Atorvastatin, piritsi yamlomo

Zamkati

• Mfundo zazikulu za atorvastatin
• Machenjezo ofunikira
• Kodi atorvastatin ndi chiyani?
• Chifukwa chimagwiritsidwa ntchito
• Momwe imagwirira ntchito
• Atorvastatin zoyipa
• Zotsatira zofala kwambiri
• Zotsatira zoyipa
• Atorvastatin amatha kulumikizana ndi mankhwala ena
• Maantibayotiki
• Mankhwala a fungal
• Mankhwala ochepetsa mafuta m'thupi
• Rifampin
• Mankhwala a HIV
• Digoxin
• Mapiritsi oletsa pakamwa
• Colchicine
• Cyclosporine
• Machenjezo a Atorvastatin
• Chenjezo la ziwengo
• Chenjezo la kuyanjana kwa chakudya
• Chenjezo logwirizana ndi zakumwa zoledzeretsa
• Machenjezo kwa anthu omwe ali ndi matenda ena
• Machenjezo kwa magulu ena
• Momwe mungatengere atorvastatin
• Mafomu ndi mphamvu
• Mlingo wopewa matenda amtima
• Mlingo wa dyslipidemia (mavuto a cholesterol)
• Tengani monga mwalamulidwa
• Zofunikira pakumwa atorvastatin
• Zonse
• Yosungirako
• Zowonjezeranso
• Kuyenda
• Kuwunika kuchipatala
• Zakudya zanu
• Kodi pali njira zina?

Mfundo zazikulu za atorvastatin

1. Pulogalamu yamlomo wa Atorvastatin imapezeka ngati mankhwala wamba komanso dzina lodziwika. Dzina Brand: Lipitor.
2. Atorvastatin imangobwera pokhapokha ngati piritsi lomwe mumamwa.
3. Pulogalamu yamlomo ya Atorvastatin imagwiritsidwa ntchito pokweza mafuta m'thupi komanso kuchepetsa chiopsezo cha matenda a mtima ndi sitiroko. Amagwiritsidwa ntchito limodzi ndi zakudya, kuchepa thupi, komanso kuchita masewera olimbitsa thupi.

Machenjezo ofunikira

• Chenjezo la mavuto a minofu: Chiwopsezo chanu cha rhabdomyolysis (kuwonongeka kwa minofu) chikuwonjezeka mukamamwa atorvastatin. Chiwopsezo chimakhala chachikulu ngati ndinu wamkulu, muli ndi vuto la chithokomiro, kapena muli ndi matenda a impso. Uzani dokotala wanu nthawi yomweyo mukayamba kukhala ndi ululu wosaneneka, kupweteka, kapena kufooka.
• Chenjezo la mavuto a chiwindi: Mayeso a labu pachiwindi akhoza kukhala okwera kwambiri mukamamwa atorvastatin ndipo mutha kukhala ndi vuto la chiwindi. Dokotala wanu adzawunika izi mukamamwa mankhwalawa.
• Chenjezo la matenda ashuga: Atorvastatin imakulitsa shuga m'magazi anu. Inu ndi dokotala muyenera kuyang'anitsitsa kuchuluka kwa shuga wamagazi mukamamwa mankhwalawa.

Kodi atorvastatin ndi chiyani?

Atorvastatin m`kamwa piritsi ndi mankhwala mankhwala. Ipezeka ngati mankhwala odziwika omwe amatchedwa Lipitor. Ikupezekanso mu mawonekedwe achibadwa. Mankhwala achibadwa nthawi zambiri amakhala otsika poyerekeza ndi mtundu wamaina. Nthawi zina, sangapezeke mwamphamvu zonse kapena mitundu yonse monga dzina lodziwika bwino la mankhwalawa.

Chifukwa chimagwiritsidwa ntchito

Atorvastatin imagwiritsidwa ntchito pokweza mafuta m'thupi mwa anthu omwe ali ndi mitundu yosiyanasiyana yamavuto a cholesterol. Amagwiritsidwanso ntchito kuchepetsa chiopsezo cha matenda a mtima ndi sitiroko. Amagwiritsidwa ntchito limodzi ndi zakudya, kuchepa thupi, komanso kuchita masewera olimbitsa thupi.

Atorvastatin imathandiza kuteteza cholesterol kuti isakule m'mitsempha yanu. Mitsempha yotsekedwa imatha kulepheretsa magazi kulowa mumtima ndi ubongo wanu.

Atorvastatin itha kugwiritsidwa ntchito ngati njira imodzi yophatikizira. Izi zikutanthauza kuti mungafunike kumwa mankhwala ena. Izi zitha kuphatikizira utomoni wa bile acid ndi mankhwala ena ochepetsa mafuta m'thupi.

