Amitriptyline / Chlordiazepoxide, Piritsi Yamlomo

Zamkati

• Machenjezo ofunikira
• Machenjezo a FDA
  
• Machenjezo ena
• Kodi amitriptyline / chlordiazepoxide ndi chiyani?
• Chifukwa chimagwiritsidwa ntchito
• Momwe imagwirira ntchito
• Amitriptyline / chlordiazepoxide zotsatira zoyipa
• Zotsatira zofala kwambiri
• Zotsatira zoyipa
• Amitriptyline / chlordiazepoxide itha kuyanjana ndi mankhwala ena
• Mankhwala omwe simuyenera kugwiritsa ntchito ndi amitriptyline / chlordiazepoxide
• Kuyanjana komwe kumawonjezera chiopsezo cha zotsatirapo
• Amitriptyline / chlordiazepoxide machenjezo
• Chenjezo la ziwengo
• Chenjezo logwirizana ndi zakumwa zoledzeretsa
• Machenjezo kwa anthu omwe ali ndi matenda ena
• Machenjezo kwa magulu ena
• Momwe mungatengere amitriptyline / chlordiazepoxide
• Mlingo wa kukhumudwa ndi nkhawa limodzi
• Tengani monga mwalamulidwa
• Zofunikira pakumwa amitriptyline / chlordiazepoxide
• Zonse
• Yosungirako
• Zowonjezeranso
• Kuyenda
• Kuwunika kuchipatala
• Kodi pali njira zina?

Mfundo zazikulu za amitriptyline / chlordiazepoxide

1. Amitriptyline / chlordiazepoxide imapezeka kokha ngati mankhwala achibadwa. Ilibe mtundu wazolemba.
2. Mankhwalawa amangobwera ngati piritsi lomwe mumamwa.
3. Amitriptyline / chlordiazepoxide ndi kuphatikiza kwa mankhwala awiri m'njira imodzi. Amagwiritsidwa ntchito pochiza anthu omwe ali ndi nkhawa komanso nkhawa.

Machenjezo ofunikira

Machenjezo a FDA

• Mankhwalawa ali ndi machenjezo a bokosi lakuda. Awa ndi machenjezo ovuta kwambiri ochokera ku Food and Drug Administration (FDA). Machenjezo akuda akuchenjeza madokotala ndi odwala za zovuta zamankhwala zomwe zitha kukhala zowopsa.
• Kuchenjeza ndi kudzipha: Mankhwalawa akhoza kuwonjezera chiopsezo chofuna kudzipha mwa ana, achinyamata, komanso achinyamata. Izi zikuyenera kuchitika miyezi ingapo yoyambirira ya mankhwalawa. Mukayamba kumwa mankhwalawa, dokotala ndi banja lanu ayenera kuyang'anitsitsa. Ayenera kuyang'ana kusintha kwamakhalidwe kapena kukulirakulira kwa kukhumudwa.
• Zotsatira zowopsa ndikugwiritsa ntchito opioid: Kugwiritsa ntchito mankhwalawa ndi mankhwala opioid, monga hydrocodone, kapena codeine, kumatha kubweretsa zovuta. Chiwopsezo chanu chimakhala chachikulu ngati mutamwa kwambiri mankhwalawa ndikuwatenga nthawi yayitali. Itanani dokotala wanu kapena 911 nthawi yomweyo ngati inu kapena munthu amene mukumusamalira ali ndi zizindikilo zosazolowereka kapena mutu wopepuka, kugona kwambiri, kupuma pang'ono kapena kuvuta, kapena kusayankha. Zizindikirozi zimatha kukomoka ngakhale kufa kumene.

Machenjezo ena

• Kuchepetsa koyambirira kwa chenjezo la kukhumudwa: Mutha kukhala kuti mwakhala mukukula kwambiri zizindikilo zakukhumudwa, malingaliro ofuna kudzipha, ndikusintha kwamakhalidwe mukangoyamba kumwa mankhwalawa. Mutha kupitiliza kukhala ndi zizindikirizi mpaka mankhwalawa atayamba kukugwirirani ntchito. Izi zitha kutenga milungu ingapo.
• Zizindikiro zochotsa: Simuyenera kusiya kumwa mankhwalawa osalankhula ndi dokotala. Mukasiya kuzitenga modzidzimutsa, mutha kukhala ndi zizindikiritso zakusiya. Izi zimatha kuphatikizira kunjenjemera (mayendedwe osalamulirika amtundu umodzi wa thupi lanu), kupweteka m'mimba, thukuta, ndi mutu. Chiwopsezo chanu chimakhala chachikulu ngati mwamwa mankhwalawa kwa nthawi yayitali. Ngati mukufuna kusiya kumwa mankhwalawa, dokotala wanu amachepetsa pang'onopang'ono mlingo wanu.
• Chenjezo la dementia: wanena kuti mankhwala amtunduwu amatha kuyambitsa mavuto ofanana ndi omwe amayamba chifukwa cha mankhwala otchedwa anticholinergics. Izi zitha kukulitsa chiopsezo cha matenda amisala.

