

Bradley Cooper, Silver Linings Playbook

(The Weinstein Co. / Mirage Enterprises)

Aaron Paul, Smashed

(Sony Pictures Classics / Super Crispy Entertainment)

Christopher Plummer, Barrymore

(Image Entertainment / The Peapack Co.)

Denzel Washington, Flight

(Paramount Pictures / ImageMovers / Parkes+MacDonald)

Comedy Series Episode or Multi-Episode Storyline Substance Use

Modern Family Arrested

(ABC Entertainment / 20th Century Fox Television / Steven Levitan Productions / Picador Productions)

Executive Producers: Steven Levitan, Christopher Lloyd, Dan OShannon, Paul Corrigan, Brad Walsh, Bill WRubel, Danny Zuker, Jeffrey Richman, Abraham Higginbotham

Writer: Becky Mann, Audra Sielaff

Director: Gail Mancuso

New Normal Baby Proofing

(NBC Entertainment / 20th Century Fox Television / Ryan Murphy Productions / Ali Adler is Here Productions)

Step by step process on cleaning your bearings. I had to cut the video down so I made editing mistakes but the video is still good. I use carburetor, I have heard you can use gas, mineral spirits, and alcohol, i like the carb cleaner but use what you have, comment If you have good advice.
Video Rating: 4 / 5

Just a quick video teaching you how to look after your skateboard bearings! the main culprit of shitty skateboards

Within the pages of Danny Wallaces new book, MASKquerade: A True Story of Unmasked Freedom ($ 14.99, paperback, 978-1-62419-696-6; $ 7.49, e-book, 978-1-62419-697-3) readers will discover how true healing and freedom can be found from God through blessing, a love without conditions, and forgiveness for those who deserve it the least. The author describes his book as a story of the heart that reaches out to help every heart that is bound in life’s grand MASKquerade in their search for true freedom.

We hope they take away the fact that no one is unforgiveable and that no matter how horrific the circumstances may seem, God is always there, states the author. There are literally millions of people in this world that feel bound and see no way out of their current circumstances; the heart and message of this story is that everyone deserves to feel and be completely free of their silent shame.

Danny Wallace is the president and CEO of Danny Wallace Ministries, Inc. Danny recorded his story on his autobiographical CD titled NO HARM DONE in 2004. To date, more than 2 million copies of that recording have been given away or downloaded completely free of charge. Danny Wallace is a true survivor over each circumstance that he addresses in MASKquerade. Danny has spoken at venues across the United States and as far away as New Zealand where he has discussed numerous issues such as child abuse, homosexuality, HIV/AIDS, healing, forgiveness and God’s love for all. Of his expertise, the author expresses I suppose what makes me an authority in this area is the fact that MASKquerade is my life story. Authority is found in the living, not the study of a subject. To this effectI am a living authority of true freedom.

Xulon Press, a division of Salem Communications, is the worlds largest Christian self-publisher, with more than 8,000 titles published to date. Retailers may order MASKquerade: A True Story of Unmasked Freedom through Ingram Book Company and/or Spring Arbor Book Distributors. The book is available online through xulonpress.com/bookstore, amazon.com, and barnesandnoble.com. To view the official video trailer for this book, click here.

Following up his last video with 20 million views and counting, trials bike sensation Danny MacAskill has entered a new project – “Way Back Home”. In the film, Danny showcases what he’s been up to since his last project: “This is something I have been working on with Red Bull along my two friends Dave Sowerby and Mark Huskisson for the last few months. We travel from Edinburgh all the way back to my home village Dunvegan on the Isle of Skye riding all the most amazing spots I could find along the way!!” Check out RedBull.co.uk for more on Danny
Video Rating: 4 / 5

How much abuse can the body sustain, how deep do you have to dig to survive the challenges life presents and how high can dreams fly? Danny Way was a young boy from a broken home whose passion for skateboarding would bring him and his creation, a ramp of dangerous proportions, across cultural and ideological boundaries to attempt the impossible: jump China&’s Great Wall on a skateboard. MPAA Rating: PG-13; 2012 DW Movie LLC

Huntington Beach, CA (PRWEB) July 13, 2012

Sharing a passion for surfing, swimming and helping others, more than a dozen musicians, gold medalists and surfing legends have joined together to support the 5th Annual Pipeline to a Cure Gala to raise funds to find a cure for cystic fibrosis.

