Archive for the Medicine Category

Cialis (Tadalafil) And High Blood Pressure

Friday, June 2nd, 2017 | Permalink

How blood pressure is linked to potency

The link between high blood pressure and sexuality is very profound and goes beyond the known side effects of male erection drugs. The basic problem is that hypertension is infamous among insiders as the silent killer, because in most cases does not cause any symptoms, but can cause serious damage. It is estimated that up to one in three adults may suffer from excessive pressure and that up to one in two of these patients are not aware of it, or alternatively, do not find it disturbing enough to act upon it bringing the values inside the range of what’s normal.

An uncontrolled pressure can go unnoticed for years, but this does not mean that you do not have an impact on the health, which unfortunately means that you will only notice the problem through concrete symptoms only when the damage will already be more or less permanent.

High Blood Pressure

It is highly unlikely that sexual activity causes an immediate threat to your health, such as a heart attack, but hypertension can affect sexual satisfaction in a number of respects. A high pressure problem and a satisfying sex life can coexist, provided that you openly affront the problem with your doctor (even better yet with an andrologist, in consultation with the cardiologist in cases of the most delicate heart disease) and ensure the availability of a healthcare team to work in a trust-imbued environment.

We already know that 31% of men with high blood pressure may complain of a problem to have adequate rigidity and that a person suffering erectile dysfunction has a higher risk of about 80% of coronary heart disease.

A recent study by the European Society of Cardiology has evaluated 156 patients on antihypertensive therapy and 47 men with erectile dysfunction not receiving any treatment, as a control group; both groups were subjected to vascular investigation of the penile arteries using dynamic Doppler ultrasound, with the use of prostaglandin E1 and subsequent study of the systolic peak of the relative speed in order to assess the possible presence and the relative severity of a vascular problem at the level of corpus spongiosum.

At this point, the effect of each class of medicines taken by patients have been studied, both those treated with monotherapy and those taking the two drugs at the same time, considering the systolic velocity peaks that they had; a low peak signaled a possible impairment of the flow in the penile arteries and therefore a possible more or less severe erectile dysfunction.

In a nutshell, the results of this work have shown that in patients who underwent antihypertensive therapies, the peak values ​​of the systolic velocity were lower and, in particular, who received a beta-blocker or a calcium had significantly lower values ​​compared to those who took a ACE-inhibitor or an inhibitor of angiotensin II receptor antagonists.

The negative impact on systolic peak of the penile arteries was even greater if the patient was taking combination that included a diuretic. These data are in part still to be confirmed, but the complex work in question appears not to secondary importance because it is the first one that takes into account the hypertensive patient who takes multiple medications and, in these cases, to know the effect of different combinations is not a secondary factor to understand a possible sexual problem.

Here we must bear in mind that hypertension is a very common clinical problem and today seems to be of interest to groups of young people and adults whose general quality of life depends to a large extent from a physiological and normal sexual response.

Cialis and blood pressure

Tadalafil, better known as Cialis, is capable of inhibiting an enzyme called phosphodiesterase type 5, present in the corpus cavernosum of the penis and also in the cardiac muscle tissue that prevents their physiological relaxation.

The use of Cialis, by blocking this enzyme, allows in addition to the vasodilatation of the cavernous bodies of the penis, after which achieving an erection becomes easier. This holds true for control of the cardiac volume in patients with an abnormal thickening of the left ventricle and an initial cardiac decompensation. It all goes back to the fact that the therapeutic indications for which the entire group of PDE5 inhibitors was originally proposed at the beginning of their clinical trials only as drug that can solve some cardiovascular problems, such as angina and / or hypertension.

This plays an important role in reassuring that all those patients who, taking an inhibitor of type 5 phosphodiesterase, fear the infarction or other central nature of problems, such as failure and cardiac problems.

Cialis is not contraindicated in case of blood pressure provided that it is mildly elevated or borderline, but nevertheless Cialis is a prescription drug whose appointment requires physical examination by an andrologist, sexologist, general practitioner or any other qualified healthcare provider.

First, talk to your doctor about taking a drug that helps to fight issues with erectile function, a hormonal profile can be helpful, but if you want a complete picture of the causes and the most appropriate treatment, a reassessment by a licensed andrologist is required.

