I-Sibutramine - imiyalo yokusebenzisa, ama-analogues, umbono wodokotela kanye nokunciphisa isisindo

I-World Health Organisation ibize inkinga yokukhuluphala ngokweqile ngomqedazwe wekhulu lama-21. Kubantu abayizigidi eziyizinkulungwane eziyisikhombisa emhlabeni, izigidi eziyi-1,700 zikhuluphele kanti izigidi ezingama-500 zikhuluphele. Ngokusho kwesimo sezulu esidumazayo, ngonyaka ka 2025 isibalo sabantu abakhuluphele sizodlula i-1 bhiliyoni! E-Russia, ama-46,5% abantu besilisa nama-51% abesifazane abakhuluphe ngokweqile, kanti lezi zibalo zihlala zikhula njalo.

Ngokwemiqondo yezokwelapha, ukukhuluphala kubhekwa njengokweqile kwesisindo somzimba ngamaphesenti angama-30 noma ngaphezulu. Isisindo sizuza ngenxa yamafutha, asendaweni ikakhulukazi esiswini nasemathangeni.

Ngaphezu kokungaphatheki kahle ngokomzimba nangokwengqondo, inkinga eyinhloko yokukhuluphala yizingqinamba: amathuba wokuhlakulela ukuqina kwenhliziyo, izifo zesistimu ye-musculoskeletal, hypertension ye-arterial, isifo sokuqina kwemizwa kanye nesifo sikashukela sohlobo 2 siyakhula.

Ukwenza kube ngokwejwayelekile isisindo ezimeni ezinjalo kuphela ngosizo lokuqina nokudla okufashisayo akwenzeki kuwo wonke umuntu, abaningi baphendukela kusizo lwemithi. Umgomo wokuchayeka ezidakamizweni ezinjalo uhlukile: abanye banciphisa isifiso sokudla, abanye bavimba ukumuncwa kwama-carbohydrate namafutha, kanti abanye banomphumela we-laxative ongavumeli ukudla kungenwe ngokuphelele.

Phakathi kwale mithi enamandla kunayo iSibutramine (embhalweni wesiLatini - uSibutramine).

I-antidepressant, eyakhiwa ngasekupheleni kwekhulu leminyaka edlule yinkampani yaseMelika i-Abbott Laboratories, ayizange iphilele lokho eyayikulindele, kodwa yabonakala njenge-anorectic enamandla. Ukwehla kwesisindo kwakubaluleke kangangokuba waqala ukuqoka iziguli ezinokukhuluphala kakhulu, ezingalawuliwe isifiso sazo sokudla.

Kungani uSibutramine Evinjelwe

Phakathi kwabalandeli bazo zonke izinkinga zokuxazulula iphilisi lezimangaliso, umuthi usetholakele emhlabeni jikelele. Isidakamizwa esivusa izinqubo ze-metabolic futhi sicindezele isifiso sokungenakuphikwa, i-WHO yaprofeta ngekusasa elihle.

Ngaphezu kwalokho, uSibutramine wabangela ukuncika okuhlobene nezidakamizwa (umphumela we-ecstasy noma i-amphetamine). Iziguli zobudala obuvuthiwe zazinzima ngokukhethekile ukubekezelela ukwelashwa. Ngaphambi kwezifundo ezengeziwe, lesi sidakamizwa sasivinjelwe e-USA, Canada, Australia, Europe, Ukraine. Inethiwekhi yasekhaya ekhemisi, ingathengwa ngomuthi obhaliwe.

I-Anorectic imiselwe ukukhuluphala okuyisisekelo kwe-II-III degree, lapho i-BMI idlula i-30-35 kg / m 2 nezinye izindlela zokwelapha zingasebenzi. Indlela yokwelapha ifaka ukudla okhethekile, kanye nokuzivocavoca okwanele komzimba.

Wayeqokwe kubo bonke abasebenza naye ngaphandle kwakhe. Kepha ngokushesha nje odokotela baqala ukukhala i-alamu ngenxa yemiphumela emibi: iziguli zazinokuphazamiseka kwengqondo, ukwanda kwengozi yenhliziyo, ukukhuphuka kokuzibulala.