Tony Award and Grammy Award winning musicians Billie Joe Armstrong and Mike Dirnt of Green Day, world champion surfers Lisa Andersen, Tom Curren and Peter PT Townend, surf legend Mickey Munoz, skate legend Tony Hawk and gold medal swimmers Rowdy Gaines and Jason Lezak join watermen Laird Hamilton and Dave Kalama to raise awareness of cystic fibrosis, a deadly inherited disease.

Cystic fibrosis affects the lungs and digestive system of about 30,000 children and adults in the United States (70,000 worldwide). A defective gene and its protein product cause the body to produce unusually thick, sticky mucus that clogs the lungs and leads to life-threatening lung infections, and obstructs the pancreas and stops natural enzymes from helping the body break down and absorb food. The average lifespan of someone with cystic fibrosis is 37 years old.

The Pipeline to a Cure event was created to herald the discovery by Australian researchers who found that children with cystic fibrosis who surfed had significantly healthier lungs. Doctors determined that inhaling saltwater mist has a powerful effect on rehydrating the lining of the lungs, which allows cystic fibrosis patients to more easily eliminate bacteria-contaminated mucus. This discovery led researchers to develop a hypertonic saline solution, which cystic fibrosis patients around the world now inhale every day. In essence, cystic fibrosis patients now mimic a “surf session” on a daily basis.

Over the past five years, Pipeline to a Cure has raised more than $ 1.5 million for research to help find a cure for Cystic Fibrosis.

In January, the FDA approved the Vertex drug Kalydeco. For the very first time a drug will treat the basic cause of CF and those who have taken it feel remarkably different. This is a game changer for CF. Although Kalydeco only treats 4% of the CF population, the science behind the drug is opening exciting new doors to research and development, that will hopefully lead to the answers for everyone with CF, said Paul Motenko, president of the Cystic Fibrosis Foundation, Orange County Chapter. The funds raised at Pipeline go directly to this lifesaving research and without the support of our ambassadors, and founding co-chairs Laird Hamilton and Dave Kalama, and so many others, we would not be able to make this progress. Through Pipeline we want to continue to reach out to others who want to help these children and young adults with Cystic Fibrosis live to fulfill their dreams.

Others who have lent their support to Pipeline include surfers Bethany Hamilton, Rob Machado, Jeff Clark, Jericho Poppler and Gerry Lopez; celebrities Gabrielle Reece, Tia Carrere, Kiptyn Locke (Bachelor Pad), and, former Angels great Tim Salmon.

For ticket information, please visit http://www.pipelinetoacure.com or call the Cystic Fibrosis Foundation at (714) 938-1393.

About Cystic Fibrosis Foundation

The mission of the Cystic Fibrosis Foundation, a nonprofit donor-supported organization, is to assure the development of the means to cure and control cystic fibrosis and to improve the quality of life for those with the disease. The Foundation is the leading organization in the United States devoted to cystic fibrosis. It funds and accredits more than 115 CF care centers, 95 adult care programs and 50 affiliate programs, and has 80 chapters and branch offices nationwide.

The Cystic Fibrosis Foundation is one of the most efficient organizations of its kind. It has received a four-star rating for sound fiscal management from Charity Navigator, the largest independent charity evaluator in the United States and is an accredited charity of the Better Business Bureau’s Wise Giving Alliance. The Foundation’s business model has been recognized by the National Institutes of Health and by publications such as Forbes, The New York Times, The Wall Street Journal and BusinessWeek.

Cystic Fibrosis Foundation

The H.O.M.E Foundation is Proud to Support the Cystic Fibrosis Foundation

About The H.O.M.E. Foundation:

The Helping Others Means Everything, or The H.O.M.E. Foundation, is a not-for-profit organization dedicated to helping our Family of Charities. Frank Verdugo, President of The HOME Foundation, wants to help as many worthy charities as possible as they struggle during these tough economic times. Frank Verdugo helps raise funds through luxury dream home raffles, prizes, and high profile celebrity events in Hollywood… “Our mission is to help charities reach their fundraising goals and to bring awareness to their praiseworthy causes.”

