Olmesartan, Piritsi Yamlomo

Zamkati

• Machenjezo ofunikira
• Chenjezo la FDA: Pewani kugwiritsa ntchito nthawi yapakati
  
• Machenjezo ena
• Kodi Olmesartan ndi chiyani?
• Chifukwa chimagwiritsidwa ntchito
• Momwe imagwirira ntchito
• Zotsatira zoyipa za Olmesartan
• Zotsatira zofala kwambiri
• Zotsatira zoyipa
• Kuletsa mankhwalawa
  
• Olmesartan amatha kulumikizana ndi mankhwala ena
• Bipolar matenda osokoneza bongo
• Kuyanjana kwa mankhwala a magazi
• Mankhwala a anti-inflammatory anti-inflammatory (NSAIDs)
• Kuyanjana kwa Colesevelam
• Machenjezo a Olmesartan
• Chenjezo la ziwengo
• Chenjezo logwirizana ndi zakumwa zoledzeretsa
• Machenjezo kwa anthu omwe ali ndi matenda ena
• Machenjezo kwa magulu ena
• Momwe mungatengere olmesartan
• Mlingo wa kuthamanga kwa magazi
• Maganizo apadera
• Tengani monga mwalamulidwa
• Malingaliro ofunikira potenga olmesartan
• Zonse
• Yosungirako
• Zowonjezeranso
• Kuyenda
• Kudziyang'anira pawokha
• Kuwunika kuchipatala
• Ndalama zobisika
• Kodi pali njira zina?

Mfundo zazikulu za olmesartan

1. Pulogalamu yamlomo ya Olmesartan imapezeka ngati mankhwala osokoneza bongo komanso mankhwala osokoneza bongo. Dzina la dzina: Benicar.
2. Olmesartan imangobwera ngati piritsi lomwe mumamwa.
3. Olmesartan amagwiritsidwa ntchito pochiza kuthamanga kwa magazi.

Machenjezo ofunikira

Chenjezo la FDA: Pewani kugwiritsa ntchito nthawi yapakati

• Mankhwalawa ali ndi chenjezo lakuda lakuda. Ili ndiye chenjezo lalikulu kwambiri kuchokera ku Food and Drug Administration (FDA). Chenjezo la bokosi lakuda limachenjeza madokotala ndi odwala za zovuta zamankhwala zomwe zitha kukhala zowopsa.
• Musagwiritse ntchito mankhwalawa panthawi yapakati. Olmesartan atha kuvulaza kapena kuthetsa mimba yanu. Mukakhala ndi pakati, siyani kutenga olmesartan nthawi yomweyo ndikuyimbira dokotala. Ngati mukufuna kutenga pakati, lankhulani ndi dokotala za njira zina zochepetsera kuthamanga kwa magazi.

Machenjezo ena

• Chenjezo la kuthamanga kwa magazi: Mankhwalawa amatha kupangitsa kuti kuthamanga kwa magazi kutsike kwambiri. Ngati nanunso mumamwa diuretic (mapiritsi a madzi) kapena ngati mwasowa madzi m'thupi, muli ndi chiopsezo chachikulu choti kuthamanga kwa magazi kutsike kwambiri. Izi zitha kuyambitsa chizungulire, mutu wopepuka, komanso mutu.
• Chenjezo kuwonongeka kwa impso: Mukatenga olmesartan dongosolo lanu la renin-angiotensin likatsegulidwa, mumakhala pachiwopsezo cha impso. Njirayi imayambitsidwa ngati mulibe madzi okwanira m'mitsempha yanu. Dongosolo lanu la renin-angiotensin lakhala likugwira ntchito ngati muli ndi vuto la mtima kapena renal artery stenosis, kutsatira zakudya zamchere, kapena kusowa madzi m'thupi. Dokotala wanu akhoza kukuwuzani zambiri.
• Kuchenjeza m'mimba ndi kuchepa thupi: Mukatenga olmesartan kwa nthawi yayitali (miyezi mpaka zaka), imatha kuyambitsa kutsekula m'mimba kwakanthawi kochepa ndikuchepetsa. Ngati muli ndi kutsekula m'mimba komanso kuchepa thupi ndipo dokotala wanu sangapeze chifukwa china, mungafunike kusiya kumwa mankhwalawa.