Isidakamizwa sibuye sikhonjiswe ngohlobo lwe-2 sikashukela mellitus, hyper- kanye ne-hyperproteinemia. Ezimweni ezinjalo, inkomba yesisindo somzimba kufanele ibe ngaphezulu kuka-27kg / m². Ukwelashwa okuphelele, kufaka phakathi iSibutramine kanye nama-analogues ayo, kwenziwa ngaphansi kokuqashwa kwezokwelapha.

Isici esibalulekile sesifundo yisisusa sesiguli sokushintsha indlela yokuphila kanye nokudla ngenkathi sigcina umphumela ngemuva kokwelashwa. Kungani iSibutramine ivinjelwe emazweni athuthukile, bheka ividiyo embikweni we-TV:

I-Pharmacodynamics anorectic

Ekhanda, izinhlaka zobuchopho ezahlukahlukene zinesibopho sokuzizwa satiety. Ukuxhumana phakathi kwabo kungenxa yomsebenzi wama-neurons, okucasulayo okuvusa iphango, kusinxusa kwesinye isidlo.

Lapho ukudla kungena esiswini, ukufakwa kwezinzwa kujabulisa izakhi zobuchopho ezibhekene nomuzwa wokuphefumula. Kepha umuzwa wokulamba awunasisekelo sokomzimba: kwesinye isikhathi ufuna ukuba nokuluma ukuze unciphise ukungezwani komzimba, uphumule, futhi ujabulele inqubo.

ISibutramine ivumelanisa uhlelo lonke, isebenza ngama-neurons. Amaseli axhunyiwe kusetshenziswa ama-synapses - amakhompiyutha enza isibonakaliso njengabathintana ku-wiring. Noma yimuphi umsebenzi we-neuron uhambisana ne-ejection kwi-neurotransmitter - ikhemikhali esebenza ngokuxhumeka kuma-receptors ama-neurons asele. Ngakho amasignali adlula ngeketanga lawo. Imininingwane ngendlala noma satiety nayo idluliselwa kule ndlela.

Ibhalansi isiza ukulawula i-serotonin: uma ivolumu yayo iyehla, umuntu uthola indlala. Ngenqubo yokudla, i-neurotransmitter yenziwa, lapho inani layo lifinyelela umkhawulo othile, umzimba uhlangabezana nokugcotshwa.

Umuthi udala lo muzwa ngokugcina izinga elifanelekile le-serotonin emgodini we-synoptic. Ngenxa yalomphumela, isiguli sakha imikhuba yokudla okunempilo, ukuhlaselwa ebusuku kwendlala kuyanyamalala, futhi nenani lokudla elidliwayo liyancishiswa.

I-Anorectic ivimbela ukuphindaphinda kwe-norepinephrine, ekhiqizwa ohlelweni lwezinzwa oluyindawo lapho kudlala khona indima efanayo ne-neurotransmitter. Ukwanda kokuqukethwe kwaso kugeji ye-synoptic kuvusa amandla amaningi. Enye yezinto ezenziwa yile nto ukwenziwa kwe-thermogenesis, ekhipha amandla esibindini, e-adipose nasezicubu zemisipha. Lokhu kusiza ukwehlisa amafutha omzimba futhi kwenze umzimba ube ne-lipid metabolism.

Ngaphansi kwethonya lokulawula okwenziwe ngokufisa iSibutraminum, ushintsho ekuziphatheni kokudla, i-thermogenesis iyaqina. Ukugcinwa kwamafutha kuyashiswa, kanye nokudla ikhalori akubavumeli ukuthi babuyiselwe. I-Thermogenesis eyandayo isebenzisa ama-b-adrenergic receptors alawula ukukhiqizwa kwamandla. Ukwehla kwesifiso sokudla kuhlotshaniswa nokuvinjwa kokuphindwaphindwa kwe-norepinephrine ne-serotonin.

Ngokuya ngaphansi komthamo, imiphumela emibi imvamisa ikhombisa ukuguquguquka okuncane ekucindezelweni kwegazi kanye ne-tachycardia. Ungabona amathuba weSibutramine nendlela yokusebenza yayo kuvidiyo:

I-Pharmacokinetics yeSibutramine

Kuze kube ngama-80% wezidakamizwa zomlomo ezitholwa ngokushesha emgodini wokugaya ukudla. Esibindi, iguqulwa ibe ngama-metabolites - i-monodemethyl- ne-didemethylsibutramine. Iqoqo eliphakeme lesithako esiyisisekelo esisebenzayo laqoshwa ngemuva kwemizuzu engama-72 kusukela esikhathini sokusebenzisa ithebhulethi enesisindo esingu-0.015 g, ama-metabolites agxiliwe emahoreni angu-4 alandelayo.