Kodi amitriptyline / chlordiazepoxide ndi chiyani?

Amitriptyline / chlordiazepoxide ndi mankhwala akuchipatala. Zimabwera ngati piritsi lokamwa.

Amitriptyline / chlordiazepoxide imapezeka kokha ngati mankhwala achibadwa. Ilibe mtundu wazolemba.

Amitriptyline / chlordiazepoxide ndi mankhwala osakaniza. Lili ndi mankhwala awiri: amitriptyline ndi chlordiazepoxide. Ndikofunika kudziwa za mankhwala onsewa kuphatikiza chifukwa mankhwala aliwonse atha kukukhudzani mosiyana.

Chifukwa chimagwiritsidwa ntchito

Amitriptyline / chlordiazepoxide imagwiritsidwa ntchito pochiza anthu omwe ali ndi nkhawa komanso nkhawa.

Momwe imagwirira ntchito

Chlordiazepoxide ndi gulu la mankhwala otchedwa benzodiazepines. Amitriptyline ndi ya gulu la mankhwala otchedwa tricyclic antidepressants. Gulu la mankhwala ndi gulu la mankhwala omwe amagwiranso ntchito chimodzimodzi. Mankhwalawa amagwiritsidwa ntchito pochiza zofananira.

Amitriptyline / chlordiazepoxide imagwira ntchito mkati mwa dongosolo lamanjenje. Zimakulitsa mulingo wamankhwala ena muubongo wanu. Izi zimapangitsa kuti mukhale ndi nkhawa komanso kukhala ndi nkhawa.

Amitriptyline / chlordiazepoxide zotsatira zoyipa

Amitriptyline / chlordiazepoxide piritsi yamlomo imatha kuyambitsa chizungulire ndi kugona m'maola ochepa mutangomaliza kumwa. Zitha kupanganso zovuta zina.

Zotsatira zofala kwambiri

Zotsatira zofala kwambiri za amitriptyline / chlordiazepoxide zitha kuphatikiza:

• Kusinza
• pakamwa pouma
• Kuchuluka kwa mphuno
• kudzimbidwa
• kusawona bwino
• chizungulire
• kuphulika
• maloto omveka
• kunjenjemera (kayendedwe kosalamulirika kamayendedwe ka gawo limodzi la thupi lanu)
• Kulephera kwa erectile (kuvuta kupeza kapena kusunga erection)
• chisokonezo

Ngati zotsatirazi ndizochepa, zimatha kutha masiku angapo kapena milungu ingapo. Ngati ali ovuta kwambiri kapena osapita, lankhulani ndi dokotala kapena wamankhwala.

Zotsatira zoyipa

Itanani dokotala wanu nthawi yomweyo ngati muli ndi zovuta zina. Itanani 911 ngati zizindikiro zanu zikuwopseza moyo kapena ngati mukuganiza kuti mukukumana ndi vuto lachipatala. Zotsatira zoyipa komanso zizindikilo zake zimatha kukhala izi:

• Matenda amtima. Zizindikiro zimatha kuphatikiza:
  • kupweteka pachifuwa
  • kupuma movutikira
  • kusapeza bwino m'thupi lanu
• Sitiroko. Zizindikiro zimatha kuphatikiza:
  • kufooka mu gawo limodzi kapena mbali imodzi ya thupi lanu
  • mawu osalankhula
• Kukulitsa zizindikilo zakukhumudwa komanso malingaliro ofuna kudzipha

Chodzikanira: Cholinga chathu ndikukupatsani chidziwitso chofunikira kwambiri komanso chaposachedwa. Komabe, chifukwa mankhwala amakhudza munthu aliyense mosiyanasiyana, sitingatsimikizire kuti izi zimaphatikizaponso zovuta zonse zomwe zingachitike. Izi sizilowa m'malo mwa upangiri wa zamankhwala. Nthawi zonse muzikambirana mavuto omwe angakhalepo ndi othandizira azaumoyo omwe amadziwa mbiri yanu yazachipatala.

