Mankhwala Acekardol 100: malangizo ntchito

Zomwe zimagwira acetylsalicylic acid. Maziko a machitidwe a kuchitapo kanthu ndikuthekera kwa choletsa cycloo oxygenase ndi chigawo chogwira ntchito, chomwe chimayambitsa zoletsa za thromboxane A2 komanso kuchepa kwa kuphatikiza kwa mapulateleti. Mphamvu ya antiplatelet yomwe imatheka pakumwa piritsi limodzi imatha sabata limodzi.

Mlingo waukulu wa mankhwalawa ukhoza kukhala ndi zotsatira za analgesic ndi antipyretic (zoposa 300 mg). Mankhwalawa amalowetsedwa m'matumbo am'mimba ndipo amangopangika pang'ono pang'onopang'ono pakamwa.

Zisonyezero zakugwiritsa ntchito Acecardol

Kodi mapiritsiwa ndi otani?

Acecardol amalembera angina osakhazikika, kuti apewe kubwerezabwereza kwa myocardial infarction, kupewa pulmonary embolism (kuphatikiza nthambi zake) ndi mitsempha yakuya (ndikukhala nthawi yayitali m'malo opumira, mwachitsanzo, pakuchita opaleshoni kwanthawi yayitali).

Mankhwala amapatsidwa odwala omwe ali pachiwopsezo (kuchuluka kwa thupi, mafuta ambiri, matenda ashuga, kusuta, zaka, matenda oopsa) kuletsa kupweteka kwapachirichonse.

Malangizo ogwiritsira ntchito Acecardol amalimbikitsa chithandizo kwa odwala atatha kulowererapo mosavomerezeka ndi mtima. carotid angioplasty, endarterectomy of the carotid artery, corteryary artery bypass grafting, arteriovenous shunting) kupewa thromboembolism.

Mankhwalawa amaperekedwa kwa odwala omwe amakhala ndi kusokonezeka kwakanthawi kotenga magazi kupita ku ubongo kuti ateteze ischemic stroke.

Contraindication

Mankhwalawa sanalembedwe kwa odwala omwe ali ndi vuto lokhala ndi zilonda zam'mimba, hemorrhagic diathesismagazi ochokera m'mimba, duodenum. Mankhwalawa sanatchulidwe mphumu ya bronchial yomwe imayamba chifukwa cha kutenga salicylates.

Mankhwala contraindicated mu chiwindi matenda, ndi kulephera kwa mtima, ndi matenda a aimpso, poyamwitsa.

Chithandizo cha munthawi yomweyo ndi methotrexate mu Mlingo woposa 15 mg pa sabata sizovomerezeka.

Kugwiritsa ntchito Acecardol kumakhala kochepa kwa odwala omwe ali ndi hyperuricemia, gout, mankhwala osokoneza bongo, hay fever, polyposis.

Acetylsalicylic acid imatha kuyambitsa magazi pakhungu.

Zotsatira zoyipa

Matumbo: kuchuluka kwa ALT ndi michere ya AST, kusanza, kutentha kwa mtima, nseru, zotupa zam'mimba, komanso magazi.

Hematopoietic dongosolo: kuchepa magazichiopsezo chakutuluka kwa magazi chifukwa cha chopinga cha kuphatikizika kwa maplatelet.

Mayankho oyipa mu mawonekedwe a mtima matenda, kutupa kwa mucous mphuno, mucinitis, urticaria, edi ya Quincke, kuyabwa ndi zotupa. A kwambiri thupi lawo siligwirizana mtundu samayamba. anaphylaxis.

Machitidwe opatsirana: kuphipha kwa bronchi yaying'ono ndi sing'anga caliber.

Machitidwe amanjenje: kuzindikira kwamitsempha, tinnitus, mutu, chizungulire.

Kupanga ndi mawonekedwe a kumasulidwa

Acecardol imapezeka m'mapiritsi, omwe amaphatikizidwa ndi enteric zokutira, pa 50, 100 ndi 300 mg. Mapiritsi a mankhwalawa ndi biconvex ndi ozungulira, oyera (mwina pafupifupi oyera). Amagulitsidwa mumatumba okhala ndi zidutswa 10. Paketi imodzi yamakatoni mumakhala mapaketi atatu.

