Lisiprex - (Lisiprex)

Lysiprex yog yeeb tshuaj uas npaj rau kev kho mob ntawm cov kab mob ntawm lub plawv thiab leeg ntshav. Muab qhov mob hnyav rau hauv chaw kuaj mob, nws yog siv nrog lwm cov tshuaj los yog khoom siv ywj pheej. Txhawm rau kom cov hlab plawv ua haujlwm nquag rau cov kab mob mus ntev, cov tshuaj tau tawm rau kev tswj hwm prophylactic.

Pharmacological kev txiav txim

Cov tshuaj muaj nyob hauv pawg ntawm ACE inhibitors. Lisinopril ua rau qeeb ntawm cov kev ua ntawm ACE (angiotensin-hloov enzyme). Qhov no txo ​​tus nqi ntawm degeneration ntawm angiotensin ntawm thawj hom mus rau hauv lub thib ob, uas muaj lub suab vasoconstrictive thiab stimulates zus tau ntawm aldosterone los ntawm adrenal cortex.

Qhov muab tshuaj txo tus mob hauv cov ntshav me me ntawm lub ntsws, nce qhov tsis kam ntawm lub siab. Nws normalizes glomerular endothelium, lub luag haujlwm ntawm uas raug mob nyob rau hauv cov neeg mob hyperglycemia.

Cov tshuaj nquag nthuav tawm hauv cov leeg ntsa ntau dua li cuam tshuam rau lub txaj venous. Nrog lub sijhawm siv ntev ntawm cov tshuaj, mob plawv myocardial hypertrophy tsawg dua. Cov cuab yeej tuaj yeem ua kom qeeb ntawm qhov tsis ua haujlwm ntawm lub plawv nres rov qab, txhim kho cov neeg mob uas tau mob plawv.

Cov Tshuaj Pharmacokinetics

Kev noj tshuaj tsis cuam tshuam nrog zaub mov. Qhov txheej txheem nqus mus txog li 30% ntawm cov nquag cov khoom. Bioavailability yog 29%. Kev khi rau cov ntshav muaj ntshav yog qhov tsawg heev. Tsis tas hloov, cov tshuaj tseem ceeb thiab cov koom haum pabcuam nkag mus rau hauv cov ntshav.

Qhov siab tshaj plaws hauv plasma yog pom hauv 6 teev. Yuav luag tsis koom nrog hauv cov txheej txheem metabolic. Nws yog tshem tawm tsis hloov pauv ntawm lub raum nrog zis. Qhov kev tshem tawm ib nrab-lub neej yuav siv sijhawm ntev txog 12,5 teev.

Nws yog dab tsi rau?

Kev taw qhia rau kev siv lysiprex:

• qhov tseem ceeb thiab kho kom zoo hom ntshav arterial hypotension,
• ntshav qab zib nephropathy,
• mob plawv tsis ua hauj lwm
• mob myocardial infarction.

Hauv kev mob plawv hauv lub siab, cov tshuaj yuav tsum noj rau thawj hnub tom qab kev tawm tsam kom tiv thaiv tsis ua haujlwm ntawm lub plawv sab hauv ventricle.

Cov Yuav Tsum Tau Ua

Cov chaw kho mob txwv cov Lysiprex tswj hwm:

• ua kom lub cev tsis haum rau cov tshuaj ntawm cov tshuaj,
• lub xub ntiag ntawm Quincke edema nyob hauv ib tsev neeg zaj keeb kwm,
• kev tshuaj ntsuam caj nyiam rau cov tshuaj tiv thaiv xws li mob hlwb.

Tus neeg txheeb ze contraindications, nyob rau hauv muaj qhov uas siv ntawm Lysiprex raug tso cai, tab sis ua tib zoo thiab nrog kev soj ntsuam tas li ntawm tus neeg mob, tau txiav txim siab:

• mitral stenosis, aortic, lub raum hlab ntsha,

• tshuaj ischemia
• kev txhim kho ntawm txoj hlab ntsha hypotension,
• mob raum tsis zoo,
• lub xub ntiag ntawm kev nce siab ntawm cov poov tshuaj nyob rau hauv lub cev,
• kab mob sib kis hauv cov nqaij.

Nws raug txwv tsis pub siv txoj kev kho mob rau hauv kev kho mob plawv hauv cov neeg mob uas yog cov neeg sawv cev ntawm cov haiv neeg dub.

