Mankhwala Aspinat: malangizo ntchito

Mankhwalawa ali ndi antipyretic, analgesic zotsatira.

Limagwirira zake Aspinat zachokera kuletsa ntchito ya cycloo oxygenase 1 ndi 2 michere, mothandizidwa ndi momwe ma prostaglandins amapangidwira (chifukwa cha zomwe ululu ndi kutupa m'dera la zotupa).

Kuchepa kwa kuchuluka kwa ma prostaglandins mu gawo la thermoregulation mu ubongo, thukuta limachulukana ndipo kuwala kwa ziwiya kumakulirakulira, zomwe zotsatira zake zimapereka antipyretic zotsatira. Mphamvu ya analgesic imachitika chifukwa cha kupezeka kwapakati komanso kufalikira kwa mankhwalawa.

Acetylsalicylic acid imalepheretsa kaphatikizidwe ka ma enzyme ya thromboxane A2 m'magazi am'magazi, mapulateleti, omwe amachepetsa thrombosis, mapulateni am'magazi komanso kuphatikizika kwawo. Kufikira antiplatelet kwenikweni amalimbikira kwa sabata limodzi atatha kumwa kamodzi. Zadziwika kuti izi zimadziwika kwambiri mwa amuna.

Mankhwalawa acetylsalicylic acid, chiopsezo chotenga mawonekedwe osakhazikika a angina pectoris, infaration ya myocardial imachepa, ndipo chiwerengero cha anthu omwe amafa ndi matenda amtima chimatha.

Mankhwala Aspinat amagwiritsidwa ntchito moyenera popewa kulowetsedwa kwa myocardial, makamaka kwa amuna okulirapo wazaka 40.

Mlingo wa tsiku ndi tsiku wa 6 mg umachulukitsa nthawi ya prothrombin ndikulephera kaphatikizidwe prothrombin mu chiwindi. Ndikofunikira kudziwa kuti ngakhale mukumwa mankhwala acetylsalicylic acid, kuopsa kwa magazi komanso osiyanasiyana hemorrhagic zovuta pa nthawi ya opaleshoni ndi pambuyo pa kuchitapo kanthu.

Aspinate amachepetsa kuchuluka kwa mavitamini K omwe amadalira mavitamini 2, 7, 9 ndi 10. Mankhwala amathandizanso kuti michere ya magazi ipangidwe ndimagazi a cell plasma, amathandizanso njira yotupa uric acid kuchokera mthupi laling'ono (chifukwa cha kusokonezeka kwapambuyo pake pamatumbo a impso).

Ndi kufalikira kwa cycloo oxygenase-1 m'matumbo am'mimba, ntchito ya gastroprotective (yoteteza) ma prostaglandins imatsika, yomwe ingayambitse kupweteka kwa khoma la m'mimba komanso kukulitsa magazi.

Zovuta zoyipitsa kwambiri pamimba ya m'mimba zimapangidwa ndi mitundu yapadera ya acetylsalicylic acid, mitundu yokhala ngati sungunuka komanso mulingo.

Kukonzekera kwina kwa acetylsalicylic acid

Kutulutsa Fomu

Mapiritsi (Aspinat, Aspinat Cardio, Aspinat Plus, Aspinat 300), mapiritsi apamwamba (Aspinat, Aspinat C).

Aspinat: acetylsalicylic acid (100 mg kapena 500 mg).

Aspinat Cardio: acetylsalicylic acid (50 mg kapena 100 mg), otulutsa: MCC, wowuma 1500, aerosil (colloidal silicon dioxide), stearic acid, kuphimba kwa enteric: ACRYL-IZ (Copolymer ya methacosterone acid yokhala ndi ethyl acrylate 1: 1, titanium dioxide, talc, triethyl citrate, anhydrous colloidal silicon oxide, sodium bicarbonate, sodium lauryl sulfate), Copovidone, hydroxypropyl cellulose (Klucel).

Aspen 300: acetylsalicylic acid (300 mg), eric kuyanika.

Aspinat Plus: acetylsalicylic acid (500 mg), caffeine (50 mg).

Aspinat S: acetylsalicylic acid (400 mg), ascorbic acid (240 mg).