Uma uthatha i-capsule ngesikhathi sokudla, ukusebenza kwayo kwehla ngesithathu, futhi isikhathi sokufinyelela kumphumela omkhulu sinwetshwa ngamahora ama-3 (inani eliphelele nokusatshalaliswa kuhlala kungashintshiwe). Kufika kuma-90% we-sibutramine kanye nama-metabolites ayo aboshelwe ku-serum albhamuin futhi asakazwa ngokushesha kwezicubu zemisipha.

Okuqukethwe kwezakhi ezisebenzayo egazini kufinyelela esimweni sokulingana ngemuva kwamahora angama-96 kusukela esikhathini sokusebenzisa ithebhulethi yokuqala futhi kuphindeka izikhathi ezi-2 kunokweqile ngemuva komthamo wokuqala womuthi.

I-Sibutramine ngesikhathi sokukhulelwa

Umuthi lo wafundwa ezilwaneni ezikhulelwe. Umuthi awuzange uthinte amandla okukhulelwa, kepha kumavundla okuhlola bekukhona umphumela wesidakamizwa esibelethweni. Isimo esingenangqondo sabonwa ekushintsheni ukubukeka nokwakheka kwesikhumba.

Zonke izinkomba zeSibutramine zikhanseliwe ngisho nasezingeni lokuhlela ukukhulelwa. Ngokuncelisa ibele, umuthi ubuye uhlukaniswe.

Isikhathi sonke sokwelashwa ngeSibutramine nezinsuku ezingama-45 emva kwayo, abesifazane besikhathi sokuzala kufanele basebenzise izindlela zokuvimbela inzalo ezifakazelwe. Ngaphambi kokuthatha isinqumo sokunciphisa umzimba ngomuthi, kufanele ucabange ngokuhlela ukukhulelwa kwakho okulandelayo.

Umuthi ubizwa ngokuthi i-teratogenic, futhi yize amandla awo okudala ukuguqulwa kwezakhi zofuzo engakaqalwa, umuthi awunabo ubufakazi obunzima, kanti nohlu lokuphambana luzongezwa.

Uhlu lokuphulwa kwe-Sibutramine

Kwama-anorectics, okokuqala, uhlaka lweminyaka: umuthi awubekelwe izingane kanye nabantu abadala (ngemuva kweminyaka engama-65). Kukhona okunye ukwephulwa kweSibutramine:

• Ukukhuluphala kwesibili, okucasulwa yi-pathologies yohlelo lwe-endocrine nohlelo lwangaphakathi lwezinzwa, kanye nezinye izimiso zesimo sezinto eziphilayo;
• Izinkinga zokudla - kusuka ku-anorexia kuya ku-bulimia (kokubini kanye naku-anamnesis);
  ukuphazamiseka kwengqondo;
• Ukuphazanyiswa kokugeleza kwegazi kwamakhemikhali (okukhona noma emlandweni);
• I-Goiter yemvelo enobuthi;
• Pheochromocytoma;
• I-IHD, izinguquko ezilinganisweni zenhliziyo yemisipha yenhliziyo nokungasebenzi kwayo okungapheli esigabeni sokubuyiselwa;
• IGlucose-galactose malabsorption, hypolactasia;
• Ukonakala kokulethwa kwegazi emithanjeni yangaphandle;
• Amaconsi angalawulwa emfuthweni wegazi kusuka ku-145 mm Hg. Ubuciko. futhi phezulu;
• Ukuqina kwesibindi nokuqina kwezinso;
• I-Prostate adenoma yokuchama okungahambi kahle;
• Ukuluthwa utshwala nokusebenzisa kabi izidakamizwa;
• I-glaucoma evaliwe;
• Ukuzwela kunoma yiziphi izithako zefomula.

Ukuqokwa ikakhulukazi ekuqeshweni kweSibutramine kufanele kunikezwe iziguli ezinomfutho wegazi, iziguli ezinezinkinga zokugeleza kwegazi, ukukhononda kokukhishwa, umlando wokungasebenzi kahle kwe-coronary, isithuthwane, isifo sokusha kwesibindi noma izinso, i-glaucoma, i-cholecystitis, i-hemorrhage, i-tics, kanye neziguli ezidla umuthi othinta ukubumbana kwegazi.

