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.

Cchs.k12.pa.us

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NO. 209.1 ATTACHMENT 1
CENTRAL CAMBRIA SCHOOL DISTRICT
Emergency Health Care Plan and Medication Orders for Life Threatening Allergies
Student Name: _______________________________________________________Date of Birth: _____________________School Year: __________________
School: _____________________________________________________________ Grade: _____________ Unit Teacher: ______________________________
Allergy to: _____________________________________________________________________________________ Asthmatic:  YES  NO
STEP 1: TREATMENT – To be completed by Physician
Symptoms:
Give Checked Medication (to be determined by
physician)
If exposure to an allergen occurs, but no symptoms ~Mouth Itching, tingling, or swelling of lips, tongue, mouth ~Skin Hives, itchy rash, swelling of the face or extremities ~Gut Nausea, abdominal cramps, vomiting, diarrhea ~Throat* Tightening of throat, hoarseness, hacking cough ~Lungs* Shortness of breath, repetitive coughing, wheezing ~Heart* Weak or thread pulse, low blood pressure, fainting, pale, blueness ~If reaction is progressing (several of the above areas affected), give: *Potentially life-threatening. The severity of symptoms can quickly change.

DOSAGE:
Epinephrine – Inject intramuscularly:  Epi-Pen 0.3 mg.  Epi-Pen Jr. 0.15 mg.
Antihistamine – give (medication/dose/route):  Benadryl __________mg.
Repeat Epi-Pen  YES  NO in 15 minutes if squad has not arrived – 2 kits will be needed in school.
STEP 2: EMERGENCY CALLS – To be completed by Parent/Guardian
1. Call 911 for Rescue Squad and ask for Advanced Life Support – state that an allergic reaction has been treated. 2. Call: Mother: Home: _________________________________ Work: __________________________________ Cell: ____________________________ Father: Home: _________________________________ Work: __________________________________ Cell: ____________________________ First: Name: ____________________________________ Relationship: _____________________________ Phone #: ________________________ Second: Name: __________________________________ Relationship: _____________________________ Phone #: ________________________ 3. Physician: _____________________________________________________________________________________ Phone #: _______________________ 4. Preferred Hospital: _______________________________________________________________________________ Phone #: _______________________ Page 2 of 2
SELF-ADMINISTRATION
I understand and agree that my child/patient requires the administration of epinephrine or a unit dose of Benadryl in conjunction with epinephrine when exposed
to a specific allergen and he/she is capable of self-administration of the medication.  YES  NO

DESIGNEES
I understand that the school nurse, when available, is responsible for emergency care to my child/patient. In the absence of the school nurse, the nurse can
designate and train another staff member to administer one or two Epi-Pens.  YES  NO Benadryl cannot be given by any designee.
CARRYING MEDICATION
I understand that on a trip, my child/patient may carry their own Epi-Pens and Benadryl.  YES  NO

BEFORE AND AFTER SCHOL PROGRAM
This Emergency Plan and Medication Order may be used in the Before and/or After School Programs.  YES  NO  N/A
I hereby acknowledge that the Central Cambria School District, its agents and employees shall incur no liability as a result of any injury arising from
the administration of a pre-filled, single dose auto-injector mechanism containing epinephrine to my child, and agree to indemnify and hold harmless
the District, its employees, and its agents against any claims arising out of the administration of a pre-filled, single dose, auto-injector mechanism
containing epinephrine.
First Parent/Guardian (circle one) Signature: ________________________________________________________ Date: ___________________________
Second Parent/Guardian (circle one) Signature: ______________________________________________________ Date: __________________________
School Nurse’s Signature: _________________________________________________________________________ Date: __________________________
Physician’s Signature AND STAMP: ________________________________________________________________ Date: __________________________

Source: http://www.cchs.k12.pa.us/Documents/Emergency_HCP_and_Med_Orders_for_Life_Threatening_Allergies_Attachment_1_Edit_version_PDF.pdf