Yuav ua li cas noj lisiprex?

Cov ntsiav tshuaj tau noj tag nrho yam tsis muaj ntxo, tsis hais noj mov. Qhov tshuaj nruab nrab uas pom zoo yog 20 mg rau ib hnub, qhov nyiaj siab tshaj uas tau tso cai txhua hnub yog 40 mg. Lub sijhawm tiv thaiv ntawm kev kho yog suav ib tus zuj zus, nyob ntawm qhov mob hnyav thiab tus mob ntawm cov tsos mob. Kev kho mob zoo li cas ntawm kev noj tshuaj tshwm sim tom qab 14-30 hnub.

Tsuas tshuaj rau monotherapy ntawm mob plawv tsis ua hauj lwm: thawj koob tshuaj - 2.5 mg ib hnub twg. Rau 3-5 hnub, nce ntxiv txog 5-10 mg ib hnub yog ua tau. Tso cai ntau tshaj yog 20 mg.

Kev kho mob tom qab lub plawv nres hauv thawj 24 teev tom qab kev tawm tsam: 5 mg, txhua lwm hnub cov koob tshuaj tau rov ua dua nyob hauv qhov tsuas tshuaj. Tom qab 2 hnub, koj yuav tsum tau noj 10 mg, hnub tom qab, koob tshuaj yuav rov ua dua ntawm qhov koob tshuaj 10 mg. Txoj kev kho mob zoo tuaj yeem ntev txog 4 rau 6 lub lis piam.

Mob ntshav qab zib nephropathy - txog 10 mg rau ib hnub, nyob rau hauv cov ntaub ntawv ntawm cov tsos mob mob hnyav, qhov ntau npaum li cas tuaj yeem raug nce ntxiv rau qhov kev tso cai txhua hnub ntawm 20 mg.

Tso tawm daim ntawv, ntim thiab muaj pes tsawg leeg

Cov ntsiav tshuaj yog xim dawb, puag ncig, tiaj-cylindrical, nrog bevel thiab nqis siab tshaj.

Tshwjxeeb: calcium hydrogen phosphate anhydrous - 50 mg, mannitol - 20 mg, pob kws hmoov nplej - 34.91 mg, talc - 3 mg, magnesium stearate - 1.2 mg.

10 Pcs - blister packs (3) - pob ntawv ntawm cardboard.
30 pcs - Cov kaus poom polymer (1) - pob khoom los ntawm cardboard.

Tshuaj los qhia

Qhov tseem ceeb thiab kho lub plawv tawg (nyob rau hauv cov qauv ntawm cov tshuaj tua kab mob los yog ua ke nrog lwm cov tshuaj tiv thaiv kab mob siab).

Mob plawv tsis ua hauj lwm (ib feem ntawm txoj kev kho ua ke).

Mob myocardial infarction (hauv thawj 24 teev nrog cov hemodynamic ruaj khov uas tswj cov ntsuas no thiab tiv thaiv sab laug ventricular kawg thiab lub plawv tsis ua haujlwm).

Mob ntshav qab zib nephropathy (kom txo tau albuminuria hauv cov neeg mob uas muaj ntshav qab zib insulin-tiv thaiv mob ntshav qab zib uas muaj ntshav siab thiab cov neeg mob uas tsis muaj ntshav qab zib tsis yog insulin-mob ntshav qab zib).

Sab sij huam

Los ntawm cov hlab plawv: txhaws hypotension, mob qab sternum yog tau.

Los ntawm sab hauv nruab nrab ntawm lub hauv nruab nrab lub paj hlwb: kiv taub hau, mob taub hau, leeg tsis muaj zog.

Los ntawm lub plab zom mov: raws plab, xeev siab, ntuav.

Los ntawm tus txheej txheem ua pa: hnoos qhuav.

Los ntawm cov kab mob hemopoietic: agranulocytosis, txo qis hemoglobin thiab hematocrit (tshwj xeeb yog siv ntev), hauv cov teeb meem sib cais - qhov nce hauv ESR.

Ntawm ib feem ntawm cov dej-electrolyte metabolism: hyperkalemia.

Kev tiv thaiv kabmob: nce creatinine, urea nitrogen (tshwj xeeb tshaj yog rau cov neeg mob raum, mob ntshav qab zib mellitus, kho cov ntshav siab).

