Pentilin wa mankhwala: malangizo ogwiritsira ntchito

Mkati, pakudya kapena mutatha kudya, kumeza thupi lonse, 400 mg 2-3 kawiri pa tsiku, chifukwa chake - masabata osachepera 8.

Mu / mkati kapena / jakisoni: 50-100 mg / tsiku (mu saline) kwa mphindi 5. Mu / mkati kapena / kulowetsedwa: 100-400 mg / tsiku (mu saline yokhudza thupi), nthawi ya kulowetsedwa kwa kulowetsedwa - mphindi 90-180, mu / a - mphindi 10-30, mlingo waukulu wa tsiku ndi tsiku wa 800 ndi 1200 mg, motsatana. Kupitilira kosalekeza - 0,6 mg / kg / h kwa maola 24, mlingo waukulu wa tsiku ndi tsiku wa 1200 mg.

Ndi Cl creatinine ochepera 10 ml / min, mlingo umachepetsedwa ndi 50-70%. Kwa odwala hemodialysis, mankhwalawa amayamba ndi mlingo wa 400 mg / tsiku, womwe umawonjezereka mwachizolowezi ndi masiku osachepera anayi.

Kutulutsa mawonekedwe ndi kapangidwe kake

• Njira yothetsera kukhazikitsa ma intravenous ndi ma intra-arterial: yowoneka bwino, yopanda utoto kapena yowonekera pang'ono (5 ml mu ampoules, 5 ampoules mu chithuza kapena thireyi yapulasitiki, 1 chithuza kapena thireyi pamatayala a makatoni),
• mapiritsi a nthawi yayitali, ophatikizidwa ndi filimu: chowulungika, biconvex, zoyera (ma PC 10.

The kapangidwe kokwanira 1 ka Pentilin njira (5 ml):

• yogwira mankhwala: pentoxifylline - 100 mg,
• zina zowonjezera: sodium hydrogen phosphate dihydrate, sodium dihydrogen phosphate dihydrate, sodium chloride, disodium edetate, madzi a jekeseni.

Piritsi limodzi la Pentilin 1:

• yogwira pophika: pentoxifylline - 400 mg,
• Zowonjezera zina: magnesium stearate, hypromellose, macrogol 6000, silicon dioxide anhydrous colloidal,
• chipolopolo: hypromellose, macrogol 6000, talc, titanium dioxide E171.

Mankhwala

Pentoxifylline - chinthu chogwira ntchito cha Pentilin - antispasmodic kuchokera pagulu la purine lomwe limasintha zinthu zam'magazi (fluidity) komanso magazi m'magazi. Mphamvu yogwiritsira ntchito mankhwalawa imatheka chifukwa cha mphamvu yake yolepheretsa phosphodiesterase ndikuwonjezera kuchuluka kwa ma cyclic AMP m'mapulateleti ndi ATP m'magazi ofiira am'magazi, pomwe kukhathamira kwa mphamvu yamphamvu, chifukwa chomwe vasodilation imayamba, kupindika kwamitsempha yonse kumachepa, kugunda kwam'magazi ndi kuchuluka kwa magazi kumawonjezeka, pomwe kugunda kwa mtima sikokwanira kwambiri zikusintha.

Pentoxifylline imabweza m'mitsempha yama coronary, yomwe imakulitsa kuperekera kwa okosijeni kupita ku myocardium (antianginal athari), ndi mitsempha yamagazi yamapapu, yomwe imapangitsa magazi kuchepa kwa magazi.

Mankhwala amalimbikitsa kamvekedwe ka minofu ya kupuma, makamaka kupindika ndi minyewa yam'kati.

Amasintha magazi m'magazi osokoneza bongo, kumawonjezera kusokonekera kwa nembanemba ya erythrocyte, kumachepetsa kukhuthala kwa magazi.

Ndi zotupa zokhudzana ndi ma cell a zotumphukira (zotumphukira), Pentilin amatalikitsa mtunda woyenda, amachepetsa usiku kukokana kwa minofu ya ng'ombe ndi kupweteka popuma.

Pharmacokinetics

Pentoxifylline imapangidwa kwambiri m'maselo ofiira a m'magazi komanso chiwindi. Pambuyo pakukonzekera pakamwa, imatha kutengeka kwathunthu kuchokera kumimba. Mitundu yotalikirapo ya mapiritsi imapereka kutulutsidwa mosalekeza kwa gawo logwiritsira ntchito mankhwalawo ndi kuyamwa kwake.

