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.

Tmj – facial pain questionnaire

TMJ – Facial Pain Questionnaire
Name:________________________________ Referred by:___________________________ Age:______ Date:__________
HISTORY
I. Chief Complaint (Describe your problem in your own words):

II. Symptoms Total length of time some or all TMJ/Facial pain symptoms present:___________________________________
 Pain: Right Left Both Sides
Location:
Temporal Region Cheek Region Lower Jaw Ear TMJ Region (in front of ear) Neck Shoulders Teeth Other________________________ Duration/Timing: worse in the Morning Afternoon Evening
Constant Intermittent Worse after eating/talking Joint Noises: Popping/clicking: Right Left Bilateral
Grinding: Right Left Bilateral Limited mouth opening: Persistent Intermittent Difficulty opening mouth Sleeping
Difficulty closing mouth Chewing Yawning or laughing Jaw locking episodes: Locked open Locked closed How often?__________
Headaches: Right Left Bilateral Frontal (forehead) Temporal (side of head) Occipital (back of head)
Ringing in Ears: Right Left
Fullness in Ears: Right Left
 Dizziness Visual Changes Change in hearing
Other__________________________________________________________________________________________
III. Possible Contributing Factors
 Facial Trauma/Injury___________________________________________________________________________
 Whiplash/Cervical Trauma___________________ ___________________________________________________
 Bruxism (grinding teeth)
Arthritis
Sleep Disorder_________________________________________
Stress
IV. Other Diagnosis and Treatment
Have you tried?
Panoramic Radiograph TMJ Tomograms MRI of TMJ region Have you been prescribed a bite splint or night guard? Yes No
If yes, do you use it? Always Occasionally Rarely/Never V. Medications
□ Non steroidals (such as Advil, Tylenol, Aleve) □ Muscle Relaxers (such as Flexeril, Soma, Robaxin) How often? □ Sleep Meds/Anti-depressants/Anti-Anxiety? How often? VI. Previous Treatment
Oral Surgeon:____________________________ Others:_________________________________ “Complete Back Side”
Spinal & Sports Care Clinic, 12905 E. Sprague Avenue, Spokane Valley, WA (509) 922-0303
1. Put an X on the line to rate your current level of jaw/headache pain: 0 ----------------------------------------------------------------------- 10 2. Put an X on the line to rate your current level of neck pain: 0 ----------------------------------------------------------------------- 10 3. On the diagram below, please shade the areas of your pain: 4. Please check medications you are taking for TMJ/facial pain/headaches: □ Non steroidals (such as Advil, Tylenol, Aleve) How often? □ Muscle Relaxers (such as Flexeril, Soma, Robaxin) How often? □ Sleep Meds/Anti-depressants/Anti-Anxiety? How often?

Source: http://spinalandsportscare.com/wp-content/uploads/2013/09/TMJ-patient-history-09-03-13.pdf