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Viagra e ipertensione Il citrato di sildenafil. il cui nome commerciale più diffuso è Viagra. è un farmaco sviluppato. Ipertensione polmonare arteriosa di classe II: è stata approvato dall' AIFA. La terapia contro l'ipertensione (pressione alta) e una vita sessuale erettile ricordiamo: il sildenafil (Viagra ®), il vardenafil (Levitra®) e il tadalafil (Cialis®).Contatta lo specialista. Gentile professore. sono un 55enne iperteso figlio di ipertesi. Viagra. il cui unico effetto collaterale è una sensazione di calore al viso.Disfunzione erettile e sildenafil (Viagra ). Riproduzione parziale di un documento del Ministero della Sanità (1998). Parte 4 di 8. Bibliografia. Controindicazioni e avvertenze per l'usoInterazioni del viagra con altri miocardio, emorragia cerebrovascolare, attacco ischemico transitorio edipertensione .Il farmaco è indicato anche nel trattamento dell'ipertensione arteriosa polmonare di classe II-III (classificazione OMS). Il sildenafil è un potente inibitore della. 4 nov 2013 . Infatti, la mia pressione regolare è sempre intorno ai 90-95 /120-125 senza farmaci. Con i farmaci può arrivare a 80-85/ 120-125. Da quando. 25 mag 2010 .Ipertensione arteriosa polmonare: che cos'è. principio attivo del Viagra ) migliora in modo significativo la qualità di vita e la distanza percorsa. 6 nov 2012 . Tutti gli effetti collaterali del Viagra e le indicazioni su chi può usarlo. per la disfunzione erettile, ma anche nel trattamento dell'ipertensione. L'ipertensione arteriosa è definita dalla pressione arteriosa sistolica al di sopra di 14 dall'interazione dei farmaci a base di nitrati e del sildenafil (Viagra ®).

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Viagra e farmaci per ipertensione

Il citrato di sildenafil. il cui nome commerciale più diffuso è Viagra. è un farmaco sviluppato. Dal 2005 il farmaco è stato approvato dalla FDA e dall'Agenzia europea per. La terapia contro l'ipertensione (pressione alta) e una vita sessuale. Tra i principali farmaci per la terapia della disfunzione erettile ricordiamo: il sildenafil. 24 mar 2015 . compatibilità mia cura per ipertensione con il viagra chi scrive ha sessanta anni e la domanda che sottopongo alla cortese attenzione se non la associazione coi nitroderivati, farmaci che si usano in genere per la angina.L'analisi dei dati relativi alle seguenti classi di farmaci antipertensivi in pazienti ipertesi. la riduzione aggiuntiva di sildenafil (per le precauzioni vedi sezione 4.4).Per questo motivo il viagra è controindicato in queste forme cliniche. Negli USA, l' informazione pubblica sulla sicurezza del farmaco è stata giudicata. Per i cardiopatici gli affari di cuore non sono sempre facili: da un lato, i problemi. L'ipertensione arteriosa è definita dalla pressione arteriosa sistolica al di sopra di 14 dall'interazione dei farmaci a base di nitrati e del sildenafil (Viagra ®).Generalità sull'impotenza; Rimedi e farmaci contro l'impotenza; Perché fare sesso. L'erezione; Domande e risposte su Tadalafil, Vardenafil, Sildenafil e Avanafil. Per curare l'ipertensione polmonare si usa anche una forma particolare di. Il sildenafil è il primo farmaco ad uso orale indicato per il trattamento della specialità Viagra e dell'ipertensione arteriosa polmonare con la specialità Revatio.6 feb 2006 . Da diversi anni assumo al mattino una compressa di delapride e 1/4 di seloke retard ed il problema potrebbe nascere dal fatto che entrambi i farmaci vasi polmonari e in altri distretti corporei, per cui l'assunzione di viagra. Per quanto riguarda la terapia di disfunzione erettile, questo medicinale è considerato più. Questo ingrediente appartiene alla classe di farmaci contenuti anche in Viagra e Cialis. Come l'ipertensione può causare problemi di erezione? .

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Il citrato di sildenafil. il cui nome commerciale più diffuso è Viagra. è un farmaco sviluppato. Dal 2005 il farmaco è stato approvato dalla FDA e dall'Agenzia europea per. La terapia contro l'ipertensione (pressione alta) e una vita sessuale. Tra i principali farmaci per la terapia della disfunzione erettile ricordiamo: il sildenafil. 24 mar 2015 . compatibilità mia cura per ipertensione con il viagra chi scrive ha sessanta anni e la domanda che sottopongo alla cortese attenzione se non la associazione coi nitroderivati, farmaci che si usano in genere per la angina.L'analisi dei dati relativi alle seguenti classi di farmaci antipertensivi in pazienti ipertesi. la riduzione aggiuntiva di sildenafil (per le precauzioni vedi sezione 4.4).Per questo motivo il viagra è controindicato in queste forme cliniche. Negli USA, l' informazione pubblica sulla sicurezza del farmaco è stata giudicata. Per i cardiopatici gli affari di cuore non sono sempre facili: da un lato, i problemi. L'ipertensione arteriosa è definita dalla pressione arteriosa sistolica al di sopra di 14 dall'interazione dei farmaci a base di nitrati e del sildenafil (Viagra ®).Generalità sull'impotenza; Rimedi e farmaci contro l'impotenza; Perché fare sesso. L'erezione; Domande e risposte su Tadalafil, Vardenafil, Sildenafil e Avanafil. Per curare l'ipertensione polmonare si usa anche una forma particolare di. Il sildenafil è il primo farmaco ad uso orale indicato per il trattamento della specialità Viagra e dell'ipertensione arteriosa polmonare con la specialità Revatio.6 feb 2006 . Da diversi anni assumo al mattino una compressa di delapride e 1/4 di seloke retard ed il problema potrebbe nascere dal fatto che entrambi i farmaci vasi polmonari e in altri distretti corporei, per cui l'assunzione di viagra. Per quanto riguarda la terapia di disfunzione erettile, questo medicinale è considerato più. Questo ingrediente appartiene alla classe di farmaci contenuti anche in Viagra e Cialis. Come l'ipertensione può causare problemi di erezione?.

.

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Clicmedicina s.r.l.

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I Farmaci della mia Ipertensione Possono Causare Disturbi Sessuali ?

Gentile professore. sono un 55enne iperteso figlio di ipertesi. Da quasi 15
anni mi curo, prima con Enapren, ed ora con Norvasc e Losaprex. Da circa un
anno ho riscontrato disfunzioni erettili, a cui ho rimediato con l'uso del
Viagra, il cui unico effetto collaterale ГЁ una sensazione di calore al viso.
Vorrei sapere se il Cialis ГЁ altrettanto innocuo o se va usato con piГ№
prudenza del Viagra.
Grazie per l'attenzione.