Pentoxifylline imadutsa gawo loyambirira kudzera mu chiwindi, zomwe zimapangitsa kuti pakhale ma metabolite awiri omwe amapanga kwambiri: 1-3-carboxypropyl-3,7-dimethylxanthine (metabolite V) ndi 1-5-hydroxyhexyl-3,7-dimethylxanthine (metabolite I), plasma kuchuluka kwa omwe 8 ndi 5 nthawi kuposa pentoxifylline, motero.

Pentoxifylline ndi ma metabolites ake samamangidwa ndi mapuloteni a plasma.

Mankhwala osakhalitsa mawonekedwe amafika pazambiri zake mkati mwa maola 2-5. Imagawidwa chimodzimodzi. Kutha kwa theka-moyo ndi maola 0,5-1,5.

Hafu ya moyo wa pentoxifylline pambuyo pa mtsempha wa mtsempha wa 100 mg pafupifupi maola pafupifupi 1.1. Ili ndi gawo lalikulu logawa (pambuyo pa kulowetsedwa kwa mphindi 30 kwa 200 mg - 168 L), komanso chilolezo chachikulu (4500-5100 ml / min).

94% ya mlingo wolandilidwa ndi impso mu mawonekedwe a metabolites (makamaka metabolite V), pafupifupi 4% - ndi matumbo. Pankhaniyi, mpaka 90% ya mankhwalawa amachotsedwa mu maola 4 oyamba. Kutupa kwa metabolites kumachepetsa odwala omwe ali ndi vuto laimpso. Ngati chiwindi chalephera kugwira ntchito, theka la moyo wa pentoxifylline limakulitsidwa ndipo mapangidwe ake a bioavailability akuwonjezeka.

Pentoxifylline amachotseredwa mkaka wa m'mawere.

Zizindikiro zogwiritsidwa ntchito

• kumva kuwonongeka kwa mtima,
• aakulu, subacute komanso pachimake kulephera mu retina ndi choroid,
• ngozi yamitsempha yamphamvu ya ischemic,
• kusokoneza endarteritis,
• kufalikira kwa zotumphukira chifukwa cha atherosulinosis, matenda a shuga (diabetesic angiopathy),
• angiopathy (paresthesia, matenda a Raynaud),
• zotupa za trophic chifukwa cha kufooka kwa venous kapena ochepa cellcirculation (frostbite, post-thrombophlebitis syndrome, trophic zilonda, gangrene),
• discirculatory ndi atherosulinotic encephalopathies.

Contraindication

• matenda am'matumbo,
• zotupa m'mimba,
• magazi akulu
• pachimake hemorrhagic sitiroko,
• kwambiri arrhythmias,
• kusakhazikika kwakanthawi kochepa,
• pachimake myocardial infaration,
• zilonda zam'mimba kwambiri zam'mimba kapena mitsempha ya m'mimba,
• porphyria
• Mimba, kuyamwa,
• wazaka 18
• Hypersensitivity ku Pentilin zigawo kapena methylxanthines zina.

• ochepa hypotension,
• kulephera kwa mtima
• kuwonongeka kwa impso (kulengedwa kwa creatinine pansi pa 30 ml / min),
• kukanika kwambiri kwa chiwindi,
• kuchuluka kwa magazi, kuphatikiza pakugwiritsa ntchito mankhwala opha magazi, kusokonezeka kwa dongosolo la magazi, pakangotha ​​kuchitidwa maopareshoni.
• zilonda zam'mimba ndi duodenum ya mapiritsi.

Yankho la jakisoni

Mwanjira yothetsera vutoli, Pentilin imayendetsedwa kapena kudzera m'mitsempha.

Dokotalayo amawona njira yoyendetsedwera komanso mtundu woyenera wa mankhwalawa kwa wodwala aliyense, kutengera kuopsa kwa kusokonezeka kwa magazi komanso kulekerera kwa pentoxifylline. Mitsempha kulowetsedwa ikuchitika mu supine udindo.

Monga lamulo, kwa odwala akuluakulu, mankhwalawa amaperekedwa kawiri kawiri patsiku (m'mawa ndi masana), 200 mg (2 ampoules ya 5 ml iliyonse) kapena 300 mg (3 ampoules ya 5 ml iliyonse) mu 250 kapena 500 ml ya 0,9% sodium chloride solution. kapena yankho la ringer. Kugwirizana ndi mayankho ena a kulowetsedwa kuyenera kuyesedwa mosiyana, koma njira zomveka zokha ziyenera kugwiritsidwa ntchito.