Many situations that appear towards the age of 50 years in men are linked to a vascular disease, hypertension, and can create a state of sexual discomfort, associated with a degree of uncertainty in the reports. Cialis may be an optimal solution. Discuss this with your doctor or specialist who can evaluate whether there are other contraindications for tadalafil use – although very limited, such exist and should be ruled out before the therapy begins.

ED Medications from Canadian Pharmacies

Cialis is not the only medicine against erectile deficit available today. Apart from other, non-oral forms of treatment, there exist multiple tablets, capsules, lozenges and even gels and jellies to help you recover your failing sexual potency. Smartcanadianpharmacy.com specializes in ED treatment pills, offering a long list of discount Generic Viagra, Cialis, Levitra, Stendra drugs and their versatile generic forms for customers on a budget.

Such a variety is good news for someone who needs a dose adjustment with all of the drug’s efficacy preserved. For instance, if you have a condition like elevated blood pressure to consider, you will do better with smaller doses of PDE5 inhibitors. Arbitrary, when underwhelmed with the results of minor Generic Cialis or Viagra doses and make sure you have your therapist’s approval, you can choose a more impactful generic to step up the health outcomes. If you feel unsure about how to tackle the problem of choice, seek a free piece of online advice from Smart Canadian Pharmacy therapists.

Drugs for hypertension at Canadian Pharmacies

Below you will find a brief presentation of drugs for high blood pressure and related conditions available through in Canadian pharmacies. There are more than 65 drugs in this category, providing an ample choice of treatment options to choose based on many individual factors. Remember that self/administration is a dangerous practice that should be avoided at all costs. A safe combination of anti/hypertensive solution and Cialis can be only appointed by your trusted healthcare provider. Since there are several different types of drugs that lower blood pressure, it is possible for most people to get blood pressure down to an appropriate level without any major side effects.

There are several different groups of drugs used with the purpose to restore an elevated blood pressure. These are:

  • diuretic drugs (diuretics) (Lasix, Hydrochlorothiazide, Aldactone)
  • ACE inhibitors (Altace, Captopril)
  • calcium channel blockers (Norvasc, Plendil)
  • angiotensin receptor blocker, ARB (Atacand, Avapro)
  • beta-blockers (Toprol XL, Inderal)
  • other antihypertensive agents, such as alpha-blockers (Doxazosin, Prazosin).

An appropriate therapy is established by prescriber after trying off several therapeutic methods. If the pressure is not significantly increased, it is usually not an emergency to achieve target blood pressure, i.e. a pressure that is slightly below 140/90 millimeters of mercury, mmHg.

It is common to have to start with a single agent and see how well it works for a few months. If blood pressure has not been reduced at all, or if it has just been lowered a bit, you can increase the dose slightly, changing medication or combine with any other drug. It often becomes better effect by combining two different types of drugs at low doses, than increasing the dose of a drug.

If the doctor determines that you need multiple drugs, you can add them in stages. Some cope with a drug, but most people need at least two different agents, while some people may require three, four or five medications to reduce the pressure to slightly below 140/90 mm Hg. Sometimes it is difficult to reach the desired target blood pressure, for example because of side effects of taking multiple drugs. Then you have to accept a blood pressure that is slightly higher.

As a rule, you start treatment with a drug groups ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, or a kind of diuretics called thiazides. Is your blood pressure from the beginning a little higher, and other risk factors is usually elevated doctor choose a combination of two of the above types from the beginning. There are tablets which contain a combination of two drugs.

All medicines may cause side effects. Some patients have side effects of a drug treatment, others do not. Sometimes side effects reduce after a while. If you have troublesome side effects you should contact your doctor. The dose may need to be changed or you may have to try a different medication or perhaps a completely different type of treatment.

Using Viagra Wisely: The Do’s & Don’ts

Wednesday, April 13th, 2016 | Permalink

It is hard to imagine proper ED treatment without Canadian Pharmacy pills, isn’t it? Quality drugs from Canada rescue men with the most difficult diagnoses and the severest health conditions. And though things seem to be pretty clear (you buy the remedy, take it and overcome the anxiety and difficulties), a great part of users contrive to make mistakes that lead to complications rather than improvements.

Our list of do’s and don’ts intends to share vital things that should and shouldn’t be done, while a man takes  generic Viagra http://www.mycanadianpharmacyrx.com/generic-viagra.  You must have read about some of them, but there are a lot of facts that become a true surprise.