Chofunikira chachikulu mu Acecardol ndi acetylsalicylic acid.
Acecardol excipients ndi awa: ochepa molekyulu povidone, chimanga wowuma, lactose monohydrate, magnesium stearate.

Gulu la zamankhwala ndi mankhwala: NSAIDs. Antiplatelet wothandizira.

Mankhwala

Chomwe chimagwira ndi acetylsalicylic acid. Maziko a machitidwe a kuchitapo kanthu ndikuthekera kwa choletsa cycloo oxygenase ndi chigawo chogwira ntchito, chomwe chimayambitsa zoletsa za thromboxane A2 komanso kuchepa kwa kuphatikiza kwa mapulateleti. Mphamvu ya antiplatelet yomwe imatheka pakumwa piritsi limodzi imatha sabata limodzi.

Malangizo ogwiritsira ntchito

Malinga ndi malangizo ogwiritsira ntchito, Acecardol amatengedwa pakamwa asanadye, ndi madzi ambiri. Mankhwalawa adapangira kuti azigwiritsidwa ntchito kwa nthawi yayitali.

Kupewa kwa kulowetsedwa pachimake kwa myocardial infarction: 100 mg / tsiku tsiku lililonse kapena 300 mg tsiku lililonse lililonse (piritsi loyambalo liyenera kutafunidwa).
Kupewera koyamba kwa pachimake kulowetsedwa kwamatumbo poyambitsa mavuto: 100 mg / tsiku tsiku lililonse kapena 300 mg tsiku lililonse lililonse.
Kupewa kwa thromboembolism pambuyo pakuchita opaleshoni ndikulowerera kwa mitsempha yolowerera: 100-300 mg / tsiku tsiku lililonse.
Kupewa kwa ischemic sitiroko ndi kanthawi pang'ono pangozi yamitsempha: 100-300 mg / tsiku tsiku lililonse.
Kupewa kwa minyewa yayikulu ya thrinosis ndi thromboembolism yam'mitsempha yamagazi ndi nthambi zake: 100 mg / tsiku kapena 300 mg tsiku lililonse lililonse.
Kupewa kubwerezanso kwa myocardial infarction ndi angina osakhazikika: 100-300 mg / tsiku tsiku lililonse.

Munthawi yamankhwala ndikukonzekera malinga ndi acetylsalicylic acid, kuyezetsa magazi kuyenera kutengedwa nthawi zonse, chifukwa mankhwalawa amathandizira kuti ziwonjezeke. Pogwiritsa ntchito acecardol kwa nthawi yayitali komanso mosasamala, chiopsezo chotulutsa magazi mkati nchachikulu.

