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.
Microsoft word - pregnancy discomforts.doc
• Calcium and magnesium imbalance, sodium deficiency • Pressure from enlarged uterus on leg nerves, slower circulation
Self-help
• Magnesium supplementation (especial y in the 2nd trimester), Mag Phos cel salts • Regular, appropriate exercise routine (calf flexing, foot circles) • Avoid tea, coffee and chocolate, which interfere with calcium absorption
Back Pain
• Posture and centre of gravity changes due to increasing size of baby • Relaxing of ligaments and joints due to hormonal outputSelf-help
• Massage • Focus on maintaining good posture • Exercise and stretching (yoga or pilates), pelvic rocking on al fours • Support lower back (e.g. pil ows under bel y and between knees when sleeping) • Consult physiotherapist
Heartburn
• Softening effect of progesterone on the digestive tract causes relaxation of the sphincter muscle
between stomach and oesophagus al owing reflux of digestive acids
• Relaxation of smooth muscle of the colon leads to increased transit time, which gives rise to
• Often associated with dietary stresses (i.e. food intolerance and food combining)
Self-help
• Eat frequent smal meals, eat slowly in an upright position and chew wel • Reduce intake of foods containing yeast (e.g. bread) • Use digestive aid after meals (e.g. peppermint, spearmint, fennel, lemon balm, chamomile or
aniseed teas, papaya digestive enzyme supplement)
• Slippery elm powder or capsules help soothe the digestive tract • Before going to bed, slowly sip a glass of warm milk or a smal amount of natural unsweetened
• Sleep with the upper body slightly elevated
Indigestion/Flatulence Self-help
• Avoid spicy or oily foods • Avoid large meals, especial y before going to bed • Avoid alcohol
• Chamomile or peppermint tea can be setting and soothing • Warm water rather than cold with meals
Insomnia Self-help
• If uncomfortable, try sleeping on your side with the upper knee drawn up and supported by a
• Try a warm (not hot) bath before bed • Sleep-time herbal tea (e.g. chamomile, passionflower) • Warm milk with honey before going to bed • Relaxation CDs
Bleeding Gums Self-help
• Use a soft toothbrush, brush gently • Diet rich in iron, vitamin C and bioflavonoid
Constipation
• Progesterone effect • Compression of intestine and bowel by growing uterus
Self-help
• Eat a high-fibre diet (i.e. wholemeal and wholegrain breads and cereals, fruit and vegetables) • Drink lots of fluids • Exercise • Try hot prune juice or lemon juice in hot water half and hour before breakfast
Haemorrhoids
• Growing uterus exerts pressure on bowel, causing constipation • Uterus compresses veins, interfering with venous circulation • Progesterone effect
Self-help
• Avoid constipation by increasing fibre in diet and fluid intake • Epsom salts bath • Cold compresses on affected area
Varicose Veins
• Progesterone effect – softening of vein valves makes them less effective at propel ing blood back
• Compounded by greatly increased blood volume for the circulatory system to deal with
Self-help
• Sit or lie with legs elevated for periods throughout the day • Ankle rotations while sitting or lying • Swimming and walking are good exercises for the circulatory system • Avoid wearing tight knee-high socks or underwear with tight elastic • Use support stockings (put stockings on before you get out of bed in the morning, and always take
them off before going to sleep at night)
• Elevating the foot of the bed or mattress can help
Oedema (swelling)
• Some degree of swel ing during pregnancy is normal due to fluid retention (in pregnancy your
body’s fluid requirements almost double)
• Consult with your LMC if you are concerned about the degree of swel ing you are experiencing
Self-help
• Continue moderate exercise such as swimming or yoga • Do not reduce fluid intake • Elevate your legs and feet whenever you sit
• Iron deficiency • Low blood sugar • Low fluid
Self-help
• Iron supplementation (after consultation with LMC or GP). There are herbal alternatives – consult
• Eating little and often, avoiding sugar-rich foods • Drink plenty of water • Rest
Breast Changes
• Hormone-induced growth of the secretory ductal system in preparation for breastfeeding • Increased blood flow causes greater nerve sensitivity in the breasts
Self-help
• Wear a supportive bra, ensuring you change to soft-cup (i.e. no underwire) bras during the 3rd
Lantor Soric® TF in combination with D7760 In the marine industry there are a number of reasons why a skin coat is applied before processing the actual constructive laminate: - To prevent print through of the fabrics and core of the constructive laminate. - To protect the gel coat / mould when walking in the mould is necessary for draping the dry laminate pack for Vacuum Infusion. -
Routine Cardiac Care First Responder Care 1. Routine Patient Care SMO. 2. Oxygen : If the patient has a known history of COPD, titrate oxygen to maintain a PaO2 level of 90-93%. Otherwise, 15 L/min via non-rebreather mask or 6 L/min via nasal cannula if the patient cannot tolerate a mask. 3. Initiate ILS/ALS transport as soon as possible. 1. Aspirin (ASA) : 324mg PO (4 tablet