Amitriptyline / chlordiazepoxide itha kuyanjana ndi mankhwala ena

Amitriptyline / chlordiazepoxide piritsi yamlomo imatha kulumikizana ndi mankhwala ena, mavitamini, kapena zitsamba zomwe mwina mukumwa. Kulumikizana ndi pamene chinthu chimasintha momwe mankhwala amagwirira ntchito. Izi zitha kukhala zowononga kapena kuletsa mankhwalawa kuti asagwire ntchito bwino.

Pofuna kupewa kuyanjana, dokotala ayenera kuyang'anira mankhwala anu onse mosamala. Onetsetsani kuuza dokotala wanu za mankhwala onse, mavitamini, kapena zitsamba zomwe mukumwa. Kuti mudziwe momwe mankhwalawa angagwirizane ndi china chake chomwe mumatenga, lankhulani ndi dokotala kapena wamankhwala.

Zitsanzo za mankhwala omwe angayambitse kuyanjana ndi amitriptyline / chlordiazepoxide alembedwa pansipa.

Mankhwala omwe simuyenera kugwiritsa ntchito ndi amitriptyline / chlordiazepoxide

Musamamwe mankhwalawa ndi amitriptyline / chlordiazepoxide. Kuchita izi kumatha kubweretsa zovuta m'thupi. Zitsanzo za mankhwalawa ndi monga:

• Phenelzine, tranylcypromine, ndi selegiline. Kutenga mankhwalawa palimodzi kungayambitse kugwedezeka (kusuntha, kuyenda mosagwirizana) ndi malungo owopsa. Itha ngakhale kupha (kuyambitsa imfa).

Kuyanjana komwe kumawonjezera chiopsezo cha zotsatirapo

Kutenga amitriptyline / chlordiazepoxide ndi mankhwala ena kumadzetsa chiopsezo cha zotsatirapo. Zitsanzo za mankhwalawa ndi monga:

• Topiramate. Zowonjezera zoyipa za amitriptyline / chlordiazepoxide zitha kuphatikizira kugona, chizungulire, ndi kudzimbidwa. Ngati mukufuna kumwa topiramate ndi mankhwalawa, dokotala wanu akhoza kuchepetsa kuchuluka kwa amitriptyline / chlordiazepoxide.
• Opioids, monga morphine, codeine, hydrocodone, ndi oxycodone. Kumwa mankhwalawa ndi amitriptyline / chlordiazepoxide kumayika pachiwopsezo chachikulu cha kugona, kupuma pang'ono, kukomoka, kapena kufa. Dokotala wanu amangokupatsani ma opioid ndi amitriptyline / chlordiazepoxide ngati mankhwala ena sagwira ntchito. Adzakuyang'anirani mosamala.
• Flecainide ndi propafenone. Kutenga mankhwalawa palimodzi kungapangitse chiopsezo chanu chokhala osagunda pamtima.
• Sertraline, fluoxetine, ndi paroxetine. Kutenga mankhwalawa palimodzi kumatha kukulitsa mavuto amitriptyline / chlordiazepoxide. Izi zingaphatikizepo chizungulire, chisokonezo, ndi matenda amtima.
• Cimetidine ndi quinidine. Mankhwalawa atha kukulitsa kuchuluka kwa amitriptyline mthupi lanu. Izi zitha kubweretsa zovuta zoyipa. Izi zingaphatikizepo chizungulire, chisokonezo, ndi matenda amtima.

Chodzikanira: Cholinga chathu ndikukupatsani chidziwitso chofunikira kwambiri komanso chaposachedwa. Komabe, chifukwa mankhwala amagwirira ntchito mosiyanasiyana mwa munthu aliyense, sitingatsimikizire kuti izi zikuphatikizira kulumikizana kulikonse kotheka. Izi sizilowa m'malo mwa upangiri wa zamankhwala. Nthawi zonse lankhulani ndi omwe amakuthandizani zaumoyo pazomwe mungachite ndi mankhwala onse, mavitamini, zitsamba ndi zowonjezera, komanso mankhwala owonjezera omwe mumamwa.

Amitriptyline / chlordiazepoxide machenjezo

Mankhwalawa amabwera ndi machenjezo angapo.