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	Pafupifupi kupezeka kwa mphutsi akuti KUDULA mkamwa! Kamodzi patsiku, kumwa madzi ndi dontho .. Zotsatira zoyipa Malinga ndi ndemanga, Acecardol ndi analogi yake ikhoza kuyambitsa zotsatirazi: Hematopoietic dongosolo: kuchepa magazi, kuchuluka kwa magazi, Dongosolo lothandizira: bronchospasm, Ziwengo: urticaria, zotupa pakhungu, kuyabwa, kupweteka kwa Quincke, mtima matenda, kutupa kwa mucosa wamkamwa, anaphylactic mantha, Pakati wamanjenje: kuchepa kwa makutu, tinnitus, chizungulire, kupweteka kwam'mimba dongosolo: kupweteka kwam'mimba, kutentha kwa mtima, nseru, kusanza, kupweteka kwam'mimba ndi zilonda zam'mimba, kuchuluka kwa michere ya chiwindi. Mankhwala osokoneza bongo ndiwokayikitsa, popeza chinthu chogwira, acetylsalicylic acid, chimapezeka pang'ono. Mlingo waukulu wa ASA ungayambitse magazi m'matumbo. Mimba komanso kuyamwa Mimba ndi mkaka wa m`mawere ndi njira zazikulu zotsutsana ndi kugwiritsa ntchito mankhwala Acekardol. Wothandizira antiplatelet ndi woletsedwa kotheratu mu 1 ndi 3 trimester ya mimba, yachiwiri trimester iyenera kumwedwa mosamala komanso okhawo omwe adalangizidwa ndi dokotala. Kuvomerezeka mu 2nd trimester ndikofunikira pokhapokha ngati chithandizo cha chithandizo cha mayi chimaposa chiwopsezo kwa mwana wosabadwayo. Analogs a Acecardol Zofanana muzochitika zamagulu: Anopyrine, ASANI-Cardio, Aspicore Aspinat Aspirin York Aspirin Aspirin 1000 Aspirin Cardio, Aspirin Express, Acenterin, Acetylsalicylic acid Acylpyrine, Atsbirin, Bufferin CardiASK, Cardiomagnyl Colpharite Mikristin Plidol 100, Plidol 300, Polokard, Taspir Thrombo ACC, Msungwana 100, Thrombopol Walsh Asalgin, Upsarin UPSA, HSN Payne. Chidwi: kugwiritsa ntchito ma fanizo kuyenera kuvomerezana ndi adokotala. Mtengo wapakati wa ATSECARDOL, mapiritsi mumafakisi (Moscow) ndi ma ruble 25. Kutulutsa mawonekedwe ndi kapangidwe kake Acecardol imapangidwa ngati mapiritsi ozungulira biconvex, wokutira ndi chipolopolo choyera. Piritsi limodzi lili: Zothandiza: Acetylsalicylic acid (ASA) - 50, 100 kapena 300 mg, Zothandiza: lactose, titanium dioxide, magnesium stearate, mafuta a castor, microcrystalline cellulose, povidone, chimanga wowuma. Zotsatira zoyipa Malangizowa amachenjeza za mwayi wokhala ndi zotsatirapo zoyipa mukamapereka Acekardol: Pa gawo la kupuma: bronchospasm, Kuchokera kumbali yamanjenje apakati: tinnitus, kumva, chizungulire, kupweteka kwa mutu, Kuchokera ku hemopoietic system: kuchepa magazi, mwayi wowonjezera magazi, Kuchokera mmimba thirakiti: kutentha kwa mtima, kusanza, nseru, duodenal ulcer, mucosa, magazi am'mimba, kuphwanya chiwindi ntchito. Thupi lawo siligwirizana: kuyabwa pakhungu, zidzolo, uritisaria, rhinitis, edema ya Quincke, kuwopsa kwa anaphylactic. Contraindication Acekardol amatsutsana pamilandu yotsatirayi: kulephera kwa mtima kwambiri aimpso ndi kwa chiwindi kulephera, kuchuluka kwa zotupa ndi zilonda zam'mimbamo zam'mimba, hemorrhagic diathesis, m'mimba, Hypersensitivity ku acetylsalicylic acid, Mphumu ya bronchial, kufupika kwa lactase, shuga, galactose malabsorption, tsankho lactose, kumwa methotrexate muyezo wa 15 mg wa kapena kuposerapo, panthawi yoyembekezera komanso mkaka wa m`mawere, osakwana zaka 18. Gawani mosamala mukakhala: matenda a impso ndi chiwindi. Hyperuricemia, gout, mbiri ya zilonda zam'mimba ndi zilonda zam'mimba, Matenda opumira kwambiri, chifuwa cham'mphuno, hay fever, chifuwa kuchiza anticoagulant mankhwala, kumwa methotrexate