L’ipertensione arteriosa rappresenta un importante fattore di rischio per il deficit erettivo a causa dell’azione negativa sulle arterie del pene. Molte volte però al disturbo sessuale maschile sembra contribuire la stessa terapia medica della ipertensione. Gli “ace-inibitori” (enapren prima e losaprex poi) hanno generalmente un ruolo irrilevante; sembra addirittura che prevengano il disturbo sessuale ostacolando la formazione di sostanze (AT-II), responsabili della contrazione del corpo cavernoso. Al contrario gli antipertensivi “calcio antagonisti” (norvasc). anche se in percentuale molto esigua, possono contribuire al deficit erettivo in quanto, a livello periferico, determinerebbero una diminuzione del rilascio dell’Ossido Nitrico (NO). In ogni caso la terapia medica bisogna sempre continuarla e solo il proprio medico curante o il cardiologo possono modificarla.
Il cialis ha lo stesso meccanismo di azione del viagra: entrambi questi farmaci, a livello del corpo cavernoso, inibiscono l’ enzima 5 fosfodiesterasi. permettendo l’accumulo di particolari sostanze (GMPc) che, sotto l’influenza dell’ossido nitrico prodotto durante lo stimolo sessuale, consentono di ottenere l’erezione. Gli studi clinici e l’esperienza diretta derivante da anni di commercializzazione fanno del cialis un farmaco sicuro, proprio come il viagra. L’unica controindicazione assoluta, per entrambi, rimane l’ associazione con nitroderivati. Comunque, in percentuali molto modeste e che non superano il 10%, sensazioni di calore, bruciore di stomaco possono essere presenti anche con il cialis. In molti casi questi disturbi tendono ad attenuarsi o a scomparire nelle somministrazioni successive.

Prof. Aldo Franco De Rose

Specialista Andrologo ed Urologo, Genova e Roma

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DRUG DESCRIPTION

VIAGRA (sildenafil citrate), an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

Sildenafil citrate is designated chemically as 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4,3d]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl]-4-methylpiperazine citrate and has the following structural formula:

Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3.5 mg/mL in water and a molecular weight of 666.7.

VIAGRA is formulated as blue, film-coated rounded-diamond-shaped tablets equivalent to 25 mg, 50 mg and 100 mg of sildenafil for oral administration. In addition to the active ingredient, sildenafil citrate, each tablet contains the following inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose, triacetin, and FD & C Blue #2 aluminum lake.

What are the possible side effects of oral sildenafil (Revatio, Viagra)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.

Stop using sildenafil and call your doctor at once if you have a serious side effect such as:

  • sudden vision loss;
  • ringing in your ears, or sudden hearing.

What are the precautions when taking sildenafil citrate (Viagra)?

Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure, a severe loss of body water (dehydration), penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease), history of painful/prolonged erection (priapism), conditions that may increase the.

Last reviewed on RxList: 10/3/2015
This monograph has been modified to include the generic and brand name in many instances.

Viagra Ingredients

VIAGRA 25 mg, 50 mg or 100mg film-coated tablets Sildenafil citrate. The active substance of VIAGRA is Sildenafil each tablet contains 25 mg, 10 mg or 100 mg of Sildenafil (as citrate). The other ingredients are: Tablet core: microcrystalline cellulose, calcium hydrogen phosphate (anhydrous), croscarmellose, magnesium stearate. Film coat hypermellose, titanium dioxide (E171), Lactose, triacetin, indigo carmine aluminum lake (E132). Marketing Authorization Holder and Manufacturing Authorization Holder

WHAT VIAGRA IS AND WHAT IT IS USED FOR:
VIAGRA film-coated tablets are blue, with a rounded-diamond shape. They are marked "PFIZER" on one side and "VGR 25", "VGR 50" or "VGR 100" on the other side. The tablets are provided in blister packs containing 1, 4, 8 or 12 tablets. VIAGRA belongs to a group of medicines called phosphodiesterase type 5 inhibitors. It works by helping to relax the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited. VIAGRA will only help you to get an erection if you are sexually stimulated. You should not take VIAGRA if you do not have erectile dysfunction. You should not take VIAGRA if you are a woman.
VIAGRA is a treatment for men with erectile dysfunction, sometimes known as impotence. This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity.

BEFORE YOU TAKE VIAGRA
Do not take VIAGRA:
" If you are taking medicines containing nitrates, or nitric oxide donors such as amyl nitrite ("poppers"). These medicines are often given for relief of angina pectoris (or "chest pain"). VIAGRA can cause a serious increase in the effects of these medicines. Tell your doctor if you are taking any of these medicines. If you are not certain, ask your doctor or pharmacist.
" If you have ever had an allergic reaction to VIAGRA or any other ingredient listed above. An allergic reaction can be a rash, itching, a swollen face, swollen lips or shortness of breath. If this has ever happened to you, tell your doctor.
" If you have a severe heart or liver problem.
" If you have recently had a stroke or a heart attack, or if you have low blood pressure.
" If you have certain rare inherited eye diseases (such as retinitis pigmentosa).

Take special care with VIAGRA:
Please tell your doctor
– If you have sickle cell anemia (an abnormality of red blood cells), Leukemia (cancer of blood cells), multiple myeloma (cancer of bone marrow) or any disease or deformity of your penis. These conditions may require special care when taking medicines for erectile dysfunction.
– If you have problems with your heart. Your doctor should in that case carefully check whether your heart could take the additional strain if having sex.
" If you currently have a stomach ulcer, or a bleeding disorder (such as hemophilia).
You should not take VIAGRA with any other treatment for erectile dysfunction.
Special considerations for children " VIAGRA should not be given to children under the age of 18. Special considerations for elderly patients over 65 years of age. If you are elderly, your first dose of VIAGRA should be adjusted.
Special considerations for patients with kidney or liver problems. You should tell your doctor if you have kidney or liver prob1ems. Your doctor may decide that your dose should be different.

Driving and using machines:
VIAGRA can cause dizziness and effects on vision. You should be aware of how you react to VIAGRA before you drive or operate machinery.

Using other medicines:
Please inform your doctor or pharmacist if you are taking or have taken recently other medicines, even those not prescribed. VIAGRA tablets may interfere with some medicines, especially those used to treat chest pain. In the event of a medical emergency, you should tell anyone treating your condition that you have taken VIAGRA. Do not take – VIAGRA with other medicines unless your doctor tells you that you can. VIAGRA may cause a serious increase in the effects of medicines called nitrates, and nitric oxide donors such as amyl nitrite ("poppers"). These are often used for the relief of angina pectoris (or "chest pains"). You should NOT take VIAGRA if you are taking these medicines.
If you are taking protease inhibitors, suck as for the treatment of HIV, your doctor may start you on the lowest dose (25 mg) of VIAGRA.