Chenjezo la ziwengo

Amitriptyline / chlordiazepoxide angayambitse thupi lawo siligwirizana. Zizindikiro zimatha kuphatikiza:

• kuvuta kupuma
• kutupa pakhosi kapena lilime

Mukakhala ndi zizindikilozi, itanani 911 kapena pitani kuchipinda chadzidzidzi chapafupi.

Musatengerenso mankhwalawa ngati munakhalapo ndi vuto linalake. Kutenganso kumatha kukhala koopsa (kuyambitsa imfa).

Chenjezo logwirizana ndi zakumwa zoledzeretsa

Kugwiritsa ntchito zakumwa zomwe zili ndi mowa kumatha kukulitsa chiopsezo chokhala ndi tulo komanso magwero oopsa amtunduwu. Mukamwa mowa, lankhulani ndi dokotala wanu.

Machenjezo kwa anthu omwe ali ndi matenda ena

Kwa anthu omwe ali ndi mbiri yamavuto amtima: Mankhwalawa amatha kuyambitsa mavuto amtima. Izi zimaphatikizapo kugunda kwamtima mosasinthasintha, matenda amtima, ndi sitiroko. Simuyenera kutenga amitriptyline / chlordiazepoxide ngati mwadwala matenda a mtima posachedwa.

Kwa anthu omwe ali ndi mbiri ya matenda ochititsa munthu kusinthasintha zochitika: Mankhwalawa sayenera kugwiritsidwa ntchito pochiza matenda ochititsa munthu kusinthasintha zochitika. Kutenga mankhwala opatsirana pogonana, monga amitriptyline, kumatha kupangitsa kuti anthu omwe ali ndi matenda ochititsa munthu kusinthasintha zochitika asinthe kukhumudwa kupita kumalo amanjenje. Muyenera kugwiritsa ntchito mankhwala ena otchedwa mood stabilizers m'malo mopewera kupsinjika.

Kwa anthu omwe ali ndi mbiri yakugwa: Mankhwalawa akhoza kuwonjezera chiopsezo chanu chogwidwa.

Kwa anthu omwe ali ndi mbiri ya glaucoma kapena kuchuluka kwa kuthamanga kwa diso: Mankhwalawa atha kukulitsa vuto lanu.

Kwa anthu omwe ali ndi vuto la chithokomiro: Mankhwala a chithokomiro amatha kuwonjezera mavuto amitriptyline / chlordiazepoxide.

Machenjezo kwa magulu ena

Kwa amayi apakati: Kugwiritsa ntchito bwino amitriptyline / chlordiazepoxide panthawi yoyembekezera sikunakhazikitsidwe. Gawo la chlordiazepoxide la mankhwalawa awonetsedwa kuti amachulukitsa chiopsezo kumwana wosabadwa. Vutoli limakhala lalikulu m'nthawi yoyamba ya mimba.

Lankhulani ndi dokotala ngati muli ndi pakati kapena mukukonzekera kutenga pakati. Mankhwalawa ayenera kugwiritsidwa ntchito pokhapokha phindu lomwe lingakhalepo likutsimikizira kuwopsa kwake.

Kwa amayi omwe akuyamwitsa: Amitriptyline / chlordiazepoxide imatha kulowa mkaka wa m'mawere ndipo imatha kuyambitsa mavuto kwa mwana yemwe akuyamwitsa. Lankhulani ndi dokotala ngati mukuyamwitsa mwana wanu. Muyenera kusankha kuti musiye kuyamwa kapena kusiya kumwa mankhwalawa.

Kwa okalamba: Impso za anthu okalamba mwina sizigwira ntchito kale. Izi zitha kupangitsa kuti thupi lanu lizigwiritsa ntchito mankhwala pang'onopang'ono. Zotsatira zake, kuchuluka kwamankhwala kumakhalabe mthupi lanu nthawi yayitali. Izi zimawonjezera chiopsezo chanu chazovuta.

Ngati muli ndi zaka zopitilira 65, mutha kukhala pachiwopsezo chachikulu chisokonezo ndikukhala ndi zovuta kuchokera ku mankhwalawa.

Kwa ana: Mankhwalawa sanaphunzire kwa ana.

Itanani dokotala wanu kuti kukhumudwa kwanu kukukulirakulira mukamamwa mankhwalawa kapena mukuganiza zodzipha.