mu Mlingo wochepera wofika 15 mg, wachiwiri trimester wa mimba komanso isanachitike opaleshoni amafuna (kuphatikizapo ang'onoang'ono). Bongo Zizindikiro zopitirira muyeso zimaphatikizira chizungulire, mseru, mutu, chisokonezo, tinnitus, thukuta kwambiri, tachypnea, ndi Hyperventilation. Kutonthoza kwam'mimba kolimbikitsidwa, kugwiritsa ntchito kaboni yokhazikitsidwa ndikubwezeretsanso bwino kwa-electrolyte ya madzi. Ndi mankhwala osokoneza bongo kwambiri, kotheka - kutentha kwambiri kwa thupi, kupuma kwamatenda, mtima dongosolo, mantha amthupi, kagayidwe kazigazi, kutulutsa magazi m'mimba ndi matumbo. Pankhaniyi, kuthandizidwa kuchipatala mwachangu ndi chithandizo chadzidzidzi ndikofunikira, kuphatikiza kutsuka kwa m'mimba, kugwiritsa ntchito kaboni yokhazikika, hemodialysis, kukakamizidwa kwa alkaline diresis, kubwezeretsanso acid-base boma komanso madzi osankhidwa ndi electrolyte, komanso kukhazikitsidwa kwa chithandizo chamankhwala chothandizira kuthetsa zomwe zakonzedwa kuphwanya malamulo. Malangizo apadera Acekardol imatha kupangitsa bronchospasm ndi mphumu. Zowopsa: Mbiri ya polyposis ya mphuno, hay fever, ziwengo zamankhwala, mphumu ya bronchial. Mphamvu yolepheretsa kuphatikizira kwa kupatsidwa zinthu za m'magazi imapitirira kwa masiku angapo, zomwe zimatha kuyambitsa magazi pakachitika chithandizo chamankhwala. Musanagwire ntchito yake, mankhwalawo amathetsedwa pasanathe masiku 7. Odwala omwe ali pachiwopsezo, Acecardol mu Mlingo wocheperako amatha kuyambitsa gout. Pangozi ndi omwe amachepetsa uric acid excretion. Ndi kuwonjezeka kwa mlingo wa mankhwalawa, chiopsezo chotaya magazi m'magazi am'mimba chimachulukirachulukira. Sizikhudza kuthekera kuyendetsa. Pochiza glucocorticosteroids, ziyenera kukumbukiridwa kuti chifukwa cha kulephera kwawo, mankhwala osokoneza bongo ochulukirapo ndi otheka. Kuchita Kudya kwa Acecardol kumathandizira poizoni wa methotrexate, kuchepetsa kupezeka kwake kwa impso, valproic acid. Imawonjezera zotsatira za ma NSAID ena, ma analcics a narcotic, mankhwala a hypoglycemic, heparin, anticoagulants, thrombolytics ndi antiplatelet agents, sulfonamides (kuphatikizapo co-trimoxazole), T3. Imachepetsa mphamvu ya uricosuric mankhwala (benzbromarone, sulfinpyrazone), antihypertensive mankhwala, diuretics (spironolactone, furosemide). GCS, ethanol ndi mankhwala okhala ndi ethanol amathandizira kuti awonongeke m'matumbo am'mimba, achulukitse magazi. Kuchulukitsa kuchuluka kwa digoxin, barbiturates, ndi Li + salt mu plasma. Ma antacid okhala ndi Mg2 + ndi / kapena Al3 + amachepetsa ndikuletsa mayendedwe a ASA. Mankhwala a Myelotoxic amathandizira kuwonetsa kwa hematotoxicity ya mankhwalawa. Acecardol, malangizo ogwiritsira ntchito (Njira ndi Mlingo) Mankhwala tikulimbikitsidwa kumwa pamaso chakudya. Ndikofunika kumwa mapiritsi okhala ndi madzi okwanira. Mankhwala amapatsidwa mankhwala kwa nthawi yayitali. Kuchulukitsa kuvomerezeka - 1 nthawi patsiku. Ngati pachimake myocardial infarction amamuganizira kupewa sankha 100 mg tsiku lililonse kapena 300 mg tsiku lililonse. Kutafuna mapiritsi kumathandizira, komwe kumakhala kofunikira kwambiri m'maola oyamba a myocardial infarction. Ngati pali zovuta zingapo nthawi imodzi, 300 mg tsiku lililonse, kapena 100 mg tsiku lililonse, amatchulidwa kupewa matenda oopsa a myocardial infarction. Kupewa kosakhazikika kwa angina pectoris, kugunda kwamtima kosalekeza, kupewa matenda osakhazikika a mtima. ischemic stroke: 100-300 mg tsiku lililonse. Pofuna kupewa