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.

bariatric surgery rounding orders

Create date: Nov-07 SIGN DATE AND TIME ALL ENTRIES
Review date: Sept-11
Revise date: Jan-12
ORDERS AND SIGNATURE
PROGRESS NOTES AND SIGNATURE
& TIME
Bariatric Surgery Rounding Orders
Bariatric Surgery POD #:_____Date: ___/___/___ 1.  CBC w/ differential, BMP  Mg  PO BP __________ HR __________ RR______SO2 _____ 2.  CXR:  PA View  Bedside in am Weight: __________ Urine Output:_____________ JP Output: ___________ G-tube Output:__________ JP Color:  Serosanguenous  Other:__________  Bariatric Clear Liquids 30 ml q___ minutes  Bariatric Full Liquids 30 ml q___ minutes  Please keep several 30 ml cups of water or ice  Tolerating regular diet  Tolerating Soft Diet Pain Control :  Good  Fair  Poor Nausea: None  Minimum  Moderate  Severe BM:  Positive  Negative 6.  Increase IV fluids to _______________  Decrease IV fluids to _______________ Consult Case Management for home healthcare  Rhonchi  Crackles Other: ________ CXR:  Atelectasis Other: __________________ UGI:  Good flow of contrast with no leak or  Hydrocodone/Acetaminophen (Lortab) Elixir  Other: ________________________________ Labs:  Dilaudid 1 mg IV q4hr prn breakthrough pain  Oxycodone 5mg po q4hr prn mild-moderate Acetaminophen/ 24hrs, not to exceed 1 day of therapy) DC all other Acetaminophen orders  Atelectasis: Encourage incentive spirometry; flutter hours(not to exceed 4000 mg Acetaminophen/ 24hrs, not to exceed 1 day of therapy) DC all other breakthrough nausea  6.25 mg  12.5 mg  Potassium chloride liquid po  40 mEq Patient seen by:  Dr Amjad Ali  Dr Rodolfo Arreola  Other: ______ One time dose  Daily  Jackie Smith PAC  Janet Kelley CRNP Date Time Physician Signature
Date Time Physician Signature
Physician Order Sheet
& Progress Note
Create date: Nov-07 SIGN DATE AND TIME ALL ENTRIES
Review date: Sept-11
Revise date: Jan-12
ORDERS AND SIGNATURE
PROGRESS NOTES AND SIGNATURE
& TIME
 Potassium chloride 10 mEq in 0.9% NaCl 100 ml with lidocaine 10 mg over 1 hr x _____  Potassium Phosphate 20mmol in 250ml 0.9%  Metoclopromide (Reglan) 10 mg IV TID  Sucralfate (Carafate) liquid 1gm (10 ml) bid  Magnesium Sulfate 2 gram IVPB over 1 hr x 1  Ondansetron (Zofran) 4 mg  IV TID  PO  Please place patient name labels on the  Dietician consult before discharge home  RN please show bariatric video  Please help patient watch online educational video on my-emmi.com on POD #2. (Instructions are on a separate sheet) Date Time Physician Signature
Physician Order Sheet
& Progress Note

Source: http://www.mylapsurgeon.com/catalog/rounding%20orders.pdf