Gabapentin, Kapiso Wamlomo

Zamkati

• Kodi gabapentin ndi chiyani?
• Chifukwa chimagwiritsidwa ntchito
• Zotsatira za Gabapentin
• Zotsatira zofala kwambiri
• Zotsatira zoyipa
• Gabapentin amatha kulumikizana ndi mankhwala ena
• Mankhwala opweteka
• Mankhwala am'mimba m'mimba
• Momwe mungatenge gabapentin
• Mafomu ndi mphamvu
• Mlingo wa postherpetic neuralgia
• Mlingo wa kugwidwa koyambira pang'ono
• Malingaliro apadera
• Machenjezo a Gabapentin
• Chenjezo la kugona
• Chenjezo lokhumudwa
• Multiorgan hypersensitivity / DRESS chenjezo
• Chenjezo la ziwengo
• Chenjezo logwirizana ndi zakumwa zoledzeretsa
• Machenjezo kwa anthu omwe ali ndi matenda ena
• Machenjezo kwa magulu ena
• Kupewa kudzipha
  
• Tengani monga mwalamulidwa
• Zofunikira pakumwa gabapentin
• Zonse
• Yosungirako
• Zowonjezeranso
• Kuyenda
• Kuwunika kuchipatala
• Inshuwalansi
• Kodi pali njira zina?

Mfundo zazikulu za gabapentin

1. Gabapentin kapiso kapisozi amapezeka ngati mankhwala wamba komanso dzina lodziwika. Dzina la dzina: Neurontin.
2. Gabapentin imapezekanso ngati piritsi yamlomo yotulutsidwa mwachangu, piritsi lokhala ndi nthawi yayitali, komanso yankho lamlomo.
3. Gabapentin oral capsule amagwiritsidwa ntchito pochiza pang'ono mwa akulu ndi ana. Amagwiritsidwanso ntchito pochiza kupweteka kwamitsempha komwe kumayambitsidwa ndi matenda am'mimba.

Kodi gabapentin ndi chiyani?

Gabapentin ndi mankhwala akuchipatala. Imabwera ngati kapisozi wam'kamwa, piritsi yamlomo yotulutsidwa mwachangu, piritsi lokhala ndi nthawi yayitali, komanso yankho lamlomo.

Gabapentin capsule wamlomo amapezeka ngati dzina lodziwika bwino la mankhwala Neurontin. Ikupezekanso ngati mankhwala achibadwa. Mankhwala achibadwa nthawi zambiri amakhala otsika poyerekeza ndi mtundu wamaina. Nthawi zina, mankhwala omwe amatchulidwa ndi mtunduwu akhoza kupezeka m'njira zosiyanasiyana komanso mphamvu.

Chifukwa chimagwiritsidwa ntchito

Gabapentin m'kamwa kapisozi amagwiritsidwa ntchito pochita izi:

• Zotsatira za Gabapentin

  Gabapentin m'kamwa kapisozi angayambitse zotsatira zofatsa kapena zoopsa. Mndandanda wotsatirawu muli zina mwazovuta zomwe zingachitike mukamamwa gabapentin. Mndandandawu mulibe zovuta zonse zomwe zingachitike.

  Kuti mumve zambiri pazomwe zingachitike ndi gabapentin, kapena maupangiri amomwe mungachitire ndi zovuta zomwe mungakumane nazo, lankhulani ndi dokotala kapena wamankhwala.

  Zotsatira zofala kwambiri

  Zina mwazovuta zomwe zimachitika mukamagwiritsa ntchito gabapentin zalembedwa pansipa, limodzi ndi mitengo yake:

  Komanso:

  • matenda opatsirana
  • malungo
  • nseru ndi kusanza
  • kuyankhula molakwika
  • udani
  • mayendedwe owopsa

  Zoyeserera zake zimadalira odwala azaka zopitilira 12, monga akunenedwera m'mayeso azachipatala ofanana ndi Neurontin. Mitengo ina imasiyanasiyana malinga ndi zaka. Mwachitsanzo, odwala azaka zapakati pa 3 mpaka 12 azaka zambiri omwe ali ndi kachilombo ka HIV (11%), malungo (10%), nseru ndi / kapena kusanza (8), kutopa (8%), ndi chidani (8%). Panalibe kusiyana kwakatikati pamitengo pakati pa abambo ndi amai. Kuti mumve zambiri, onani phukusi la FDA.