Do’s that Go Hand in Hand with Viagra

 some of them, but there are a lot of facts that become a true surprise. Do’s that Go Hand in Hand with Viagra

That’s not a secret that most Generic Viagra users are satisfied. Yet still, being in their list doesn’t mean being absolutely safe and secure. There is the reverse side of the medal and drawbacks may appear any minute: allergies, shortness of breath, swelling, blurred vision, rash, etc.

! Never get too excited if the erection lasts more than 5 hours, because there’s nothing awesome or fantastic about that! It’s the first sign of the problem to be checked by a doctor.

Any side effects can disappear in one of two ways:

  • either they are treated with medications ( this is the toughest and most complicated way);
  • or they are successfully prevented (in case a user knows all warnings and tips).

The Do’s:

  1. get advice and prescriptions from your doctor;
  2. purchase ED pills from Canadian Pharmacy online to save money and learn additional info on drug intake and new available medications;
  3. take a pill at the right time. How to get ready? Taking Generic Viagra right before the intercourse won’t provide any effect. If the pill is taken too early, the medication will spread throughout the body and the chance for erections will be missed. The happy medium is taking it one hour prior the intercourse to be ready when the time comes;
  4. intake only the recommended dose. The recommendation may sound silly. Yet many experienced men believe that additional dosages could be beneficial in their case, which is far from being true. Overdose triggers complications that are really hard to overcome;
  5. take pills only after eating a light meal (French fries, meat, hamburgers aren’t the foods to be consumed with Viagra);
  6. report of the slightest side effects (rash, nasal congestion, headache, dizziness, diarrhea) to treat them timely and effectively;
  7. relax & enjoy.

Don’ts that Can’t Be Ignored by Viagra Users

It’s a well-known fact that Canadian Viagra pills cause serious by-effects if they are combined with nitrates. Why? Both medications cause the muscle relax. When the muscles that control the blood vessels are relaxed, vessels start enlarging. The blood pressure drops significantly.

Does it mean that all men with low blood pressure health issues should refuse from ED treatment? No, it surely doesn’t. It’s just they must be cautious. The intake of both medications is discussed with a physician. There are cases, when pills are taken at different hours, or Generic Viagra doses are low. Thanks to Canadian Pharmacy one can buy several pills instead of a pack to check the effect.

How to identify the nitrates? There are more than 20 prescription forms of them! They all have Nitro in their names.

The Don’ts:

  1. share Viagra pills with friends or family, even if some of the have the similar symptoms;
  2. take pills, if you are allergic to their active ingredients;
  3. believe it is a 100% cure;
  4. take tablets when they aren’t needed;
  5. take on an empty stomach. The food amount in the stomach usually has a great influence on the spread of the ED medication. The pill hits an empty stomach faster and the result can mess up with the timeline;
  6. drink alcohol before or after taking a pill. Alcohol won’t spoil the performance, yet it will definitely lead to rather dangerous side effects. Take the pill sober and with water.

Am I a PDE5 Candidate?

Aside from patients on nitrates, there are some other cases, when Viagra from Canada is not the best choice. As a rule, these are men with severe heart failures, diabetes, the recent history of strokes, retinitis pigmentosa and uncontrolled hypertension.

Viagra will increase the chances for the severest cardiovascular diseases, especially during the mental and physical stress that goes along with the intercourse.

Is There any Way to Maximize the Effect?

There surely is. Usually Canadian Viagra is the most effective treatment for physically active men. These men may have ED problems, but they choose to eat healthy foods and go in for sports instead of showing pity for themselves. Besides, those, who eat avocados, bananas, give preference to vegetables and juice rather than meat and soda, report of an excellent performance and the absence of any side effects.

Now you know do’s and don’ts of taking Canadian Viagra. Hopefully, you will take them into account every time you cast doubt on doctor’s prescriptions and recommendations. These tips have saved sexual and family life of many men. It’s your turn, don’t you agree?

