Tadalafil zeigt eine konstante Resorption im Gastrointestinaltrakt, mit maximalen Plasmaspiegeln nach rund zwei Stunden. Der Wirkstoff verteilt sich gut im Gewebe und weist eine hohe Plasmaproteinbindung auf. Seine lange Halbwertszeit erlaubt eine verlängerte Wirkphase. Der Metabolismus erfolgt über das hepatische Enzymsystem CYP3A4, mit der Bildung inaktiver Metaboliten. Exkretion geschieht primär über den Stuhl. Die Häufigkeit von Nebenwirkungen steigt mit der Dosis, wobei vor allem vasodilatatorische Effekte dominieren. Ein gängiger Bezugspunkt in pharmakologischen Analysen ist cialis ohne rezept, das mit dieser Wirkstoffklasse assoziiert ist.

Ephratahospital.org

Provider Orders
General Medical Admission 
  
General Medical Admission 
General  
Nursing  
Assessments / Interventions  
c Weigh daily  Fingerstick glucose ac & h.s.   Patient Care Instructions  
Activity  
Select one diet only! If combination diet is required, please use other field.  
Provider Signature_______________________________________ 
Date/Time_______________________ 
Provider Orders
General Medical Admission 
c Diet, 2gm Na low fat/low cholesterol  g Consults  
c P/T Eval & Treat (Reason:____________________)  g c OT Eval & Treat (Reason:____________________)  g c Dietary consult (Reason: Assess and educate)  g c Social Service consult (Reason:____________________)  g Labs on Admission  
c Glycohemoglobin/HGBA1C (If not done in last 3 months)  g Labs in A.M.  
c Basic metabolic panel (Daily x _______)  g c B-type natriuretic peptide (Daily x__________)  g Provider Signature_______________________________________ 
Date/Time_______________________ 
Provider Orders
General Medical Admission 
Diagnostic Tests  
c EKG (Daily x __________days)  XR chest 2 views (Reason for exam ____________________)   XR chest portable (Reason for exam ____________________)   Respiratory  
IV Fluids  
✔ 2 milliliter IV PUSH every 8 hours if no fluids   c @__________ milliliter/hour intravenously   c @__________ milliliter/hour intravenously   c @__________ milliliter/hour intravenously   c @__________ milliliter/hour intravenously   Medications  
Do not exceed 4 grams of acetaminophen in 24 hours  
Provider Signature_______________________________________ 
Date/Time_______________________ 
Provider Orders
General Medical Admission 
Analgesics  
c 650 milligram orally every 4 hours as needed for headache , mild pain or fever of 101.4 F or greater   oxyCODONE-acetaminophen 5 mg-325 mg tab (Percocet)   c 1 tablet every 4 hours as needed for moderate pain   c 2 milligram intravenously every 4 hours as needed for chest pain or severe pain   c 1 milligram intravenously every 2 hours as needed for severe pain   Anti Anxiety  
c 0.5 milligram orally every 6 hours as needed for anxiety   Antiemetics  
c 4 milligram intravenously every 6 hours as needed for nausea/vomiting   Anti-ulcer Agents  
c 15 milliliter orally every 6 hours as needed for epigatric distress   c 40 milligram intravenously once a day   Antitussive Agents  
c 10 milliliter orally every 4 hours as needed for cough   Bronchodilators  
albuterol 2.5 mg/3 mL (0.083%) neb solution   c 2.5 milligram inhaled 4 times a day  g c 2.5 milligram inhaled every 2 hours as needed for shortness of breath   albuterol-ipratropium 2.5 mg-0.5 mg/3 mL soln for inhalation (DUONEB)   c 1 ampule inhaled every 2 hours as needed for shortness of breath   Laxatives  
c 100 milligram orally 2 times a day (Hold if having diarrhea)   magnesium hydroxide (Milk of Magnesia Concentrate)   c 10 milliliter orally once a day as needed for constipation   Provider Signature_______________________________________ 
Date/Time_______________________ 
Provider Orders
General Medical Admission 
c 1-2 tablet orally once a day as needed for constipation   c 1 enema rectally once a day as needed for constipation   Nitrates  
c 0.4 milligram sublingually every 5 minutes as needed for chest pain x 3 doses. Hold if Sys BP less than ✔ Notify provider unrelieved CP (After nitroglycerin)   Sleep Aids  
c 5 milligram orally once a day, at bedtime as needed for sleep   DVT Prophylaxis  
MUST select one. If not ordered please enter reason.  
c No DVT prophylaxis (Reason:____________________)  g c Early ambulation  TED hose (Remove TEDs to inspect skin b.i.d.)   c Alternating Pressure Device (SCDs)  heparin   c 5000 unit subcutaneously every 12 hours  g c 5000 unit subcutaneously every 8 hours   c 2.5 milligram subcutaneously every 24 hours   c 40 milligram subcutaneously every 24 hours   Smoking Cessation Medications  
✔ Initiate Smoking Cessation Protocol   Provider Signature_______________________________________ 
Date/Time_______________________ 

Source: http://www.ephratahospital.org/Portals/0/docs/POS%20September%2012/General%20Medical%20Admission_V4_09_2012.pdf