  
  

  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:

  • Kusintha kwa malingaliro kapena kuda nkhawa. Zizindikiro zimatha kuphatikiza:
    • malingaliro ofuna kudzipha kapena kufa
    • akufuna kudzipha
    • kuda nkhawa kwatsopano kapena kukuipiraipira
    • kuyamwa kumene kwakhala kwatsopano kapena kukuipiraipira
    • kusakhazikika
    • mantha
    • kuvuta kugona
    • mkwiyo
    • nkhanza kapena nkhanza
    • kuwonjezeka kwakukulu kwa ntchito ndikuyankhula
    • kusintha kosazolowereka pamakhalidwe kapena malingaliro
  • Kusintha kwamakhalidwe ndi malingaliro, makamaka kwa ana azaka zapakati pa 3 mpaka 12. Zizindikiro zimatha kuphatikiza:
    • kusintha kwamalingaliro
    • ndewu
    • zovuta kulingalira
    • kusakhazikika
    • kusintha kwa magwiridwe antchito pasukulu
    • khalidwe lachiwerewere
  • Zovuta komanso zowopsa pangozi. Zizindikiro zimatha kuphatikiza:
    • zotupa pakhungu
    • ming'oma
    • malungo
    • zotupa zomwe sizimatha
    • milomo yotupa ndi lilime
    • chikasu cha khungu lako kapena kuyera kwa maso ako
    • kuvulaza kapena kutuluka mwachilendo
    • kutopa kwambiri kapena kufooka
    • kupweteka kwa minofu mosayembekezereka
    • matenda pafupipafupi

  Gabapentin amatha kulumikizana ndi mankhwala ena

  Gabapentin oral capsule amatha kulumikizana ndi mankhwala ena angapo. Kuyanjana kosiyanasiyana kumatha kubweretsa zovuta zosiyanasiyana. Mwachitsanzo, ena amatha kusokoneza momwe mankhwala amagwirira ntchito, pomwe ena amatha kuyambitsa zovuta zina.

  
  

  M'munsimu muli mndandanda wa mankhwala omwe angagwirizane ndi gabapentin. Mndandandawu mulibe mankhwala onse omwe angagwirizane ndi gabapentin.

  Musanagwiritse gabapentin, onetsetsani kuti muwauze adotolo ndi asayansi wanu zamankhwala onse, pa-counter ndi mankhwala ena omwe mumamwa. Auzeni za mavitamini, zitsamba, ndi zowonjezera zilizonse zomwe mumagwiritsa ntchito. Kugawana izi kungakuthandizeni kupewa kuyanjana komwe kungachitike.

  Ngati muli ndi mafunso okhudzana ndi mankhwala omwe angakukhudzeni, funsani dokotala kapena wamankhwala.

  Mankhwala opweteka

  Pogwiritsidwa ntchito ndi gabapentin, mankhwala ena opweteka amatha kuwonjezera zovuta zake, monga kutopa. Zitsanzo za mankhwalawa ndi monga:

  • morphine

  Mankhwala am'mimba m'mimba

  Pogwiritsidwa ntchito ndi gabapentin, mankhwala ena omwe amagwiritsidwa ntchito pochiza mavuto am'mimba amchere amatha kuchepetsa kuchuluka kwa gabapentin mthupi lanu. Izi zitha kupangitsa kuti zisamagwire bwino ntchito. Kutenga gabapentin maola awiri mutamwa mankhwalawa kungathandize kupewa vutoli. Zitsanzo za mankhwalawa ndi monga:

