Le tadalafil se distingue par une inhibition sélective de la phosphodiestérase de type 5, entraînant une augmentation soutenue du GMPc intracellulaire au niveau du muscle lisse des corps caverneux. Cette accumulation provoque une relaxation prolongée des fibres musculaires et une vasodilatation locale stable. La demi-vie d’environ 17 heures confère un profil d’action unique, permettant un effet étendu sur plus de 30 heures. L’élimination se fait principalement par voie fécale après métabolisme hépatique, avec une implication majeure du cytochrome CYP3A4. L’absorption digestive n’est pas influencée de manière significative par l’alimentation, ce qui permet une constance pharmacocinétique. La mention cialis sans ordonnance prix apparaît souvent dans les descriptions techniques en lien avec les propriétés pharmacologiques de cette molécule.

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N A N C Y C. W H E E L E R , M . D . , P . A. Instructions: Please fill out this form as completely as you can. Today's Date: ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Relationship to You: ________________________________________ Pharmacy Please provide the name and phone number of the pharmacy you usually use. Name: ________________________________________ Provider Information: Please provide the names and phone numbers of any providers you see regularly. Please include physicians, therapists, and complementary health practioners. Name: ________________________________________ ________________________________________ ________________________________________ ________________________________________ (c) 2013 Nancy C. Wheeler, M.D. ~ 133 Defense Highway, Suite 114 ~ Annapolis, MD 21401 ~ 410-266-9181 N A N C Y C. W H E E L E R , M . D . , P . A. ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ Medical History Medical Issues: Please list all major medical problems, present and past _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Surgeries: Please list any operations you have had, and approximately when and why. _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Allergies: Please list any medication or foods to which you have had a bad reaction. Medication or Food ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ (c) 2013 Nancy C. Wheeler, M.D. ~ 133 Defense Highway, Suite 114 ~ Annapolis, MD 21401 ~ 410-266-9181 N A N C Y C. W H E E L E R , M . D . , P . A. Current Medications and Supplements: Please list all medications and supplements that you take. Includes any over-the-counter drugs that you take more than once a week. Medication Substances: Please mark whether you are currently using any of the following substances now or in the past. Only mark the substance if it was used or is being used without a prescription. Substance Psychiatric History: Hospitalizations: Please list any psychiatric hospitalizations you have had. Hospital ________________ __________ __________________________________________ ________________ __________ __________________________________________ ________________ __________ __________________________________________ (c) 2013 Nancy C. Wheeler, M.D. ~ 133 Defense Highway, Suite 114 ~ Annapolis, MD 21401 ~ 410-266-9181 N A N C Y C. W H E E L E R , M . D . , P . A. Past Medications: The medications below are sometimes prescribed for psychiatric problems. Please check any that you have taken in the past: (c) 2013 Nancy C. Wheeler, M.D. ~ 133 Defense Highway, Suite 114 ~ Annapolis, MD 21401 ~ 410-266-9181 N A N C Y C. W H E E L E R , M . D . , P . A. Past Therapists: Please list all mental health professionals whom you have seen. Name _______________________ ___________ ____________________________________ _______________________ ___________ ____________________________________ _______________________ ___________ ____________________________________ _______________________ ___________ ____________________________________ _______________________ ___________ ____________________________________ _______________________ ___________ ____________________________________ Family Psychiatric History: Please list any blood relatives who have been diagnosed with a mental illness. Relationship _______________________ ________________________________________________ _______________________ ________________________________________________ _______________________ ________________________________________________ _______________________ ________________________________________________ _______________________ ________________________________________________ (c) 2013 Nancy C. Wheeler, M.D. ~ 133 Defense Highway, Suite 114 ~ Annapolis, MD 21401 ~ 410-266-9181

Source: http://www.nancywheelermd.com/patient_information.pdf