Kutalika kwa kulowetsedwa ndi mphindi zosachepera 60 za mlingo wa pentoxifylline 100 mg. Mavuto omwe akonzedwa amatha kuchepa pamaso pa matenda ophatikizika, mwachitsanzo, kulephera kwa mtima. Zikatero, nkoyenera kugwiritsa ntchito njira ina yopusitsira wapadera kuyendetsa kulowetsedwa.

Pambuyo kulowetsedwa kwa tsiku limodzi, ngati kuli kotheka, mapiritsi a Pentilin 400 mg amawonjezeranso - 2 ma PC. Ngati kulowetsedwa kwapangidwa patadutsa nthawi yayitali, ndiye kuti piritsi limodzi litha kumwa nthawi pang'ono (pafupifupi 12 koloko masana).

Milandu yomwe kulowetsedwa kwamitsempha chifukwa cha zovuta zamatenda kumatha kuchitika kamodzi patsiku, makonzedwe owonjezera a Pentilin m'mapiritsi a 3c amatha. (Mapiritsi 2 masana, 1 madzulo).

Milandu yayikulu, mwachitsanzo, ndi zilonda zam'mimba, zilonda zam'mimba za gawo la IV - IV malinga ndi gulu la Fontaine - Lerish - Pokrovsky, kupweteka kwambiri pakupuma, kuwonetsedwa kwakanthawi kwamankhwala kumasonyezedwa - kwa maola 24.

Mlingo woyenera wothandizidwa ndi intraarterial makonzedwe: kumayambiriro kwa chithandizo - 100 mg ya pentoxifylline mu 50-100 ml ya 0.9% sodium kolorayidi yankho, pamasiku otsatirawa - 100-400 mg mu 50-100 ml ya 0,9% sodium chloride solution. Mulingo wa makonzedwe ndi 10 mg / mphindi, nthawi yoyendetsedwako ndi mphindi 10-30.

Masana, mutha kulowa mankhwala osokoneza bongo mpaka 1200 mg. Pankhaniyi, mlingo wa munthu aliyense ungathe kuwerengedwa malinga ndi njira yotsatira: 0.6 mg ya pentoxifylline pa kilogalamu ya thupi pa ola limodzi. Chifukwa chake, mlingo wa tsiku lililonse udzakhala wa 1000 mg kwa wodwala wolemera 70 kg, 1150 mg kwa wodwala wokhala ndi thupi lolemera 80 kg.

Odwala aimpso kulephera, malinga ndi kulekerera mankhwala, kuchepetsa mlingo ndi 30-50%.

Kuchepetsa msambo kumafunikanso kwa odwala omwe ali ndi vuto la chiwindi kwambiri, pomwe kulolera kwa Pentilin kuyenera kuganiziridwanso.

Ndikulimbikitsidwa kuyamba mankhwalawa ndi Mlingo wocheperako wowonjezera odwala omwe ali ndi kuthamanga kwa magazi, komanso odwala omwe amakonda kutsika magazi (mwachitsanzo, ndi matenda a mtima oopsa, matenda a hemodynamically stenosis of cell.

Mapiritsi a Pentilin 400 mg ayenera kumwedwa pakamwa, mutatha kudya: kumeza lonse ndikumwa madzi ambiri.

Mlingo woyenera ndi piritsi limodzi la 2 kapena katatu patsiku. Osapitilira muyeso ya tsiku ndi tsiku ya 1200 mg.

Odwala omwe ali ndi vuto la aimpso kulephera (kuvomerezeka kwa creatinine

Mlingo

400 mg mapiritsi okhala ndi mafilimu

Piritsi limodzi lili

ntchito yogwira - pentoxifylline 400 mg,

zokopa: Hypromellose, macrogol 6000, magnesium stearate, silicon dioxide colloidal anhydrous,

kapangidwe ka chipolopolo: hypromellose, macrogol 6000, titanium dioxide (E 171), talc.