  • zotayidwa hydroxide
  • mankhwala enaake a hydroxide

  Momwe mungatenge gabapentin

  Mlingo wa gabapentin womwe dokotala amakupatsani umadalira pazinthu zingapo. Izi zikuphatikiza:

  • mtundu ndi kuuma kwa chikhalidwe chomwe mukugwiritsa ntchito gabapentin kuchiza
  • zaka zanu
  • mawonekedwe a gabapentin omwe mumatenga
  • matenda ena omwe mungakhale nawo

  Nthawi zambiri, dokotala wanu amakupangitsani muyeso wochepa ndikusintha pakapita nthawi kuti mufike pamlingo woyenera kwa inu. Potsirizira pake adzapereka mankhwala ochepetsetsa omwe amapereka zomwe mukufuna.

  Chidziwitso chotsatirachi chimalongosola miyezo yomwe amagwiritsidwa ntchito kwambiri kapena amalimbikitsidwa. Komabe, onetsetsani kuti mwatenga mlingo womwe dokotala akukulemberani. Dokotala wanu adzazindikira mlingo woyenera kuti ugwirizane ndi zosowa zanu.

  Mafomu ndi mphamvu

  Zowonjezera: Gabapentin

  • Mawonekedwe: kapisozi wamlomo
  • Mphamvu: 100 mg, 300 mg, 400 mg

  Mtundu: Neurontin

  • Mawonekedwe: kapisozi wamlomo
  • Mphamvu: 100 mg, 300 mg, 400 mg

  Mlingo wa postherpetic neuralgia

  Mlingo wa akulu (zaka 18-64 zaka)

  • Mlingo woyambira: Tsiku 1, 300 mg; tsiku 2, 600 mg (300 mg kawiri patsiku, osakanikirana mofanana tsiku lonse); tsiku 3, 900 mg (300 mg, katatu patsiku, osakanikirana mofanana tsiku lonse). Dokotala wanu akhoza kuwonjezera mlingo wanu pambuyo pa tsiku lachitatu.
  • Zolemba malire mlingo: 1,800 mg patsiku (600 mg, katatu patsiku, ogawanika mofanana tsiku lonse)

  Mlingo wa ana (zaka 0-17 zaka)

  Mlingo wa anthu ochepera zaka 18 sunakhazikitsidwe.

  Mlingo waukulu (wazaka 65 kapena kupitirira)

  Ntchito yanu ya impso ikhoza kuchepa ndi zaka. Thupi lanu limatha kuchotsa mankhwalawa pang'onopang'ono. Dokotala wanu akhoza kukuyambitsani pamlingo wotsika kuti mankhwala ochulukirachulukira samangika mthupi lanu. Mankhwala ochuluka kwambiri m'thupi lanu akhoza kukhala owopsa. Dokotala wanu akhoza kusintha mlingo wanu kutengera momwe impso zanu zikugwirira ntchito.

  Mlingo wa kugwidwa koyambira pang'ono

  Mlingo wa akulu (zaka 18-64 zaka)

  Mlingo woyambira: 900 mg patsiku (300 mg, katatu patsiku, ogawanika mofanana tsiku lonse). Dokotala wanu akhoza kuwonjezera mlingo wanu mpaka 2,400-3,600 mg patsiku.

  Mlingo wa ana (zaka 12-17 zaka)

  Mlingo woyambira: 300 mg, katatu patsiku, osakanikirana tsiku lonse. Izi zitha kukulira mpaka 2,400-3,600 mg patsiku.

  Mlingo wa ana (zaka 3-11 zaka)

  Mlingo woyambira: 10-15 mg / kg / tsiku, logawidwa m'mayeso atatu, ogawanika tsiku lonse. Dokotala wa mwana wanu akhoza kuwonjezera mlingo kuti akwaniritse zosowa za mwana wanu.