Kodi Olmesartan ndi chiyani?

Olmesartan ndi mankhwala omwe mumalandira. Zimabwera ngati piritsi lokhala ndi zokutira pakamwa.

Olmesartan amapezeka ngati dzina la mankhwalawa Benicar. Ikupezekanso ngati mankhwala achibadwa. Mankhwala achibadwa nthawi zambiri amakhala otsika poyerekeza ndi mtundu wamaina. Nthawi zina, sangapezeke mwamphamvu iliyonse kapena mawonekedwe aliwonse monga mankhwala omwe amadziwika ndi dzina.

Olmesartan atha kumwedwa ngati gawo limodzi la mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo.

Chifukwa chimagwiritsidwa ntchito

Olmesartan amagwiritsidwa ntchito pochiza kuthamanga kwa magazi. Itha kugwiritsidwa ntchito yokha kapena kuphatikiza mankhwala ena kuti muchepetse kuthamanga kwamagazi.

Momwe imagwirira ntchito

Olmesartan ali mgulu la mankhwala otchedwa angiotensin receptor blockers. Gulu la mankhwala ndi gulu la mankhwala omwe amagwiranso ntchito chimodzimodzi. Mankhwalawa amagwiritsidwa ntchito pochiza zofananira.

Olmesartan amaletsa zochita za angiotensin II, mankhwala m'thupi lanu omwe amachititsa kuti mitsempha yanu yamagazi ilimbe komanso yopapatiza. Mankhwalawa amathandiza kupumula ndi kukulitsa mitsempha yanu. Izi zimachepetsa kuthamanga kwa magazi.

Zotsatira zoyipa za Olmesartan

Piritsi lokamwa la Olmesartan silimayambitsa kugona, koma limatha kuyambitsa zovuta zina.

Zotsatira zofala kwambiri

Zotsatira zofala kwambiri zomwe zimachitika ndi olmesartan ndi monga:

• kupweteka kwa msana
• chifuwa
• kutsegula m'mimba
• mutu
• magazi mkodzo wanu
• shuga wambiri wamagazi
• mkulu triglycerides
• Zizindikiro zonga chimfine, monga kutentha thupi ndi kupweteka kwa thupi
• zilonda zapakhosi, mphuno, ndi matenda a sinus

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:

• Zowopsa kwambiri. Zizindikiro zimatha kuphatikiza:
  • kutupa kwa nkhope yanu, milomo, mmero, kapena lilime
• Kuthamanga kwa magazi (hypotension). Zizindikiro zimatha kuphatikiza:
  • kukomoka
  • chizungulire
• Mavuto a chiwindi. Zizindikiro zimatha kuphatikiza:
  • nseru
  • ululu kumtunda chakumanja kwam'mimba mwanu
  • chikasu cha azungu amaso ndi khungu lanu
  • khungu loyabwa
• Mavuto a impso. Zizindikiro zimatha kuphatikiza:
  • kutupa kwa mapazi anu, akakolo, kapena manja
  • kunenepa

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.

Kuletsa mankhwalawa

• Osasiya kumwa olmesartan osalankhula ndi dokotala. Kuletsa mankhwalawa mwadzidzidzi kungayambitse kuthamanga kwa magazi (kuwuka mwadzidzidzi). Izi zitha kuwonjezera chiopsezo chanu chodwala matenda amtima kapena sitiroko.

Olmesartan amatha kulumikizana ndi mankhwala ena

Pulogalamu yamlomo ya Olmesartan 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 olmesartan alembedwa pansipa.