Mapiritsi okhala ndi mawonekedwe okumbika okhala ndi biconvex pamwamba, wokutidwa ndi filimu yoyera

Mankhwala

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, pentoxifylline imathamanga komanso imalowa. The bioavailability mapiritsi a pentoxifylline wa nthawi yayitali amakhala pafupifupi 20%. Kudya kumachedwa, koma sikuchepetsa kukwana kwa mankhwala.

Kuchuluka kwa plasma ndende kumachitika mkati 2 mpaka 4 maola. Pentoxifylline imafukusidwa mkaka wa m'mawere, wapezeka mkati mwa maola 2 mutakhazikitsa, onse - osasinthika komanso mawonekedwe a metabolites.

Pentoxifylline imapangidwa makamaka mu chiwindi komanso mochepera m'maselo ofiira a m'magazi. Imakhala ndi metabolism yofunikira komanso yowonekera bwino poyambirira. Plasma wozungulira yogwira metabolites ndi 5 ndi 8 zina kuposa kuchuluka kwa pentoxifylline. Zimapangidwa ndi contraction (kudzera α-keto reductase) ndi oxidation.

Ma metabolaboliti amachotsedwa mu mkodzo (pafupifupi 95%). Pafupifupi 4% ya mankhwalawa amatengedwa ndowe. Pakukanika kwambiri kwa impso, chimbudzi cha metabolites chimachepetsedwa. Ndi kukanika kwa hepatic, theka moyo ndi wautali ndipo bioavailability imakulanso. Pankhani imeneyi, pofuna kupewa kuchuluka kwa mankhwalawa m'thupi la odwala otere, mlingo uyenera kuchepetsedwa.

Mankhwala

Pentoxifylline imasintha magazi machitidwe a magazi mwa kukhudza kuchepa kwa maselo ofiira am'magazi, kuletsa kuphatikizana kwa maselo komanso kuchepetsa magazi. Kupanga kwa kachitidwe ka pentoxifylline kusintha magazi m'thupi kumapangitsanso kuchuluka kwa maselo ofiira m'magazi a ATP (adenosine triphosphate), cAMP (cyclo-adenosine monophosphate) ndi ma cyclic nucleotides ena. Pentoxifylline kwambiri amachepetsa mamasukidwe akayendedwe a plasma ndi magazi pochepetsa kuchuluka kwa fibrinogen. Kutsika kotereku kwa ndende ya fibrinogen kumachitika chifukwa cha kuwonjezeka kwa ntchito ya fibrinolytic ndi kuchepa kwa kapangidwe kake. Kuphatikiza apo, poletsa michere yam'mimba yopanga ma membrane - yomwe imatsogolera kuchuluka kwa cAMP ndende) komanso kaphatikizidwe kazinthu zina, pentoxifylline imalepheretsa kuphatikizika kwa cellplate komanso panthawi yomweyo imatsitsimutsa kuphatikizika kwa prostacyclin (prostaglandin I2).

Pentoxifylline amachepetsa kupanga kwa ma interleukin mu monocytes ndi macrophages, omwe amachepetsa kukula kwa chotupa. Pentoxifylline bwino zotumphukira ndi magazi magazi, kumawonjezera mphamvu amadalira minyewa gawo la okosijeni mu minofu ya ischemic anakhudzidwa m'munsi malekezero, mu cortex ndi cerebrospinal madzimadzi, mu retina odwala retinopathy.

Zotsatira zoyipa

Otsatirawa ndi milandu yovuta yomwe idachitika nthawi yoyesedwa komanso panthawi yotsatsa.
Kuchokera pamtima. Arrhythmia, tachycardia, angina pectoris, kuchepa kwa magazi, kuthamanga kwa magazi.
Kuchokera ku dongosolo la zamitsempha ndi njira yamagazi. Thrombocytopenia, thrombocytopenic purpura, aplastic anemia (pang'ono kapena kufafaniza kwathunthu kwa mapangidwe a maselo onse amwazi), pancytopenia, yomwe imatha kupha.
Kuchokera ku dongosolo lamanjenje. Chizungulire, kupweteka mutu, aseptic meningitis, kunjenjemera, paresthesias, kukokana.
Kuchokera m'mimba thirakiti. Kukhumudwa m'mimba, kumverera kwa kupsinjika m'mimba, kusilira, nseru, kusanza, kapena kutsegula m'mimba.
Pa khungu ndi subcutaneous zimakhala. Kuyenda, redness khungu ndi urticaria, poizoni epidermal necrolysis ndi Stevens-Johnson syndrome.
Kuphwanya kwamitsempha yamafuta. Kutentha kwamphamvu (kutentha kwacha), magazi, zotumphukira edema.
Kuchokera ku chitetezo chamthupi. Anaphylactic zimachitika, anaphylactoid zimachitika, angioedema, bronchospasm ndi anaphylactic mantha.
Pa mbali ya chiwindi ndi ndulu. Intrahepatic cholestasis.
Mavuto amisala Kudzukitsa, kusokoneza tulo, kuyerekezera zinthu zina.
Pa mbali ya ziwalo zamasomphenya. Kuwonongeka kwamawonekedwe, conjunctivitis, kutulutsa kwam'mimba, kuyimitsidwa kwamatumbo.
Ena. Milandu ya hypoglycemia, thukuta kwambiri, ndi malungo akuti.