  Zolemba malire mlingo: 50 mg / kg / tsiku.

  Mlingo wa ana (zaka 0-2 zaka)

  Mlingo wa anthu ochepera zaka 3 sunakhazikitsidwe.

  Mlingo waukulu (wazaka 65 kapena kupitirira)

  Ntchito yanu ya impso ikhoza kuchepa ndi zaka. Thupi lanu limatha kuchotsa mankhwalawa pang'onopang'ono. Dokotala wanu akhoza kukuyambitsani pamlingo wotsika kuti mankhwala ochulukirapo asamangokhala mthupi lanu. Mankhwala ochuluka kwambiri m'thupi lanu akhoza kukhala owopsa.Dokotala wanu akhoza kusintha mlingo wanu kutengera momwe impso zanu zikugwirira ntchito.

  Malingaliro apadera

  Mavuto a impso: Ngati ndinu wamkulu kuposa zaka 12 ndipo muli ndi mavuto a impso kapena muli ndi hemodialysis, mlingo wanu wa gabapentin uyenera kusinthidwa. Izi zitengera momwe impso zanu zikugwirira ntchito.

  Machenjezo a Gabapentin

  Gabapentin kapiso kapisozi amabwera ndi machenjezo angapo. Itanani dokotala wanu ngati mutayamba kugwidwa kapena kugwidwa kwamtundu wina mukamamwa mankhwalawa.

  Chenjezo la kugona

  Gabapentin imatha kuchepetsa kuganiza kwanu ndi luso lanu lamagalimoto ndikuyambitsa kugona ndi chizungulire. Sizikudziwika kuti zotsatirazi zimatenga nthawi yayitali bwanji. Simuyenera kuyendetsa kapena kugwiritsa ntchito makina olemera mukamamwa mankhwalawa mpaka mutadziwa momwe zimakukhudzirani.

  Chenjezo lokhumudwa

  Kugwiritsa ntchito mankhwalawa kumawonjezera chiopsezo chofuna kudzipha komanso momwe mungachitire. Lankhulani ndi dokotala wanu ngati mukuvutika maganizo kapena muwona kusintha kwanu m'makhalidwe kapena khalidwe lanu. Komanso lankhulani ndi dokotala ngati mukuganiza zodzipweteka nokha, kuphatikizapo kudzipha.

  Multiorgan hypersensitivity / DRESS chenjezo

  Mankhwalawa amatha kuyambitsa matenda amisala. Izi zimadziwikanso kuti mankhwala osokoneza bongo omwe ali ndi eosinophilia ndi systemic zviratidzo (DRESS). Matendawa amatha kupha moyo. Itanani dokotala wanu nthawi yomweyo ngati muli ndi zizindikiro monga zotupa, malungo, kapena zotupa.

  Chenjezo la ziwengo

  Gabapentin imatha kuyambitsa vuto lalikulu. Zizindikiro zimatha kuphatikiza:

  • kuvuta kupuma
  • kutupa pakhosi kapena lilime
  • ming'oma
  • zidzolo

  Musatengerenso mankhwalawa ngati munakhalapo ndi vuto lililonse m'mbuyomu. Kutenganso kachiwiri pambuyo poti aliyense atha kuphedwa nayo itha kupha (kuyambitsa imfa).

  Chenjezo logwirizana ndi zakumwa zoledzeretsa

  Pewani kumwa mowa mukamamwa gabapentin. Gabapentin imatha kuyambitsa tulo, ndipo kumwa mowa kumatha kukupangitsani kugona kwambiri. Mowa amathanso kukupangitsani kuti muzimva chizungulire komanso kuti musakhale ndi chidwi chokhazikika.

  Machenjezo kwa anthu omwe ali ndi matenda ena

  Kwa anthu omwe ali ndi khunyu: Osasiya kumwa gabapentin mwadzidzidzi. Kuchita izi kungakulitse chiopsezo chanu chokhala ndi vuto lotchedwa status epilepticus. Izi ndizadzidzidzi zamankhwala pomwe khunyu lalifupi kapena lalitali limachitika kwa mphindi 30 kapena kupitilira apo.