Momwe mungatengere amitriptyline / chlordiazepoxide

Mlingo uliwonse wotheka ndi mitundu ya mankhwala sizingaphatikizidwe pano. Mlingo wanu, mawonekedwe a mankhwala, komanso kuchuluka kwa momwe mumamwa mankhwalawo zimadalira:

• zaka zanu
• matenda omwe akuchiritsidwa
• kuopsa kwa matenda anu
• Matenda ena omwe muli nawo
• momwe mumachitira ndi mankhwala oyamba

Mlingo wa kukhumudwa ndi nkhawa limodzi

Zowonjezera: Amitriptyline / chlordiazepoxide

• Mawonekedwe: piritsi yamlomo

Mphamvu:

• 5 mg chlordiazepoxide / 12.5 mg amitriptyline
• 10 mg chlordiazepoxide / 25 mg amitriptyline

Mlingo wa akulu (zaka 18-64 zaka)

• Mlingo woyambira: mapiritsi 3 mpaka 4 (amphamvu zilizonse) patsiku omwe amamwa m'magulu awiri.
• Mlingo ukuwonjezeka: Dokotala wanu akhoza kuwonjezera pang'onopang'ono mlingo wanu mpaka mapiritsi 6 (a mphamvu iliyonse) patsiku lomwe limagawidwa m'magawo awiri.

Mlingo wa ana (zaka 0-17 zaka)

Mankhwalawa sanaphunzire kwa ana.

Mlingo waukulu (wazaka 65 kapena kupitirira)

Impso za anthu okalamba mwina sizigwira ntchito kale. Izi zitha kupangitsa kuti thupi lanu lizigwiritsa ntchito mankhwala pang'onopang'ono. Zotsatira zake, kuchuluka kwamankhwala kumakhalabe mthupi lanu nthawi yayitali. Izi zimawonjezera chiopsezo chanu chazovuta.

Dokotala wanu akhoza kukuyambitsani pamlingo wotsika kapena dongosolo lina la dosing. Izi zitha kuthandiza kuti mankhwalawa asakule kwambiri mthupi lanu.

Chodzikanira: Cholinga chathu ndikukupatsani chidziwitso chofunikira kwambiri komanso chaposachedwa. Komabe, chifukwa mankhwala osokoneza bongo amakhudza munthu aliyense mosiyanasiyana, sitingatsimikizire kuti mndandandawu umaphatikizira miyezo yonse yotheka. Izi sizilowa m'malo mwa upangiri wa zamankhwala. Nthawi zonse lankhulani ndi dokotala kapena wamankhwala za mlingo woyenera kwa inu.

Tengani monga mwalamulidwa

Amitriptyline / chlordiazepoxide piritsi la m'kamwa limagwiritsidwa ntchito nthawi yayitali. Zimabwera ndi zoopsa zazikulu ngati simukuzitenga monga mwalamulo.

Mukasiya kumwa mankhwalawa kapena osamwa konse: Mukapanda kumwa mankhwalawa, kukhumudwa kwanu ndi nkhawa zanu zitha kukulirakulira. Mukasiya kumwa mankhwalawa modzidzimutsa, mutha kukhala ndi zizindikiritso zakusiya. Izi zimatha kuphatikizira kunjenjemera (mayendedwe osalamulirika amtundu umodzi wa thupi lanu), kupweteka m'mimba, thukuta, ndi mutu. Ngati mukufuna kusiya kumwa mankhwalawa, lankhulani ndi dokotala wanu. Adzachepetsa pang'onopang'ono mlingo wanu.

Ngati mwaphonya Mlingo kapena osamwa mankhwalawo panthawi yake: Mankhwala anu mwina sagwira ntchito kapena akhoza kusiya kugwira ntchito kwathunthu. Kuti mankhwalawa agwire bwino ntchito, kuchuluka kwake kumayenera kukhala mthupi lanu nthawi zonse.

Ngati mutenga zochuluka kwambiri: Mutha kukhala ndimankhwala owopsa mthupi lanu. Zizindikiro za bongo za mankhwalawa zingaphatikizepo:

• kugunda kwamtima kosasinthasintha
• kutsika mtima kwambiri
• kugwedezeka (kusuntha, kusuntha mosachita kufuna)
• kuyerekezera zinthu m'maganizo (kuwona kapena kumva china chomwe kulibe)
• chisokonezo
• minofu yolimba

Ngati mukuganiza kuti mwamwa kwambiri mankhwalawa, itanani dokotala wanu kapena funsani malangizo kuchokera ku American Association of Poison Control Center ku 1-800-222-1222 kapena kudzera pa chida chawo pa intaneti. Koma ngati matenda anu akukulira, itanani 911 kapena pitani kuchipatala chapafupi pomwepo.