Aspinat:

  • Mapiritsi 10 mu paketi ya contour bezjacheykovoy, 1 kapena 2 mapaketi mu katoni,
  • 10 kapena 20 ma PC. mumtsuko wama polymer pamatayala okhala ndi makatoni,
  • Mapiritsi 10 a paketi yolumikizira, mapaketi 1 kapena 2 amkatoni,
  • Mapiritsi 12 ochita bwino mu polymer kesi pamakatoni.

Aspinat Cardio:

  • Ma PC 10 mumapaketi a matuza, 1, 2, 3, 5, 10 pakatoni katoni,
  • 10, 20, 30, 50 kapena 100 ma PC. mumtsinje wa polymer pamatoni a makatoni.

Aspen 300:

  • Ma PC 10 mu paketi ya contour bezjacheyakovoy, 1, 2, 3, 5 kapena 10 m'makatoni,
  • 10, 20, 30, 50 kapena 100 ma PC. mumtsuko wama polymer pamatayala okhala ndi makatoni,
  • Ma PC 10 m'mapaketi a chithuza, 1, 2 kapena 10 m'makatoni.

Aspinat Plus:

  • Ma PC 10 m'matumba otupa, 1, 2, 3 kapena 5 mumakatoni,
  • 10, 12, 15, 16, 20 kapena 30 ma PC. mumtsinje wa polymer pamatoni a makatoni.

Aspinat S: 10 ma PC mu polymer kesi mumapaketi amakhadi.

Zotsatira za pharmacological

Ubwino wa mtundu wosungunuka wa mankhwala poyerekeza ndi miyambo ya acetylsalicylic acid m'mapiritsi ndi njira yomaliziratu komanso yogwira ntchito mwachangu.

  • Kupweteka kwapang'onopang'ono kapena kofatsa mwa achikulire osiyanasiyana komwe kumachokera: mutu wambiri (kuphatikizapo omwe amaphatikizidwa ndi vuto lochotsa mowa), mano, mutu, neuralgia, radicular radicular syndrome, kupweteka kwa minofu ndi kuphatikizana, kupweteka pakapita msambo.
  • Kuchuluka kwa kutentha kwa thupi kuzizira ndi matenda ena opatsirana komanso otupa (mwa akulu ndi ana opitilira zaka 15).

Aspinat Cardio:

  • Kupewera kuphwanya kwamtima m'matumbo amisala pakachitika zinthu zoopsa (mwachitsanzo, matenda a shuga, matenda oopsa, matenda oopsa, kunenepa kwambiri, kusuta, kukalamba)
  • angina wosakhazikika,
  • kupewa matenda opha ziwalo (kuphatikizapo odwala omwe ali ndi matenda osakhalitsa a cerebrovascular matenda),
  • kupewa ngozi yochepa yam'mimba,
  • kupewa thromboembolism pambuyo ntchito ndi zowonjezera mtima kulowerera (mwachitsanzo corteryary artery bypass grafting, carotid artery endarterectomy, arteriovenous bypass grafting, carotid artery angioplasty),
  • kupewa kwamitsempha yama mtima ndi thromboembolism yam'mitsempha ya m'mimba ndi nthambi zake (mwachitsanzo, ndi kusakhazikika kwa nthawi yayitali chifukwa cha kulowererapo kwakukulu kwa opaleshoni).

Contraindication

  • Hypersensitivity to ASA, okonda mankhwala ndi NSAID ena,
  • zotupa ndi zotupa zam'mimba, magazi am'mimba,
  • hemorrhagic diathesis,
  • mphumu ya bronchial inayamba mwa kutenga ma salicylates ndi NSAIDs, a Fernand Widal triad (kuphatikiza mphumu ya bronchial, kubwereza kwa m'mphuno, kupindika kwa m'mphuno, kusalolera kwa ASA),
  • kuphatikiza methotrexate pa mlingo wa 15 mg pa sabata kapena kupitirira,
  • kulephera kwaimpso,
  • mimba (I ndi III trimester),
  • kuyamwa
  • wazaka 18.

Ndi chisamaliro:

  • gout
  • Hyperuricemia
  • mbiri ya zotupa zam'mimba zam'mimba kapena magazi m'matumbo, kulephera kwa impso ndi chiwindi, mphumu ya bronchial, matenda opuma a chifuwa, hay fever, polyposis yammphuno, matupi awo sagwirizana ndi mankhwala ena.
  • II trimester wa pakati,
  • kuphatikiza ndi methotrexate muyezo wosakwana 15 mg pa sabata,
  • kuchepa kwa vitamini K ndi glucose-6-phosphate dehydrogenase.