Kev ua xua rau: tawv nqaij ua pob xua, mob caj dab.

Lwm yam: hauv cov teeb meem raug rho tawm - arthralgia.

Cov lus qhia tshwj xeeb

Lisinopril yuav tsum tsis txhob siv rau hauv cov neeg mob aortic stenosis, mob ntsws ntsws. Tsis txhob siv rau hauv cov neeg mob uas muaj mob myocardial infarction: nrog rau kev hem thawj ntawm cov ntshav tsis zoo cuam tshuam nrog kev siv cov vasodilator, nrog kev ua haujlwm tsis zoo hauv lub raum.

Ua ntej thiab thaum kho, raum kev ua haujlwm yuav tsum raug saib xyuas.

Ua ntej pib kev kho mob nrog lisinopril, nws yog ib qho tsim nyog yuav tsum tau them nyiaj rau qhov ua kua dej thiab cov ntsev ploj.

Lawv siv nrog kev ceev faj tshwj xeeb hauv cov neeg mob uas lub raum tsis ua haujlwm, nrog lub raum leeg ntshav hlab plawv, thiab mob plawv tsis ua hauj lwm ntau.

Qhov ntxim nyiam ntawm kev txhim kho arterial hypotension nce nrog kua dej vim kev kho diuretic, kev noj zaub mov nrog ntsev txwv, xeev siab, thiab ntuav.

Hauv cov neeg mob uas muaj lub plawv tsis ua hauj lwm nrog cov ntshav siab los yog qis me ntsis, lisinopril tuaj yeem ua rau mob ntshav khov ntau heev.

Kev siv ua ke nrog lisinopril nrog cov tshuaj potassium-sparing diuretics, kev noj zaub mov zoo rau cov zaub mov thiab ntsev hloov chaw muaj cov poov tshuaj tsis pom zoo.

Nrog rau kev siv lisinopril tib lub sijhawm nrog lithium kev npaj, kev saib xyuas ntawm lithium hauv cov ntshav ntshav yuav tsum tau saib xyuas.

Yeeb tshuaj sib cuam tshuam

Nrog rau kev siv tib lub sijhawm nrog cov tshuaj tiv thaiv kab mob siab, ib qho kev tiv thaiv kabmob txuas ntxiv tuaj yeem ua tau.

Nrog rau kev siv ua ke nrog cov potassium-sparing diuretics (spironolactone, triamteren, amiloride), kev npaj poov tshuaj, ntsev hloov cov ntsev, muaj kev pheej hmoo ntawm hyperkalemia nce, tshwj xeeb tshaj yog nyob rau cov neeg mob uas tsis zoo lub raum kev ua haujlwm.

Nrog rau siv ACE inhibitors thiab NSAIDs tib lub sijhawm, qhov kev pheej hmoo ntawm kev txhim kho lub raum ua kom lub siab zuj zus, hyperkalemia tsis tshua pom.

Nrog tib lub sijhawm siv nrog "voj" diuretics, thiazide diuretics, cov nyhuv antihypertensive yog kho kom zoo. Qhov tshwm sim ntawm cov ntshav liab ntau heev, tshwj xeeb tshaj yog tom qab noj thawj koob ntawm diuretic, thaj tshwm sim vim yog hypovolemia, uas ua rau muaj qhov hloov pauv sai hauv cov nyhuv hypotensive ntawm lisinopril. Nce kev pheej hmoo ntawm qhov tsis zoo lub raum.

Nrog rau kev siv ib txhij nrog indomethacin, cov nyhuv antihypertensive ntawm lisinopril poob qis, pom meej vim yog inhibition ntawm prostaglandin synthesis nyob rau hauv cov NSAIDs (uas ntseeg tau los ua lub luag haujlwm ntawm kev txhim kho hypotensive nyhuv ntawm ACE inhibitors).

Nrog rau siv ua ke nrog cov tshuaj insulin, hypoglycemic agents, sulfonylurea derivatives, hypoglycemia yuav tshwm sim vim muaj kev tiv thaiv ntshav qabzib ntau dua.

Nrog rau kev siv ib txhij nrog clozapine, cov ntsiab lus ntawm clozapine hauv ntshav ntshav nce ntxiv.