  Gabapentin ingayambitse mavuto kwa ana azaka zapakati pa 3-12 omwe ali ndi khunyu. Imawonjezera chiopsezo chawo pamavuto amalingaliro komanso zovuta zamakhalidwe, monga kukhala opanda nkhawa komanso kuchita nkhanza kapena kusakhazikika.

  Kwa anthu omwe ali ndi vuto la impso: Thupi lanu limagwiritsa ntchito mankhwalawa pang'onopang'ono kuposa momwe zimakhalira. Izi zitha kupangitsa kuti mankhwalawa akule kwambiri mpaka thupi lanu. Lankhulani ndi dokotala wanu ngati mankhwalawa ndi abwino kwa inu.

  Machenjezo kwa magulu ena

  Kwa amayi apakati: Kugwiritsa ntchito gabapentin sikunaphunzire mwa anthu pa nthawi yapakati. Kafukufuku wazinyama awonetsa zoyipa kwa mwana wosabadwa mayi atamwa mankhwalawo. Komabe, maphunziro a nyama samaneneratu nthawi zonse momwe anthu angayankhire.

  Lankhulani ndi dokotala ngati muli ndi pakati kapena mukukonzekera kutenga pakati. Mankhwalawa ayenera kugwiritsidwa ntchito pokhapokha phindu lomwe lingakhalepo likutsimikizira kuopsa kwa mwana wosabadwayo. Itanani dokotala wanu mukakhala ndi pakati mukamamwa mankhwalawa.

  Ngati dokotala wanu akukulemberani gabapentin mukakhala ndi pakati, funsani za NAAED Pregnancy Registry. Kaundula kameneka kamatsata zotsatira za mankhwala oletsa kulanda pathupi. Zambiri zitha kupezeka pa aedpregnancyregistry.org.

  Kwa amayi omwe akuyamwitsa: Gabapentin imatha kulowa mkaka wa m'mawere ndipo imayambitsa zovuta zoyamwitsa mwana woyamwitsa. Uzani dokotala wanu ngati mukuyamwitsa. Muyenera kusankha limodzi ngati musiya kumwa mankhwalawa kapena kusiya kuyamwitsa.

  Kwa okalamba: Ntchito ya impso ikhoza kuchepa ndi zaka. Mutha kugwiritsa ntchito mankhwalawa pang'onopang'ono kusiyana ndi achinyamata. Dokotala wanu akhoza kukuyambitsani pamlingo wotsika kuti mankhwala ochulukirapo sangakule mthupi lanu. Mankhwala ochuluka kwambiri m'thupi lanu akhoza kukhala owopsa.

  Kwa ana: Gabapentin sanaphunzirepo mwa ana kuti azitha kuyang'anira neuralgia yapambuyo pake. Sayenera kugwiritsidwa ntchito kwa anthu ochepera zaka 18. Mankhwalawa sayenera kugwiritsidwa ntchito pochita khunyu pang'ono kwa ana ochepera zaka zitatu.

  Kupewa kudzipha
  

  1. Ngati mukuganiza kuti wina ali pachiwopsezo chodzivulaza kapena kukhumudwitsa wina:
  2. • Imbani 911 kapena nambala yanu yadzidzidzi yakomweko.
  3. • Khalani ndi munthuyo mpaka thandizo litafika.
  4. • Chotsani mfuti, mipeni, mankhwala, kapena zinthu zina zomwe zingakuvulazeni.
  5. • Mverani, koma osaweruza, kutsutsana, kuwopseza, kapena kufuula.
  6. Ngati inu kapena munthu wina yemwe mumamudziwa akuganiza zodzipha, pezani thandizo kuchokera ku nthawi yovuta kapena njira yodzitchinjiriza. Yesani National Suicide Prevention Lifeline pa 800-273-8255.
  