Mlingo ndi makonzedwe

Mkati, kumwa zamadzi zambiri. Mapiritsi a mphamvu a ngokuyambirira ayenera kusungunuka mu 100-200 mg ya madzi owiritsa firiji.

Mlingo ndi ndandanda ya kuvomerezedwa imatsimikiziridwa ndi adotolo, chifukwa pano zonse zimatengera zaka komanso momwe wodwalayo alili.

Ndi ululu waukulu, mutha kutenga 400-800 mg ya acetylsalicylic acid katatu patsiku (koma osapitirira 6 g patsiku). Monga othandizira antiplatelet, milingo yaying'ono imagwiritsidwa ntchito - 50, 100, 300 mg ya yogwira ntchito. Pa malungo, tikulimbikitsidwa kuti muthe kutenga 0,5-1 g wa acetylsalicylic acid patsiku (ngati kuli kotheka, mlingo utha kupitilizidwa mpaka 3 g). Kutalika kwa chithandizo sikuyenera kupitilira masiku 14.

Aspinat Cardio:

Mankhwalawa adapangira kuti azigwiritsidwa ntchito kwa nthawi yayitali. Kutalika kwa mankhwala kumatsimikiziridwa ndi adokotala.

  • Kupewa pakukayikira kumayambitsa kupweteka kwambiri ndi 100-200 mg / tsiku (piritsi loyambalo liyenera kutafunidwa).
  • Kupewera koyambirira kwa myocardial infaration pamaso pa zinthu zoopsa - 100 mg / tsiku.
  • Kupewa kwa kubwerezanso kwa myocardial infaration, angina osakhazikika, kupewa kugunda kwa mtima komanso kuchepa kwamitsempha yamagazi, kupewa masoka a thromboembolic pambuyo pa opaleshoni kapena maphunziro owonjezera - 100 mg / tsiku.
  • Kupewera kwa minyewa yayikulu ndi thromboembolism yam'mitsempha yamagazi ndi nthambi zake ndi 100-200 mg / tsiku.

Zotsatira zoyipa

  • Zotsatira zamagetsi: urticaria, edema ya Quincke.
  • Kuchokera ku chitetezo chathupi: anaphylactic reaction.
  • Kuchokera m'mimba thirakiti: nseru, kutentha pa chifuwa, kusanza, kupweteka pamimba, zilonda zam'mimba zam'mimba ndi duodenum, kuphatikiza magazi, magazi m'mimba, kuchuluka kwa michere ya chiwindi.
  • Kuchokera pakupuma dongosolo: bronchospasm.
  • Kuchokera ku hemopoietic dongosolo: magazi ochulukirapo, kuchepa magazi (kawirikawiri).
  • Kuchokera kumbali ya chapakati mantha dongosolo: chizungulire, tinnitus.

Bongo

Muyenera kusamala ndi kuledzera kwa okalamba makamaka ana aang'ono (mankhwala osokoneza bongo kapena kuledzera mwangozi, omwe amapezeka nthawi zambiri mwa ana aang'ono kwambiri), omwe angayambitse imfa.

Zizindikiro za kuchuluka kwa zolimbitsa kukula: nseru, kusanza, tinnitus, kumva, chizungulire, chisokonezo.

Chithandizo: kuchepetsa mlingo.

Zizindikiro Zosokoneza bongo Zambiri: fever, hyperventilation, ketoacidosis, kupuma alkalosis, chikomokere, mtima ndi kupuma kulephera, kwambiri hypoglycemia.

Chithandizo: Kugonekedwa kuchipatala mu dipatimenti yapadera yothandizidwa mwadzidzidzi - kupuma kwam'mimba, kutsimikiza kwa acid-base, alkaline ndi kukakamizidwa kwa zamchere, hemodialysis, makonzedwe a zothetsera, kukhazikitsidwa kwa kaboni yodziyimira, dalili.

Pochita alkaline diuresis, ndikofunikira kukwaniritsa mfundo za pH pakati pa 7.5 ndi 8. Kukakamizidwa kwa zamchere za diresis ziyenera kuchitidwa pamene kuchuluka kwa salicylates mu plasma kupitilira 500 mg / l (3.6 mmol / l) mwa akulu ndi 300 mg / l (2, 2 mmol / l) - mwa ana.