Nrog tib lub sijhawm siv nrog lithium carbonate, cov concentration ntawm lithium hauv cov ntshav cov ntshav nce ntxiv, nrog cov tsos mob ntawm lithium intoxication.

Ib qhov xwm txheej ntawm kev loj hlob ntawm mob hyperkalemia loj hauv tus neeg mob ntshav qab zib mellitus nrog kev siv ua ke nrog lovastatin tau piav qhia.

Cov teeb meem ntawm txoj kev mob ntshav ntawm cov ntshav khov nrog kev siv nrog pergolide tau piav qhia ib zaug.

Nrog tib lub sij hawm siv nrog ethanol, cov nyhuv ntawm ethanol yog kho dua.

Kev ntsuas rau siv

Yuav tsum tau lysiprex yog tias muaj cov xwm txheej hauv qab no:

1. Arterial hypertension - qhov tseem ceeb thiab kho lub plawv (ob qho tib si raws li cov tshuaj thiab ua ke nrog lwm cov tshuaj)
2. Mob plawv tsis ua hauj lwm (ua ib feem ntawm txoj kev kho ua ke)
3. Thawj hnub tom qab mob myocardial infarction, thiab ntxiv rau tom qab ua ib feem ntawm kev sib xyaw ua ke
4. Mob ntshav qab zib nephropathy - kom txo tau albuminuria

Txoj kev ntawm daim ntawv thov

Nws raug nquahu kom noj Lysiprex thaum sawv ntxov ib hnub ib zaug. Kev siv cov tshuaj tsis yog nyob ntawm kev txais khoom noj.

Cov neeg mob ntshav siab tsis noj lwm yam tshuaj yog kws kho mob 5 milligrams ntawm Lisiprex. Yog tias tsis muaj kev cuam tshuam, qhov koob tshuaj tau nce ntxiv ntawm 5 milligrams txhua ob rau peb hnub, kom txog thaum lawv mus txog 20-40 milligrams ib hnub.

Kev saib xyuas txhua hnub ib txwm muaj li 20 milligrams ntawm cov tshuaj, thiab qhov siab tshaj plaws yog 40. Cov nyhuv tag nrho feem ntau tshwm sim tom qab ob rau plaub lub lim tiam ntawm kev kho mob.

Rau cov neeg muaj lub plawv tsis ua haujlwm ntev, qhov pib siv tshuaj yog 2.5 milligrams ib hnub. Tom qab peb mus rau tsib hnub, nws raug tso cai nce ntxiv mus rau 5-10 milligrams. Qhov siab kawg txhua hnub koob yog 20 milligrams.

Yog tias tus neeg mob tau mob lub ntsws myocardial infarction, nws yuav tsum tau muab 5 milligrams ntawm Lysiprex thaum nruab hnub, thiab lwm qhov 5 milligrams hauv ib hnub. Yav tom ntej, nws yog ib qho tsim nyog yuav tsum noj 10 milligrams ntawm cov tshuaj tom qab ob hnub thiab lwm qhov 10 tom qab ib hnub. Lub chav kawm ntawm kev kho mob kav rau lub lis piam.

Nrog cov ntshav qab zib nephropathy, nws tau pom zoo kom noj 10 milligrams ntawm cov tshuaj ib hnub. Yog tias tsim nyog, nws tuaj yeem nce ntxiv txog 20 milligrams.

Tso tawm daim ntawv, muaj pes tsawg leeg

Cov tshuaj saum toj no muaj nyob hauv cov ntawv hauv qab no:

Cov muaj pes tsawg leeg ntawm Lysiprex suav nrog cov tshuaj zoo li no:

• 5, 10 lossis 20 milligrams ntawm lisinopril nyob rau hauv daim ntawv ntawm lisinopril dihydrate
• 40, 50 lossis 100 milligrams ntawm anhydrous calcium hydrogen phosphate
• 15, 20 lossis 40 milligrams ntawm mannitol
• 34.91, 36.06 lossis 69.83 milligrams cov hmoov txhuv nplej pob kws
• 2.5, 3 lossis 6 milligrams ntawm talcum hmoov
• 1, 1.2 lossis 2.4 milligrams ntawm magnesium stearate.

