Das pharmakologische Profil von Sildenafil zeigt neben der PDE5-Inhibition auch eine geringe Aktivität an der PDE6 in der Retina. Dies erklärt visuelle Nebenwirkungen wie Farbsehstörungen, die gelegentlich auftreten. Die orale Bioverfügbarkeit beträgt etwa 40 %, mit einer hohen Bindung an Plasmaproteine. Das Verteilungsvolumen ist groß, sodass die Substanz rasch in verschiedene Gewebe gelangt. Die Metabolisierung erfolgt hepatisch und produziert einen aktiven Metaboliten, der die pharmakologische Wirkung ergänzt. Nebenwirkungen sind dosisabhängig und umfassen Kopfschmerzen, Hautrötung und Dyspepsie. Bei Vergleichen innerhalb der Wirkstoffklasse wird viagra original regelmäßig als Beispiel für eine Substanz mit schneller, aber kurzzeitiger Wirkung aufgeführt.

Spa intake form - the nardella clinic

INTAKE FORM
HOW DID YOU HEAR ABOUT OUR THE NARDELLA CLINIC? MEDICAL HISTORY PRIMARY FAMILY PHYSICIAN: MAY WE HAVE PERMISSION TO CONSULT WITH PRIMARY PROVIDER? YES ___ NO ___ PLEASE LIST: CURRENT MEDICATIONS (TOPICAL & INTERNAL): PLEASE CHECK ANY & ALL CONDITIONS THAT APPLY TO YOU: ___ ALCOHOL ADDICTION HAVE YOU HAD A FAMILY HISTORY OF SKIN DISEASE? YES DO YOU HAVE A PACEMAKER? YES: __ NO: __METAL PLATES OR PINS? YES: __ NO: __ LIFESTYLE DO YOU HAVE ANY DIFFICULTIES WITH YOUR HANDS OR FEET? HOW MUCH WATER DO YOU DRINK IN A DAY? _____ CAFFEINE? ______ ALCOHOL? PLEASE DESCRIBE YOUR DIET (I.E. VEGAN, LOW CARB, ETC.) DO YOU ENJOY HOT OR SPICY FOODS? YES: __ DESCRIBE _________ NO: _____ DO YOU SMOKE? ___________IF YES, HOW MANY? ___________ HOW LONG? ____YRS HOW WOULD YOU DESCRIBE YOUR DAILY LEVEL OF STRESS? DO YOU EXERCISE REGULARLY? YES: __ NO: __ DESCRIBE: PLEASE LIST ANY OTHER INFORMATION WE MAY NEED TO KNOW ABOUT: 202, 1910- 20th Ave. NW Calgary, AB T2M 1H5 email: [email protected] Web: www.aquaterraspa.ca INTAKE FORM
FOR WOMEN: ARE YOU PREGNANT: YES: __ NO: __ IF YES, STAGE: _______ DUE DATE: _________ ARE YOU TRYING TO BE PREGNANT? _____ ARE YOU ON ORAL CONTRACEPTIVES? YES: __ NO: __ MEDICAL & AESTHETIC HISTORY ARE YOU UNDER THE CARE OF A DERMATOLOGIST? YES: __ NO: __ DERMATOLOGISTS NAME: _________________ REASON FOR TREATMENT: _____________ DO YOU TAKE DIETARY SUPPLEMENTS/VITAMINS? YES: __ NO: __ IF YES, PLEASE DESCRIBE: _______________________________________________ DO YOU TRAVEL; FOR WORK OR PLEASURE? _W / P_______ HOW OFTEN? ______________ IF YES, TYPE _____________ AREA ______________ IF YES, TYPE _____________ DATE ______________ HOW LONG HAVE YOU BEEN USING THIS MEDICATION? IF YES, AREA _____________ DATE ______________ ______________________________________________ IF YES, HOW OFTEN? _____________________ EYES__________ HAIR__________ SKIN___________ I HAVE STATED ALL MEDICAL CONDITIONS THAT I AM AWARE OF AND WILL UPDATE THE TECHNICIAN OF ANY CHANGES IN MY HEALTH STATUS. SIGNATURE: _______________________________________ 202, 1910- 20th Ave. NW Calgary, AB T2M 1H5 email: [email protected] Web: www.aquaterraspa.ca INTAKE FORM
INFORMED CONSENT
Statement of Acknowledgement
I confirm that I have the ability to accept or reject this care of my own free will and that I am not an agent of any private,
local, county, provincial or federal agency attempting to gather information without so declaring. I understand that, as a patient, I am responsible for all costs incurred as a result of the decision including, but not limited to; the cost of all procedures involved in the treatment plan, the care provider’s time, supplements, supplies and appointments missed or cancelled without sufficient notice (48 hours). I am aware that treatments are not covered through Alberta Health Care and may not be covered under private health insurance. ___________________________ SIGNATURE
DATE Witness
202, 1910- 20th Ave. NW Calgary, AB T2M 1H5 email: [email protected] Web: www.aquaterraspa.ca

Source: http://www.drnardella-nd.ca/files/spa-intake-form.pdf