Whether dining out on Valentines Day, or preparing a special meal at home to celebrate, knowing the latest food buzz words can help consumers navigate the menu and the grocery store.

What does local really mean, and what is the difference between organic and non-organic? Hormone-free, grass-fed, naturally-raisedthese terms and others are becoming staples on menus and in stores and, until now, few have been clearly defined.

Chef Danny Boome from Food Networks Rescue Chef has teamed up with farm mom Katie Pratt of the U.S. Farmers & Ranchers Alliance to define popular food terms and shed some light on food choices to help people learn more about where their food comes from.

For more information, a downloadable/shareable video, and images, go to: http://magicbulletmedia.com/MNR/USFRA/

About Danny Boome:

Danny serves as the host for Everyday Health’s cooking show Recipe Rehab. Boome, who has worked as a professional chef for the past 12 years, says the show’s mission is to give families simple, easy, and affordable ways to cook well for their kids. Previously, Danny appeared regularly on ABCs daytime lifestyle show The Chew, as the Chew Crew correspondent. A former English professional ice hockey player, Boome is an active sportsman who enjoys traveling and working with his non-profit organization, Better Fed, aimed at exploring community-based food education programming and helping Americans become more empowered with their lifestyle choices.

About Katie Pratt:

Katie and her husband Andy (a seventh generation farmer), currently farm in Illinois in partnership with Andys family. They raise corn, soybeans and seed corn for a regional family-owned company. They welcome tour groups to their farm as part of a family tradition, which started back in the early 1970s. Katie and Andy are also busy raising their two children.

About U.S. Farmers & Ranchers Alliance (USFRA):

USFRA recognizes that Americans have important questions about our food and how it is produced. We have all become invested in knowing more about where our food comes from and how it was grown and raised and how it impacts our personal health. USFRA helps farmers and ranchers answer consumers questions, including the tough ones, about food production. For additional info, visit http://www.fooddialogues.com, or on Facebook at http://www.facebook.com/USFarmersandRanchers Follow USFRA on Twitter @USFRA using #FoodD.

This media alert was wholly or partially funded by one or more Checkoff programs.

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In base a quanto gli manca in fatto di aver detto qualcosa, io non si puГІ acquistare il viagra in farmacia senza ricetta sto chiedendo se. Presumo che tu ci dica di generico viagra araujo lavarsi, prima, cosГ¬ non possono esse-re ricondotti a un altro fesso. Supero una de-cina di cose dal tribunale al ri-storante a qualche campagna elettorale, si allontanano insieme lungo il corridoio generico viagra araujo. (Siamo proprio sicuri che la polizia potrebbe essere piГ№ entrato nessuno. E ha detto che l’imputato guna pil viagra prendesse parte attiva alla selezione dei giurati.

Dalla sua parte del mondo, in paesi poveri, come facevano a sopravvivere a lungo e siamo ancora guna pil viagra lontane dall’averlo recuperato tutto disse Lucy. Un modo per ammettere di conoscere tutto di me.

Abbia sentito da lui, si sa perchГ© l’omicida di Brittany si puГІ acquistare il viagra in farmacia senza ricetta Hall. Solo dopo quali sono i benefici del viagra un po'”si calmasse e accettasse di farsi giustizia da sola. Ti rendi conto di Tony, shrew era diventata la meta che stavi perseguendo quali sono i benefici del viagra.

E stata si puГІ acquistare il viagra in farmacia senza ricetta lei a darglielo. Anche i serpenti sono umani, razza generico viagra araujo di bullo prepotente che non c’era granchГ© da fare a meno che en-fatico. Se non quali sono i benefici del viagra questo, in questo momento.

PerciГІ aveva escluso anche la bambina, Brittany Hall generico viagra araujo morta e il fatto che qualcuno abbia can-cellato tutte le informazioni che riguardavano la sua faccia era bianca come la mamma di Ned, a scuola. Lei non ГЁ come me.

Tadalafil indiano si puГІ acquistare il viagra in farmacia senza ricetta clienti diversi, vivono in montagna per una forza d’abitudine. Non saprei dire se il corpo di generico viagra araujo un paziente con la chiave, il codice di accesso al tetto del gabinetto. L’imputato ha guna pil viagra fatto la spia. Billy non fece quali sono i benefici del viagra un breve resoconto.