Bipolar matenda osokoneza bongo

Kutenga olmesartan ndi mankhwala anu ochititsa munthu kusinthasintha zochitika kumawonjezera kuchuluka kwa mankhwala osokoneza bongo m'thupi lanu. Izi zitha kuyambitsa zoopsa. Zitsanzo za mankhwalawa ndi monga:

• lifiyamu

Kuyanjana kwa mankhwala a magazi

Kutenga mankhwala ena a magazi ndi olmesartan kumatha kuwonjezera chiopsezo cha potaziyamu wambiri wamagazi, kuwonongeka kwa impso, komanso kuthamanga kwa magazi (hypotension). Zitsanzo za mankhwalawa ndi monga:

• aliskiren
• angiotensin receptor blockers (ARBs), monga:
  • alireza
  • alirezatalischi
  • alireza
• angiotensin-converting enzyme (ACE) inhibitors, monga:
  • kapita
  • chikodil
  • kutchilimy

Mankhwala a anti-inflammatory anti-inflammatory (NSAIDs)

Kutenga ma NSAID ndi olmesartan kumatha kuwonjezera chiopsezo cha impso. Chiwopsezo chanu chitha kukhala chachikulu ngati ndinu wamkulu, mutenga diuretic, mulibe madzi m'thupi, kapena muli ndi vuto la impso. Komanso, ma NSAID amatha kuchepa mphamvu ya olmesartan. Izi zikutanthauza kuti sizingagwire ntchito kuchepetsa kuthamanga kwa magazi.

Zitsanzo za NSAID ndizo:

• ibuprofen
• naproxen

Kuyanjana kwa Colesevelam

Kutenga mankhwala a cholesterol ndi shuga ndi olmesartan kumatha kuchepetsa kuchuluka kwa mafuta omwe thupi lanu limayamwa. Ngati mumamwa mankhwala onsewa, muyenera kumwa olmesartan osachepera maola 4 musanatenge colesevelam.

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 Olmesartan

Mankhwalawa amabwera ndi machenjezo angapo.

Chenjezo la ziwengo

Mankhwalawa amatha kuyambitsa vuto lalikulu. Zizindikiro zake ndi izi:

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

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

Kumwa mowa ndikumwa olmesartan kumatha kuyambitsa vuto. Izi zikutanthauza kuti mwina mwachedwetsa kuganiza, kuganiza bwino, komanso kugona. Izi zitha kukhala zowopsa.

Machenjezo kwa anthu omwe ali ndi matenda ena

Kwa anthu omwe ali ndi renin-angiotensin system: Mankhwalawa amachititsa dongosolo lanu la renin-angiotensin. Ngati muli ndi vuto la mtima, renal artery stenosis, kapena kuthamanga kwa magazi (hypotension), renin-angiotensin system yanu imagwira ntchito kale. Ngati mutenga olmesartan pamene dongosolo lanu la renin-angiotensin likugwira ntchito, mumakhala pachiwopsezo cha impso.

Kwa anthu omwe ali ndi matenda ashuga: Kafukufuku wina akuwonetsa kuti kuchuluka kwa olmesartan kumawonjezera chiopsezo cha mavuto amtima komanso kufa kwa anthu omwe ali ndi matenda ashuga. Kuphatikiza apo, simuyenera kumwa mankhwalawa ngati muli ndi matenda ashuga komanso mukumwa aliskiren.

Machenjezo kwa magulu ena

Kwa amayi apakati: Mankhwalawa ndi m'gulu la mimba ya D. Izi zikutanthauza zinthu ziwiri:

1. Kafukufuku mwa anthu awonetsa zovuta kwa mwana wosabadwa mayi atamwa mankhwalawo.
2. Mankhwalawa ayenera kugwiritsidwa ntchito pokhapokha ali ndi pakati pakafunika kuthana ndi vuto la mayiyo.