Kuyanjana kwa mankhwala osokoneza bongo

Ndi kugwiritsa ntchito nthawi yomweyo za ASA kumathandizira zochita za mankhwala otsatirawa:

  • methotrexate - chifukwa cha kuchepa kwa chilolezo cha impso komanso kuchoka kwake pakulankhulana ndi mapuloteni,
  • heparin ndi anticoagulants osalunjika - chifukwa cha kusokonezeka kwa mapulogalamu am'matumbo ndikuthamangitsidwa kwa anticoagulants osadziwika polumikizana ndi mapuloteni,
  • mankhwala a thrombolytic ndi antiplatelet (ticlopidine),
  • digoxin - chifukwa cha kuchepa kwa impso zake,
  • hypoglycemic othandizira (insulin ndi sulfonylurea zotumphukira) - chifukwa cha hypoglycemic katundu wa ASA palokha waukulu komanso kusamutsidwa kwa zotuluka sulfonylurea polumikizana ndi mapuloteni,
  • valproic acid - chifukwa chosamutsidwa kuchokera kumayankhulana ndi mapuloteni.

Mphamvu yowonjezera imawonedwa ndikumamwa ASA ndi mowa.

ASA imafooketsa mphamvu ya uricosuric mankhwala (benzbromarone) chifukwa cha mpikisano wa kuchepa kwa uric acid.

Mwa kukulitsa kuchotsa kwa ma salicylates, systemic corticosteroids imafooketsa mphamvu yawo.

Mimba komanso kuyamwa

Kugwiritsa ntchito milingo yayikulu ya ma salicylates m'nthawi yoyamba ya mimba kumalumikizidwa ndi kuchuluka kwa zolakwika za fetal (kugawanika kwa pakhungu, zolakwika zamtima).

Mu trimester yachiwiri yokhudzana ndi kubereka, ma salicylates amatha kuyikidwa pokhapokha ngati akuwonetsetsa kuti ali pachiwopsezo komanso kupindula.

Mu trimester yomaliza yamimba, ma salicylates omwe ali ndi mlingo waukulu (wopitilira 300 mg / tsiku) amalepheretsa kugwira ntchito, kutsekeka msanga kwa ductus arteriosus mu mwana wosabadwayo, kuchuluka kwa magazi m'mayi ndi mwana wosabadwayo, komanso kuyang'anira asanabadwe kungayambitse kukha magazi kwakanthawi, makamaka ana akhanda.

Kukhazikitsidwa kwa salicylates mu trimester yomaliza yam'mimba imatsutsana.

Ma salicylates ndi ma metabolites awo ochepa amapita mkaka wa m'mawere. Mwadzidzidzi kudya kwa salicylates pa mkaka wa m`mawere sikuyenda limodzi ndi zovuta mu zimachitika mwa mwana ndipo sikutanthauza kuti kuyamwa yoyamwitsa. Komabe, pogwiritsa ntchito mankhwalawa kwa nthawi yayitali kapena kupatsidwa mlingo waukulu, kuyamwitsa kuyenera kuyimitsidwa nthawi yomweyo.

Malangizo apadera

Aspen akuyenera kugwiritsidwa ntchito pokhapokha ngati dokotala wasankhidwa.

Mankhwalawa amatha kuthandizira kutaya magazi, komanso kuonjezera nthawi ya msambo. Acetylsalicylic acid imawonjezera mwayi wokhetsa magazi ngati atachitidwa opaleshoni.

Aspinate sagwiritsidwa ntchito ali mwana chifukwa cha chiwopsezo cha Reye syndrome.

Mphamvu pa kuyendetsa galimoto / njira sizimawonedwa.

Zizindikiro zogwiritsidwa ntchito

Aspen adayikiratu kuyimitsa febrile syndrome, yomwe imayendera ndi matenda ambiri opatsirana komanso otupa.

Pakadali pano, acetylsalicylic acid sagwiritsidwa ntchito pochiza pericarditisnyamakazi rheumatic chorea, rheumatism ndi Matupi opatsirana myocarditis.