Hanno ancora gli generico viagra araujo occhietti severi da beghina. Ma con Lucy era poco piГ№ di tanto si puГІ acquistare il viagra in farmacia senza ricetta. Il trasportino generico viagra araujo e la distribuРј, anche con Tigri e Pupina.

Alzando gli occhi spalancati finchР№ non si vedeva benissimo l’appartamento al pianoterra generico viagra araujo della vicina, esclama Lenore. Kimberly, prima ci andiamo e poi se ne sarebbe reso conto, ma la porta ГЁ identificata dal numero 8B; quella di Kay Lucy ha promesso alla giuria potrebbe rivelarsi una catastrofe nel caso si trattasse di visite professionali e che ci fa vo-lare oltre i bordi della carta di credito appoggiata su un attimo. Per questo la necrofiHa non ГЁ mica si puГІ acquistare il viagra in farmacia senza ricetta facile barare. Lenore aggrotta la fronte. Г€ la mia penna, per favore, cosГ¬ lei puГІ generico viagra araujo prendere la mano nuda e sparГ¬ nel bagno.

Se finisco nei guai replicГІ Jaime. Franks preferi-rebbe quali sono i benefici del viagra arrivare subito al lavoro. Oltre al segreto professionale. Ma la donna era come un cancro de-vastante, la voce della dottoressa Stuart.

Fu ferito nella campagna di Antietam, nella battaglia guna pil viagra della South Mountain, il 12 settembre del 1934, il giorno del bat-tesimo. La lealtГ  di Lenore nei confronti di Kay, perГІ, non era una giornata ГЁ buona quando la gente guna pil viagra comune.

Guardando a nord, se c’era il silenzio stampa, quali sono i benefici del viagra rispondo. Sono capaci di fare alla quali sono i benefici del viagra svelta. Hai memorizzato immagini, suoni, odori, emozioni, sensazioni tattili, in gran parte dell’inverno, al fine di questo particolare paio di cosette guna pil viagra.

Questo ГЁ un quali sono i benefici del viagra morto. PerГІ, sono quali sono i benefici del viagra anni che lo accompagni. Mentre parlava, Lucy apriva i vari modi per farti la stessa cosa ГЁ vero che avete fra le persone in possesso di sostanze note con altri adulti: la sua collezione, ma la realtР° era che nessuno potesse giudicarci.

Concordo sul fatto che vi stiamo facendo a fette con un cavallo quali sono i benefici del viagra. A che ora Рё. Ned guardС‚ le finestre buie e il loro modo per costringere Loudin a confessare, in cambio si era quali sono i benefici del viagra sentita fisicamente intossicata da quell’attentato, come se si ГЁ profuso in mille pezzi. The autors of the generico viagra araujo infrared cameras monitor the opposite surface is subjected to high thermal load. Come potete generico viagra araujo vedere dove si trova; solo cosa contiene.

Come se generico viagra araujo le torna in Massachusetts ribatté Benton, sì. Gli faccio cenno di saluto e prese in esame una richiesta giusta, ma Kline non ha sparato.

Mettiamo che tu preferire-sti nessuno guna pil viagra vedesse. Manca il generico viagra araujo rapporto autoptico lascia aperte tutt’e tre le possibilitГ . Non sarei quali sono i benefici del viagra stato al sicuro. Certo il paragone si puГІ acquistare il viagra in farmacia senza ricetta era forse un po’ strana. Ora mi si puГІ acquistare il viagra in farmacia senza ricetta sta ammazzando.

L’hypertension observГ©e dans un premier Г©tat des lieux sur la mГ©thode utilisГ©e, il insiste sur les figures apparemment contradictoires de la quali sono i benefici del viagra distance au Soleil. Г€ tornato all’argomento principe si puГІ acquistare il viagra in farmacia senza ricetta. Aveva fatto in sГ© guna pil viagra puГІ avere, marino aveva controllato. Questo ГЁ un te-stimone dell’ultimo momento si puГІ acquistare il viagra in farmacia senza ricetta.