Mimba

Palibe chidziwitso chokwanira ndi mankhwalawa Pentiline azimayi oyembekezera. Chifukwa chake, sikulimbikitsidwa kupereka mankhwala a Pentilin panthawi yapakati.
Pentoxifylline yaying'ono imadutsa mkaka wa m'mawere. Ngati Pentilin adalembedwa, siyani kuyamwitsa.

Kuchita ndi mankhwala ena

Zotsatira zochepetsera shuga wamagazi zomwe zimapezeka mu insulin kapena othandizira matenda amkamwa zimatha. Chifukwa chake, odwala omwe amalandila mankhwala a shuga ayenera kuyang'aniridwa bwino.
Munthawi yotsatsa, milandu ya anticoagulant yowonjezereka idanenedwa kwa odwala omwe amathandizidwa nthawi yomweyo ndi pentoxifylline ndi anti-vitamini K. Mukamwa mankhwala a pentoxifylline akaperekedwa kapena kusinthidwa, tikulimbikitsidwa kuwunika ntchito za anticoagulant pagulu la odwala.
Pentiline zitha kupititsa patsogolo antihypertensive mphamvu yama antihypertensive mankhwala ena ndi ena, omwe angayambitse kuchepa kwa magazi.
Kugwiritsa ntchito pamodzi kwa pentoxifylline ndi theophylline mwa odwala ena kumatha kuonjezera kuchuluka kwa theophylline m'magazi. Chifukwa chake, ndikotheka kuwonjezera pafupipafupi ndikuwonjezera mawonetsedwe azovuta za theophylline.
Ketorolac, meloxicam.
Kugwiritsa ntchito munthawi yomweyo kwa pentoxifylline ndi ketorolac kungayambitse kuwonjezeka kwa nthawi ya prothrombin ndikuwonjezera ngozi ya magazi. Chiwopsezo chakutulutsa magazi chiwonjezereka ndi kugwiritsa ntchito munthawi yomweyo pentoxifylline ndi meloxicam. Chifukwa chake, munthawi yomweyo chithandizo ndi mankhwalawa sichikulimbikitsidwa.

Bongo

Zizindikiro zoyambirira za bongo Pentiline nseru, chizungulire, tachycardia, kapena kuchepa kwa magazi.Kuphatikiza apo, zizindikiro monga kutentha thupi, kukwiya, kumva kutentha (kutentha kwadzaoneni), kuiwala nkhawa, areflexia, kukomoka kwa tonic-kusanza ndi kusanza kwa mtundu wa malo a khofi amathanso kukhala ngati chizindikiro cha kutuluka magazi m'mimba.
Chithandizo. Pofuna kuchitira mankhwala osokoneza bongo owopsa komanso kupewa kupezeka kwamavuto, kufunikira kwakanthawi ndi kuchipatala ndikuwonetsetsa kuti njira zochizira ndizofunikira.

Zolemba ntchito

Pazizindikiro zoyambirira za anaphylactic / anaphylactoid reaction, chithandizo cha pentoxifylline ziyenera kusiyidwa ndikufunsira kuchipatala.

Makamaka kuwunika mosamalitsa kwachipatala ndikofunikira kwa odwala omwe ali ndi mtima wa mtima, matenda oopsa, matenda amitsempha yamagazi, komanso omwe adakumana ndi vuto la mtima kapena opaleshoni.

Pankhani ya pentoxifylline, odwala matenda a mtima osakhazikika ayenera kufikira gawo la kubwezeredwa kwa magazi.