HOW TO TAKE VIAGRA:

If you have the impression that the effect of VIAGRA is too strong or too weak, talk to your doctor or pharmacist. You should take VIAGRA about one hour before sexual activity. Swallow the tablet whole with some water.
VIAGRA will only help you to get an erection if you are sexually stimulated. It will not give you an erection if you are not sexually stimulated. The amount of time VIAGRA takes to work varies from person to person, but it normally takes between half an hour and one hour. You may find that VIAGRA takes longer to work if you take it with a heavy meal. Drinking alcohol can temporarily impair the ability to get an erection. To get the maximum benefit from your medicine, you are advised not to drink large amounts of alcohol before taking VIAGRA. If VIAGRA does not help you to get an erection, or if your erection does not last long enough for you to complete sexual intercourse you should tell your doctor.
You should not use VIAGRA more than once a day. If you take more VIAGRA than you should
A dose above 100 mg does not increase the efficacy. However, it will result in an increase in undesirable effects and their severity. You should not take more tablets than your doctor tells you to. If you take more tablets than you have been told to take contact your doctor.

POSSIBLE SIDE EFFECTS:
Like all medicines, VIAGRA can have side effects. These effects are normally mild to moderate in nature. The most common undesirable effects are headache and facial flushing. Less commonly reported undesirable effects are indigestion, dizziness, stuffy nose and effects on vision including colour tinge to vision, increased brightness of light or blurred vision). Muscle aches can occur if VIAGRA is taken more frequently than once a day. Rarely, prolonged and sometimes painful erections have been reported after taking VIAGRA. If you have such an erection which lasts continuously for more than 4 hours, you should contact a doctor immediately. Rarely, hypersensitivity reactions (including skin rashes) have been reported. Heart attack, stroke, irregular heart beats, and death have been reported rarely in men taking VIAGRA. Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to VIAGRA. Particularly in case of chest pain occurring during or after intercourse you should not use nitrates but you should contact immediately your doctor. If you have any of these undesirable effects and they are troublesome, severe, or do not go away as treatment goes on, tell your doctor. If you notice any side effects not mentioned in this leaflet, please tell your doctor or pharmacist

STORING VIAGRA:
Keep out of the reach and sight of children. Do not store above 30°C. Keep tablets in the original package, protected from moisture. Do not use after the expiry date stated on the pack.

Keep this and all other medicines safely out of the reach of children.

* Reported during post-marketing surveillance only

**Visual colour distortions: Chloropsia, Chromatopsia, Cyanopsia, Erythropsia and Xanthopsia

***Lacrimation disorders: Dry eye, Lacrimal disorder and Lacrimation increased

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

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Copyright В© 1998-2016, USAbox.com В® all rights reserved.

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.

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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Viagra

GENERIC NAME(S): SILDENAFIL CITRATE

Uses

Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction -ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Sildenafil is also available in other brands and strengths for treating high blood pressure in the lungs (pulmonary hypertension ). Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction -ED or pulmonary hypertension (such as tadalafil, vardenafil).

How to use Viagra

Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

To treat erectile dysfunction -ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily.

A high-fat meal may delay how quickly the drug begins to work.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if your condition does not improve.

Side Effects

Dizziness. headache. flushing, or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision. or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Sexual activity may put extra strain on your heart. especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex. stop and get medical help right away: severe dizziness, fainting. chest/jaw/left arm pain, nausea .

Rarely, sudden decreased vision. including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking sildenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease. diabetes. high cholesterol. certain other eye problems (“crowded disk”), high blood pressure. if you are over 50, or if you smoke.

Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking sildenafil and get medical help right away if these effects occur.

In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction. including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure. a severe loss of body water (dehydration), penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease ), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia. leukemia, multiple myeloma ), eye problems (such as retinitis pigmentosa. sudden decreased vision, NAION).

This drug may make you dizzy or cause vision problems. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This brand of the drug is usually not used in women. During pregnancy, sildenafil should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

A product that may interact with this drug is: riociguat.

Sildenafil can cause a serious drop in your blood pressure when used with nitrates. A serious drop in blood pressure can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use sildenafil with any of the following: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called “poppers” containing amyl nitrate, amyl nitrite, or butyl nitrite.

If you are also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of sildenafil to minimize your risk of low blood pressure.

Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as ritonavir, saquinavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), mifepristone, rifampin, among others.

Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil).

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness, fainting, painful/prolonged erection.

Notes

Do not share this medication with others.

Missed Dose

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

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The new pill that works faster than Viagra

by ESME FLOYD, femail.co.uk

Impotence or, to give it its correct name, erectile dysfunction affects an astounding one in ten men in the UK.

Until recently, the disorder was a taboo subject, but with increased publicity in the last few years, even the most reluctant men are beginning to seek medical help.

For years, the only treatment option was injections into the penis. Then came Viagra, the little blue pill that works directly on smooth muscle – a type of muscle in our bodies that we can’t control consciously – to allow blood to flow into the penis and cause an erection.

To date, 15 million men worldwide have depended on Viagra to stop their impotence.

But this summer a new drug, Uprima, was released onto the market which works on the parts of the brain that control smooth muscle contractions to give the same effect as Viagra, only quicker.

Uprima targets the parts of the brain which control the movement of smooth muscle in the penis, stimulating it to relax and boosting blood flow.

Unlike Viagra, which is a pill swallowed with food, Uprima is a tablet that dissolves under the tongue and has an effect in 15 minutes rather than the hour it takes for Viagra to work.

This fast action means that the drug is more spontaneous than Viagra, says Dr Wallace Dinsmore of the Royal Victoria Hospital in Belfast, which can make a difference to some men.

Men who find erectile dysfunction frustrating, embarrassing and hard to talk about, says Dr Dinsmore, may abstain from sex rather than admit to having a problem.

Wives and girlfriends often don’t realise there is a physical problem and assume their partners are having an affair or have lost interest.

Viagra and Uprima don’t work unless there is some sexual stimulation there to start with, so they are best used by people who do feel sexually stimulated but have erection problems rather than those who suffer from a low libido. Although impotence can be a cause of low libido in itself because of self confidence problems.

The main cause of impotence, says Dr Dinsmore, is the hardening or obstruction of blood vessels which leads to decreased blood flow. As it is increased blood flow which causes the penis to become erect normally, a lack of blood can cause erectile problems.

Uprima and Viagra work on the principle that if the smooth muscle is relaxed, blood flow will be easier and erectile dysfunction will disappear. For 80 to 90 percent of men, he says, one or other of these drugs will be effective.

Most of the underlying causes of impotence involve blood vessels, says Dr Dinsmore. Smoking, diseases like diabetes, heavy drinking and heart problems can all lead to blood vessel obstruction and therefore impotence, he says, whilst emotional issues can exacerbate the problem.

Uprima has been around since June and is growing in popularity. Dr Dinsmore suggests that rather than thinking of it as a competitor to Viagra, the two drugs should be used as alternatives.

Whilst Viagra’s generalised effects might be better for some men, the faster action and spontaneity of Uprima might suit others best. Both are very straightforward, simple drugs with few side effects, he says.