Kev cuam tshuam nrog lwm yam tshuaj

Thaum ua ntawv thov Lysiprex, nws yog ib qho tsim nyog yuav tsum coj mus rau hauv tus yam ntxwv ntawm nws kev cuam tshuam nrog lwm cov tshuaj, uas yuav piav qhia hauv qab no:

1. Kev sib xyaw ntawm cov tshuaj piav qhia nrog cov poov tshuaj npaj, potassium-sparing diuretics, hloov ntsev, uas suav nrog potassium, ntxiv rau cyclosporine, ua rau muaj kev cuam tshuam ntawm hyperkalemia
2. Kev siv lysiprex nrog diuretics, beta-blockers, qeeb calcium calcium blockers, antipsychotics, tricyclic cov tshuaj tiv thaiv kab mob thiab tshuaj tiv thaiv ntshav siab ua rau cov nyhuv antihypertensive
3. Qhov sib xyaw ua ke nrog cov roj ntsha lithium tuaj yeem ua rau nce qhov kev nce ntxiv ntawm cov tshuaj no hauv cov ntshav
4. Kev sib xyaw ntawm lysiprex nrog cov tshuaj hypoglycemic txhim kho lawv cov nyhuv thiab tuaj yeem ua rau kev txhim kho ntawm hypoglycemia
5. Cov tshuaj nonsteroidal anti-inflammatory, estrogens, thiab adrenergic agonists txo cov nyhuv ntawm lisiprex. Tsis tas li ntawd, kev sib xyaw nrog thawj hom tshuaj yuav ua rau lub raum ua haujlwm tsis zoo.
6. Kev siv lysiprex nrog rau xaiv serotonin reuptake inhibitors yuav ua rau mob hyponatremia.
7. Kev sib xyaw ua ke ntawm kev piav qhia tshuaj nrog ethanol txhim kho cov nyhuv tom qab.
8. Kev sib xyaw ntawm lisiprex nrog procainamide, cytostatics thiab allopuripole yuav ua rau mob leukopenia
9. Indomethacin txo cov nyhuv antihypertensive ntawm lisiprex
10. Thaum ua ntawv thov lysiprex nrog clozapine, cov ntsiab lus tom kawg hauv cov ntshav nce ntxiv

Muaj ntau tus yeeb tshuaj uas tsis tuaj yeem sib xyaw nrog lysiprex. Cov no suav nrog:

Sab sij huam

Kev siv lysiprex tuaj yeem ua rau cov kev mob tshwm sim hauv qab no:

1. Mob hauv pob tw
2. Muaj zog poob siab
3. Tachycardia
4. Lub Neej Bradycardia
5. Myocardial infarction
6. Nce Cov tsos mob ntawm mob ntsws ua tsis tiav
7. Ua txhaum ntawm atrioventricular conduction
8. Kiv taub hau
9. Mob taub Hau
10. Paresthesia
11. Txoj Kev Txaus Siab
12. Cov tsos mob Asthenic
13. Cramps
14. Kev nkees nkees
15. Kev ntxhov siab
16. Agranulocytosis
17. Leukopenia
18. Neutropenia
19. Thrombocytopenia
20. Mob Kev Plab
21. Bronchospasm
22. Txog siav
23. Kev Mob Nkeeg
24. Kev mob caj dab
25. Mob plab
26. Qhov muag daj
27. Kab mob siab
28. Yeeb Ncuab
29. Saj Tau Hloov
30. Qhuav ntawm lub qhov ncauj mucosa
31. Muaj hws ntau
32. Khaus ntawm daim tawv nqaij
33. Urticaria
34. Alopecia
35. Photophobia
36. Oliguria
37. Kev Mob Nkeeg
38. Lub raum tsis zoo
39. Kev Proteinuria
40. Kev sib deev tsis sib haum
41. Tshaj cov poov tshuaj
42. Sodium tsis muaj peev xwm
43. Pob Tsuas Xyooj
44. Neej Hmoob
45. Vasculitis
46. Mob caj dab
47. Kev ua xua tsis haum

Noj ntau dhau

Feem ntau, cov tsos mob ntawm kev noj haus ntau dhau ntawm Lysiprex tshwm sim tawm tsam ib zaug ntawm 50 grams ntawm cov tshuaj. Lawv qhia raws li hauv qab no:

1. Lub qhov ncauj qhuav
2. Kev poob siab poob haujlwm tam sim ntawd
3. Tso zis cia
4. Kev nkees nkees
5. Vauv
6. Cem quav
7. Ntxhov siab vim

Thaum cov tsos mob zoo li no tshwm sim, kev kho cov tsos mob yog tsim nyog, vim tias tsis muaj ib qho tshuaj tua kab mob tshwj xeeb. Tus neeg mob tau ntxuav nrog lub plab, muab cov tshuaj enterosorbents thiab laxatives. Ib qho 0.9% sodium chloride tov yog muab tshuaj kom tso ntshav.