pulmonary embolism, mitsempha yayikulu ikani 300 mg tsiku lililonse, kapena 100 mg tsiku lililonse. Bongo Zizindikiro zofowoka monga chizungulire, mseru, mutu, chisokonezo, tinnitus, thukuta kwambiri, tachypnea, ndi Hyperventilation ndizotheka. Pankhaniyi, mankhwalawa aphatikizira zakumwa zam'mimba, kumwa kwambiri kwa mpweya woyambitsa, ndikubwezeretsa bwino kwa-electrolyte usawa. Ndi zovuta kwambiri mankhwala osokoneza bongo, zotheka: kutentha kwambiri, kupuma, kayendedwe ka mtima, mantha amthupi, kagayidwe kazigazi, kutaya magazi m'mimba ndi matumbo. Ndipo panthawiyi nkofunika kuchipatala mwachangu ndikofunikira. Pharmacokinetics Pambuyo pakukonzekera pakamwa, ASA imatengedwa mwachangu komanso kwathunthu kuchokera kumimba, pomwe imapukusidwa pang'ono. Momwe mayamwidwe ndikumayamwa, ASA imasandulika kukhala metabolite yayikulu - salicylic acid, yomwe imapangidwa makamaka mu chiwindi (motsogozedwa ndi michere) kupanga metabolites monga salicylic acid, salicylic acid glucuronide ndi phenyl salicylate. Amapezeka m'misempha yambiri komanso mkodzo. Mwa akazi, njira ya metabolic imachedwa pang'ono kuposa amuna. Mutatenga Acecardol mkatikati, kuchuluka kwa ASA m'madzi a m'magazi kumawonedwa pambuyo pa mphindi 10 - 20, salicylic acid - pambuyo pa maola 0.3-2. Mapiritsi a Acecardol amakhala ndi zokutira zomwe zimalepheretsa asidi, zomwe zimalepheretsa mankhwalawa kusungunuka m'mimba, kotero chinthu chogwira ntchito chimamasulidwa m'malo a alkaline a duodenum. Pankhaniyi, kuyamwa kwa ASA ndi maola 3-6 pang'onopang'ono kuposa pamene mumatenga mapiritsi ochiritsira (osakutidwa ndi chipolopolo chotere). Acetylsalicylic ndi salicylic acid amamangidwa kumapuloteni a plasma (kutengera mlingo, chizindikiro ichi ndi 66-98%) ndipo amagawidwa mwachangu mthupi. Salicylic acid imadutsa placenta ndikulowetsa mkaka wa m'mawere. Kagayidwe ka salicylic acid amachepetsa mphamvu ya enzymatic dongosolo, chifukwa chake, kupukusa kwake kumadalira mlingo.Hafu ya moyo imatenga maola awiri kapena atatu (pakakhala Mlingo wotsika) mpaka maola 15 (mukamagwiritsa ntchito Mlingo wambiri monga antipyretic ndi analgesic). Pogwiritsa ntchito nthawi yayitali, ASA yopanda hydrolyzed siziunjikira mu seramu yamagazi, mosiyana ndi ma salicylates ena. Salicylic acid ndi ma metabolites ake amuchotsa impso. Ndi matenda abwinobwino a impso, kuchokera pa 80 mpaka 100% ya muyezo umodzi wa ASA umachotsedwa mkati mwa maola 24-72. Mlingo ndi makonzedwe Mapiritsi a Acecardol amatengedwa pakamwa musanadye, otsukidwa ndi madzi. Mankhwalawa adapangira kuti azigwiritsidwa ntchito kwa nthawi yayitali. Ngati myocardial infarction ikukayikira, Acecardol amatengedwa 100 mg kamodzi patsiku kapena 300 mg tsiku lililonse lililonse. Pazithandizo zoyenera, piritsi loyamba limatha kutafuna. Pofuna kupewa kubwereza kwaposachedwa kwamkati, kutsekeka kwa chotupa ndi mapapo ake okhala ndi magazi, kutsika kwamitsempha komanso ngati angina osakhazikika, Acecardol amatengedwa 100-300 mg patsiku. Pofuna kupewa thromboembolism pambuyo pazowukira ndi zowonjezera zina, mulingo wa Acecardol ndi 100-300 mg tsiku lililonse. Mimba komanso kuyamwa Mu trimester yoyamba ya mimba, salicylates waukulu Mlingo kumaonjezera ngozi ya mapangidwe mwana wosabadwayo (kugawanika palate, vuto la mtima), chifukwa chake Acecardol ndi contraindicated kuti ntchito. Munthawi yachiwiri ya mimba, mankhwalawa amatha kuikidwa pokhapokha ngati phindu lomwe likuyembekezeredwa limakhala lalikulu kuposa zoopsa zomwe zingachitike. Nthawi