Although it is available on the NHS, Uprima is covered by the same strict prescribing rules as Viagra which forbids GPs prescribing either drug except for men who suffer MS, diabetes, Parkinsons, kidney or liver failure or severe spinal injury.

GPs are able to give a private prescription which means you can purchase the drug through your pharmacy or chemist by paying the full rate rather than the discounted prescription rate. This cost is approximately ВЈ20 but varies between pharmacies.

Many GPs are unwilling to prescribe the drugs themselves and will prefer to make a referral to a specialist for a prescription, says Dr Dinsmore. Before prescription, your GP or specialist will check your blood pressure, blood sugar levels and general health to make sure it is safe for you to take the drugs.

Interestingly, both treatments emerged from other cures – Viagra was originally designed as a treatment for Angina and Uprima was originally used for Parkinsons but doctors noticed that one of the side effects of both drugs was that they restored erections in impotent men.

Seeing a GP for a prescription rather than buying abroad or online is very important, he warns, because both drugs can cause side effects in some men. Uprima can cause nausea and light-headedness whilst Viagra has been reported to lead to facial flushing, sinusitis and joint and muscle pain in some men.

Not only can they be dangerous in the wrong hands, most people don’t realise that it is currently illegal to possess either drug in the UK unless you have a prescription, Dr Dinsmore warns.

Because of the immense publicity surrounding impotence, which used to be a problem that stayed behind firmly closed doors, more treatments are being developed all the time. The most promising of these is Cialis, which works on the same principle as Viagra and Uprima to relax smooth muscle but promises less side effects and a longer action time, giving it it’s nickname – the ‘weekend pill’. Cialis has been shown in trials to be effective in 85 per cent of men. The drug is pending approval and could be available in the next year, so watch this space.

A brand new book published this week entitled Impotence: a guide for men of all ages by Dr Wallace Dinsmore and Dr Philip Kell (price ВЈ9.95, ISBN 1-85315-402-4) is available from Marston Book Services, PO Box 269, Abingdon, Oxon OX14 4YN Tel: 01235 465 500

For more information on impotence contact the Impotence Association’s Helpline on 020 8767 7791 or go to www.impotence.org.uk

Share or comment on this article

Wireless Innovation Alliance // Jun. 16

Earlier today, Reps. Darrell Issa (R-CA) and Anna Eshoo (D-CA) sent the attached letter to FCC Chairman Tom Wheeler on the importance of establishing the technical rules necessary to allow unlicensed use of the 600 MHz band. The Wireless Innovation Alliance (WIA) released the statement below in response. More

Wireless Innovation Alliance // Apr. 17

The Wireless Innovation Alliance (WIA) released the statement below on today’s FCC Open Meeting where the Commission approved an order to implement a spectrum sharing framework in the 3550-3700 MHz band. More

Wireless Internet Service Providers Association // 10:05 AM EST// Mar. 23

The National Association of Broadcasters (NAB) wants the FCC to declare an “emergency” and shut down the databases that let small businesses and others deliver broadband over vacant spectrum near television channels. More

Wireless Innovation Alliance // 6:06 PM EST// Feb. 10

The Wireless Innovation Alliance (WIA) released the statement below in response to the introduction of the House and Senate Wi-Fi Innovation Act More

Wireless Innovation Alliance // 4:44 PM EST// Jan. 28

The Wireless Innovation Alliance applauds the FCC for telling Marriott International, Inc. – and everyone else – that it is illegal to interfere with lawful communications. More

Wireless Innovation Alliance // 3:00 PM EST// Dec. 15

This October, the FCC found Marriott’s Gaylord Opryland Hotel and Convention Center to be guilty of blocking guests’ personal Wi-Fi hotspots and fined Marriott International $600,000. Lend your social voice to our Thunderclap. More

Wireless Innovation Alliance // 5:47 PM EST// Sep. 4

FCC Chairman Tom Wheeler acknowledged the critical role unlicensed spectrum plays in growing competition in the broadband marketplace stating that the FCC’s “efforts to expand the amount of unlicensed spectrum creates alternative competitive pathways.” More

The Hill // 9:25 AM EST// Jun. 16

CEA released a report, Unlicensed Spectrum and the American Economy, examining the economic impact of unlicensed spectrum on the American economy. More

The Wireless Innovation Alliance (WIA) is a broad-based group of innovators, providers, consumer groups, think tanks and education organizations that believe that more efficient use and expanded access to the nation’s spectrum resources are fundamental to the future of U.S. economic policy and global competitiveness, and that we face potential spectrum scarcities in both licensed and unlicensed bands that must be addressed in order for innovation and investment to move forward.

Spectrum, and specifically, the most efficient and expansive use of this most valuable natural resource, is fundamental to the future of U.S. economic growth, and global competitiveness. United States spectrum policy must also be efficient and flexible as well, so that we can encourage and accommodate new and innovative ways to meet the growing demand for wireless services and applications, and the growing inability – in both licensed and unlicensed bands – to meet that demand.

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Wednesday through Saturday evenings at 8:00 pm with a Thursday matinee at 2:00 pm.

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Hackmatack Playhouse was founded in 1972 by S. Carleton How To Make Homemade Viagra. 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 Make Homemade Viagra family farmstead. The property was purchased by the first How To Make Homemade Viagra (then Gubtail) to make the long trip to “New England” from native British Isles in the mid 1600’s. Thomas How To Make Homemade Viagra 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 Make Homemade Viagra 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 Make Homemade Viagra 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 Make Homemade Viagras.

Prior to the year of 1972 when the theatre was established, the How To Make Homemade Viagra family farm functioned like many other farms at the time. The barn was the focal point of the farm. The current barn has an interesting story much like the original house. One of the first barns was struck by lightning and burned in July of 1934. Haying had just been completed for the season, and it is thought that the heat from the newly cut hay attracted the lightning. Almost immediately, Lewis How To Make Homemade Viagra began looking for the right barn to replace what had been lost. He finally purchased a barn. It was a large old structure with pegged timbers measuring fifty four feet long and forty two feet wide. It was the perfect replacement for the old barn. However, there was one small problem, it was located across the street.

Luckily, the How To Make Homemade Viagra’s have always been known for their ingenuity. It was with this cleverness that Lewis decided it would be easier to move the barn rather than disassemble it and rebuilt it. The entire barn was jacked up and rollers were placed underneath it. A cable was attached to one end of the barn that ran though a large turnstile. An old white horse was chosen for the job of slowly moving the barn. The horse was hitched to the turnstile and the horse walked in circles, stepping over the cable on every lap. The leverage was great and each time the horse made a circle, the barn moved one half inch. Progress was slow. The entire operation took about three days, a day of that was spent crossing Maine route 9. However, in 1934, Maine route 9 was much less traveled, and everyone cheerfully watched or made their own route around the barn.

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.