Hemodialysis tuaj yeem ua tau. Nws yog ib qho tsim nyog los tswj cov ntsuas ntawm dej-electrolyte tshuav nyiaj li cas, nrog rau kev ntsuas ntshav siab.

Thaum cev xeeb tub

Cov poj niam uas yuav xeeb menyuam, tsis pub coj Lysiprex. Yog tias cev xeeb tub tau tshwm sim thaum kho nrog cov tshuaj no, koj yuav tsum tsum tsis txhob noj sai li sai tau.

Cov kws tshaj lij tau ua pov thawj tias kev siv cov tshuaj no rau hauv cov thib ob thiab thib peb lub cev muaj qhov tsis zoo rau cov menyuam hauv plab, uas tau tshwm sim hauv kev txo qis hauv cov ntshav siab, kev txhim kho lub raum tsis ua haujlwm, cranial hypoplasia, hyperkalemia, thiab mob ntshav tuag.

Raws li rau thawj peb lub hlis thaum cev xeeb tub, tsis muaj ib qho pov thawj qhia txog qhov tsis zoo ntawm Lisiprex ntawm tus me nyuam hauv plab. Tab sis nws yuav tsum nco ntsoov tias cov tshuaj no tuaj yeem nkag rau hauv lub tsho me nyuam.

Cov lus thiab cov xwm txheej ntawm kev cia

Khaws cov tshuaj tau piav qhia rau hauv qhov chaw qhuav, tiv thaiv los ntawm tshav ntuj ncaj qha thiab siv tsis tau rau menyuam yaus. Cia qhov kub thiab txias yuav tsum tsis tshaj 25 degrees Celsius.

Lub txee lub neej ntawm Lysiprex yog ob xyoos.

Txog hnub tim, Lysiprex tsis muaj nyob hauv cov khw muag tshuaj ntawm Lavxias teb sab Federation.

Tam sim no, hauv cov chaw muag tshuaj Ukrainian, Lisiprex tsis yog rau muag.

Hauv cov chaw muag tshuaj niaj hnub no, muaj ntau cov tshuaj uas zoo ib yam hauv lawv cov kev coj ua rau Lisiprex. Cov no suav nrog cov tshuaj hauv qab no:

Txog rau hnub tim, muaj kev ntsuam xyuas tsis tau ntawm Lysiprex online. Tab sis tom kawg ntawm tsab xov xwm, koj tuaj yeem paub txog cov kev xav ntawm cov neeg uas tau siv rau kev kho.

Yog tias koj tau noj cov tshuaj no, thov qhia koj lub tswv yim rau nws nrog lwm tus nyeem.

Los ntawm ib sab ntawm cov metabolism

Kev nce siab ntawm creatinine ntau dua. Hauv cov neeg muaj lub raum tsis ua hauj lwm thiab ntshav qab zib pathology, urea nitrogen nce ntxiv.

Cov tawv nqaij ua pob ua xua, kev txhim kho tshuaj mob pob khaus.

Nws tsis tsim nyog los tswj cov cuab yeej nyuaj rau cov neeg uas muaj kiv taub hau thiab mob taub hau thaum noj Lisiprex.

Siv thaum cev xeeb tub thiab lactation

Muaj kev pheej hmoo ntawm qhov tsis zoo ntawm tus menyuam, tshwj xeeb tshaj yog nyob rau ntawm ncua sijhawm thib 2 thiab thib peb ntawm tus xeeb ceem. Ib tug poj niam noj Lysiprex ntsiav tshuaj tom qab paub txog cev xeeb tub yuav tsum tsis txhob noj cov tshuaj. Tsis muaj pov thawj dab tsi ntawm kev muaj peev xwm ua haujlwm ntawm cov tshuaj mus rau niam mis. Thaum pub niam mis, noj cov tshuaj no yog txwv nruj me ntsis vim tias muaj kev pheej hmoo tshwm sim tsis zoo rau tus menyuam.