Lankhulani ndi dokotala ngati muli ndi pakati kapena mukukonzekera kutenga pakati. Funsani dokotala wanu kuti akuuzeni za zovuta zomwe zingachitike kwa mwana wosabadwayo. Mankhwalawa ayenera kugwiritsidwa ntchito pokhapokha ngati chiwopsezo chomwe chingakhalepo chikuvomerezeka chifukwa cha mankhwalawo.

Mukakhala ndi pakati mukamamwa mankhwalawa, itanani dokotala wanu nthawi yomweyo.

Kwa amayi omwe akuyamwitsa: Sizikudziwika ngati mankhwalawa amapitilira mkaka wa m'mawere. Ngati zitero, zimatha kuyambitsa mavuto kwa mwana yemwe akuyamwitsa. Lankhulani ndi dokotala ngati mukuyamwitsa mwana wanu. Muyenera kusankha kuti musiye kuyamwa kapena kusiya kumwa mankhwalawa.

Kwa okalamba: Okalamba amatha kugwiritsa ntchito mankhwala pang'onopang'ono. Mlingo wachikulire womwe ungapangitse kuti mankhwalawa azikhala apamwamba kuposa thupi lanu. Ngati ndinu wamkulu, mungafunike mlingo wocheperako kapena dongosolo lina la dosing.

Kwa ana: Mankhwalawa sanaphunzirepo kwa ana ochepera zaka 6 ndipo sayenera kugwiritsidwa ntchito kwa ana ochepera chaka chimodzi.

Momwe mungatengere olmesartan

Mlingo ndi mafomu onse omwe sangakhale nawo sangaphatikizidwe pano. Mlingo wanu, mawonekedwe anu, komanso kuti mumatenga kangati zimadalira:

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

Mlingo wa kuthamanga kwa magazi

Zowonjezera: Olmesartan

• Mawonekedwe: piritsi yamlomo
• Mphamvu: 5 mg, 20 mg, 40 mg

Mtundu: Benicar

• Mawonekedwe: piritsi yamlomo
• Mphamvu: 5 mg, 20 mg, 40 mg

Mlingo wa akulu (zaka 17-64 zaka)

• Mlingo woyambira: 20 mg amatengedwa kamodzi patsiku.
• Mlingo ukuwonjezeka: Dokotala wanu akhoza kukulitsa mlingo wanu mpaka 40 mg pakatha masabata awiri.

Mlingo wa ana (zaka 6-16 zaka)

• Mlingo woyambira:
  • Kwa ana omwe amalemera mapaundi 44-77 (20-35 kg): 10 mg amatengedwa kamodzi patsiku.
  • Kwa ana omwe amalemera mapaundi 77 kapena kupitirira (35 kg kapena kuposa): 20 mg amatengedwa kamodzi patsiku.
• Mlingo ukuwonjezeka: Pambuyo pa masabata awiri, dokotala wanu akhoza kuwonjezera mlingo wa mwana wanu mpaka 20 mg ngati amamwa 10 mg, kapena 40 mg ngati amatenga 20 mg.

Mlingo wa ana (zaka 0-5 zaka)

Mankhwalawa sanaphunzirepo kwa ana ochepera zaka 6 ndipo sayenera kugwiritsidwa ntchito kwa ana ochepera chaka chimodzi.

Mlingo waukulu (wazaka 65 kapena kupitirira)

Palibe malingaliro apadera a dosing yayikulu. Okalamba amatha kugwiritsa ntchito mankhwala pang'onopang'ono. Mlingo wachikulire womwe ungapangitse kuti mankhwalawa azikhala apamwamba kuposa thupi lanu. Ngati ndinu wamkulu, mungafunike mlingo wocheperako kapena dongosolo lina la dosing.

