Tadalafil entfaltet seine Wirkung über eine selektive Hemmung der PDE5, wodurch die Konzentration von cGMP im glatten Muskelgewebe stabil bleibt. Diese biochemische Modulation resultiert in einer langanhaltenden Relaxation der Gefäßwände. Der Wirkstoff wird nach oraler Einnahme effizient resorbiert, mit einer Bioverfügbarkeit von rund 80 %. Seine Halbwertszeit von bis zu 36 Stunden ist innerhalb dieser Substanzklasse außergewöhnlich. Abgebaut wird er in der Leber, hauptsächlich durch CYP3A4, mit anschließender biliärer Exkretion. Typische unerwünschte Wirkungen entstehen durch eine verstärkte Vasodilatation, etwa Kopfschmerzen oder Flush. Pharmakologisch wird cialis generika vor allem durch die verlängerte Wirkungsdauer charakterisiert.

Microsoft word - family mtg minutes - oct 18, 2012.doc

Family Meeting Minutes
Recreation Room – Belvedere Care Centre ACCEPTANCE OF AGENDA
ADOPTION OF PREVIOUS MINUTES
Minutes of February 15, 2012 adopted as circulated.
NEW BUSINESS
Guest Speaker – Alan Glasser, Pharmacist “Dementia / Alzheimer’s medication and the use/misuse of anti-psychotics
in the elderly
Importance of medication – medication is not absorbed in the stomach:  Do not dry swallow any medication.
 Drink 6 – 8 ounces of water with medications.
 Medication can stick in throat and depending on medication can burn the  Reduce effects of upset stomach by taking liquid.
 You can delay/reduce effects of medications by taking it without liquid.
Handout of medications being discussed was distributed and referred to:  Increased acetylcholine in brain – increased chemical messengers in brain is the action of the dementia medications that will be discussed.
Need a form advising families re: anti-psychotic drugs for information Goal is to improve brain function and behaviour thus person feels better:- MMSE - 30/30 = perfect score- 16/30 = medication is no longer effective Temporary delay in progression of dementia High blood sugar can do brain damage and research is showing increased blood sugarcan result in Alzheimer’s.
- ARICEPT – 5-10 mg. daily Side Effects = nausea, vomiting, diarrhea
- MEMANTINE – may be used in combination with Aricept Dementia – sometimes results in aggressive behaviour and anti-psychotic medicationswere given.
- Side effects of anti-psychotics are serious and may result in increased mortality- Increased heart failure; affects immune system which can result in frail elderly - Alan explained that most anti-psychotics have been discontinued. However, if a resident’s behaviour is not controllable there may be instances where anti-psychoticsare prescribed. Consideration given to quality of life, not just quantity.
C:\Documents and Settings\Belvedere\My Documents\BSL & Intercare\Belvedere\Family Meetings\Minutes\2012\Family Mtg Minutes - Oct 18, 2012.doc Resident & Family Meeting MinutesOctober 18, 2012 MOST – New Protocol for Degree of Intervention
Process for completion of the document; onus is on the Physician to sign the document.
Kathy explained document and responsibilities of families, Physicians and Nurses atBelvedere Care Centre.
“My Voice” – document being introduced to everyone and is the vehicle to express plan ofcare up to and including death.
FLU VACCINE
 Arrives October 19, 2012.
 Residents and Staff receive vaccine next week.
 Pneumovax vaccine will be given to residents who have never had it or had it 5  Staff who do not receive flu vaccine will wear a mask all the time they are at work.
 Kathy explained education for Staff for Infection Control Week (displayed in Activity NEW CODE FOR ELEVATOR ON 3 WEST
CHRISTMAS EVENTS DATES
December 15th is the Resident/Family party during the day.
Details included in November statements.
OPEN FORUM
If there is a death, how is this handled for the other residents?- Table mates are told gently and comforted.
- No notice is posted.
Bring treats to residents at Christmas?- Probably not a good idea as there are several diabetics.
Take family out. Have a sign out sheet on each floor.
- Good idea.
Medication changed and all medications thrown out and we were charged for ALLthe medications.
- Kathy replied that medication changes may change at next delivery.
Is the cellophane package the best way of packaging drugs? What if medicationfalls on floor from the “little bag”?- Packaging has not been an issue and if a medication is missing (resident noticed),there are ways of replacing it.
Do you ever meet with families one-on-one?- Difference between Care Conference and family conference explained.
want to meet with Kathy and Joy, please call and let us know and we can do that.
ADJOURNMENT
C:\Documents and Settings\Belvedere\My Documents\BSL & Intercare\Belvedere\Family Meetings\Minutes\2012\Family Mtg Minutes - Oct 18, 2012.doc

Source: http://www.belvederecare.com/wp-content/uploads/2012/04/Oct-18-2012.pdf