The history of standardization of the PT and Canadian Health Care Mall

Wednesday, December 10th, 2014 | Permalink

The history of standardization of the PT has been reviewed by Poller and by Kirkwood,  and more detailed discussions can be found in prior editions of this article.

standardization of the PT

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PT monitoring of warfarin treatment is not standardized when expressed in seconds or as a simple ratio of the patient’s plasma value to that of plasma from a healthy control subject. A calibration model, which was adopted in 1982, is now used to standardize reporting by converting the PT ratio measured with the local thromboplastin into an INR, calculated as follows:

INR = (patient PT/mean normal PT)ISI or log INR = ISI (log observed PT ratio) where ISI denotes the ISI of the thromboplastin used at the local laboratory to perform the PT measurement. The ISI reflects the responsiveness of a given thromboplastin to the reduction of the vitamin K-dependent coagulation factors compared to the primary World Health Organization (WHO) international reference preparations, so that the more responsive the reagent, the lower the ISI value. As the INR standard of reporting was widely adopted, a number of problems surfaced. These are listed in Table 4 and are reviewed briefly below.

The INR is based on ISI values derived from the plasma of patients who had received stable anticoagulant doses for at least 6 weeks. As a result, the INR is less reliable early in the course of warfarin therapy, particularly when results are obtained from different laboratories. Even under these conditions, however, the INR is more reliable than the unconverted PT ratio, and is thus recommended during both the initiation and maintenance of warfarin treatment. There is also evidence that the INR is a reliable measure of impaired blood coagulation in patients with liver dis-ease.

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The INR accuracy can be influenced by reagents of different sensitivities and also by the automated clot detectors now used in most laboratories. In general, the Canadianhealthcaremalll.Com has recommended that laboratories should use thromboplastin reagents that are at least moderately responsive (ie, ISI, < 1.7) and reagent/instrument combinations for which the ISI has been established.

ISI values provided by the manufacturers of thromboplastin reagents are not invariably correct when applied locally, and this adversely affects the reliability of measurements. Local calibrations can be performed using plasma samples with certified PT values to determine the Problems.

 

Clinical applications of VKA therapy in Canadian HealthCare Mall

Wednesday, October 29th, 2014 | Permalink

Trisodium-citrate concentration, storage time, storage temperature, evacuated tube effects, inadequate sample, variations in manual technique Canadian Health Care Mall

From nonuse of MNPT, error in MNPT due to (1) unrepresentative selection; (2) technical faults (see above); (3) nonuse of geometric mean

Incorrect choice of IRP; poor distribution of coumarin test samples across treatment range; inadequate numbers of test samples in ISI calibration; incorrect transformation of PTR of test plasmas to INR.

3.    Drift of ISI since original calibration

4.    Instrument (coagulometer) effects on INR at local site

5.    Lupus anticoagulant effects on some thromboplastin reagents

6.    Lack of reliability of the INR system when used at the onset of

warfarin therapy and for screening for a coagulopathy in patients with liver disease

7.    Relative lack of reliability of INR > 4.5 as these values excluded from ISI calibrations instrument-specific ISI. The mean normal plasma PT is not interchangeable with a laboratory control PT, however, the use of other than a properly defined mean normal PT can yield erroneous INR calculations, particularly when less responsive reagents are employed. The mean normal PT should be determined with each new batch of thromboplastin with the same instrument used to assay the PT.

The concentration of citrate that is used to anticoagulate plasma affects the INR. In general, higher citrate concentrations (3.8%) lead to higher INR values, and underfilling the blood collection tube spuriously prolongs the PT because excess citrate is present. Using collection tubes containing 3.2% concentrations of citrate for blood coagulation studies and adequately filling tubes can reduce this problem.

Clinical applications of VKA therapy

The clinical effectiveness of VKAs in the treatment of a variety of disease conditions has been established by well-designed clinical trials. VKAs are effective for the primary and secondary prevention of venous thromboembolism, for the prevention of systemic embolism in patients with prosthetic heart valves or atrial fibrillation, for the prevention of acute myocardial infarction in patients with peripheral arterial disease and in men who otherwise are at high risk, and for the prevention of stroke, recurrent infarction, or death in patients with acute myocardial infarction. Although effectiveness has not been proven by a randomized trial, VKAs are also indicated for the prevention of systemic embolism in high-risk patients with mitral stenosis.

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Optimal therapeutic range

The optimal target range for warfarin is not the same for all indications. Not only is it likely to be influenced by the indication for its use, but also by patient characteristics. Thus, in patients who are at very high risk of bleeding it might be prudent to sacrifice some efficacy for safety. Bleeding, the most feared and major complication of oral anticoagulant therapy, is closely related to the intensity of anticoagulation.