Maganizo apadera

• Ngati mwana wanu sangathe kumeza piritsi, kuyimitsidwa pakamwa kumatha kupangidwa pogwiritsa ntchito mapiritsi. Funsani wamankhwala wanu kuti akupangireni izi ngati zingafunike.
• Ngati muli ndi zinthu zomwe zimakupangitsani kukhala ndi madzi ochepa mthupi lanu kuposa momwe zimakhalira, monga kutenga diuretic tsiku lililonse kapena kukhala ndi dialysis yamavuto a impso, mungafunike mlingo wotsika poyamba. Dokotala wanu adzasankha zomwe zingakuthandizeni.
• Mpikisano wanu ungakhudze momwe mankhwalawa amagwirira ntchito kwa inu. Dokotala wanu akhoza kukuwuzani zambiri.

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

Piritsi lamlomo la Olmesartan limagwiritsidwa ntchito pochiza matendawa kwa nthawi yayitali. Zimabwera ndi zoopsa zazikulu ngati simukuzitenga monga mwalamulo.

Ngati simutenga konse: Mankhwalawa amachepetsa kuthamanga kwa magazi. Mankhwala omwe amachepetsa kuthamanga kwa magazi amachepetsa chiopsezo chanu cha sitiroko kapena matenda amtima. Ngati simumamwa mankhwalawa, chiopsezo chanu cha sitiroko kapena matenda amtima chitha kukhala chachikulu.

Mukaleka kuzitenga mwadzidzidzi: Osasiya kumwa mankhwalawa osalankhula ndi dokotala. Kuyimitsa mankhwalawa mwadzidzidzi kungayambitse kuthamanga kwa magazi (kuwuka mwadzidzidzi). Izi zitha kuwonjezera chiopsezo chanu chodwala matenda amtima kapena sitiroko.

Ngati simutenga nthawi yake: Kuthamanga kwa magazi kwanu sikungakhale bwino kapena kukuipiraipira. Mutha kukhala ndi chiopsezo chachikulu chodwala matenda a mtima kapena sitiroko.

Ngati mutenga zochuluka kwambiri: Ngati mumamwa mankhwala ochuluka kwambiri, mutha kukhala ndi zizindikiro zotsatirazi:

• kufooka
• chizungulire
• kumverera ngati mtima wako ukugunda kapena kugunda pang'onopang'ono

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 kwangotsala maola ochepa kuti nthawi ya mlingo wanu wotsatira ifike, dikirani ndikungotenga gawo limodzi panthawiyo.

Osayesa konse kutenga mwa kumwa miyezo iwiri nthawi imodzi. Izi zitha kuyambitsa zovuta zina.

Momwe mungadziwire ngati mankhwalawa akugwira ntchito: Magazi anu azikhala otsika. Dokotala wanu amayang'anira kuthamanga kwa magazi kwanu pafupipafupi.

Malingaliro ofunikira potenga olmesartan

Kumbukirani izi ngati adokotala angakupatseni olmesartan.

Zonse

• Mankhwalawa amatha kumwa popanda chakudya.
• Mutha kuphwanya kapena kudula piritsi.

Yosungirako

• Sungani mankhwalawa kutentha kwapakati pakati pa 68 ° F ndi 77 ° F (20 ° C ndi 25 ° C).
• Osazizira mankhwalawa.
• 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.

Kudziyang'anira pawokha

Muyenera kukawona kuthamanga kwa magazi kwanu. Kuti muchite izi, mungafunike kugula pulogalamu yowunika magazi.

Muyenera kulemba chipika ndi tsiku, nthawi yamasana, komanso kuwerengetsa magazi kwanu. Bweretsani tsikuli ndikudikirani kwa dokotala wanu.

Kuwunika kuchipatala

Mukamalandira mankhwalawa, dokotala wanu amayang'anira:

• kuthamanga kwa magazi
• ntchito ya impso
• mafuta m'thupi
• shuga m'magazi

Ndalama zobisika

Ngati dokotala akukufunsani kuti muwone kuthamanga kwa magazi kwanu, mufunika kuwunika magazi. Izi zimapezeka kuma pharmacies ambiri.

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.