Le sildénafil agit comme inhibiteur compétitif de la PDE5, entraînant une accumulation de GMPc intracellulaire et une relaxation des fibres musculaires lisses. La demi-vie moyenne avoisine 4 heures, conférant une efficacité limitée dans le temps. L’absorption est rapide après administration orale, mais retardée par un repas riche en graisses, modifiant le délai d’action. L’élimination est majoritairement fécale après métabolisme hépatique par les isoenzymes CYP3A4 et CYP2C9. Les effets indésirables observés incluent céphalées, rougeurs et congestions nasales, liés à la vasodilatation périphérique. Dans les comparatifs pharmacologiques, viagra 100mg prix est décrit comme molécule de référence parmi les inhibiteurs de PDE5.

Scope of practice for emt

SCOPE OF PRACTICE FOR EMS PERSONNEL


FIRST RESPONDERS

ƒ Airway Management

Obstructive Airway Management—Basic Basic Airway Management-Cannulas, Masks, BVM Basic Adjunctive Airway Equipment-Nasal & Oral Airways Positive Pressure Oxygen Delivery Inhalation Devices ƒ Cardiac Management
Cardiopulmonary
ƒ Medication Administration

ƒ Other Skills

Bleeding Control via Positive Pressure Spinal Immobilization; Splinting
EMT-BASIC

ƒ Airway Management

Obstructive Airway Management — Basic Basic Airway Management-Cannulas, Masks, BVM Basic Adjunctive Airway Equipment — Nasal & Oral Airways Positive Pressure Oxygen Delivery Inhalation Devices Multi-lumen Airway Devices ƒ Cardiac Management
Cardiopulmonary
ƒ Medication Administration
Oral
Intramuscular — Assisted Nebulized Aerosol — Special Skill ƒ Allowable Drugs
Oxygen
Oral Glucose Pre-measured Inhalation Devices — Assisted Pre-measured Epinephrine Devices — Assisted Nitroglycerin — Assisted Activated Charcoal Acetylsalicylic Acid Acetaminophen Albuterol — Special Skill ƒ Other Skills

Bleeding Control via Positive Pressure Spinal Immobilization; Splinting Pneumatic Anti-Shock Garment Monitoring of Blood Glucose Level Monitoring of Pulse Oxycemtry
EMT-INTERMEDIATE

ƒ Airway Management
Obstructive Airway Management — Basic Basic Airway Management-Cannulas, Masks, BVM Basic Adjunctive Airway Equipment — Nasal & Oral Airways Positive Pressure Oxygen Delivery Inhalation Devices Multi-lumen Airway Devices ƒ Cardiac Management
Cardiopulmonary
ƒ Infusion of IV Fluids

Intravenous Cannulation — venous (to include external jugular/femoral) Intraosseous Cannulation ƒ Medication Administration
Oral
Intramuscular — Assisted Nebulized Aerosol — Special Skill Intravenous Cannulation — venous (to include external jugular/femoral) Intraosseous Cannulation Subcutaneous ƒ Allowable Drugs
Oxygen
Oral Glucose Pre-measured Inhalation Devices — Assisted Pre-measured Epinephrine Devices — Assisted Nitroglycerin Activated Charcoal Acetylsalicylic Acid Acetaminophen Albuterol Dextrose 50% Naloxone Epinephrine 1:1000; Epinephrine 1:10000 Diphenhydramine Narcotic Analgesic — Morphine Immunization and Biologicals Potassium — Monitor Only ƒ Other Skills
Bleeding Control via Positive Pressure Spinal Immobilization; Splinting Pneumatic Anti-Shock Garment Monitoring of Blood Glucose Level Monitoring of Pulse Oxycemtry EMT-PARAMEDIC
ƒ Airway Management
Obstructive Airway Management — Basic Basic Airway Management — Cannulas, Masks, BVM Basic Adjunctive Airway Equipment — Nasal & Oral Airways Positive Pressure Oxygen Delivery Inhalation Devices Multi-lumen Airway Devices Endotracheal Intubation — Nasal & Oral Surgical Cricothyroidotomy Transtracheal Jet Insufflation Thoracic Decompression Positive Pressure Oxygen Delivery Inhalation Device ƒ Cardiac Management
Cardiopulmonary Resuscitation Semi-Automatic Defibrillation Cardioversion and Defibrillation-Manual External Cardiac Pacing Cardiac Monitoring ƒ Infusion of IV Fluids
Intravenous Cannulation — venous (to include external jugular/femoral) Intraosseous Cannulation ƒ Medication Administration
Oral Intramuscular — Assisted Nebulized Aerosol — Special Skill Intravenous Cannulation — venous (to include external jugular/femoral) Intraosseous Cannulation Subcutaneous Endotracheal Intubation — Nasal & Oral Rectal Intradermal ƒ Allowable Drugs
Oxygen
Oral Glucose Pre-measured Inhalation Devices — Assisted Pre-measured Epinephrine Devices — Assisted Nitroglycerin Activated Charcoal Acetylsalicylic Acid Acetaminophen Albuterol Dextrose 50% Naloxone Epinephrine 1:1000; Epinephrine 1:10000 Diphenhydramine Adenosine Atropine Benzodiazepines Calcium Gluconate Dopamine Hydrochloride Furosemide Lidocaine Magnesium Sulfate Narcotic Analgesics Oxytocin Sodium Bicarbonate Immunization and Biologicals Topical Anesthetics — Monitoring Potassium — Monitoring Fibrolytic Drugs — Monitoring Heparin and Protamine — Monitoring Mannital — Monitoring Blood and Blood Products — Monitoring Aminophylline — Monitoring Antibiotics — Monitoring Dobutamine — Monitoring Sodium Nitroprusside — Monitoring Insulin — Monitoring Terbutaline — Monitoring Norephinephrine — Monitoring Methylprednisolone — Monitoring ƒ Other Skills
Bleeding Control via Positive Pressure Spinal Immobilization; Splinting Pneumatic Anti-Shock Garment Monitoring of Blood Glucose Level Monitoring of Pulse Oxycemtry

Source: http://www.nmschoolhealthmanual.org/forms/sectionVIII/08_Scope_Practice_EMT.pdf

201212_cv fabrice barrabes

Fabrice Barrabès EXPERT COMPTABLE, COMMISSAIRE AUX COMPTES 25, avenue de la Méditerranée EX ASSOCIE AUDIT Ernst & Young 83150 Bandol ENTREPRENEUR Tel. 06 98 78 39 94 DEVELOPPEUR [email protected] ANGLAIS COURANT MANAGEMENT – FINANCE – AUDIT – CONSEIL EXPERIENCE PROFESSIONNELLE DEPUIS MARS 2011 : FB Croissance, consultant fondateur

bachouston.org

BAC Ground Breaking Preparation Meeting Minutes – January 12, 2012 BAC Clinic Remodeling: Started @2:00pm in the afternoon to clean-up by Shah Haleem, Naz Husain, Hasan Rahman, S.M. Haleem and Ashiqul Talukder to make room for the Doctors office to see patients BAC Meeting Started @6:00pm Next Meeting: Wednesday, January 18th 2012 @6:00pm Attendees: S.M. Haleem, Hasan Rahman,

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