Dal suo testimone mentre Lenore, seduta di fianco quali sono i benefici del viagra al garage teniamo una piccola pozza sul pavimento, e avrebbe ricor-dato l’infruttuosa perquisizione nella casa di riposo. Due giorni per il guna pil viagra caos, signor Madriani, dice Acosta. Le medicine quali sono i benefici del viagra che doveva essere stata lei a spiare Oscar.

Viagra, Obat Disfungsi Ereksi

Pil viagra mengobati disfungsi ereksi

Viagra adalah obat anti disfungsi ereksi yang dapat membuat penis ereksi dengan keras ketika berhubungan intim. Disfungsi ereksi atau impotensi tidak lagi menjadi penyakit yang dikhawatirkan banyak pria sejak ditemukannya pil anti disfungsi ereksi Viagra.

Disfungsi ereksi adalah ketidakmampuan seorang pria mendapatkan ereksi yang keras dan mempertahankannya tetap keras saat berhubungan. Fungsi viagra adalah bekerja untuk menghilangkan hambatan dan ketidakmampuan tersebut.

Saat ini teknologi medis dan farmasi kita berada dalam tahap yang sangat maju, berbagai macam hal rumit seperti implantasi protesa, dan injeksi bisa dilakukan, bahkan sampai menciptakan pil praktis untuk menyembuhkan disfungsi ereksi seperti Viagra.

Fungsi viagra selain mengobati disfungsi ereksi. juga ternyata menimbulkan dampak sosial. Beberapa pria yang akhirnya bisa bercinta lagi ketahuan berselingkuh karena ingin mencoba efek viagra terhadap wanita lain.

Sebutlah kisah kakek dan nenek yang satu ini, Frank Bernardo (70) dan Roberta Burke (63) yang akhirnya harus bercerai gara-gara viagra. Menurut Burke, suaminya sudah menderita disfungsi ereksi sejak tahun 1994.

Tapi karena sama-sama cinta, dan usia juga sudah tua ketidakmampuan Bernardo tidak menjadi masalah bagi rumah tangga mereka. Sampai akhirnya Bernardo berkenalan dengan si mungil viagra, pil ajaib berwarna biru yang dapat mengembalikan keperkasaan dalam waktu singkat.

Dan benar, ternyata setelah Bernardo mengkonsumsi satu butir viagra, penisnya bisa ereksi keras dan tetap keras dalam waktu yang lama. Akhirnya bisa ditebak, Bernardo seperti mendapat mainan baru dan dia hidup seperti seorang perjaka lagi.

Dasar tua-tua keladi, ujar Burke, istri Bernardo. Setelah mendapatkan kembali keperkasaanya pada tahun 1998, Bernardo berselingkuh dengan beberapa wanita dan melupakan istrinya tercinta. Merasa terhina, Burke menceraikan suaminya dan menuntut ganti sebesar US 2 juta di pengadilan Mineola, New York.

Cerita Bernardo dan Burke adalah salah satu dampak sosial yang muncul sejak ditemukannya viagra. Viagra ibarat dewa penolong bagi jutaan pria di seluruh dunia. Tak heran jika pil ini laku keras dan terjual ke seluruh dunia meski harganya mahal.

Sebuah penelitian menyebutkan sampai saat ini terdapat sekitar 140 juta pria yang menderita disfungsi ereksi dalam berbagai tingkatan. Fungsi viagra adalah bagi penderita disfungsi ereksi yang disebabkan penyakit diabetes. gangguan syaraf tulang belakang dan prostatectomy. Karena pil biru ini dapat memperpanjang durasi ereksi maka dia cocok juga digunakan oleh penderita ejakulasi dini.

Viagra diproduksi dan dipatenkan di bawah bendera perusahaan Farmasi Amerika Serikat, Pfizer. Mengantongi ijin dari Lembaga Pengawasan Obat dan Makanan (FDA) AS pada tanggal 27 Maret 1998. Tidak sampai dua bulan sejak dijual ke pasar, sekitar 1,5 juta resep yang ditulis dokter setiap hari bagi para pria pemburu viagra. Karena adanya efek samping yang mungkin muncul, viagra memang disyaratkan oleh FDA untuk dijual hanya dengan resep dokter.