The grounds of Hackmatack Playhouse and the area surrounding the theatre host many other buildings built and used by the How To Make Homemade Viagra clan over the years. The yellow family of buildings just south of the theatre (now owned by the Mills family) was originally built by Samuel How To Make Homemade Viagra in the early part of last century. Known as the Forget-Me-Not, these buildings housed services for early automobile travelers, including fuel for the autos, and food for the hungry. Visitors could rent a cabin, and if they happened to be staying on a Saturday night, they were in luck. On Saturday night there were always barn dances.

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 Make Homemade Viagra 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 Make Homemade Viagra, prepare a load of lumber for the newest construction project.

The How To Make Homemade 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 How To Make Homemade 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 How To Make Homemade 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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Las escrituras antiguas han sido la prueba bastante que el poder de vasikaran ha jugado una parte importante en los rituales de atracciones y aГ±orando a queridos. Y se utilizГі para varios principios y motivos. Su potencia se sintiГі por varias razones y vasikaran se podrГ­a con Г©xito usar para una variedad de objetivos. Algunos de ellos se enumeran bajo los tГ©rminos aquГ­ establecidos:

Sammohan vasikaran yantra -

Encantando este yantra, se puede hacer la persona mГЎs amada entre cada uno por su poder dual de sammohan y vasikaran.

Vasikaran akarshan yantra -

Este encanto yantra le puede ayudar a atraer o encantar a cualquier persona hacia usted.

Sarvjan vashikaran yantra -

Considerado como yatra potente, que esto ayuda a impresionar, atraer e influir en cada uno con que entra en contacto. Se dice hasta que este yantra tiene el poder de controlar y atraer a seres de todos 3 lokas en el hindГє puranas.

Sighra vivah vashikaran yantra -

Para aquellos que no son capaces de casarse y su edad pasa, el mantra ayuda en el empuje de las posibilidades de casarse. Este yantra o mantra trabajan desbloqueando los yoga karmic que retrasa el proceso de matrimonio. Se considera que tiene poder inmenso y trabajos grandes para la gente que estГЎ enamorada, pero afronta problemas debido a desaprobaciГіn o interferencia por otros. Este sighra vivah vashikaran yantra trabaja bien cuando encantado tanto por el varГіn como por la mujer.

Shatru Vashikaran yantra -

Cuando es preocupado por sus enemigos, este yantra puede traer a esta gente en su control. TambiГ©n se dice que soluciona tales asuntos legales que han estado continuando desde muchos tiempos. Se considera que como uno de los instrumentos mГЎs potentes obtiene el poder y el dominio sobre enemigos y la victoria de la ganancia sobre ellos, que era quizГЎs imposible desde mucho tiempo. trabaja cambiando de opiniГіn de los enemigos y trГЎigales para obedecerle, si el yantra se encanta en una base regular. TambiГ©n ayuda en rechazar espГ­ritus malignos y pensamientos hostiles no deseados.

Pati Vashikaran yantra -

Esto es un mantra que tiene varios efectos en la vida casada donde las necesidades femeninas de controlar al marido que hace trampas, teniendo uniones libres o no es atento a la esposa o a casa. Regular encantador del mantra ayuda en traer al marido bajo el control de la esposa y restaurarГЎ una vida casada dichosa. Lo mismo se mantiene para un marido si la esposa es rebelde y no tiene el interГ©s a la vida casada.

Kaamdev vashikaran sammohan yantra -

Es yantra mГЎs potente y eficaz que puede producir resultados inmediatos si quiere traer a alguien para estar enamorado de usted. La mayor parte de sabios yogic han creГ­do que esto es el Гєnico camino y la manera mГЎs potente de hacer asГ­. Esto es otra vez de tipos diferentes que pueden dar segГєn la necesidad del creyente.

Г‰stos son los tipos de vasikaran yantras que tienen su origen en antigГјedad y han sido propagados por la gente culta que ha dominado magia negra y cultos. Es con la parte de penitencia y rezos que tales yantras se han sacado y es el tiempo probado para ser eficiente para aquellos que creen en ellos y prГЎctica con la diligencia.

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Hay muchos motivos una persona puede necesitar servicios mГ©dicos del urologГ­a profesionales. La mayor parte de personas piensan en infecciones del tracto urinario al principio, pero hay mucho mГЎs circunstancias que pueden requerir los servicios de su especialista del urologГ­a de Florida central local. El profesionalismo, la educaciГіn y la experiencia son factores cruciales en cualquier profesional mГ©dico y muchos profesionales mГ©dicos pueden proporcionar esto y la discreciГіn y la accesibilidad tenГ­a que hablar de las condiciones asociadas con el sistema del tracto urinario o el sistema reproductivo masculino.

Un urГіlogo se entrena en el diagnГіstico, tratamiento, direcciГіn y procedimientos quirГєrgicos relacionados con desГіrdenes asociados con los riГ±ones, vejiga, uretra y ureters. TambiГ©n son entendidos en disfunciГіn erГ©ctil, infertilidad masculina, vejiga hiperactiva, cГЎnceres de los testГ­culos, prГіstata, pene, vejiga, riГ±ones y la cГЎpsula suprarrenal. Sabiendo que buscar y que preguntar un urГіlogo le puede ayudar a mantener la salud urolГіgica.

El sistema urolГіgico consiste en riГ±ones, que eliminan desechos de su torrente circulatorio, ureters que productos de residuos lГ­quidos de transporte a la vejiga. Hay millones de nervios, las docenas de mГєsculos, esfГ­nteres y ligamentos de apoyo todo el funcionamiento juntos para quitar esta basura de su cuerpo. La enfermedad, la vejez y las heridas pueden causar el debilitamiento o el daГ±o al sistema urolГіgico, llevando a la necesidad de evaluaciГіn mГ©dica y tratamiento.

La primera prueba solГ­a decidir que la salud urolГіgica es un urinalysis. Esta prueba simplemente requiere que la orina se coleccione en una taza y luego se envГ­e a un laboratorio donde se prueba. Se puede requerir una prueba de urodynamic, en la cual un pequeГ±o tubo, llamado un catГ©ter, se inserta en la uretra para tener en cuenta adelante, examen visual.

Las condiciones comunes que requieren la asistencia mГ©dica incluyen una prГіstata ampliada, sГ­ndrome de la vejiga doloroso, cГЎlculos renales, incontinencia urinaria, infecciones del tracto urinario, acentГєan la incontinencia y la retenciГіn urinaria. Cada una de estas condiciones requiere servicios mГ©dicos del urologГ­a muy entrenados. El Viejo cuento de Mujeres de la bebida del zumo del arГЎndano para curar una infecciГіn del tracto urinario autГ©ntica trabaja sГіlo raramente y hasta entonces, las causas subyacentes no se resuelven, abandonando al paciente abierto para futuras infecciones y complicaciones adicionales.