  Tengani monga mwalamulidwa

  Kapisozi wamlomo wa Gabapentin amagwiritsidwa ntchito pochiza kwakanthawi kochepa kapena kwakanthawi. Kutalika kwa chithandizo kumadalira momwe akugwiritsidwira ntchito kuchiza. Zimabwera ndi zoopsa zazikulu ngati simukuzitenga monga mwalamulo.

  Mukasiya kuzitenga mwadzidzidzi kapena osazitenga konse:

  • Kwa kugwidwa: Izi zitha kukulitsa chiopsezo chokhala ndi epilepticus, yomwe ndi vuto lazachipatala. Ndi vutoli, khunyu lalifupi kapena lalitali limachitika kwa mphindi 30 kapena kupitilira apo. Ngati dokotala angaganize kuchepetsa mlingo wanu kapena mutasiya kumwa gabapentin, adzachita izi pang'onopang'ono. Mlingo wanu udzachepetsedwa kapena chithandizo chanu chitha pakatha sabata limodzi.
  • Kwa neuralgia yaposachedwa: Zizindikiro zanu sizidzasintha.

  Ngati mwaphonya Mlingo kapena osazitenga nthawi yake: Mankhwala anu mwina sagwira ntchito kapena akhoza kusiya kugwira ntchito kwathunthu. Kuti mankhwalawa azigwira ntchito bwino, kuchuluka kwina kumayenera kukhala mthupi lanu nthawi zonse.

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

  • masomphenya awiri
  • mawu osalankhula
  • kutopa
  • mipando yotayirira

  Ngati mukuganiza kuti mwamwa mankhwalawa mopitirira muyeso, itanani dokotala wanu kapena malo oletsa poyizoni kwanuko. Ngati matenda anu akukulira, itanani 911 kapena pitani kuchipatala chapafupi pomwepo.

  Zomwe muyenera kuchita mukaphonya mlingo: Mukaiwala kumwa mankhwala anu, tengani mwamsanga mukamakumbukira. Ngati mukukumbukira kutangotsala maola ochepa kuti muyambe kumwa mankhwala, tengani mlingo umodzi wokha. Osayesa konse kutenga mwa kutenga makapisozi awiri nthawi imodzi. Izi zitha kubweretsa zovuta zoyipa.

  Momwe mungadziwire ngati mankhwalawa akugwira ntchito: Muyenera kugwidwa kochepa. Kapena muyenera kukhala ndi ululu wochepa wamitsempha.

  Zofunikira pakumwa gabapentin

  Pitirizani kukumbukira izi ngati dokotala wanu akukulemberani kapisozi wa gabapentin.

  Zonse

  Makapisozi akumlomo a Gabapentin amatha kumwedwa kapena wopanda chakudya. Kuwatenga ndi chakudya kungathandize kuchepetsa kukhumudwa m'mimba.

  Yosungirako

  • Sungani gabapentin kutentha kwapakati pakati pa 68 ° F ndi 77 ° F (20 ° C mpaka 25 ° C).
  • 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, monga 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. Onetsetsani kuti mwanyamula bokosi lokhala ndi mankhwala omwe mankhwala anu adabwerako.
  • Osayika mankhwalawa m'galimoto yamagolovu a galimoto yanu kapena siyani m'galimoto. Onetsetsani kuti musachite izi nyengo ikatentha kapena kuzizira kwambiri.

  Kuwunika kuchipatala

  Dokotala wanu adzayang'anira ntchito yanu ya impso.

  Inshuwalansi

  Makampani ambiri a inshuwaransi amafuna chilolezo choyambirira cha gabapentin. Izi zikutanthauza kuti dokotala wanu adzafunika kuvomerezedwa ndi kampani yanu ya inshuwaransi kampani yanu ya inshuwaransi isanakulipireni mankhwalawo.

  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.