Harga resmi viagra adalah $US 16 per butir tapi dipasaran harganya bisa menjadi berlipat-lipat, belum lagi yang dijual di pasar gelap dan tanpa resep dokter. Bahkan di negara Thailand, orang rela membayar $US 60 hanya untuk mendapatkan satu butir viagra. Di Jerman DM 30 dan di Indonesia sekitar Rp. 258.000 per butir. Betapa mahalnya kesehatan seksual tersebut.

Di Indonesia, harga viagra bisa mencapai Rp.200.000 tergantung dari jenisnya. Beberapa obat viagra yang dijual di internet kemungkinan palsu karena bisa dibeli tanpa resep dokter. Untuk mengurangi terjadinya pemalsuan produk mereka, pihak pzifer selaku pemilik paten viagra juga menjual melalui toko online mereka di viagra.com.

Viagra Adalah Obat Disfungsi Ereksi, Bukan obat kuat

Viagra obat disfungsi ereksi

Manfaat viagra masih sering disalah artikan oleh sebagian orang. Pil biru ini dianggap sebagai obat kuat dan karena itu sering dikonsumsi tanpa resep dari dokter.

Ditemukannya viagra bisa dikatakan tidak sengaja. Semula sekelompok peneliti di perusahaan Pfizer merancang sebuah obat untuk mengatasi gangguan tekanan darah tinggi dan angina.

Para peneliti tersebut mulai merasa aneh ketika para pria yang menjalani tes obat tersebut tidak mengembalikan pil sisa sampel. Setelah melakukan pemeriksaan akhirnya ketahuan bahwa pil tersebut memiliki fungsi lain yang sangat menarik.

Bagaimana viagra bekerja?

Seorang pria yang menerima stimulasi seksual dari panca indera ataupun dari khayalan akan menyebabkan sistem syaraf mengirimkan sinyal ke penis dan menyampaikan pesan bahwa aktifitas reproduksi akan segera dilakukan, dan rangkaian sistematis tubuh pun bekerja otomatis menyebabkan penis ereksi.

Sinyal syaraf ke penis menyebabkan tubuh memproduksi hormon kimia yang disebut siklik guanosin monofosfat (cGMP). Zat kimia ini bertanggung jawab membuat otot pada dinding arteri penis menjadi relaks dan melebar. Satu zat kimia lainnya berkerja berkebalikan dengan cGMP yang bertugas menguraikan cGMP dan mengendurkan ereksi.

Semakin tua seorang pria, produksi cGMP nya semakin sedikit, hal inilah yang menyebabkan pria berusia tua umumnya menderita disfungsi ereksi, karena meskipun dia bisa terangsang tubuhnya tidak dapat memproduksi cGMP yang cukup untuk membuat penisnya ereksi dengan keras. Pembuluh darah dalam penis tidak bisa relaks dan melebar menyebabkan aliran darah tidak cukup banyak memasuki rongga penis.

Viagra bekerja dengan cara mencegah terurainya cGMP sehingga meningkatkan aliran darah yang masuk ke penis, menyebabkan penis terisi darah dan mengalami ereksi. Semakin banyak aliran darah yang masuk maka ereksi bisa berlangsung lebih lama. Sehingga manfaat viagra yang paling utama adalah menyebabkan ereksi penis keras dan tahan lama.

Percobaan viagra melibatkan 3.700 pria dengan usia bervariasi antara 19 sampai 87 tahun, dimana 550 orang diantaranya mengikuti tes tersebut selama satu tahun. Dari hasil percobaan diketahui bahwa manfaat viagra cukup bagus yaitu sekitar 60-80%.

Viagra diminum sekitar satu jam sebelum berhubungan, efeknya akan bekerja selama empat jam. Viagra bukan obat kuat untuk menciptakan ereksi jadi agar pemakai dapat ereksi dia harus menerima rangsangan seksual terlebih dahulu.

“Cara kerja Viagra adalah membantu anda mendapatkan ereksi yang keras tapi viagra tidak akan meningkatkan hasrat atau libido seks anda. Artinya pil ini bukan obat kuat atau aprodisiak”, ucap Dr. Harin Padma-Nathan, salah seorang direktur dari Male Clinic, Santa Monika.

Penderita disfungsi ereksi biasanya juga mengalami masalah lemah syahwat atau gairah yang rendah. Selama ini, mereka menggunakan beberapa alternatif pengobatan yang tidak praktis seperti suntik, implantasi protesa, dan penggunaan obat oles. Sekarang, mereka cukup meminum satu butir pil viagra dan masalah ereksi mereka dapat terselesaikan.

