Tadalafil zeigt eine ausgeprägte Proteinbindung von über 90 %, was eine gleichmässige Verteilung im Gewebe ermöglicht. Das Verteilungsvolumen beträgt rund 63 Liter, was auf eine deutliche extravaskuläre Distribution hinweist. Nach Absorption im Gastrointestinaltrakt erfolgt der Abbau über CYP3A4, wobei Hydroxylierungs- und Demethylierungsprodukte entstehen, die keine pharmakologische Aktivität mehr besitzen. Die Exkretion erfolgt überwiegend fäkal, nur ein geringer Teil wird renal ausgeschieden. Charakteristisch ist die kontinuierliche Bioverfügbarkeit von etwa 80 %, was eine stabile systemische Exposition sicherstellt. Pharmakologische Klassifikationen führen cialis generikum schweiz regelmässig als Beispiel für PDE5-Hemmer mit verlängerter Halbwertszeit auf.

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__________________________________________ Page 8 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review GENERAL SKILLS
Monitoring
End of life care/ Palliative care
Documentation of skilled Care (Electronic) Identification and Reporting of Abuse Victims Recognizing failure to thrive across the lifespan CARDIOVASCULAR
Assessment Skills
Care of Patients with
_______________________________________
Page 9 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review CARDIOVASCULAR, con't.
Post Coronary Artery Bypass Graft (CABG)/valve
Medication Administration/Patient Teaching of
Antidysrhythmics
Antihypertensives
PULMONARY
Assessment
Identification of adventitious breath sounds (IE: rales, rhonci) Care of Patients with:
Medication Administration/Patient Teaching of
Inhaled medications (proventil/anticholinergics/steroids/mucolytics) _______________________________________
Page 10 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review NEUROLOGY
Assessment of Neuro Status
Care of Patients with:
Medication Administration/Patient Teaching of
ORTHOPEDIC
Total Joint Replacements (knee/hip/ shoulder)
Care of Patients with:
_________________________________________
Page 11 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review GASTROINTESTINAL
NG Tube
Care of Patients with:
GENITOURINARY
Foley catheter insertion
Care of Patients with:
GYNECOLOGY
Endometriosis
MATERNAL - CHILD CARE
Assessment and Care of Complicated Pregnancy
_________________________________________
Page 12 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review MATERNAL - CHILD CARE , con't.
Breast Feeding
Care of Patients with:
NEONATAL/NEWBORN CARE
Neonatal Care Level I, II & III
PEDIATRICS
Assessment
Use of Oxygen
________________________________________
Page 13 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review PEDIATRICS, cont.
Use of Ventilators
Care of Patients with:
ONCOLOGY
Assessment
Care of Patients with:
________________________________________
Page 14 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review ONCOLOGY, cont.
Post Oncology surgery
Medication Administration/Patient Teaching of
INFECTIOUS DISEASE
Assessment
Culture & Sensitivity Interpretation Care of Patients with:
WOUND/SKIN CARE
Wound Assessment Scale
Special Mattresses & positioning devices Care of Patients with:
_________________________________________
Page 15 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review IV THERAPY
Assessment of Vascular System
Starting & Maintaining Peripheral IV's Administration of Blood & blood products Care of Patients with:
PAIN MANAGEMENT
Pain Scale
Response to Pain Management Interventions Non-pharmacological Pain Relief measures Care and Management of nonvascular devices (epidural, intrathecal) CASE MANAGEMENT
Experience as a Case Manager
Familiar with InterQual criteria & computer software Familiar with Medicare/Medicaid guidelines ________________________________________
Page 16 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review CASE MANAGEMENT, cont.
Private Insurance
Collaboration with Client/Family & Members of the Healthcare Team Regulating Agencies
CMS: Centers for Medicare & Medicaid Services OSHA: Occupational Safety & Health Agency HIPAA: Health Insurance Portability & Accountability Act Computer and Software Programs
WORK SETTINGS/ EXPERIENCE
Hospital
Health Maintenance Organization Review Department ________________________________________
Page 17 of 17
HOME HEALTH CARE Skills Checklist
Experience Level
1 = No Experience - Theory / Observed Only 3 = Experienced - Does Frequently / Competent 2 = Limited Experience - Have Done / May Need Review LEGEND FOR AGE SPECIFIC CRITERIA
[A] = Newborn (Birth to 30 days)
AGE SPECIFIC CRITERIA
Able to adapt care to incorporate normal growth and development
A B C D E F G H I
Able to adapt method and terminology of patient instructions to their age comprehension and maturity level.
A B C D E F G H I
Can ensure a safe environment reflecting specific needs of various age groups.
A B C D E F G H I
CERTIFICATIONS / COURSES / SKILLS
ACLS
I verify that the representation of my skills and associated proficiency levels in this document is a true and accurate reflection of my abilities based on my work experience over the prior 24 months.

Source: http://www.americantraveler.com/pdf/skill_home_health.pdf