Imiphumela engathandeki

ISibutramine ingumuthi obucayi, futhi njenganoma imuphi umuthi onzulu nemiphumela emibi, akuyona ingozi ukuthi emazweni amaningi umuthi wayo osemthethweni uyenqabela. Elula ukusabela komzimba. Hhayi ukushaqeka kwe-anaphylactic, kunjalo, kepha ukuqubuka kwesikhumba kungenzeka. Ukuqhuma ngokwakho kuyenzeka lapho umuthi uyekwa noma ngemuva kokuzivumelanisa nezimo.

Umphumela obubi kakhulu umlutha. Isiphuzo esidakayo iminyaka engu-1-2, kepha abaningi abakwazi ukuyeka, ukuqinisa ukuncika kwezidakamizwa, ngokuqhathaniswa nokuluthwa izidakamizwa. Ukuthi umzimba wakho uzwelana kangakanani neSibutramine, akunakwenzeka ukuthola kusengaphambili.

Umphumela wokuncika ubonwa kakade ngenyanga yesi-3 yokusetshenziswa okujwayelekile.

Ukuluka kufanele kube kancane kancane. Isimo esifana “nokuphuka” yi-migraine, ukuhlangana kahle, ukungalali kahle, ukungakhathazeki njalo, ukungabekezeleki kahle, ukushintshana nokunganaki nemicabango yokuzibulala.

Umuthi uphazamisa umsebenzi we "ngcwele yama holies" - ubuchopho bomuntu nohlelo lwezinzwa. Akukenzeki ngaso sonke isikhathi ukuthinta ubuchopho kanye nohlelo oluphambili lwezinzwa ngaphandle kwemiphumela yengqondo. Imizamo yokuqala yokwelashwa yaphela ngokuncika kakhulu, ukuzibulala, ukuphazamiseka kwengqondo, ukufa kusuka ekuhlaselweni yinhliziyo nobuchopho.

Umuthi wesimanjemanje uhlanza ikhwalithi ephezulu, imithamo incishiswa kakhulu, kepha imiphumela engalindelekile ayifakiwe. Ngokuphathelene nokubamba iqhaza kwezokuphepha kanye nokuphathwa kwezindlela eziyinkimbinkimbi, ukusebenza ubude, kunoma yiziphi ezinye izimo ezidinga ukusabela okusheshayo nokunaka ukunakwa, kuyenqatshelwa ngesikhathi sokwelashwa ngeSibutramine.

KuSibutramine, imiyalelo yokusetshenziswa iqinisekisa ukuthi iningi lezimpawu (tachycardia, hyperemia, umfutho wegazi ophakeme, ukuswela isifiso sokudla, ushintsho ekunambithekeni, ukuphazamiseka kusigqi sokudilizwa, i-hemorrhoids, ukuphazamiseka kwengqondo, ukujuluka, ukukhathazeka kanye ne-isomnia) kunyamalala ngemuva kokukhishwa kwezidakamizwa.

Ucwaningo lweSibutramine eYurophu - umbono wesazi

Ucwaningo lwe-SCOUT, olwaqalwa yiziphathimandla ze-EU ezifanele ngemuva kokuhlaziya izibalo ezidabukisayo zezokwelapha, lwalubandakanya izisebenzi zokuzithandela ezinesibalo esikhulu senkomba yomzimba kanye nengozi yokuhlakulela i-pathology ye-inhliziyo

Eminye imicimbi emibi ifaka ukusabela kokungezwani kokuhlukahluka kokwehluka kobukhulu, ukonakala ekwakhiweni kwegazi (ukwehla kwesibalo seplateli), ukulimala kwe-autoimmune ezindongeni zemithambo yegazi, nokulimala kwengqondo.

Uhlelo lwezinzwa lukhiphe ukuvela kwesimo semisipha yemisipha, ukwehluleka kwememori. Abanye ababambiqhaza babenobuhlungu ezindlebeni zabo, emuva, ikhanda, nombono nokuzwa bekukhubazekile. Ukuphazamiseka kwesisu nakho kwabonwa. Ekupheleni kombiko, kwaphawuleka ukuthi ukuhoxiswa kwe-syndrome kungadala ikhanda nokudla okungalawulwa.