Malangizo ogwiritsira ntchito Aspinat amalimbikitsa kupereka mankhwala kuti akwaniritse mphamvu ya antiplatelet (pa mlingo wa mpaka 300 mg patsiku) kwa odwala omwe ali ndi vuto losakhazikika la angina, matenda a mtima, kubwereza kwa myocardial infarction, ischemic stroke, ndi mavetera amtima oyenda, coronary balloon angioplasty.

Mankhwalawa amagwiritsidwa ntchito kuti athetse ululu wamavuto osiyanasiyana: lumbago, arthralgia, kupweteka kwa mutu (kuphatikizapo kupweteka kwa mutu wa migraine chifukwa cha chizindikiro chochokera), neuralgia, mano, algomenorrhea, chifuwa radicular syndrome, kupweteka kwa minofu.

Pa allergology ndi matenda immunology, Aspinat akulimbikitsidwa kuti agwiritsidwe ntchito kuwonjezera Mlingo kuti apitirize kupirira (kukana) kwa mankhwala omwe si a antiidal "Aspirin triad" ndi "Mpweya wa aspirin".

Zotsatira zoyipa

Kuchiza kumayambitsa nseru, kutsegula m'mimba, Reye matenda (kupangika mwachangu kwa kulephera kwa chiwindi, kuchepa kwamafuta kwa chiwindi ndi encephalopathy), kusowa chidwi cha chakudya, mayankho a matupi awo a bronchospasm, zotupa pakhungu ndi angioedema.

Acetylsalicylic acid imatha kupangitsa "asipirin triad" komanso "mphumu ya aspirin" chifukwa cha kupangika kwa limagwirira.

Kuchiza kwa nthawi yayitali kumayendetsedwa ndi mutu, kuwonongeka kwa m'maganizo, zotupa ndi zotupa zam'mimba zam'mimba, tinnitus, kusanza, chizungulire, nephrotic syndromepapillary necrosis, bronchospasm, kusokonezeka kwa malingaliro, chisangalalo, interstitial nephritis, hypercalcemia, prerenal azotemia, kutupa, kuchuluka kwa michere ya chiwindi, kuwonjezeka kwa matenda osalephera a mtima, matenda aseptic meningitis.

Aspinat, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Mapiritsi a Aspinat a solpleat amalimbikitsidwa kuti azisungunuka pang'ono m'madzi musanagwiritse ntchito: 2-3-8 pa tsiku 400-800 mg (koma osapitirira 6 magalamu).

Acetylsalicylic acid mu Mlingo wa 50-70-100-300-325 mg umagwiritsidwa ntchito kukwaniritsa antiplatelet kwenikweni, muyezo wa 325 mg - kukwaniritsa analgesic ndi anti-kutupa kwenikweni.

Mu rheumatism pachimake sankha 100 mg pa 1 kg pa tsiku kwa 5-6 waukulu.

Ndi kupweteka kwambiri komanso febrile syndromes Akuluakulu amayikidwa 0,5-1 magalamu patsiku (kwa 3 waukulu).

Kutalika kwa mankhwala a Aspinat sikuyenera kupitilira masiku 14.

Mphamvu za mitundu ya mankhwala yokwanira ayenera kusungunuka mu 100-200 ml ya madzi musanalowe, makamaka mukatha kudya.

Kutalika kwa mankhwalawa kumatha kusintha kwa mlingo umodzi mpaka miyezi ingapo.

Kwa odwala omwe adakumana ndi myocardial infarction, mankhwalawa amathandizidwa kuti apewe kupweteketsa kwapakati pa 40-325 mg wa patsiku (pafupifupi Mlingo wa 160 mg).

Kupititsa patsogolo machitidwe okongola a magazi zimatheka pogwiritsa ntchito 0,15-0.25 magalamu a acetylsalicylic acid patsiku (mankhwalawa adapangidwa kwa miyezi ingapo).

Pa mlingo wa 300-325 mg patsiku, mankhwalawa amalepheretsa kuphatikiza kwa maselo a m'magazi.

Atthromboembolism chiyambi cha matenda a chithokomiro, okhala ndi ngozi zoopsa zamisempha kwa amuna, 325 mg patsiku zimayikidwa (kuchuluka kwa mankhwalawa kumawonjezeka mpaka gramu imodzi patsiku).

Kupewanso kuyambiranso kumachitika mwa kutenga 125-300 mg patsiku.

Pofuna kupewa kukonzekera kwa msempha wa msempha ndi thrombosis, tikulimbikitsidwa kuti mankhwalawa athandizidwe kudzera mu chubu chapamimba chokhazikitsidwa ndi mankhwala a 325 mg maola 7 aliwonse. Kuphatikiza apo, pakamwa pa acetylsalicylic acid katatu patsiku a 325 mg tikulimbikitsidwa (nthawi zambiri, dipyridamole imawonjezeredwa sabata limodzi.

Kuchita

Aspinate kumawonjezera kawopsedwe wa heparin, sulfonamides, hypoglycemic othandizira, narcotic analgesics, yotsalira, Co-trimoxazole, anticoagulants, methotrexate, plelet aggregation inhibitors, thrombolytics.

Mankhwala amatha kuchepetsa mphamvu ya mankhwala okodzetsa (mangochinos, Veroshpiron), antihypertensive mankhwala.

Kuopsa kwa magazi m'mimba kumachulukirachulukira mukamamwa mankhwala okhala ndi ethanol, glucocorticosteroids.

Hematotoxicity ya Aspen imachuluka ndi mankhwala a myelotoxic.

Mankhwala a Antacid kukulitsa mayamwidwe acetylsalicylic acid.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mapiritsi osungunuka: mkati, omwe adasungunuka pang'ono m'madzi pang'ono, 400-800 mg katatu patsiku (osaposa 6 g). Mu rheumatism pachimake - 100 mg / kg / tsiku mu 5-6 waukulu.

Mapiritsi okhala ndi ASA mu Mlingo pamwambapa 325 mg (400-500 mg) adapangidwa kuti agwiritsidwe ntchito ngati mankhwala a analgesic komanso odana ndi kutupa, mu Mlingo wa 50-75-100-300-325 mg mu akulu, makamaka ngati mankhwala a antiplatelet.

Mkati, wokhala ndi febrile ndi ululu matenda, achikulire - 0,5-1 g / tsiku (mpaka 3 g), logawidwa 3 waukulu. Kutalika kwa chithandizo sikuyenera kupitilira masabata awiri.

Mapiritsi a Mphamvuolositi amasungunuka mu 100-200 ml ya madzi ndikuwamwa pakumwa, pakumwa kamodzi - 0,25-1 g, kumwa katatu patsiku. Kutalika kwa mankhwalawa - kuchokera pa mlingo umodzi kupita kumaphunziro a miyezi yambiri.

Kusintha rheological katundu wamagazi - 0,15-0.25 g / tsiku kwa miyezi ingapo.

Ndi kulowetsedwa kwa myocardial, komanso kupewa kwachiwiri kwa odwala pambuyo poyambira, 40-325 mg kamodzi patsiku (nthawi zambiri 160 mg). Monga zoletsa za kuphatikiza kwa maselo am'magazi - 300-325 mg / tsiku kwa nthawi yayitali. Ndi kusokonezeka kwa mphamvu ya cerebrovascular in men, ubongo wa thromboembolism - 325 mg / tsiku ndi kuwonjezeka pang'onopang'ono mpaka 1 1 / tsiku, kupewa kupewa kuyambiranso - 125-300 mg / tsiku. Pofuna kupewa thrombosis kapena kung'ambika kwa msempha wamatumbo, 325 mg maola 7 aliwonse kudzera mu chubu cham'mimba, ndiye kuti 325 mg pamlomo katatu katatu patsiku (nthawi zambiri umagwirizana ndi dipyridamole, womwe umathetsedwa pakatha sabata, ukupitilira chithandizo chanthawi yayitali ndi ASA.

Ndi rheumatism yogwira imalembedwa (pakadali pano yopanda mankhwala) tsiku lililonse la 5-8 g kwa achikulire ndi 100-125 mg / kg kwa achinyamata (zaka 15-18), pafupipafupi kugwiritsa ntchito 4-5 pa tsiku. Pambuyo pa chithandizo cha milungu iwiri kapena itatu, ana amachepetsa mlingo mpaka 60-70 mg / kg / tsiku, chithandizo chachikulire chimapitilizidwa ndi mlingo womwewo, nthawi yayitali imakhala mpaka masabata 6. Kuletsa kumachitika pang'onopang'ono mkati mwa masabata 1-2.

Kusiya Ndemanga Yanu