(Loperamide / Imodium) / ?

' ' ! (Acute Diarrhea), / 'IBS-D' (Irritable Bowel Syndrome) , / .

Opioid (/) (Synthetic opioid), ( ). , (Mu-opioid receptors) , / (Myenteric plexus) 100% / . , .

. (High) ! (Loperamide Toxicity / Black Box Warning). (Torsades de pointes / QT prolongation) , ! (: /C. diff) (Toxic megacolon) .

ꯅꯍꯥꯛ ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯁꯤꯖꯤꯟꯅꯔꯤꯕꯔꯥ? ꯑꯗꯨꯗꯒꯤ ꯃꯁꯤ ꯀꯔꯤꯅꯣ ꯍꯥꯌꯕꯗꯨ ꯇꯁꯦꯡꯅꯥ ꯈꯉꯂꯁꯤ! (ꯏꯕꯨꯞꯔꯣꯐꯦꯟ) ꯑꯃꯁꯨꯡ ꯑꯦꯟ.

ꯑꯩꯈꯣꯌꯅꯥ ꯃꯀꯣꯛ ꯊꯣꯡꯕꯥ, ꯍꯀꯆꯥꯡ ꯁꯣꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯂꯥꯏꯍꯧ ꯍꯧꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯑꯩꯈꯣꯌꯅꯥ ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯌꯧꯔꯀꯄꯥ ꯑꯍꯥꯅꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯗꯨꯗꯤ ꯄꯦꯟ ꯀꯤꯂꯔꯅꯤ, ꯅꯠꯇꯦ? ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯑꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯃꯔꯛꯇꯒꯤ ꯀꯌꯥ ꯑꯃꯅꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯁꯤꯖꯤꯟꯅꯔꯤꯕꯥ ꯍꯤꯗꯥꯛ ꯑꯃꯅꯤ, ꯑꯃꯁꯨꯡ ꯃꯁꯤ ꯐꯥꯔꯃꯥꯁꯤꯁꯤꯡꯗꯒꯤ ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯂꯧꯕꯥ ꯌꯥꯏ꯫ ꯑꯗꯨꯕꯨ ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯁꯤꯖꯤꯟꯅꯕꯗꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯆꯦꯀꯁꯤꯅꯒꯗꯕꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯋꯥꯐꯝ ꯀꯌꯥ ꯂꯩꯔꯤ꯫ ꯃꯁꯤ ꯁꯨꯞꯅꯒꯤ ꯄꯦꯟ ꯀꯤꯂꯔ ꯑꯃꯈꯛꯇꯃꯛ ꯅꯠꯇꯦ꯫ ꯑꯗꯨꯅꯥ ꯉꯁꯤꯗꯤ ꯏꯕꯨꯡꯉꯣ ꯏꯕꯨꯡꯉꯣꯒꯤ ꯃꯔꯃꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯁꯤ, ꯃꯌꯥꯝꯅꯥ ꯈꯉꯅꯤꯡꯕꯥ ꯄꯨꯝꯅꯃꯛ꯫

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ꯃꯁꯤ ꯏꯕꯨꯡꯉꯣꯟ (ibuprofen) ꯍꯥꯌꯕꯁꯤ ꯀꯔꯤꯅꯣ?

ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯑꯁꯤ ꯑꯅꯥꯕꯥ, ꯁꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯂꯥꯏꯍꯧ ꯍꯟꯊꯍꯅꯕꯗꯥ ꯁꯤꯖꯤꯟꯅꯕꯥ ꯗ꯭ꯔꯒ ꯑꯃꯅꯤ꯫ ꯃꯁꯤ ꯅꯟ-ꯁ꯭ꯇꯦꯔꯣꯏꯗ ꯑꯦꯟꯇꯤ-ꯏꯅꯐ꯭ꯂꯦꯃꯦꯇꯔꯤ ꯗ꯭ꯔꯒ ꯀꯧꯕꯥ ꯗ꯭ꯔꯒ ꯀꯥꯡꯂꯨꯞ ꯑꯃꯒꯤ ꯃꯅꯨꯡ ꯆꯜꯂꯤ꯫ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯋꯥꯍꯟꯊꯣꯛꯀꯤ ꯃꯇꯨꯡ ꯏꯟꯅꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯃꯁꯤꯕꯨ ꯅꯟ-ꯁ꯭ꯇꯦꯔꯣꯏꯗꯜ ꯑꯦꯟꯇꯤ-ꯏꯅꯐ꯭ꯂꯦꯃꯦꯇꯔꯤ ꯗ꯭ꯔꯒꯁꯤꯡ ꯅꯠꯔꯒꯥ (ꯑꯦꯟ.ꯑꯦꯁ.ꯑꯦ.ꯑꯥꯏ.ꯗꯤ.ꯁꯤꯡ) ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫

ꯍꯥꯌꯕꯗꯤ ꯍꯤꯗꯥꯛ ꯑꯁꯤꯅꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯊꯕꯛ ꯀꯌꯥ ꯇꯧꯏ:

ꯑꯅꯥꯕꯥ ꯍꯟꯊꯍꯜꯂꯤ: ꯑꯔꯊ꯭ꯔꯥꯏꯇꯤꯁꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯃꯀꯣꯛ ꯊꯣꯡꯕꯥ, ꯍꯥꯠꯄꯥ, ꯃꯁꯜ ꯁꯣꯀꯄꯥ, ꯑꯃꯁꯨꯡ ꯁꯔꯨ ꯇꯥꯡꯒꯤ ꯑꯅꯥꯕꯁꯤꯡ ꯑꯁꯤꯅꯆꯤꯡꯕꯥ ꯃꯌꯥꯏ ꯑꯣꯏꯕꯥ ꯑꯃꯁꯨꯡ ꯃꯌꯥꯏ ꯑꯣꯏꯕꯥ ꯑꯅꯥꯕꯁꯤꯡ ꯀꯣꯀꯍꯜꯂꯤ꯫
ꯏꯅꯐ꯭ꯂꯦꯃꯦꯁꯟ (swelling) ꯍꯟꯊꯍꯜꯂꯤ: ꯍꯀꯆꯥꯡꯗꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯅꯠꯠꯔꯒꯥ ꯏꯅꯐꯦꯛꯁꯟ ꯑꯃꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯁꯣꯛ-ꯄꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯂꯥꯎꯕꯥ ꯑꯁꯤꯅꯆꯤꯡꯕꯥ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯏ꯫
ꯂꯥꯏꯍꯧ ꯍꯟꯊꯍꯜꯂꯤ: ꯍꯀꯆꯥꯡꯒꯤ ꯇꯦꯝꯄꯦꯔꯦꯆꯔ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯗꯨꯅꯥ ꯂꯥꯏꯍꯧ ꯍꯟꯊꯍꯅꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫

ꯑꯥꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯂꯧꯗ꯭ꯔꯤꯉꯩ ꯃꯃꯥꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯈꯪꯍꯅꯒꯗꯕꯥ ꯋꯥꯐꯃꯁꯤꯡ꯫

ꯑꯩꯈꯣꯌꯅꯥ ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯁꯤꯖꯤꯟꯅꯔꯕꯁꯨ, ꯃꯁꯤ ꯑꯀꯛꯅꯕꯥ ꯍꯀꯁꯦꯂꯒꯤ ꯐꯤꯚꯝ ꯈꯔꯗꯥ ꯌꯥꯝꯅꯥ ꯐꯠꯇꯦ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ, ꯅꯍꯥꯛꯅꯥ ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯁꯤꯖꯤꯟꯅꯗ꯭ꯔꯤꯉꯩ ꯃꯃꯥꯡꯗꯥ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤꯕꯥ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯑꯃꯍꯦꯛꯇꯥ ꯂꯩꯔꯕꯗꯤ, ꯅꯍꯥꯛꯅꯥ ꯃꯗꯨꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯁꯣꯌꯗꯅꯥ ꯈꯪꯍꯅꯒꯗꯕꯅꯤ꯫

