Momwe mungagwiritsire ntchito Metglib?

Chonde musanayambe kugula mapiritsi a Metglib atakutidwa. 2,5 mg + 400 mg, ma 40 ma PC., Onani zambiri zokhudza nkhaniyi ndi zambiri patsamba lawebusayiti la wopanga kapena tchulani mtundu winawake wa manambala omwe amayang'anira kampani yathu!

Zomwe zikuwonetsedwa patsamba lino sizoperekedwa pagulu. Wopangayo ali ndi ufulu wosintha kapangidwe kake, kapangidwe kake ndi katengedwe ka katundu. Zithunzi zamalonda pazithunzi zomwe zaperekedwa pamndandanda wazomwe zili patsamba lino zimasiyana ndi zomwe zidachokera.

Zambiri pamutengo wa zinthu zomwe zawonetsedwa pamndandanda wa masamba tsambalo zingasiyane ndi zenizeni panthawiyo yokhazikitsa dongosolo la zomwe zikugwirizana.

Wopanga

Piritsi limodzi lili:

yogwira zinthu: metformin hydrochloride 400 mg, glibenclamide 2.5 mg,

zotuluka: calcium hydrogen phosphate dihydrate 50 mg, chimanga wowuma 45 mg, croscarmellose sodium 12 mg, sodium stearyl fumarate 3 mg, povidone 52 mg, microcrystalline cellulose 35,5 mg, chovala chamafilimu: Opadry lalanje 20 mg, kuphatikiza: hypromellose (hydroxypropyl methyl cellulose ) 6.75 mg, hyprolose (hydroxypropyl cellulose) 6.75 mg, talc 4 mg, titanium dioxide 2.236 mg, utoto wa iron oxide ofiira 0,044 mg, utoto wachikasu wa oksidi 0,22 mg.

Zotsatira za pharmacological

Kuphatikizika kwokhazikika kwamankhwala awiri am'magazi a hypoglycemic a magulu osiyanasiyana a pharmacological: metformin ndi glibenclamide. Metformin ndi ya gulu la Biguanides ndipo amachepetsa zomwe zimakhala ndi basal ndi postprandial glucose m'magazi a m'magazi. Metformin simalimbikitsa kubisirana kwa insulin, chifukwa chake siyambitsa hypoglycemia.

Ili ndi njira 4 zochitira:

- amachepetsa kupanga shuga ndi chiwindi poletsa gluconeogeneis ndi glycogenolysis,

- kumawonjezera kukhudzika kwa zotumphukira zolandilira ku insulin, kumwa ndi kugwiritsa ntchito shuga m'maselo a m'mitsempha,

- Iachedwetsa mayamwidwe amkati m'matumbo,

- imakhazikika kapena kuchepetsa thupi mwa odwala omwe ali ndi matenda a shuga.

Type 2 shuga mwa akulu:

- ndi mphamvu ya mankhwala othandizira kudya, masewera olimbitsa thupi komanso monotherapy yam'mbuyo yokhala ndi metformin kapena zotumphukira za sulfonylurea,

- kusintha chithandizo chamankhwala am'mbuyomu ndimankhwala awiri (metformin ndi zotumphukira za sulfonylurea) mwa odwala omwe ali ndi khola komanso glycemia yoyendetsedwa bwino.

Contraindication

- Hypersensitivity to metformin, glibenclamide kapena zotumphukira zina za sulfonylurea, komanso magawo ena a kukonzekera kwa Metglib,

- lembani matenda ashuga 1

- matenda ashuga ketoacidosis, matenda a shuga, matenda a shuga,

- Kulephera kwaimpso kapena kuwonongeka kwaimpso (kulengedwa kwa creatinine zosakwana 60 ml / min),

- pachimake zinthu zomwe zingayambitse kusintha kwa impso: kuchepa madzi m`thupi, matenda opatsirana, mantha, kupangika kwa chitetezo cha othandizira ayodini.

- matenda owopsa kapena osakhazikika omwe amayenda ndi minofu hypoxia: kulephera kwa mtima kapena kupuma, chinyengo cham'kati posachedwa,

-mimba, nthawi yoyamwitsa,

- munthawi yomweyo miconazole,

- matenda opatsirana, chithandizo chachikulu chopangira opaleshoni, kuvulala, kuwotcha kwakukulu ndi zina zomwe zimafuna chithandizo cha insulin,

- uchidakwa wambiri, kuledzera kwambiri,

- lactic acidosis (kuphatikizapo mbiri),

- kutsatira zakudya zochepa zopatsa mphamvu (zosakwana 1000 kcal / tsiku),

- zaka za ana mpaka 18.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa mwa anthu opitirira zaka 60 omwe amagwira ntchito zolimbitsa thupi, zomwe zimagwirizanitsidwa ndi chiwopsezo chokhala ndi lactic acidosis mwa iwo.

- hypofunction wa anterior pituitary,

- matenda a chithokomiro (monga kuphwanya kwa ntchito yake)

- okalamba azaka zopitilira 70 chifukwa choopsa cha hypoglycemia.

Zotsatira zoyipa

Zotsatira zotsatirazi zimatha kuchitika ndi mankhwala a Metglib ®. Gulu la WHO lazomwe zimayambitsa mavuto:

nthawi zambiri - nthawi ya ≥1 / 10 (> 10%)

nthawi zambiri - kuchokera ≥1 / 100 mpaka 1% ndi

pafupipafupi - kuchokera ≥1 / 1000 mpaka 0.1% ndi

osowa - kuchokera ku ≥1 / 10000 to0.01% ndi

Kugawika kwa zovuta zosagwirizana molingana ndi kuwonongeka kwa ziwalo ndi ziwalo zamankhwala (dikishonare ya zamankhwala yoyang'anira ntchito Med-DRA).

- Kuphwanya magazi ndi zamitsempha yamagazi:

Zochitika zoyipa izi zimatha pambuyo pakutha kwa mankhwalawa.

Pafupipafupi: leukopenia ndi thrombocytopenia.

Osowa kwambiri: agranulocytosis, hemolytic anemia, apuloya wam'mafupa, ndi pancytopenia.

- Matenda owononga chitetezo chamthupi:

Zosowa kwambiri: kugwedezeka kwa anaphylactic.

Mtanda-hypersensitivity zimachitika sulfonamides ndipo zotumphukira zawo zimachitika.

- Zovuta zakuyenda kwa metabolism ndi zakudya: Hypoglycemia.

Pafupipafupi: maulendo a hepatic porphyria ndi porphyria wolekerera.

Osowa kwambiri: lactic acidosis.

Kuyamwa kwa vitamini B12, limodzi ndi kuchepa kwa ndende yake m'magazi a seramu ndi ntchito yayitali ya metformin. Ngati matenda am'madzi a megaloblastic apezeka, mwayi wa etiology wotere uyenera kuganiziridwa. Disulfiram monga anachita ndi Mowa.

- Kuphwanya kwamanjenje:

Nthawi zambiri: kusokonezani kwa kukoma (“zitsulo” mkamwa).

Zosokoneza Zoonekera: Kumayambiriro kwa chithandizo, kuwonongeka kwakanthawi kwakanthawi kumatha kuchitika chifukwa cha kuchepa kwa shuga wamagazi.

- Kuphwanya kwam'mimba thirakiti:

Nthawi zambiri: nseru, kusanza, kutsegula m'mimba, kupweteka kwam'mimba komanso kusowa kwa chakudya. Zizindikirozi ndizofala kumayambiriro kwa chithandizo ndipo nthawi zambiri zimadutsa zokha. Popewa kukula kwa zizindikirozi, tikulimbikitsidwa kumwa mankhwalawa mu 2 kapena 3, kuwonjezeka kwapang'onopang'ono kwa mlingo wa mankhwalawa kumathandizanso kulolerana kwake.

- Kusokonezeka kwa chiwindi ndi njira yothandizira:

Osowa kwambiri: kuwonongeka kwa chiwindi kuwonetsa kapena hepatitis yomwe ikufuna kusiya kulandira chithandizo.

Zovuta za pakhungu ndi minofu yolowera:

Pafupipafupi: zimachitika pakhungu, monga: pruritus, urticaria, zotupa za maculopapular.

Osowa kwambiri: khungu kapena visceral matupi a vasculitis, erythema ya polymorphic, exermative dermatitis, photosensitivity.

- Zambiri zasayansi:

Pafupipafupi: kuwonjezeka kwa kuchuluka kwa urea ndi creatinine mu seramu kuchokera pang'ono mpaka pang'ono.

Osowa kwambiri: hyponatremia.

Kuchita

Omwe amagwiritsidwa ntchito ndi glibenclamide

Miconazole imatha kupangitsa kukula kwa hypoglycemia (mpaka kukula kwa chikomokere).

Zokhudzana ndi Metformin

Muli mankhwala okhala ndi ayodini: kutengera ntchito yaimpso, mankhwalawa amayenera kusiyidwa maola 48 isanachitike kapena atatha kulowetsedwa mwaukadaulo wa ayodini.

Kuphatikizika komwe kunaphatikizidwa: Kuphatikizidwa ndi kugwiritsidwa ntchito kwa sulfonylurea

Ethanol: kusachita ngati disulfiram (ethanol tsankho) sikamawonedwa kwambiri mukamamwa ethanol ndi glibenclamide. Ethanol imatha kuwonjezera kuchuluka kwa hypoglycemic (mwa kuletsa zovuta zomwe zimachitika kapena kuchedwetsa kuchepa kwa metabolic), zomwe zimathandizira kukulitsa kukomoka kwa hypoglycemic. Pa mankhwalawa ndi Metglib ®, mowa ndi mankhwala okhala ndi ethanol ayenera kupewedwa. Phenylbutazone amachulukitsa mphamvu ya hypoglycemic ya zotumphukira za sulfonylurea (m'malo mwa sulfonylurea zotumphukira pamalo opangira mapuloteni komanso / kapena kuchepetsa kutulutsa kwawo). Ndikofunikira kugwiritsa ntchito mankhwala ena odana ndi kutupa omwe akuwonetsa kuyanjana pang'ono, kapena kuchenjeza wodwalayo za kufunika kodziyimira pawokha kuchuluka kwa glycemia, ngati kuli koyenera, mlingowo uyenera kusinthidwa pamene mankhwala odana ndi kutupa agwiritsidwa ntchito limodzi komanso atayimitsidwa.

Omwe amagwiritsidwa ntchito ndi glibenclamide

Bozentan kuphatikiza ndi glibenclamide kumawonjezera chiopsezo cha hepatotoxicity.

Ndikulimbikitsidwa kuti mupewe kumwa mankhwalawa nthawi imodzi. Mphamvu ya gloglycemic ya glibenclamide ingathenso kuchepa.

Zokhudzana ndi Metformin

Ethanol: Chiwopsezo chotenga lactic acidosis imachulukitsidwa ndi kuledzera kwakumwa kwambiri, makamaka ngati mukufa ndi njala, kapena musadye zakudya zoperewera, kapena ngati chiwindi chilephera. Pa mankhwalawa ndi Metglib ®, mowa ndi mankhwala okhala ndi ethanol ayenera kupewedwa.

Momwe mungatenge, njira ya makonzedwe ndi kumwa

Mlingo ndi dongosolo la mankhwalawo, komanso nthawi yayitali ya mankhwala amatsimikiziridwa ndi adokotala, choyambirira, mogwirizana ndi momwe wodwalayo amathandizira kugaya chakudya, kutengera kuchuluka kwa shuga m'magazi a magazi. Monga lamulo, mlingo woyambirira ndi mapiritsi 1-2 patsiku ndi chakudya chachikulu, pang'onopang'ono kusankha kwa mankhwalawa mpaka kuphatikizika kwa mawonekedwe a shuga m'magazi a m'magazi kumatheka. Mulingo wapamwamba wa tsiku ndi tsiku wa Metglib ® ndi mapiritsi 6, ogawidwa pazigawo zitatu.

Bongo

Ngati mankhwala osokoneza bongo, hypoglycemia imatha kupezeka chifukwa cha kukhalapo kwa sulfonylurea pokonzekera.

Wofatsa komanso wofatsa zizindikiro za hypoglycemia popanda kutaya chikumbumtima komanso minyewa yake imatha kuwongoleredwa pakumwa shuga msanga. Ndikofunikira kuchita kusintha kwa mlingo ndi / kapena kusintha zakudya. Kupezeka kwa zovuta zamaganizidwe a hypoglycemic mwa odwala matenda a shuga, limodzi ndi chikomokere, paroxysm, kapena matenda ena amitsempha, amafunikira chithandizo chamankhwala mwadzidzidzi. Mothandizidwa kulowetsedwa kwa njira ya dextrose ndikofunikira msanga atazindikira kapena kukayikira kwa hypoglycemia, asanafike kuchipatala. Pambuyo podziwikanso, ndikofunikira kuti mupatse wodwalayo chakudya chambiri m'zakudya zamafuta ochepa (kuti mupewe kukonzanso kwa hypoglycemia).

Plasma glibenclamide chilolezo chitha kuchuluka kwa odwala omwe ali ndi matenda a chiwindi. Popeza glibenclamide imagwira mwachangu mapuloteni amwazi, mankhwalawa samachotsedweranso pakhungu.

Kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali kapena kupezeka kwa zinthu zomwe zingayambitse chiopsezo kumatha kuyambitsa lactic acidosis, popeza metformin ndi gawo limodzi la mankhwalawa.

Lactic acidosis ndi vuto lofunika kuchipatala msanga, mankhwalawa a lactic acidosis ayenera kuchitika kuchipatala. Njira yothandizira kwambiri pochotsa lactate ndi metformin ndi hemodialysis.

Dzinalo Losayenerana

Glibenclamide + Metformin (Glibenclamide + Metformin)

Mankhwalawa amaphatikizidwa ndi gulu la mankhwala omwe amayendetsa shuga.

A10BD02. Metformin osakanikirana ndi sulfonamides

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa ali ngati mapiritsi. Monga zida zazikulu zogwiritsidwa ntchito, metformin hydrochloride ndi glibenclamide amagwiritsidwa ntchito. Kuphatikizika kwawo piritsi limodzi: 400 mg ndi 2.5 mg. Zina zomwe sizikuwonetsa zochitika za hypoglycemic:

• calcium hydrogen phosphate dihydrate,
• wowuma chimanga
• sodium croscarmellose,
• sodium yozizira fumarate,
• povidone
• microcrystalline mapadi.

Chogulikacho chimapezeka m'mapaketi a ma cell a 40.

Mankhwalawa ali ngati mapiritsi.

Pharmacokinetics

Mafuta a glibenclamide akalowa m'mimba am'mimba ndi 95%. Kwa maola 4, chizindikiritso chapamwamba kwambiri cha chinthucho chimakwaniritsidwa. Ubwino wa panganoli ndikugwirizana kwathunthu ndi mapuloteni a plasma (mpaka 99%). Gawo lofunika kwambiri la glibenclamide limasinthidwa m'chiwindi, chifukwa cha zomwe ma metabolites awiri amapangidwa, omwe samawonetsa ntchito ndipo amatsitsidwa m'matumbo, komanso impso. Njirayi imatenga nthawi ya maola 4 mpaka 11, omwe amatsimikiziridwa ndi boma, mulingo wa chinthu chomwe chikuchitika, kupezeka kwa ma pathologies ena.

Metformin imatengeka pang'ono ponse, bioavailability sichidutsa 60%. Katunduyu amayamba kugwira ntchito mwachangu kuposa glibenclamide. Chifukwa chake, mphamvu yapamwamba kwambiri ya metformin imatsimikiziridwa patatha maola 2,5 mutatha kumwa mankhwalawa.

Pulogalamuyi ili ndi drawback - kuchepa kwakukulu kwa kuthamanga kwa zochita mukamadya chakudya. Metformin sikugwirizana ndi mapuloteni amwazi. Thupi limachotsedwa osasinthika, monga pang'onopang'ono zimasintha. Impso ndizomwe zimayambitsa kuphipha kwake.

Metformin sikugwirizana ndi mapuloteni amwazi.

Zizindikiro zogwiritsidwa ntchito

Cholinga chachikulu ndikuti matenda akhale ndi vuto la matenda ashuga a 2.

Ntchito zotsatirazi zimachitika:

• m`malo mankhwala a yapita regimen odwala ndi amazilamulira shuga,
• kupereka zotsatira motsutsana ndi maziko otsika ogwira zakudya mankhwala, zolimbitsa thupi zochizira odwala onenepa kwambiri.

Ndi chisamaliro

Zowerengeka zingapo zachinyengo zimadziwika kuti zimafuna kugwiritsa ntchito mankhwala mosamala:

• malungo
• kuchepa kwa ntchito ya tinthu touluka,
• Matenda a chithokomiro omwe akuphatikizidwa ndi kuphwanya kwa chithokomiro.
• adrenal kusowa.

Ndi matenda ashuga

Malangizo ogwiritsira ntchito Metglib:

• pakuyambirira kwa mankhwalawa, tikulimbikitsidwa kumwa mapiritsi 1-2 patsiku,
• Pambuyo pake, mlingo wa tsiku ndi tsiku umasintha, zimatengera kuchuluka kwa shuga m'magazi, ndikofunikira kuti zitheke.

pa gawo loyambirira la mankhwalawa, tikulimbikitsidwa kumwa mapiritsi 1-2 patsiku.

Mulingo wovomerezeka wamankhwala patsiku la mtundu wa 2 shuga ndi mapiritsi 6. Ndipo simungathe kuzitenga nthawi yomweyo. Ndikofunikira kugawa kuchuluka kwa mitundu yayikulu kapena zitatu mosiyanasiyana.

Kuchepetsa thupi

Amadziwika kuti kugwiritsa ntchito zinthu (metformin ndi glibenclamide), zomwe ndi gawo la Metglib, kumapangitsa kuchepa kwa mafuta. Mlingo womwe umalimbikitsa patsiku ndi mapiritsi atatu. Zilandiridwa mosiyanasiyana. Njira ya mankhwala ndi masiku 20. Pofuna kupewa kuwonda kwambiri, mlingo umachepetsedwa mpaka 200 mg kamodzi, kuchuluka kwa tsiku ndi tsiku ndi 600 mg.

Mankhwalawa samapereka chifukwa chofunira popanda thandizo. Zinthu zomwe zimapangidwa zimangopangitsa kuti pakhale kusintha kwa mphamvu kuti ikhale mafuta.

Pofuna kupewa kuwonjezeka kwa mafuta ambiri, amafunika kuwonjezera masewera olimbitsa thupi ndikusintha zakudya zamagulu komanso kugwiritsa ntchito mankhwalawa.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Mankhwalawa amaletsedwa kugwiritsidwa ntchito poyambira ndi kuyamwa. Zinthu zogwira zimalowa mkaka wa mayi. Ngati pakufunika kugwiritsa ntchito mankhwalawa panthawi yachuma ndi kukonzekera, njira ya insulin imachitika.

Mankhwalawa amaletsedwa kugwiritsidwa ntchito poyambira ndi kuyamwa.

Ndani amakupatsani mankhwala?

Kukula kwa Metglib ndi mtundu wachiwiri wa matenda ashuga. Komanso, mankhwalawa amawonetsedwa osati kumayambiriro kwa matendawa, koma ndi momwe akumvera. Kumayambiriro kwa matenda ashuga, odwala ambiri adanenanso kuti insulin ikukana, ndipo palibe kusintha kapena kuperewera kwenikweni pa kapangidwe ka insulin. Chithandizo chokwanira panthawiyi ndi chakudya chamafuta ochepa, masewera olimbitsa thupi, ndi metformin. Metglib imafunika pakakhala kuchepa kwa insulin.Pafupipafupi, vutoli limawonekera patatha zaka 5 kuchulukitsa koyamba kwa shuga.

Mankhwala a Metglib omwe ali ndi magawo awiri amatha kutumikiridwa:

• Ngati chithandizo cham'mbuyomu sichikupereka kapena kwa nthawi yatha kupereka chipepeso kwa matenda ashuga,
• atangozindikira matenda a shuga 2, ngati wodwalayo ali ndi shuga yokwanira (> 11). Pambuyo pakukula kwa kulemera ndi kuchepa kwa insulin kukana, pali kuthekera kwakukulu kuti mulingo wa Metglib udzachepetsedwa kapena ungopita ku Metformin kokha,
• ngati mayeso a C-peptide kapena insulin ali ocheperako, osatengera kutalika kwa matenda ashuga,
• pofuna kugwiritsa ntchito mosavuta, odwala matenda ashuga omwe amamwa mankhwala awiri, glibenclamide ndi metformin. Kutenga Metglib kumakuthandizani kuti muchepetse chiwerengero cha mapiritsi. Malinga ndi odwala matenda ashuga, izi zimachepetsa kwambiri ngozi yakuyiwala kumwa mankhwalawo.

Momwe mungatenge Metglib

Zakumwa za Metglib nthawi yomweyo ndi chakudya. Mankhwala ali ndi zofunika zapadera pazomwe zimapangidwira. Mu shuga mellitus, zakudya zopatsa mphamvu ziyenera kupezeka mu chakudya chilichonse, gawo lawo lalikulu liyenera kukhala ndi index yotsika ya glycemic.

Ndi kuchuluka kwa mapiritsi, amagawika pawiri (m'mawa, madzulo), kenaka ndikuyamba kukhala atatu.

Mndandanda wazotsatira zoyipa

Mndandanda wazotsatira zoyipa zomwe zingachitike mutatenga Metglib:

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Zotsatira zoyipa kwambiri za Metglib zimatchedwa hypoglycemia. Kupezeka kwake kumadalira zochita za wodwala yemwe ali ndi matenda ashuga, motero kuopsa kwake ndikosatheka. Popewa madontho a shuga, muyenera kudya zakudya zamafuta tsiku lonse, osadumpha chakudya, kulipira zakudya zazitali zamoto, mungafunike zakudya zamkati nthawi yophunzirira. Ngati izi sizikuthandizani, ndi bwino kusiya Metglib ndi mankhwala osalala.

Gwiritsani ntchito mu ukalamba

Kugwiritsa ntchito Metglib kuyenera kupewedwa ngati wodwala akuchita ntchito yayikulu. Pankhaniyi, pali chiopsezo cha lactic acidosis. Zoletsa zoterezi zimakhudzanso odwala opitilira zaka 60. Kuphatikiza apo, kusamala kuyenera kuchitika pochiza odwala okalamba kuyambira zaka 70 kapena kupitirira. Izi zingayambitse kukula kwa hypoglycemia.

Kugwiritsa ntchito kwa vuto la chiwindi

Mankhwala amaletsedwa kuti agwiritsidwe ntchito ngati thupi lanu limaperewera. Ganizirani mulingo wa creatinine (malire a chizindikiro ichi mwa amuna ndi 135 mmol / l, mwa akazi - 110 mmol / l).

Mankhwala ndi oletsedwa kugwiritsidwa ntchito ngati chiwindi chikulephera.

Kuyenderana ndi mowa

Mankhwala omwe akufunsidwa amathandizira kuti thupi lawo lizigwira ntchito molakwika mothandizidwa ndi Mowa. Kuphatikiza apo, pali kuwonjezeka kwa mphamvu ya Metglib motsutsana ndi zakumwa zoledzeretsa, zomwe zingayambitse zovuta.

Mafotokozedwe ogwira mtima omwe ali ndi mawonekedwe omwewo:

• Gluconorm,
• Glibomet,
• Glucovans, koma pankhaniyi, Mlingo wa metformin ndiwokwera - 500 mg,
• Mphamvu ya Metglib (kuchuluka kwa metformin - 500 mg).

Mafuta a Gluconorm analogue.
Analogue ya mankhwalawa ndi Glibomet.
Glucovans analogue.
analogue ya mankhwala a Metglib Force.