Momwe imagwirira ntchito

Atorvastatin ndi gulu la mankhwala otchedwa HMG-CoA reductase inhibitors, kapena ma statins. Gulu la mankhwala ndi gulu la mankhwala omwe amagwiranso ntchito chimodzimodzi. Mankhwalawa amagwiritsidwa ntchito pochiza zofananira.

Mankhwalawa amagwira ntchito pochepetsa lipoprotein (LDL) kapena cholesterol "choyipa" ndikukweza lipoprotein (HDL) kapena cholesterol "chabwino". Atorvastatin imathandizira thupi lanu kuthana ndi LDL cholesterol kudzera m'chiwindi.

Atorvastatin zoyipa

Atorvastatin piritsi la pakamwa silimayambitsa kugona, koma limatha kuyambitsa zovuta zina.

Zotsatira zofala kwambiri

Zina mwazovuta zomwe zimachitika mukamagwiritsa ntchito piritsi ya atorvastatin ndi awa:

• zizindikiro zozizira monga kuthamanga kwa mphuno, kuyetsemula, ndi kutsokomola
• kutsegula m'mimba
• mpweya
• kutentha pa chifuwa
• kupweteka pamodzi
• kuyiwala
• 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:

• Mavuto a minofu. Zizindikiro zimatha kuphatikiza:
  • kufooka kosamveka kwa minofu, kukoma mtima, kapena kupweteka
  • kutopa
• Mavuto a chiwindi. Zizindikiro zimatha kuphatikiza:
  • kutopa kapena kufooka
  • kusowa chilakolako
  • kupweteka kwa m'mimba
  • mkodzo wamtundu wakuda
  • chikasu cha khungu lako kapena kuyera kwa maso ako

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.

Atorvastatin amatha kulumikizana ndi mankhwala ena

Pulogalamu yamlomo ya Atorvastatin 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 atorvastatin alembedwa pansipa.

Maantibayotiki

Kutenga atorvastatin ndi maantibayotiki ena kumawonjezera ngozi yanu yamatenda. Zitsanzo za mankhwalawa ndi monga:

• chithuchithu
• erythromycin

Mankhwala a fungal

Kutenga atorvastatin ndi mankhwala ena omwe amagwiritsidwa ntchito pochiza matenda am'fungulo kumatha kuyambitsa atorvastatin mthupi lanu. Izi zimawonjezera chiopsezo chanu cha kuwonongeka kwa minofu. Ngati mukufuna kumwa mankhwalawa palimodzi, dokotala wanu akhoza kuchepetsa mlingo wanu wa atorvastatin. Zitsanzo za mankhwalawa ndi monga:

• chithu
• ketoconazole

Mankhwala ochepetsa mafuta m'thupi

Kutenga atorvastatin ndi mankhwala ena ochepetsa mafuta m'thupi kumakulitsa chiopsezo chanu cham'mimba. Dokotala wanu akhoza kusintha mlingo wa mankhwalawa kapena mwapewa kuwatenga pamodzi. Zitsanzo za mankhwalawa ndi monga:

• alireza
• mankhwala omwe ali ndi fibrate
• ndiine

Rifampin

Kutenga rifampin ndi atorvastatin kumatha kutsitsa kuchuluka kwa atorvastatin mthupi lanu. Izi zikutanthauza kuti atorvastatin mwina singagwirenso ntchito.

Mankhwala a HIV

Kutenga atorvastatin ndi mankhwala ena omwe amagwiritsidwa ntchito pochiza HIV kumatha kupangitsa kuti atorvastatin imange mthupi lanu. Izi zimawonjezera chiopsezo chanu cha kuwonongeka kwa minofu. Ngati mukufuna kumwa mankhwalawa palimodzi, dokotala wanu akhoza kuchepetsa mlingo wanu wa atorvastatin. Zitsanzo za mankhwalawa ndi monga protease inhibitors monga:

• alireza
• alireza
• lopinavir
• mwambo
• alireza
• alireza

Digoxin

Kutenga digoxin ndi atorvastatin kumatha kukulitsa kuchuluka kwa digoxin m'magazi anu kukhala owopsa. Ngati mukufuna kumwa mankhwalawa palimodzi, dokotala wanu adzawunika magawowa ndikusintha mankhwala anu ngati kuli kofunikira.

Mapiritsi oletsa pakamwa

Kutenga atorvastatin ndi mapiritsi oletsa kubereka kumatha kukulitsa kuchuluka kwa mahomoni am'mimba m'magazi anu.

Colchicine

Kutenga colchicine ndi atorvastatin kumawonjezera chiopsezo chanu cha kuwonongeka kwa minofu.