Funda kabanzi mayelana nokuthi uSibutramine uwashisa kanjani amanoni futhi athuthukisa ukuguquguquka - kuvidiyo

Ungayisebenzisa kanjani i-anorectics

Ithebhulethi ithathwa kanye. Ukudla ukudla akuwuthinti umphumela. Ekuqaleni kwesifundo, kunconyelwa ukuphuza i-capsule eyodwa enesisindo esingu-0,01 g ..igwenyiwe iphelele futhi igezwa ngamanzi.

Uma ngenyanga yokuqala isisindo sesidlulile ngaphakathi kwe-2 kg futhi umuthi udluliswa ngokujwayelekile, ungangezelela isilinganiso sibe ngu-0, 015 g Uma uma ngenyanga ezayo ukwehla kwesisindo kungaphansi kwe-2 kg, umuthi ukhanseliwe, ngoba kuyingozi ukuguqula umthamo uqhubeke.

Phazamisa inkambo yokwelashwa ezimweni ezilandelayo:

1. Uma ngaphansi kwe-5% yesisindo sokuqala ilahlekile ezinyangeni ezi-3;
2. Uma inqubo yokulahlekelwa isisindo imile ezinkomba aze afike ku-5% wesisindo sokuqala;
3. Isiguli saqala ukuthola isisindo futhi (ngemuva kokulahlekelwa isisindo).

Sebenzisa umuthi onconyelwe akukho ngaphezulu kweminyaka engu-2.

Ngemininingwane engaphezulu ngeSibutramine, bheka okokufundisa kwevidiyo kuvidiyo:

Ukweqisa

Ukwehluleka ukulandela izincomo, ukwanda kwemithamo kukhulisa ubungozi be-overdose. Imiphumela yemiphumela enjalo ayifundwanga ngokwanele, ngakho-ke i-antidote ayikakhiwa. Njengengxenye yokunakekelwa okuphuthumayo kwezimpawu ezinjengalesi, isisu sihlanzwa isisulu, sinikezwa ama-enterosorbents uma kungakadluli ihora elilodwa ngemuva kokuthatha uSibutramine.

Bheka izinguquko esimweni sesisulu phakathi nosuku. Uma kuboniswa izimpawu zemiphumela emibi, kuyabonakala ukwelashwa okubonakalayo. Imvamisa, umfutho wegazi ophakeme kanye nezinga lokukhuphuka kwenhliziyo kuyabonakala. Izimpawu ezinjalo ziyeka ngama-β-blockers.

Izinketho zokusebenzisana kweSibutramine neminye imithi

Akunconywa ukusebenzisa i-anorectic:

• Ngemithi yokwelapha ukuphazamiseka kwengqondo noma ukukhuluphala kwamazinyo, okunomphumela ophakathi nendawo;
• Ngemithi evimba amathuba we-monoamine oxidase (phakathi kokusetshenziswa kweSibutramine kanye nokusetshenziswa kwama-inhibitors, isikhawu okungenani izinsuku eziyi-14 kufanele sigcinwe);
• Ngezidakamizwa ezithuthukisa ukukhiqizwa kwe-serotonin kanye nokuvimbela ukuphinda kuqalwe;
• Izidakamizwa ezifaka ama-microsomal hepatic enzymes;
• Ngemithi evusa i-tachycardia, yehla ekucindezelweni kwegazi, ukukhuthaza kohlelo lwezinzwa olunozwela.

ISibutramine ayihambelani notshwala. Amathebulethi asuselwa kulawula isifiso sokudla awashintshi ama-pharmacodynamics wokuvimbela inzalo ngomlomo.

Imibandela yokuthenga nokugcina

Ngaphandle kokuthi emazweni amaningi iSibutramin iyenqatshelwe kwinethiwekhi esemthethweni yasokhemisi, i-Intanethi igcwele okunikezwayo okunjalo. Ngakho-ke ungathenga ama-anorectics ngaphandle kadokotela. Kuliqiniso, imiphumela kuleli cala kuzodingeka inakekelwe uqobo. KuSibutramin, intengo (cishe ama-ruble ayizinkulungwane ezimbili) nayo akuyona eyawo wonke umuntu.