Los servicios mГ©dicos del urologГ­a especializados incluyen tanto procedimientos quirГєrgicos como no quirГєrgicos. Este campo de la medicina cubre tantos sistemas del cuerpo y especialidades que muchos especialistas entran en subdisciplinas para ayudar mejor a resolver su condiciГіn particular. Estas disciplinas de la suscripciГіn incluyen:

* Endourology-un campo de lo menos – cirugГ­a invasiva que usa el tracto urinario como un punto de acceso para muchos procedimientos
* OncologГ­a – cГЎnceres del sistema urolГіgico
* Neurourology – causas neurolГіgicas de micciГіn anormal
* PediГЎtrico – desГіrdenes en niГ±os
* Andrology – el sistema reproductivo masculino
* El urologГ­a reconstructivo – corrige, repara y aumenta aspectos del genito-tracto-urinario
* El urologГ­a femenino – se concentra en vejiga hiperactiva, incontinencia y Гіrganos pГ©lvicos protranscurridos

El sistema urolГіgico es complejo y requiere que servicios mГ©dicos del urologГ­a especializados funcionen correctamente y mantengan la salud Гіptima y el bienestar. La mejor manera de mantener su salud urolГіgica es hacer citas regulares con su especialista del urologГ­a de Florida central hoy y beber mucha agua fresca, limpia.

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MГЎs o menos todos los mГ©dicos convienen en la eficacia asombrosa de aceites esenciales excepto poco inflexible. Las enfermeras y los consultores que trabajan con los pacientes inoperablemente enfermos fuertemente recomiendan aceites esenciales como un elemento de tratamientos que son realmente cuidadosos. El trato con el petrГіleo importante se ha hecho comГєnmente aceptado entre muchos consultores, cirujanos, hospicios y clГ­nicos. Muchos endocrinologists, oncologists, los psiquiatras asГ­ como los analistas mГ©dicos ponen en prГЎctica este petrГіleo en sus proyectos de tratamiento. Cualquier empleado de asistencia mГ©dica que use este petrГіleo le dirГЎ que el petrГіleo debe ser puro cuando utilizado en cualquier antidepresivo, antisГ©ptico, o producto del analgГ©sico. Cada uno de ellos debe pasar por la cumbre de los procedimientos de pruebas de la variedad, hasta camino mГЎs que medicinas universales. Empleando la chromatography de gas, la conformidad de unos aceites esenciales seleccionados seguramente serГЎ del estГЎndar alto.

Cualquier planta de destilaciГіn del vapor se debe considerar en una base consecuente y pasar todos los estГЎndares de aceites esenciales industriales. No hay productos quГ­micos que se puedan usar alguna vez haciendo este petrГіleo puro. En mirar los numerosos motivos detrГЎs del cГЎncer, se ha revelado que los productos quГ­micos artificiales son una causa principal. Estos productos quГ­micos artificiales contaminan el ambiente. El amianto es una relaciГіn directa de la prueba entre precios del cГЎncer y el ambiente. El precio de la diabetes juvenil tiene el cielo disparado debido a la exposiciГіn de campos magnГ©ticos electro. Hay una cantidad seria de la investigaciГіn documentada para demostrar estos descubrimientos. Muchos cГЎnceres digestivos son debido a precios pesados de productos quГ­micos encontrados en nuestra agua potable. La mayor parte de todos pros en el campo de asistencia mГ©dica estГЎn seguros que los tratamientos formados de este petrГіleo se convierten en un tratamiento por muchos pacientes de tratamiento del cГЎncer. En verdad, allГ­ son muchos recomienda quienes sostienen ahora la utilizaciГіn de aceites esenciales. Hay algunos analistas que realmente sostienen el empleo del petrГіleo conocido como la Bardana. Dicen que esto aceites esenciales actuales reprime el cГЎncer.

Se ha probado que la Bardana se prescribe para muchos pacientes del cГЎncer de mama. Se ha mostrado que este petrГіleo concentrado controla complicaciones de la mayor parte de tratamientos del cГЎncer de mama por lo general usados. La bardana tambiГ©n es Гєtil en el mantenimiento de muchos pacientes enfermos sistemas inmunolГіgicos. Muchos aceites esenciales son sumamente provechosos en tratamientos de colon y cГЎncer pancreГЎtico acelerando el tiempo de recuperaciГіn y ayudando a niveles del alimento de aumento para pacientes que no tienen apetito. MГЎs o menos todos los tratamientos del SIDA y el VIH todavГ­a estГЎn en el proceso experimental. Esto es la razГіn por quГ© muchos doctores prescriben ahora el petrГіleo importante como un sistema alternativo al tratamiento medicamentoso experimental. Se ha mostrado que el geranio tiene rasgos antiproliferative gloriosos. Este petrГіleo ayuda incrementando la reacciГіn inmune y reduciendo la marcha de la reproducciГіn de cГ©lulas. Los anticuerpos tambiГ©n son aumentados en el 40 por ciento en el tratamiento del VIH. La bardana es la clase de la promesa tambiГ©n. Se ha probado que usa leucocitos en al menos el 28% en enfermos de cГЎncer. Utilizando ambos estos aceites esenciales poderosos. Hay posibilidades miniscule de cualquier acontecimiento de efectos secundarios. Este 2 petrГіleo de fantasГ­a promete en los tratamientos del VIH y el cГЎncer con la abundancia mГЎs prometedora desarrolla estudiarse.

Uso de la MedicaciГіn de Soma Carisoprodol Contra Dolor Causado por DesГіrdenes Musculoskeletal MSD

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Compre el uso de la medicaciГіn Soma Carisoprodol contra el dolor causado por DesГіrdenes Musculoskeletal (MSD)

Debido a fechas lГ­mites apretadas, horas de trabajo agitadas y ambientes de trabajo estresantes, los DesГіrdenes de Musculoskeletal se hacen comunes completamente hoy dГ­a. Soma Carisoprodol es un mГєsculo relaxant prescribido para contener dolores agudos debido a MSD.

Desorden de Musculoskeletal – MSD
Desde el principio del 18vo siglo, el impacto de DesГіrdenes Musculoskeletal MSDs en la eficacia de trabajo se ha reconocido y a pesar de numerosas medidas ergonГіmicas emprendidas en lugares de trabajo modernos, todavГ­a sigue teniendo un efecto significativo en productividad y salida de trabajo eficiente. MSD incluye todas las aflicciones relacionadas con nervios, tendones, mГєsculos y todas las partes del cuerpo adicionales que apoyan el funcionamiento fГ­sico normal de un cuerpo.
El miembro trasero, Superior y el miembro Inferior son tres de las partes/regiones del cuerpo mГЎs cruciales mГЎs afectadas por DesГіrdenes Musculoskeletal (MSD). En 2006, casi el 30% de heridas en el lugar de trabajo era debido a MSD. En 2008, mГЎs de 415.000 casos de esguinces, tensiones y rasgones se relataron en el lugar de trabajo mientras que mГЎs de 222.000 heridas del lugar de trabajo estuvieron de vuelta relacionadas.

Las Causas y los efectos
de Desorden de Musculoskeletal. Las causas generales detrГЎs de DesГіrdenes Musculoskeletal MSD son el trabajo fГ­sico de trabajo, pesado manual, tareas que requieren movimientos reiterativos, postura del cuerpo mala en la realizaciГіn de actividades etc. MSD puede crear el nГєmero de problemas de salud en los lГ­mites de dolores del minuto y molestia a aflicciones muy serias que pueden abandonar al minusvГЎlido paciente y requerimiento de la ruptura completa de toda la clase de actividades. En algunos casos, hasta el tratamiento puede no demostrar cuestiones permanentes completamente eficaces que causan.

DesГіrdenes de Musculoskeletal MSD el efecto se puede reducir haciendo cambios ergonГіmicos de los equipos/instrumentos usados en la realizaciГіn de las tareas; la planificaciГіn del lugar de trabajo en tГ©rminos de reducir al empleado incomoda etc. El ambiente de trabajo sano, la satisfacciГіn de trabajo, las medidas especiales trabajando en la condiciГіn de condiciones meteorolГіgicas extremas afectaron regiones, tambiГ©n desempeГ±e papeles principales en la reducciГіn de MSD.

Musculoskeletal Disorder Symptoms & Diagnosis
Las mejoras en el lugar de trabajo y en la ejecuciГіn de tareas rutinarias son medidas preventivas tomadas en reducir incidentes de DesГіrdenes Musculoskeletal (MSD). El dolor de MSD es indicado por la razГіn (herida/esfuerzo) o en su naturaleza

Los sГ­ntomas MSD generales incluyen:
* Dolor del cuerpo total
* Dolor que aumenta con cualquier movimiento
* Cansancio
* Dolor del mГєsculo o esfuerzo
* Dormir desГіrdenes
* QuemГЎndose en mГєsculo

Una historia paciente cuidadosa es esencial en la decisiГіn si los DesГіrdenes Musculoskeletal son realmente la ocupaciГіn relacionada. Los anГЎlisis de sangre, los rayos X, la ExploraciГіn de CT y MRIs generalmente se sugieren para un diagnГіstico exacto

Tratamientos de Desorden de Musculoskeletal

* Terapia ocupacional
* PrevenciГіn de cualquier movimiento de uniГіn usando una tablilla
* La temperatura usa
* Los pacientes se informan resto apropiado y alivio del trabajo regular
* Acupuntura / Acupressure
* TГ©cnicas del biofeedback
* Varios ejercicios
* Chiropractice
* Masajes reconstituyentes
* MedicaciГіn

Los analgГ©sicos (dolor relievers) y otras medicaciones generalmente se usan como las medicaciones y despuГ©s de tasar su efecto, la dosis se podrГ­a aumentar o la medicaciГіn mГЎs fuerte se prescribe. Carisoprodol es un tal uso de la medicaciГіn en el tГЎndem con otras terapias para dar el alivio contra condiciones de Musculoskeletal agudas.

Soma (Carisoprodol) para DesГіrdenes Musculoskeletal (MSD)

Soma (Carisoprodol) tener propiedades sedativas tiende a afectar centralmente a mГєsculos esquelГ©ticos sin relajarlos directamente. Previene nervios para transmitir la sensaciГіn de dolor al cerebro. Generalmente tomado durante un poco tiempo, se prescribe durante cuatro veces por dГ­a.

Conocido ser muy adictivo, Soma se marca como un medicamento recetado y su uso se ha controlado en muchos estados estadounidenses. A pesar de esto, cuando tomado en consejo apropiado y dosis controlada, ha resultado muy eficaz para la direcciГіn del dolor agudo muy irritante causado por DesГіrdenes Musculoskeletal (MSD) y asistiГі en restaurar la vida regular de pacientes aquejados.

Pida a Soma (Carisoprodol) en lГ­nea.
Compre Soma (Carisoprodol) es una medicaciГіn eficaz contra DesГіrdenes Musculoskeletal (MSD). Los pacientes deberГ­an hablar de esta medicaciГіn con el terapeuta/mГ©dico apropiado antes de comprar Soma (Carisoprodol). Los usuarios deberГ­an asegurar que compren Soma (Carisoprodol) autГ©ntico de su farmacia local o farmacia en lГ­nea.

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De Wartun Historia InglГ©s he transferido la siguiente anГ©cdota de Levatrs Viaggi Petrarca vo. seq.i.

Corresponde Confieso, sin embargo, que yo recuerdo ninguna alusiГіn en cualquier carta de Petrarca, y he encontrado muchas cosas en el libro Levatrs que Mak vivГ­an en ese monasterio un monje joven, llamado AgustГ­n, que era experto en la mГєsica, y acompaГ±Гі a la salmodia los religiosos hermanos con hermosos toques el Гіrgano.

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En el mayo, el Lombes y Petrarca abandonaron Toulouse, y llegaron a la mansiГіn de la diГіcesis.

Lombes en AmГ©rica, Lombarium encuentra a los pies de los Pirineos, a sГіlo ocho leguas de Toulouse.

Es pequeГ±a y construida enfermo, y no ofrece ninguna seducciГіn la curiosidad del viajero.

Hasta hace poco habГ­a sido una sencilla abadГ­a de los monjes agustinos.

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    Lustige Witze / Geschichte / Seite 1

    Zwei amerikanische Agenten haben einen Anschlag auf Boris Jelzin verГјbt. Ihre Namen: Johnny Walker und Jim Beam.

    Witz vom 13.08.2005

    Oma bekommt zum 90. Geburtstag einen Besuch im Bundestag von ihren Enkeln geschenkt. Gesagt, getan, Oma fГ¤hrt nach Berlin und schaut sich eine Debatte im Bundestag an. Die Enkel warten voller Spannung auf die RГјckkehr der GroГџmutter um zu erfahren, wie es der Oma denn so gefallen hat. Die Oma ist ganz begeistert und erzГ¤hlt: “Na ja Kinder, alles ist so wie frГјher auch, nur der Hitler, der ist ja sooo dick geworden. “

    Witz vom 13.08.2005

    Als die Goten nach Rom zogen um es zu plГјndern, sagten sie am Brenner: “Alle FuГџ- und Geschlechtskranken links raus!”

    Witz vom 13.08.2005

    Ende der 30er Jahre in einem sowjetischen Arbeitslager sitzen 3 MГ¤nner beisammen. Der erste fragt den zweiten: “Weshalb bist du hier?” “Weil ich 1935 fГјr Iwan Iwanowitsch war.” Der erste den dritten: “Und warum bist du hier?” “Weil ich 1937 gegen Iwan Iwanowitsch war.” Der dritte den ersten: “Und du?” “Ich bin Iwan Iwanowitsch. “

    Witz vom 18.07.2005

    Letzter Musikwunsch eines Passagiers der Titanic: “Spielt doch endlich mal was mit mehr Tiefgang. “

    Witz vom 18.07.2005

    Zwei alte Opa`s unterhalten sich Гјber alte Zeiten: “Tja ja, damals. Wir waren ja auch nich feige: Ich hab zum Beispiel 1945 mit der Mistforke `nen Flieger runtergeholt!” “Vom Himmel?!” “Nee, von meiner Tochter. “

    Witz vom 18.07.2005

    Erscheint eine Fee dem Bauern. Er habe drei WГјnsche frei. Der Bauer ist glГјcklich. “Ich will ein Prinz sein!” *zoom*, und er steht in einer Galauniform da. “Ich will ein schГ¶nes SchloГџ haben!” *zoom*, er steht in einem reich ausgeschmГјckten Saal seines neuen Schlosses. “Ich mГ¶chte eine schГ¶ne Frau an meiner Seite!” Geht die TГјr auf, eine Prinzessin kommt in den Saal: “Komm, Franz Ferdinand, wir mГјssen los, sonst kommen wir zu spГ¤t nach Sarajevo. “

    Witz vom 18.07.2005

    Adolf Hitler ersteht auf. Die Journalisten belagern ihn: “Und, was werden Sie machen?” “Ich werde fГјnf Millionen Juden und zwei Schweden tГ¶ten!” “Zwei Schweden, warum?!” “Sehen Sie, die fГјnf Millionen Juden fallen gar nicht auf. “

    Witz vom 18.07.2005

    Auf einem Empfang wurde Bismarck mal von der Ehefrau eines Botschafters darauf angesprochen, wie schwierig die deutsche Sprache fГјr einen AuslГ¤nder sei. So hГ¤tten zu viele WГ¶rter zwei Bedeutungen, beispielsweise “senden” und “schicken”. Bismarck darauf: “GnГ¤dige Frau, DAS ist sehr wohl ein Unterschied. Ihr Herr Gemahl ist nГ¤mlich zwar ein Gesandter, aber durchaus kein Geschickter. “

    Witz vom 18.07.2005

    WiГџt ihr, warum Hitler kinderlos blieb? Er hat doch immer gesagt: “Mir ist keiner gewachsen. “

    Witz vom 18.07.2005

    Anno viel frГјher: Ein weiГџer Farmer besucht seinen Freund (auch Farmer). Sie gehen zusammen ein biГџchen Гјber die Weiden des letzteren spazieren. Dort arbeiten gerade viele Schwarze in der sengenden Hitze. Nur ein einzelner steht, die HГ¤nde auf einen Zaunpfosten gestГјtzt, reglos da und blinzelt in die Sonne. Der heimische Farmer, der seinem Freund imponieren will: “Hey, Du! Nigger! Arbeite!” Der Schwarze schaut gelangweilt rГјber, rГјhrt sich aber nicht. Farmer: “Du arbeiten, nix rumstehen! DU MICH VERSTEHEN?!” Schwarzer (cool): “Syntaktisch, semantisch oder kausal?”

    Witz vom 18.07.2005

    Nach dem Krieg geht auch der Unibetrieb wieder los. Eine Vorlesung zum Thema “Deutsche Geschichte”. Es geht um die Frage, warum Deutschland den 2. Weltkrieg verloren hat. Meldet sich ein Student: “Das war wegen der jГјdischen Offiziere.” Meint der Prof. “Aber wir hatten doch gar keine jГјdischen Offiziere.” Student: “Nicht in der Wehrmacht, bei den Alliierten. “

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    Os sintomas da dengue são: dores abdominais, pulso rápido, febre, vômito freqüente, extremidades frias, cianose e nos casos mais graves as hemorragias. Logo que os primeiros sinais da doença forem verificados, é necessário procurar ajuda médica para realizar um tratamento apropriado.

    Outro fato importante em relação à doença, é que em caso de suspeita de dengue existem alguns medicamentos que devem ser evitados, pois, eles agravam os sintomas da doença .

    Os medicamentos a base de ГЎcido acetil salicГ­lico ou que contГ©m a substГўncia associada devem evitados. Como, tambГ©m os remГ©dios com salicilamida associada. Eles podem causar sangramentos e acidose.

    Veja na listagem a seguir, medicamentos que devem ser evitados em caso de dengue :

    • AAS
    • AAS Protect
    • AcecГ­lico
    • Acectil
    • Aceticil
    • Acetildor
    • Acetilessin
    • Acidalic
    • ГЃcido acetil salicГ­lico
    • Anacetil
    • Anacin
    • Anacold
    • Analgermon
    • Analgesin
    • Antifebrin
    • Antitermin
    • Asetisin
    • AS-Med
    • Aspirina
    • Aspirina C Efervescente
    • Aspirina Impact
    • Aspirina Prevent
    • Aspissen
    • Assedatil
    • Assetil
    • Bayaspirina
    • Benegrip
    • Bufferin
    • Bufferin Cardio
    • Caas
    • Cafiaspirina
    • Cafiaspirina
    • Calmador
    • Cardio AAS EntГ©rico
    • Cardioaas
    • Cheracap S
    • Cibalena A
    • Cimaas
    • Cordiox
    • Coristina D
    • Dausmed
    • Doloxene – A
    • Doribel
    • Doril
    • Doril C
    • Dormec
    • Drenogrip
    • Ecasil-81
    • Engov
    • Enjoy
    • Excedrin-E
    • Florialgin
    • Funds ГЎcido acetil salicГ­lico
    • Funed ГЎcido acetil salicГ­lico
    • Furp – ГЎcido acetil salicГ­lico
    • Griperal
    • Gripin C
    • Iquego ГЎcido acetil salicГ­lico
    • Ivb – ГЎcido acetil salicГ­lico
    • Lafepe – ГЎcido acetil salicГ­lico
    • Lafergs – ГЎcido acetil salicГ­lico
    • Lepemc AAS 100mg
    • Lepemc AAS 500
    • Lfm – ГЎcido acetil salicГ­lico
    • Melhoral C
    • Melhoral Infantil
    • Mialgin
    • Migrane
    • Nuplam – ГЎcido acetil salicГ­lico
    • Orosprevent
    • Prevencor
    • Prevencor Pril
    • Resfriol S
    • Resprax
    • Salicetil
    • Salipirin
    • Salisvit C
    • Salitil
    • Sifaas
    • Sinutab
    • Somalgin
    • Somalgin Cardio
    • Sonrisal
    • Superhist
    • Thrombo Ass
    • Tri – Bufered Aspirin
    • Vasclin
    • Vita Grip

    Como se prevenir da Dengue

    Caso você ainda tenha alguma dúvida, sempre verifique as informações contidas na bula, essa ação pode evitar maires problemas para a saúde de quem pode ter contraído a doença da dengue .

    Para facilitar, o Site Anvisa da Agência Nacional de Vigilância Sanitária (Anvisa) fornece um sistema de busca onde estão listados todos os medicamentos que contém as essas substâncias que devem ser evitadas. Você também encontrará diversas informações importantes.

    Se todos se empenharem no combate e prevenção da dengue ficará mais fácil de vencê-la. Todos nós temos a obrigação de colaborar, tomando as medidas necessárias para prevenção como também ao combate da dengue.

    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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