Cyclosporine

Kutenga cyclosporine ndi atorvastatin kumawonjezera chiopsezo chanu cha kuwonongeka kwa minofu. Dokotala wanu ayenera kupewa izi.

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 pa zaumoyo momwe mungachitire ndi mankhwala, mavitamini, zitsamba ndi zowonjezera, komanso mankhwala omwe mumamwa.

Machenjezo a Atorvastatin

Mankhwalawa amabwera ndi machenjezo angapo.

Chenjezo la ziwengo

Atorvastatin imatha kuyambitsa vuto lalikulu. Zizindikiro zimatha kuphatikiza:

• kutupa kwa nkhope yanu, milomo, lilime, kapena mmero
• kuvuta kupuma
• vuto kumeza

Itanani 911 kapena pitani kuchipinda chadzidzidzi mukakhala ndi izi. Musatengerenso mankhwalawa ngati munakhalapo ndi vuto linalake. Kutenganso kumatha kukhala koopsa (kuyambitsa imfa).

Chenjezo la kuyanjana kwa chakudya

Pewani kumwa madzi ambiri amphesa mukamamwa atorvastatin. Kumwa msuzi wamphesa kumatha kubweretsa kuchuluka kwa atorvastatin m'magazi anu, zomwe zimawonjezera chiopsezo chanu chofooka kwa minofu. Funsani dokotala wanu za kuchuluka kwa madzi amphesa omwe ndi abwino kwa inu.

Chenjezo logwirizana ndi zakumwa zoledzeretsa

Kugwiritsa ntchito zakumwa zomwe zili ndi mowa kumabweretsa chiopsezo cha matenda a chiwindi kuchokera ku atorvastatin. Lankhulani ndi dokotala wanu ngati mumamwa mowa wopitilira awiri patsiku.

Machenjezo kwa anthu omwe ali ndi matenda ena

Kwa anthu omwe ali ndi vuto la impso: Kukhala ndi mavuto a impso kumawonjezera chiopsezo chanu cha kuwonongeka kwa minofu mukamamwa atorvastatin. Dokotala wanu akhoza kukuyang'anirani mosamala kwambiri pamavuto aminyewa.

Kwa anthu omwe ali ndi matenda a chiwindi: Simuyenera kutenga izi ngati muli ndi matenda a chiwindi chifukwa mankhwalawa amatha kuwonjezera zotsatira zoyesa chiwindi. Izi zikutanthauza kuti mutha kuwonongeka ndi chiwindi.

Kwa anthu omwe ali ndi matenda ashuga: Atorvastatin imakulitsa shuga m'magazi anu. Dokotala wanu akhoza kusintha mankhwala anu a shuga ngati izi zichitika.

Machenjezo kwa magulu ena

Kwa amayi apakati:Atorvastatin sayenera kugwiritsidwa ntchito panthawi yapakati. Chitetezo mwa amayi apakati sichidziwika ndipo palibe phindu lililonse lowoneka ndi mankhwalawa panthawi yapakati.

Itanani dokotala wanu nthawi yomweyo mukakhala ndi pakati mukamamwa mankhwalawa.

Kwa amayi omwe akuyamwitsa: Atorvastatin sayenera kugwiritsidwa ntchito poyamwitsa.Ngati mukuyamwitsa mwana wanu, lankhulani ndi dokotala za mankhwala omwe angakhale oyenera kwa inu.

Kwa okalamba: Anthu azaka zopitilira 65 ali pachiwopsezo chachikulu chakuwonongeka kwa minofu (rhabdomyolysis) akamamwa atorvastatin.

Kwa ana: Atorvastatin sanaphunzirepo ndipo sayenera kugwiritsidwa ntchito kwa ana ochepera zaka 10. Mankhwalawa awonetsedwa kuti ndi otetezeka komanso othandiza kwa ana azaka 10-17.

Momwe mungatengere atorvastatin

Chidziwitso cha mlingowu ndi cha piritsi la atorvastatin. 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
• momwe matenda anu alili
• Matenda ena omwe muli nawo
• momwe mumachitira ndi mankhwala oyamba

Mafomu ndi mphamvu

Zowonjezera: Atorvastatin

• Mawonekedwe: piritsi yamlomo
• Mphamvu: 10 mg, 20 mg, 40 mg, ndi 80 mg

Mtundu: Lipitor

• Mawonekedwe: piritsi yamlomo
• Mphamvu: 10 mg, 20 mg, 40 mg, ndi 80 mg

Mlingo wopewa matenda amtima

Mlingo wa akulu (zaka 18-64 zaka)

• Mlingo woyambira: 10-20 mg amatengedwa kamodzi patsiku.
• Miyezo yosamalira bwino: 10-80 mg amatengedwa kamodzi patsiku.