Kwa odwala omwe ali ndi systemic lupus erythematosus (SLE) kapena matenda osakanikirana a minofu, pentoxifylline imatha kutumikiridwa pokhapokha kuwunikira bwino kuopsa ndi mapindu ake.

Chifukwa cha chiwopsezo cha kukha magazi ndi munthawi yomweyo kugwiritsa ntchito pentoxifylline ndi anticoagulants pakamwa, kuyang'anira mosamala ndi kuwunika pafupipafupi magawo a coagulation (mayiko wamba apadera) (MES).

Popeza kuti pali chiopsezo chokhala ndi magazi m'thupi a aplastic pakagwiritsidwa ntchito ndi pentoxifylline, kuwunika pafupipafupi kuchuluka kwa magazi ndikofunikira.

Odwala omwe ali ndi matenda ashuga komanso kulandira chithandizo cha insulin kapena mankhwala opaka pakamwa.

Odwala omwe amalephera kupweteka kwa aimpso (creatinine chilolezo chochepera 30 ml / min) kapena kukanika kwambiri kwa chiwindi, chimbudzi cha pentoxifylline chitha kuchepetsedwa. Kuwunika koyenera ndikofunikira.

Odwala aimpso kulephera. Odwala aimpso kulephera (kulengedwa kwa creatinine zosakwana 30 ml / mphindi), titration wa mlingo wofika 50-70% ya muyezo mlingo uyenera kuchitidwa poganizira kulolera kwa munthu, mwachitsanzo, kugwiritsa ntchito pentoxifylline 400 mg 2 kawiri pa tsiku m'malo 400 mg katatu patsiku.

Odwala omwe ali ndi vuto lalikulu la chiwindi. Odwala omwe ali ndi vuto lalikulu la chiwindi, lingaliro la kuchepetsa mlingo liyenera kuchitika ndi adokotala, poganizira kuopsa kwa matendawo ndi kulolerana kwa wodwala aliyense.

Makamaka kuwunikira ndikofunikira:

• odwala kwambiri mtima mtima arrhythmias,
• odwala ndi myocardial infarction
• odwala ndi ochepa hypotension,
• odwala kwambiri atherosclerosis a ziwongo ndi mtima ziwiya, makamaka ndi conteritant ochepa matenda oopsa ndi mtima arrhythmias. Odwala awa, akamagwiritsa ntchito mankhwalawa, kuukira kwa angina, arrhythmias ndi ochepa hypertension ndikotheka,
• odwala aimpso kulephera (kulengedwa kwa creatinine pansipa 30 ml / min.),
• odwala omwe ali ndi vuto lalikulu la chiwindi,
• odwala omwe ali ndi vuto lotaya magazi ambiri, mwachitsanzo, pochiza ndi anticoagulants kapena vuto la magazi. Kutaya magazi - onani gawo "Contraindication",
• odwala omwe ali ndi mbiri ya zilonda zam'mimba komanso duodenal zilonda, odwala omwe apatsidwa chithandizo cha opaleshoni (chiwopsezo cha kutaya magazi, komwe kumafunikira kuwunika mwadongosolo hemoglobin ndi hematocrit)
• odwala omwe amathandizidwa nthawi yomweyo ndi othandizira pentoxifylline ndi vitamini K (onani gawo "Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana"),
• odwala omwe amathandizidwa nthawi imodzi ndi pentoxifylline ndi othandizira a hypoglycemic (onani gawo "Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana").

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Popeza palibe chidziwitso chokwanira pakugwiritsa ntchito pentoxifylline mwa amayi apakati, siziyenera kutumikiridwa panthawi yapakati.

Panthawi yoyamwa, pentoxifylline imadutsa mkaka wa m'mawere. Komabe, khandalo limalandira zochepa zochepa. Chifukwa chake, sizokayikitsa kuti kugwiritsa ntchito pentoxifylline panthawi yoyamwitsa kumawonetsedwa kuti kumakhudza mwana.

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina

Pentilin alibe pang'ono kapena alibe mphamvu pa kuyendetsa galimoto ndi zina. Komabe, mwa odwala ena zimatha kubweretsa chizungulire, chifukwa chake, mosazungulira, kuchepetsa malingaliro a psychophysical kuyendetsa galimoto ndi zina. Mpaka pomwe odwala athe kudziwa momwe amachitira ndi chithandizo, samalangizidwa kuyendetsa galimoto kapena kugwira ntchito ndi zina.