yomweyo, tikulimbikitsidwa kugwiritsa ntchito Acecardol mu Mlingo wosaposa 150 mg kwa maphunziro apafupi kwambiri. Mu gawo lachitatu lokhala ndi pakati, ma salicylates omwe ali ndi Mlingo waukulu (woposa 300 mg / tsiku) amachepetsa mphamvu ya ntchito, amachititsa magazi ochuluka mwa mayi ndi mwana wosabadwa, komanso kutsekedwa msanga kwa ductus arteriosus mwana wosabadwayo. Kutenga ASA musanabadwe kumatha kubweretsa kutaya kwa magazi mkati, makamaka ana akhanda. Pankhaniyi, mu trimester yomaliza ya mimba, Acecardol imatsimikiziridwa kuti imagwiritsidwa ntchito. Ma salicylates ndi metabolites awo amalowera mkaka wa m'mawere, chifukwa chake Acecardol imaphatikizidwa mwa amayi omwe akuyamwitsa. Ngati kumwa mankhwalawo kuli koyenera, muyenera kusiya kuyamwitsa. Kuyanjana kwa mankhwala osokoneza bongo Pankhani yogwiritsidwa ntchito munthawi yomweyo, acetylsalicylic acid imafooketsa zotsatira za mankhwala otsatirawa: diuretics, angiotensin-akatembenuka enzyme inhibitors (ACE), mankhwala a uricosuric (benzbromarone). Pankhani yogwiritsidwa ntchito munthawi yomweyo, acetylsalicylic acid imakulitsa zochita za mankhwala otsatirawa: antiplatelet agents ndi mankhwala a thrombolytic, digoxin, heparin ndi anticoagulants osagwirizana, methotrexate, valproic acid, mankhwala a hypoglycemic (insulin ndi sulfonylurea zotumphukira). Komanso, kuphatikiza kwa ASA ndi methotrexate kumalumikizidwa ndi chiopsezo chowonjezereka chochokera ku ziwalo za hemopoietic, ndi thrombolytics, antiplatelet agents ndi anticoagulants - chiopsezo chowonjezeka magazi. ASA imawonjezera poizoni wama ethanol pa chapakati mantha dongosolo. Izi zimawonjezera mwayi wa kuwonongeka kwa mucous nembanemba am'mimba ndipo nthawi yayitali magazi. Systemic glucocorticosteroids imathandizira kuthetsedwa kwa mankhwalawa, kuposa kufooketsa mphamvu yake. Maumbidwe aphatikizidwe a Acecardol ndi kukonzekera kwa Terombo ACC, Aspirin, Cardiopyrine, Aspinate, Aspicor, Taspir, Thrombopol, Acetylsalicylic acid. Ndemanga pa Acecardol Malinga ndi ndemanga, Acekardol ndi othandizira antiplatelet omwe amasokoneza magazi ndikuletsa thrombosis. Ubwino wowonjezerapo umaphatikizapo mtengo wotsika (poyerekeza ndi ma analogues ambiri), kuyendetsa bwino ntchito (nthawi 1 patsiku), mawonekedwe a mankhwala (enteric enting) amateteza m'mimba ku zotsatira zoyipa za acetylsalicylic acid), komanso kupezeka kwa mitundu yosiyanasiyana ya mapiritsi (50, 100 ndi 300 mg), yomwe imakulolani kusankha bwino kwambiri. Zoyipa za Acecardol zimaphatikizapo kukhalapo kwa contraindication. Komabe, zilipo kwa masalicylates onse, chifukwa chake adotolo amayenera kupereka chithandizo. Akulimbikitsidwa Ma cookie a peanut - mankhwala othandizira tiyi ndi zina zambiri Cholowa chosasinthidwa Cholesterol mayamwidwe zoletsa: kodi mankhwala amagwira ntchito bwanji? Kusiya Ndemanga Yanu Popular Nkhani Insulin Resistance ndi HOMA-IR Index Matenda a shuga Kodi ndingathe kudya mapeyala omwe ali ndi matenda ashuga a 2? Zakudya za shuga Momwe mungagwiritsire ntchito mankhwala Katena? Chithandizo ndi kupewa Posts Popular Zakudya za shuga Mitundu yachiwiri ya matenda ashuga: glycemic index yamalonda Zakudya za shuga 2018 Mndandanda wathunthu wa mndandanda wazinthu za glycemic Kuti athandize odwala matenda ashuga, gome lokhala ndi mndandanda wama glycemic lidapangidwa. Ndi chithandizo chake, mutha kupeza zogulitsa mwachangu kapena kusankha zomwe zingakonzereni mbale. ... 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