Mlingo wa ana (zaka 0-17 zaka)

Atorvastatin sanavomerezedwe kuti agwiritsidwe ntchito kwa ana ochepera zaka 18 popewa matenda amtima.

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, mankhwala ambiri amakhala mthupi lanu kwa nthawi yayitali. Izi zimawonjezera chiopsezo chanu pazotsatira zoyipa.

Dokotala wanu akhoza kukuyambitsani pamlingo wotsika kapena ndandanda ina yamankhwala. Izi zitha kuthandiza kuti mankhwalawa asakule kwambiri mthupi lanu.

Mlingo wa dyslipidemia (mavuto a cholesterol)

Mlingo wa akulu (zaka 18-64 zaka)

• Mlingo woyambira: 10-20 mg amatengedwa kamodzi patsiku.
• Miyezo yosamalira bwino: 10-80 mg amatengedwa kamodzi patsiku.
• Zindikirani: Pochiza homozygous banja hypercholesterolemia, mlingowo ndi 10-80 mg womwe umatengedwa kamodzi patsiku.

Mlingo wa ana (zaka 10-17 zaka)

Kwa ana, atorvastatin imagwiritsidwa ntchito pochiza matenda am'magazi am'magazi a hypercholesterolemia.

• Mlingo woyambira: 10 mg kamodzi patsiku.
• Zolemba malire mlingo: 20 mg kamodzi patsiku.

Mlingo wa ana (zaka 0-9 zaka)

Atorvastatin sanaphunzirepo kwa ana ochepera zaka 10 pazifukwa izi. Sichiyenera kugwiritsidwa ntchito pamibadwo ino pazifukwa izi.

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, mankhwala ambiri amakhala mthupi lanu kwa nthawi yayitali. Izi zimawonjezera chiopsezo chanu pazotsatira zoyipa.

Dokotala wanu akhoza kukuyambitsani pamlingo wotsika kapena ndandanda ina yamankhwala. 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 kulankhula ndi dokotala kapena wamankhwala za mlingo woyenera kwa inu.

Tengani monga mwalamulidwa

Atorvastatin m'kamwa piritsi ntchito mankhwala yaitali. Zimabwera ndi zoopsa ngati simukuzitenga monga mwalamulo.

Mukasiya kumwa mankhwalawa kapena osamwa konse: Ngakhale kudya zakudya zopatsa thanzi nthawi zina kumatha kukulitsa mafuta m'thupi, atorvastatin imatha kuwathandiza kwambiri. Ngati simutenga atorvastatin, kuchuluka kwama cholesterol anu sikungayang'aniridwe. Izi zitha kubweretsa chiopsezo chanu chodwala matenda amtima kapena sitiroko.

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. Mutha kukhala ndi zizindikiro zotsatirazi:

• kutsegula m'mimba
• mpweya
• kutentha pa chifuwa
• kupweteka pamodzi
• kuyiwala
• chisokonezo
• kufooka kosamveka kwa minofu, kukoma mtima, kapena kupweteka
• kusowa chilakolako
• kupweteka kwa m'mimba
• mkodzo wamtundu wakuda
• chikasu cha khungu lako kapena kuyera kwa maso ako

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: Simungathe kumva kuti atorvastatin ikugwira ntchito. Dokotala wanu adzayeza kuchuluka kwama cholesterol anu kuti awone momwe atorvastatin ikugwiritsirani ntchito. Dokotala wanu amatha kusintha mlingo wanu kutengera kuchuluka kwama cholesterol.

Zofunikira pakumwa atorvastatin

Kumbukirani izi ngati dokotala akukulemberani piritsi yamlomo ya atorvastatin.

Zonse

• Osadula kapena kuphwanya phale.

Yosungirako

• Sungani atorvastatin kutentha kwapakati pakati pa 68 ° F (20 ° C) ndi 77 ° F (25 ° C). Sungani kutali ndi kutentha kwambiri.
• 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

Mukamalandira mankhwala a atorvastatin, dokotala wanu amayang'ana kuchuluka kwama cholesterol anu komanso momwe chiwindi chimagwirira ntchito. Izi zichitika kudzera pakuyezetsa magazi.

Zakudya zanu

Dokotala wanu atha kukutsatirani mafuta ochepa, osadya mafuta ambiri mukamamwa mankhwalawa.

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:Nkhani Zamankhwala Masiku Ano yachita khama kwambiri kuti zitsimikizire kuti zidziwitso zonse ndizolondola, zomveka bwino, komanso zatsopano. 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.