Zomwe muyenera kuchita mukaphonya mlingo: Tengani mlingo wanu mukangokumbukira. Koma ngati mukukumbukira kutangotsala maola ochepa kuti muyambe kumwa mankhwala, tengani mlingo umodzi wokha. Osayesa konse kutenga mwa kumwa miyezo iwiri nthawi imodzi. Izi zitha kubweretsa zovuta zoyipa.

Momwe mungadziwire ngati mankhwalawa akugwira ntchito: Zizindikiro zanu zakukhumudwa komanso nkhawa zimayenera kukhala bwino pakapita nthawi.

Zofunikira pakumwa amitriptyline / chlordiazepoxide

Kumbukirani izi ngati adokotala akukupatsani amitriptyline / chlordiazepoxide.

Zonse

• Mutha kumwa amitriptyline / chlordiazepoxide kapena wopanda chakudya.
• Tengani mankhwalawa panthawi yomwe dokotala akukulangizani.
• Mutha kudula kapena kuphwanya phale.

Yosungirako

• Sungani amitriptyline / chlordiazepoxide kutentha. Sungani pakati pa 68 ° F ndi 77 ° F (20 ° C ndi 25 ° C).
• Sungani mankhwalawa kutali ndi kuwala.
• Musasunge mankhwalawa m'malo onyowa kapena onyowa, monga mabafa.

Zowonjezeranso

Mankhwala a mankhwalawa amakonzanso. Simuyenera kusowa mankhwala atsopano kuti mudzazidwenso. Dokotala wanu adzalemba kuchuluka kwa mafuta obwezerezedwanso pamankhwala anu.

Kuyenda

Mukamayenda ndi mankhwala anu:

• Nthawi zonse muzinyamula mankhwala anu. Mukamauluka, musayikenso m'thumba lofufuzidwa. Sungani m'thumba lanu.
• Osadandaula za makina a X-ray pabwalo la ndege. Sangathe kuvulaza mankhwala anu.
• Mungafunike kuwonetsa ogwira ntchito ku eyapoti chizindikiro cha mankhwala anu. Nthawi zonse muzinyamula chidebe choyambirira cholembedwa ndi mankhwala.
• Musayike mankhwalawa m'galimoto yamagolovu amgalimoto yanu kapena siyani m'galimoto. Onetsetsani kuti musachite izi nyengo ikatentha kapena kuzizira kwambiri.

Kuwunika kuchipatala

Inu ndi dokotala muyenera kuyang'anira zovuta zina zaumoyo. Izi zitha kuthandizira kuti mukhale otetezeka mukamamwa mankhwalawa. Izi zikuphatikiza:

• Mavuto amisala ndi machitidwe: Inu ndi dokotala muyenera kuwonera zosintha zilizonse zachilendo pamakhalidwe ndi malingaliro anu. Mankhwalawa amatha kuyambitsa mavuto atsopano azaumoyo. Zingapangitsenso mavuto omwe muli nawo kale.

Kodi pali njira zina?

Palinso mankhwala ena omwe amapezeka kuti athetse vuto lanu. Ena akhoza kukuyenererani kuposa ena. Lankhulani ndi dokotala wanu za mankhwala ena omwe angakuthandizeni.

Chodzikanira: Healthaline yayesetsa kwambiri kuti zidziwitso zonse zikhale zolondola, zokwanira, komanso zaposachedwa. Komabe, nkhaniyi sikuyenera kugwiritsidwa ntchito m'malo mwa chidziwitso ndi ukadaulo wa akatswiri pazachipatala. Muyenera kufunsa adotolo kapena akatswiri azaumoyo musanamwe mankhwala aliwonse. Zambiri zamankhwala zomwe zili pano zitha kusintha ndipo sizingapangidwe kuti zigwiritse ntchito, mayendedwe, zodzitetezera, machenjezo, kulumikizana ndi mankhwala, kusokonezeka, kapena zovuta zina. Kusapezeka kwa machenjezo kapena zidziwitso za mankhwala omwe apatsidwa sikuwonetsa kuti kuphatikiza mankhwala kapena mankhwalawa ndiwotetezeka, ogwira ntchito, komanso oyenera kwa odwala onse kapena ntchito zina zilizonse.