Le sildénafil présent dans Kamagra exerce une inhibition réversible de la PDE5, modulant la cascade GMPc et favorisant une vasodilatation localisée. L’absorption digestive varie selon la forme utilisée, comprimés classiques ou gels oraux. La distribution tissulaire est large et la liaison protéique élevée, avoisinant 96 %. La métabolisation hépatique génère un métabolite actif contribuant à l’effet pharmacologique global. La demi-vie reste courte, avec disparition plasmatique en quelques heures. Les interactions significatives concernent surtout les nitrés organiques et inhibiteurs puissants du CYP3A4. Dans les publications techniques, kamagra en ligne est souvent cité dans le cadre d’analyses comparatives portant sur les différences de formulations et de cinétique d’absorption.

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Paroxysmale nächtliche Hämoglobinurie (PNH)
Pathogenese, Diagnostik und Therapie
A. Röth, U. Dührsen, H. Schrezenmeier, J. Schubert Literatur
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the disease. Ser Haematol 1972; 5: 3–23 2 Fachinformation Soliris® 2007
Frickhofen N, Heimpel H, Kaltwasser JP, Schrezenmeier H. Antithymocyte globulin with or without cyclosporin A: 11-year follow-up of a randomized trial comparing treatments of aplastic anemia. Blood 2003; 101: 1236–42 3 Hall C, Richards S, Hillmen P. Primary prophylaxis with warfarin prevents thrombosis in paroxysmal nocturnal
hemoglobinuria (PNH). Blood 2003; 102: 3587–91 4 Hegenbart U, Niederwieser D, Forman S et al. Hematopoietic cell transplantation from related and unrelated
donors after minimal conditioning as a curative treatment modality for severe paroxysmal nocturnal hemoglobinuria. Biol Blood Marrow Transplant 2003; 9: 689–97 5 Hill A, Rother RP, Hillmen P. Improvement in the symptoms of smooth muscle dystonia during eculizumab
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with paroxysmal nocturnal hemoglobinuria. N Engl J Med 2004; 350: 552–9 7 Hillmen P, Lewis SM, Bessler M, Luzzatto L, Dacie JV. Natural history of paroxysmal nocturnal hemoglobinuria.
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patients with paroxysmal nocturnal hemoglobinuria. Blood 2007; 110: 4123–4128 9 Hillmen P, Young NS, Schubert J et al. The complement inhibitor eculizumab in paroxysmal nocturnal
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hemoglobinuria. Am J Hematol 1987; 25: 77–83 12 Luzzatto L, Bessler M. The dual pathogenesis of paroxysmal nocturnal hemoglobinuria. Curr Opin Hematol
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14 Richards SJ, Hill A, Hillmen P. Recent advances in the diagnosis, monitoring, and management of patients with
paroxysmal nocturnal hemoglobinuria. Cytometry B Clin Cytom 2007; 72: 291–8 15 Rosse WF. Paroxysmal nocturnal hemoglobinuria as a molecular disease. Medicine (Baltimore) 1997; 76: 63–93
16 Rosse WF, Hillmen P, Schreiber AD. Immune-mediated hemolytic anemia. Hematology (Am Soc Hematol Educ
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plasma hemoglobin: a novel mechanism of human disease. JAMA 2005; 293: 1653–62 18 Saso R, Marsh J, Cevreska L et al. Bone marrow transplants for paroxysmal nocturnal haemoglobinuria.
19 Schubert J, Alvarado M, Uciechowski P et al. Diagnosis of paroxysmal nocturnal haemoglobinuria using
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Source: http://www.deutscher-internistentag.de/fileadmin/PDF/bdi_aktuell/2009/04/BDI_aktuell_4_2009_Literaturliste_1.pdf.pdf

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