Imithetho yokugcina ngokusetshenziswa kwalo muthi ijwayelekile: izinga lokushisa lamakamelo (kufika ku-25 ° C), ukulawulwa kwempilo yeshelufu (kuze kube yiminyaka emi-3, ngokwemiyalo) nokufinyelela kwezingane. Amathebulethi agcinwa kahle kakhulu kumaphakeji wangempela.

USibutramine - ama-analogues

Isisekelo sobufakazi esikhulu kunazo zonke (kepha hhayi izindleko eziphansi kakhulu) sinama-Xenical - umuthi onomphumela ofanayo wemithi, osetshenziselwa ukukhuluphala kwe-alimentary. Inethiwekhi yokuhweba kune-Orlistat enegama elifanayo. Ingxenye esebenzayo ivimba ukumunca kwamafutha yizindonga zamathumbu futhi izisuse ngokwemvelo. Umphumela ogcwele (20% ngaphezulu) ubonakala kuphela lapho udla.

Umehluko phakathi kweSibutramine ne-Xenical ngamathuba wemithi: uma okwedlule kunciphisa isifiso sokusebenza ngengqondo nasezikhungweni zezinzwa, owokuqala ususa amafutha, ebopha kuwo bese ephoqa umzimba ukuthi uchithe owawo amafutha abekelwe wona ukukhokhela izindleko zamandla. Ngohlelo oluphambili lwezinzwa, uSibutramine usebenza kuzo zonke izitho zesistimu, i-Xenical ayingeni ohlelweni lokujikeleza, futhi ayithinti izitho nezinhlelo.

I-Fenfluramine iyi-analogue ye-serotonergic eqenjini lezinto eziphuma ku-amphetamine. Inomshini wokusebenza ofana neSibutramine futhi uvinjelwe emakethe njengento eyi-narcotic.

I-Fluoxetine, isithasami sokucindezela esithambisa ukucwaswa kwe-serotonin, nayo inamandla we-anorectic.

Uhlu lungahlinzekelwa, kepha yonke imishanguzo ye-anorexigenic, njengasekuqaleni, inemiphumela emibi eminingi futhi ingalimaza kakhulu impilo. Okwangempela akunazo i-analogues egcwele ngokugcwele, abalawuli bezithelo zomenzi weNdiya bayaziwa noma baziwa kakhulu - iSlimia, Gold Line, Redus. Asikho isidingo sokukhuluma ngezengezo zokudla zamaShayina - ikati eli-100% esikhwameni.

I-Reduxin Light - isengezo sokudla esuselwa ku-oxetriptan, esingahlobene ne-sibutramine, sinamandla okuwohloka, futhi sivimbela isifiso sokudla. Ingabe zikhona ezinye izikhalo ezingabizi kakhulu zeSibutramine? Izithako zokudla ezikhona ze-Listata ne-Gold Line Light zinokwakheka okuhlukile, kepha ukwakhiwa kokupakisha kufana kakhulu neSabutramine yasekuqaleni. Icebo elinjalo lokuthengisa alithinti ikhwalithi yesengezo.

Imibono yokulahlekelwa isisindo nodokotela

Okunye ukubuyekezwa kukhathazeka ngeSibutramine, izisulu nezihlobo zabo basatshiswa yimiphumela emibi engalungiseki, banxusa ukuthi bayeke ukwelashwa. Kepha labo abasinda esikhathini sokuzivumelanisa nezimo futhi abangayekanga izifundo, baphawula inqubekela phambili enkulu.

Mayelana neSibutramine, ukubuyekezwa kodokotela kuvinjelwe kakhudlwana: odokotela abakuphiki ukusebenza okuphezulu kweSibutramine, basikhumbuza ukunamathela ngokuqinile emgqomeniweni kanye nokuqapha okujwayelekile kokunciphisa umzimba. Baxwayisa ngengozi yokuzelapha, ngoba umuthi mubi kakhulu futhi akekho ophephile emiphumeleni emibi.

Ngokwezibalo, okungenani eyodwa yemiphumela engathandeki itholwa yi-50% yalabo abanciphisa isisindo ngeSibutramine. Akusikho nje ukuthi umuthi uvinjelwe emazweni athuthukile kakhulu kwezomnotho, kanti neRussia nayo ifakiwe ohlwini lwezidakamizwa ezinamandla.

Ukubonisana nochwepheshe ngokusetshenziswa kweSibutramine nokuzilungisa isimo somzwelo - kule vidiyo: