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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in children, 74environmental control measures and, 42 Note: Page numbers in italics indicate figures.
Allergic reactions. See also Inflammatory cascade. Page numbers followed by t refer to tables.
Numbers preceded by CP indicate Color Plates.
ABRS. See Bacterial rhinosinusitis, acute. causes of, 15t, 32-33. See also Allergens. chronic, 135. See also Rhinosinusitis, chronic. skin tests in. See Allergy skin tests. Adolescents, adenoid hypertrophy in, 13, 27 Afrin. See Oxymetazoline nasal spray. Age. See also Adolescents; Children. inflammatory cascade in, 21-22, 22-24, 24-26 Air-fluid levels, in sinuses, CP4, CP7, CP8, CP9, 110, 139, 141 intranasal vs oral antihistamines for, 54-55 Alkylamines. See also specific drugs.
treatment of. See Rhinitis treatment. Allergic Rhinitis and Its Impact on Asthma (ARIA), 38, 68 Allergy and Asthma Network/Mothers of Asthmatics, Inc.
dust mites as, 25t, 30-31, 34, 40, 40t, 80 American Academy of Allergy, Asthma, and Immunology (AAAAI), American Academy of Otolaryngic Allergy (AAOA), 147 American Academy of Otolaryngology Head and Neck Surgery American Academy of Pediatrics (AAP), 148 American College of Allergy and Immunology (ACAI), 148 American Rhinologic Society (ARS), 148-149 dosage of, 118t, 121, 122-123, 126-127, 128t, 130t susceptibility/resistance to, 104t, 124t, 141 Anti-immunoglobulin E monoclonal antibody dosage of, 118t, 121, 122, 126, 128t-130t, 132 against Haemophilus influenzae, 101, 103, 104t Anti-inflammatory drugs, in pregnancy, 76t-77t against Moraxella catarrhalis, 103 against Streptococcus pneumoniae, 104t, 124t-125t Angiotensin-converting enzyme inhibitors, 31 Animal allergens, extracts for allergy shots, 80 Astelin Nasal Spray. See Azelastine nasal spray. alteration of bacterial target or binding site in, 99 β-lactamase production and, 98-99, 101, 102, 103 selection of, nasal endoscopy in, CP3, 108 Anticholinergic side effects, of oral antihistamines, 48 Antigen-presenting cell, 21, 22-23 Antihistamines. See also specific drugs.
Asthma and Allergy Foundation of America (AAFA), 149 Atrovent. See Ipratropium bromide nasal spray. Augmentin. See Amoxicillin/clavulanate. Autumn, environmental allergens in, 25t, 30 Avelox (moxifloxacin). See Moxifloxacin. Azelastine nasal spray (Astelin Nasal Spray) Beconase AQ. See Beclomethasone nasal spray. Bed covers, in dust mite avoidance, 40t, 41 -lactam antibiotics, allergic reactions to, 132-133 in β-lactam allergic patients, 121, 128t-129t, 132 -lactamase production, 98-99, 101, 102, 103 Birth control pills, 31Blood pressure medications, 15t, 31 Bacteria, translocation into sinus cavities, 97 Bacterial rhinosinusitis, acute (ABRS). See also Rhinosinusitis; antibiotic resistance in, 98-99, 101, 103, 104t-105t Budesonide nasal spray (Rhinocort AQ), 44t orbital invasion by, CP11, 142, 143-144 treatment of, 117, 139-140. See also specific drugs and drug types.
unilateral, computed tomography of, 105 Bactrim. See Trimethoprim/sulfamethoxazole (TMP/SMX). Beclomethasone nasal spray (Beconase AQ, Vancenase) for ABRS, 121, 122, 124t, 128t, 132 against Haemophilus influenzae, 101, 103, 104t against Moraxella catarrhalis, 103 penicillin cross-reactivity with, 132-133 against Streptococcus pneumoniae, 104t amoxicillin or clindamycin with, 123, 127t, 130t indications for, 101, 103, 122, 124t susceptibility/resistance to, 101, 103, 104t, 124t Ceftin (cefuroxime). See Cefuroxime. for ABRS, 122, 124t-126t, 128t-129t Clavulanate. See Amoxicillin/clavulanate. Cephalosporins, drug cross-reactivity with, 132-133 rifampin with, 124t-125t, 127t, 129t-130t of intranasal corticosteroids, 56-57, 66-69 in chronic rhinosinusitis, 136t, 137, 138 drugs for, 117, 120t, 121, 128t-131t, 132 of sinus opacification, CP9, 140-141, 143-144 in sinusitis diagnosis, 109-110, 111-115 Congenital abnormalities, chronic rhinosinusitis and, 135 eczema in, adult atopic dermatitis and, 29 rhinosinusitis in, diagnosis of, 107, 109 clinically distinguishing factors of, 65t Corticosteroid nasal sprays (continued) Desloratadine (Clarinex) (continued) Dexamethasone nasal spray, 44t, 61, 64, 65t leukotriene receptor antagonists vs, 72-73 Diagnosis and Management of Rhinitis: Parameter Documents of the Joint Task Force on Practice Parameters in Allergy, Asthma, Cromolyn sodium ophthalmic drops (Opticrom), 74, 75t Cromolyn sodium solution (Nasalcrom), 44t in β-lactam allergy, 121, 123, 127t Dristan Long-Lasting. See Oxymetazoline nasal spray.
Dristan Nasal (phenylephrine HCl/pheniramine maleate), 59t Decongest. See Oxymetazoline nasal spray. Duration. See Phenylephrine nasal spray. rebound congestion from, 31, 57recommended duration of use, 57 Eczema, childhood, adult atopic dermatitis and, 29 Endoscopic sinus surgery, computer-aided, 137, 138 Endoscopy, nasal. See Nasal endoscopy.
over-the-counter, dosage and delivery of, 58t-59t Environmental allergens, seasonal, 25t, 28t, 30-31, 92t, 142-145.
Environmental chemicals/pollutants, chronic rhinosinusitis and, 135 Enzyme-linked immunosorbent assay (ELISA), for IgE, 35-36 Eosinophil(s), in inflammatory cascade, 21-22, 22-23 in nonallergic rhinitis. See Nonallergic rhinitis with eosinophilia Folate inhibitors, 104t, 119t. See also Trimethoprim/ susceptibility/resistance to, 105t, 124t-127t Gemifloxacin (Factive), 105t, 120tGenetic abnormalities, chronic rhinosinusitis and, 135 Geographic locations, allergen variation in, 30 Granulocyte-macrophage colony-stimulating factor, in early- and Fall, environmental allergens in, 25t, 30 Granulomatous disease, in nasal obstruction, 27, 28t, 92t duration of action, 49effectiveness of, 50, 52-53, 55-56 antibiotic resistance/susceptibility of, 99, 101, 103, 104t, 124t-125t, β-lactamase production by, 99, 102, 103 as rhinosinusitis pathogen, 97, 98-99 Flonase. See Fluticasone nasal spray. Flunisolide nasal spray (Nasalide, Nasarel), 44t Heart, antihistamine adverse effects on, 49-50, 51t High-efficiency particulate air (HEPA) filters, 41 Fluoroquinolones, against Streptococcus pneumoniae and Haemophilus influenzae, 101, 103, 105t, 106, 123t, 126t Immunodeficiency, chronic rhinosinusitis in, 135 pharmacokinetics of, 65tpotency of, 61, 63t, 63-64in pregnancy, 76t-77t Immunoglobulin E (IgE). See also Anti-immunoglobulin E Laboratory tests, in rhinitis diagnosis, 33-36 monoclonal antibody; Omalizumab. in treating allergic rhinitis, 44t-45t, 72-73, 145 in early and late phase allergic response, 24 in inflammatory cascade, 21-22, 22-24 In vitro assays. See Blood tests. Inflammatory cascade, in allergic rhinitis, 21-22, 22-24, 24-26 in early- and late-phase allergic response, 24, 26 in inflammatory cascade, 21-22, 23 Ipratropium bromide nasal spray (Atrovent), 44t Macrophage, in inflammatory cascade, 21, 22-23 Magnetic resonance imaging, in chronic rhinosinusitis, 136t, 137Major basic protein, 23 in early- and late-phase allergic response, 24 in inflammatory cascade, 21-22, 22-23, 24 opacification of, CP5, CP9, 141, 143 Ketotifen fumarate (Zaditor), 74, 75t, 78 drugs for, 26. See also Decongestants. Mometasone nasal spray (Nasonex), 44t, 61 Nasal drainage, in chronic rhinosinusitis, CP10, 141 in chronic rhinosinusitis diagnosis, 135, 136t Monoclonal antibody, against IgE, 74-75. See also Omalizumab. with Gram’s stain, in detecting sinus bacteria, 97 in rhinitis. See Structural rhinitis. antibiotic resistance/susceptibility of, 99, 101, 103 as rhinosinusitis pathogen, 97, 98-99 susceptibility/resistance to, 105t, 123, 125t Mucociliary dysfunction, chronic rhinosinusitis and, 135 inflammation of, in polyposis etiology, 19 Mucosal barrier, inhaled allergen penetration of, 21 Nasal septal deformity. See Septal deviation. Nasal spray. See Decongestants, as nasal sprays. Nasal trauma, structural rhinitis and, 15t NARES. See Nonallergic rhinitis with eosinophilia syndrome. Nasalcrom. See Cromolyn sodium solution. Nasacort. See Triamcinolone acetonide nasal spray. Nasalide. See Flunisolide nasal spray. Nasarel. See Flunisolide nasal spray. Nasonex. See Mometasone nasal spray. Oxymetazoline nasal spray (Afrin, Decongest, Dristan Long-Lasting, National Ambulatory Medical Care Survey, 11 Neo-Synephrine. See Oxymetazoline nasal spray; Phenylephrine Nonallergic rhinitis with eosinophilia syndrome (NARES), 92t cross-reactivity with cephalosporins, 132-133 cross-resistance with other antibiotic classes, 103t Streptococcus pneumoniae resistance to, 99, 101, 102, 104t-105t, 123 Northern United States, seasonal allergens in, 25t endoscopy of. See Nasal endoscopy. Phenylephrine HCl/naphazoline HCl/pyrilamine maleate Nostrilla. See Oxymetazoline nasal spray. Phenylephrine HCl/pheniramine maleate (Dristan Nasal), 59t Phenylephrine HCl/pyrilamine maleate (MYCl Spray), 59t Phenylephrine nasal spray (Duration, Neo-Synephrine, Nostril, Occupational irritants. See Workplace. Opacification, of sinuses, CP5, CP7, CP9, 140-141, 143-144 Opticrom (cromolyn sodium ophthalmic drops), 74, 75t Oral contraceptives, rhinitis medicamentosa from, 31 Orbital abscess, from ABRS, CP11, 142, 143-144 asthma/allergy medications in, 75, 76t-77t dosage of, 58tduration of action, 44t, 58t treatment of. See Rhinitis treatment. Pseudoephedrine (Novafed, Pseudogest, Sudafed), 44t types of, 14t-15t, 92t. See also specific type, eg, Allergic rhinitis; Pyrilamine maleate, in hybrid intranasal spray, 59t factors associated with, 15tsymptoms of, 14t pharmacologic. See also specific drugs or drug types.
in sinus air-fluid level determination, CP4, 108-109 anticholinergics in, 44t-45t, 70, 71t, 72 in sinusitis diagnosis, 108-109, 110 corticosteroids in, 43, 44t-45t, 60-61, 63, 65t, 66-69 comparative antihistamine effectiveness against, 53-54, 67 inhaled antihistamines in, 43, 44t-45t, 54-55 oral antihistamines in, 43, 44t-47t, 45, 48-54, 54-55 Respiratory infection, viral. See Viral upper respiratory infection. Rhinocort AQ. See Budesonide nasal spray. Rhinitis. See also Rhinosinusitis. Rhinoscopy, in loss of sense of smell/taste, 27 Rhinosinusitis. See also Rhinitis; Sinusitis. acute bacterial. See Bacterial rhinosinusitis, acute. Sinus and Allergy Health Partnership (SAHP), 149 Sinusitis, 92t. See also Bacterial rhinosinusitis, acute; Rhinosinusitis. treatment of, 15t, 110, 117. See also specific drugs and drug types.
antibiotics in, 11, 15t, 111, 117, 124t-125t bilateral, computed tomography of, 106 diagnosis of, computed tomography in, 109-110, 115 Skin tests. See Allergy skin tests. clindamycin with, 124t-125t, 127t, 129t-130t asthma symptoms and, 41chronic rhinosinusitis and, 135 in environmental allergens, 25t, 28t, 30-31, 92t Spring, environmental allergens in, 25t, 30 Staphylococcus pyogenes, as ABRS pathogen, 97, 99 Steroids. See Corticosteroid nasal spray. antibiotic susceptibility of, 97, 99, 101, 103, 104t-105t, 124t-125t, other antibiotic class cross-resistance in, 103t Septra. See Trimethoprim/sulfamethoxazole (TMP/SMX). nasal polyps in, 27. See also Nasal polyps. septal deformity in. See Septal deviation. air-fluid levels in, CP4, CP7, CP8, CP9, 139, 141 Summer, environmental allergens in, 25t, 30 Sympathomimetics. See Corticosteroid nasal spray. Ultrasonography, in rhinosinusitis diagnosis, 108 in early- and late-phase allergic response, 26 in inflammatory cascade, 21-22, 22-24 TMP/SMX. See Trimethoprim/sulfamethoxazole. Toothache, maxillary, 107Torsade de pointes, 49 Vancenase. See Beclomethasone nasal spray. Triamcinolone acetonide nasal spray (Nasacort, Tri-Nasal Spray), 44t Vicks-Sinex. See Phenylephrine nasal spray. Trimethoprim/sulfamethoxazole (TMP/SMX) (Bactrim, Septra) Wegener granulomatosis, in nasal obstruction, 27, 28t, 92t Tri-Nasal Spray (triamcinolone acetonide). See Triamcinolone Winter, environmental allergens in, 25t, 30 in early- and late-phase allergic response, 24, 25 lost time at, from chronic rhinitis/sinusitis, 11 Xolair. See Omalizumab.
Xylometazoline nasal spray (Otrivin, Sinex) dosage of, 58tduration of action, 44t, 58trebound congestion from, 57 Zaditor (ketotifen fumarate), 74, 75t, 78Zafirlukast, 76t-77tZileuton, 76t-77t, 78Zithromax (azithromycin), 119t in β-lactam allergy, 121, 128t-129t, 132in children, 128t-129tindications for, 121, 124tsusceptibility/resistance to, 104t, 124t

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