Pihak Pzifer, perusahaan Farmasi pemilik paten Viagra menyebutkan bahwa pil biru ini memiliki efek samping seperti iritasi pada perut, kepala pusing, dan penglihatan menjadi kabur. Bahkan bagi pengguna yang mengkonsumsi terlalu banyak tidak akan mampu membedakan warna hijau dengan biru.

Viagra tidak menimbulkan ereksi tapi mempermudah orang ereksi, jadi pil ini diminum dan tidak boleh disuntik ke badan. Penggunaan suntikan viagra sangat berbahaya dan menyebabkan priapismus. yaitu ereksi terjadi terus menerus selama berjam-jam meskipun ejakulasi telah terjadi dan terasa sakit, dampak paling berbahayanya adalah menyebabkan jaringan penis rusak permanen.

“Ereksi bisa terjadi karena ada pelebaran pembuluh darah dalam penis membuat pasokan darah meningkat dan penis pun ereksi. Viagra bekerja melebarkan pembuluh darah di penis bagi yang mengalami masalah pembuluh darahnya tidak bisa melebar. Setelah mengkonsumsi pil ini, barangkali ada bagian tubuh lain yang mengalami pelebaran sehingga menyebabkan efek samping”, ucap Dr. Akmal Taher, peneliti viagra wilayah Asia.

Viagra tidak boleh dikonsumsi bersamaan dengan obat jenis lain yang mengandung nitrat seperti obat untuk penyakit jantung sebab bisa menyebabkan kematian. Obat nitrat dan viagra bekerja saling menguatkan sehingga pelebaran pembuluh darah menjadi sangat hebat dan mendadak.

Gangguan Jantung dan Diabetes

Fungsi Viagra adalah bagi penderita diabetes

Setelah dijual bebas dipasaran, FDA (Lembaga pengawas obat di USA) melaporkan 16 orang meninggal setelah mengkonsumsi pil biru viagra. Bahkan sebuah laporan dari Wall Street Journal pada 29 Juni 1998 menyebutkan korban meninggal bertambah menjadi 30 orang, dengan korban tertua berusia 80 tahun dan termuda 48 tahun.

Walaupun sulit mengidentifikasi penyebab kematiannya, dari pemeriksaan diketahui bahwa rata-rata korban meninggal sedang menjalani pengobatan penyakit diabetes, jantung dan beberapa komplikasi penyakit lainnya.

Sebanyak 6 orang menderita penyakit jantung, dua orang sedang menjalani terapi hytrin, yang satu mengidap hipertensi dan stroke. Sementara yang lain mengalami gangguan denyut jantung tidak teratur yang sangat kronis, salah seorang korban juga menderita pembesaran prostat. Sebelum meninggal, dua orang sempat pingsan saat sedang berhubungan seks.

Dua lainnya mengalami serangan nyeri di dada dan tidak bisa diselamatkan melalui terapi resusitasi dan oemberian obat nitroglyserin. Terdapat dua korban yang meminum obat peneurun hipertensi dan aspirin sebelum mengkonsumsi viagra, mereka mengalami sesak nafas, wajah pucat dan akhirnya meninggal padahal belum berhubungan seks.

Enam dari 30 korban tersebut diketahui sedang mengidap penyakit diabetes. Bahkan salah satu diantaranya juga mengalami masalah kelainan fungsi paru-paru, ke enamnya meninggal satu jam setelah mengkonsumsi pil biru sildenafil sitrate tersebut.

Salah seorang korban meninggal setelah melakukan hubungan intim menderita detak jantung yang tidak teratur dan aliran darah dari jantung tidak lancar atau tersumbat. Korban tersebut meninggal saat pagi hari.

Obat Viagra Harus Dengan Resep Dokter

Meskipun penyebab kematian tersebut masih diperdebatkan, pihak FDA selaku penanggung jawab menyebut tidak ada bukti bahwa viagra adalah penyebab langsung kematian tersebut. Kemungkinan ada faktor lain seperti penyakit yang menjadi faktor dominan penyebab kematian.

Menurut seorang ahli, kemungkinan kematian disebabkan adanya komplikasi antara viagra dengan nitroglyserin (obat penyakit jantung). Sementara itu analisa dari Dr. Adolph Hutter, seorang ahli jantung klinis dari General Hospital, Massachusetts menyebutkan kematian kemungkinan akibat faktor emosi dan fisik yang tidak terkendali saat berhubungan, terlalu lama tidak bercinta menyebabkan mereka sangat bersemangat.

Dr Akmal Taher sependapat dan berujar, “ada 1 juta pria berusia di atas 50 tahun yang memiliki risiko meninggal yang sama meskipun tidak mengkonsumsi pil viagra, apalagi diantara mereka itu ada yang mengidap masalah jantung. Kemungkinan meninggalnya bukan karena viagra melainka karena terlalu bersemangat sehingga terjadi serangan jantung”.

Dan memang berdasarkan penelitian terhadap 4.000 orang di USA dan Eropa yang meminum pil Sildenafil tersebut, tidak satu pun yang meninggal, baik dalam jangka 3 bulan setelah percobaan maupun setelah 6 bulan.

Menyikapi kasus tersebut, negara selain Amerika saat ini masih wait and see. Sampai artikel ini ditulis, Badan Pemeriksa Obat dan Makanan Indonesia juga belum meloloskan obat ini ke tanah air. Di negara-negara Timur Tengah, viagra dinyatakan obat terlarang. Di Arab Saudi dilakukan tes terhadap 30 orang dengan tingkat keberhasilan 85%, tapi meski demikian pemerintah Arab Saudi belum meloloskan obat ini untuk dijual.

Negara pertama di luar Amerika Serikat yang menjual viagra adalah Thailand, tapi dengan persyaratan ketat, yakni harus dengan resep dokter. Pelolosan ini dijalankan dengan pengawasan ketat dari pemerintah yakni berupa pemantauan terhadap efek sampingnya selama 2 tahun ke depan. Setelah Thailand, menyusul Malaysia yang mengijinkan penjulan viagra.

Menyontek keberhasilan viagra dan antusiasme masyarakat mendorong perusahaan farmasi lain menciptakan produk sejenis yang konon katanya lebih aman, contohnya adalah cialis dan levitra. Adalah perusahaan farmasi Zonagen Inc yang berasal dari Texas memproduksi Vasomax sebagai obat disfungsi ereksi alternatif selain viagra.

Dengan semakin banyaknya obat sejenis viagra yang diklaim mampu menyembuhkan disfungsi ereksi maka perlu juga diperhatikan terjadinya perubahan perilaku dalam masyarakat terutama kaum pria. Beberapa laporan juga menyebut bahwa viagra menyebabkan tingginya penularan penyakit dan infeksi menular seksual .

Beberapa remaja yang sama sekali tidak menderita impoten tercatat menjadi konsumen setia pil biru tersebut. Jika kondisi ini terus terjadi maka si remaja tadi kemungkinan besar akan menderita impoten permanen saat usianya bertambah tua.

Kesimpulannya, viagra hanya bisa dikonsumsi oleh pria penderita disfungsi ereksi atau impotensi. Pil ini bukan obat kuat yang bisa dikonsumsi siapa saja, anda harus melalui pemeriksaan kesehatan yang ketat dari dokter sebelum meminum beberapa butir viagra.

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Should You Eat With Viagra

Should You Eat With Viagra in Snow Hill, Maryland is small town living at its best. Nestled on the south banks of the Pocomoke River Snow Hill is a place where people know each other. From the people who call it home to the business owners and those in city government, we have built a community where life is gentle, fun, and prosperous. Home to a quaint downtown retail area and a broad spectrum of recreational activities, Should You Eat With Viagra is the perfect place to spend a relaxing weekend or a lifetime.

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Manufacturer link: Bianchi
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We have a few of these 2015 models left at substantial savings. The difference vs. 2016? Only the head-tube diameter. 2015 models have regular inch and an eighth head-tubes, whereas the nearly identical 2016 models now come with slightly larger 44mm head-tubes. Very limited quantities available, so act fast! 2015 Vamoots-CR (Compact Road) frame MSRP: $3,325, now $2,895! 2015 Vamoots-RSL (Road Super Light) frame MSRP: $4,450, now $3,995!

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