ꯍꯀꯁꯦꯂꯒꯤ ꯀꯟꯗꯤꯁꯟ ꯅꯠꯠꯔꯒꯥ ꯍꯦꯕꯤꯠ꯫	ꯀꯔꯤꯒꯤ ꯈꯉꯍꯅꯒꯗꯒꯦ?
ꯍꯥꯔꯠ ꯗꯤꯖꯤꯖ, ꯍꯥꯔꯠ ꯑꯦꯇꯦꯛ, ꯍꯥꯔꯠ ꯐꯦꯜ ꯑꯣꯏꯕꯥ ꯅꯠꯠꯔꯒꯥ ꯍꯥꯏ ꯕ꯭ꯂꯗ ꯄ꯭ꯔꯦꯁꯔ꯫	ꯏꯕꯨꯞꯔꯣꯐꯦꯅꯅꯥ ꯍꯥꯔꯠ ꯑꯦꯇꯦꯛ ꯑꯃꯁꯨꯡ ꯁ꯭ꯠꯔꯣꯀꯀꯤ ꯔꯤꯁ꯭ꯛ ꯍꯦꯅꯒꯠꯍꯅꯕꯥ ꯌꯥꯏ꯫
ꯅꯨꯃꯤꯠ ꯲ꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯍꯥꯔꯠ ꯕꯥꯏꯄꯥꯁ ꯁꯔꯖꯔꯤ (ꯀꯣꯔꯣꯅꯥꯔꯤ ꯑꯥꯔꯇꯦꯔꯤ ꯕꯥꯏꯄꯥꯁ ꯒ꯭ꯔꯥꯐ - ꯁꯤ.ꯑꯦ.ꯕꯤ.ꯖꯤ.) ꯑꯃꯥ ꯄꯥꯡꯊꯣꯀꯈꯤ꯫	ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯁꯤꯖꯤꯟꯅꯕꯅꯥ ꯌꯥꯝꯅꯥ ꯈꯨꯗꯣꯡꯊꯤꯅꯤꯉꯥꯏ ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫
ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯂꯁꯔ, ꯒꯦꯁ꯭ꯠꯔꯥꯏꯇꯤꯁ ꯅꯠꯠꯔꯒꯥ ꯏꯟꯇꯦꯁ꯭ꯇꯥꯏꯅꯒꯤ ꯏ ꯊꯣꯀꯄꯥ꯫	ꯏꯕꯨꯞꯔꯣꯐꯦꯅꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯃꯁꯨꯡ ꯏꯟꯇꯦꯁ꯭ꯇꯥꯏꯅꯒꯤ ꯏ ꯊꯣꯀꯄꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯦꯅꯒꯠꯍꯜꯂꯤ꯫
ꯀꯤꯗꯅꯤ ꯅꯠꯠꯔꯒꯥ ꯂꯤꯚꯔꯒꯤ ꯂꯥꯌꯅꯥ꯫	ꯍꯥꯌꯔꯤꯕꯥ ꯑꯣꯔꯒꯥꯅꯁꯤꯡ ꯑꯁꯤ ꯏꯕꯨꯞꯔꯣꯐꯦꯅꯅꯥ ꯁꯣꯀꯍꯅꯕꯒꯤ ꯆꯥꯡ ꯍꯦꯟꯅꯥ ꯋꯥꯡꯏ꯫
ꯑꯅꯥꯕꯥ ꯂꯥꯌꯅꯥ꯫	ꯏꯕꯨꯞꯔꯣꯐꯦꯅꯅꯥ ꯑꯦꯖꯃꯥ ꯄꯦꯁꯦꯟꯇ ꯈꯔꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯍꯦꯟꯅꯥ ꯐꯒꯠꯍꯅꯕꯥ ꯌꯥꯏ꯫
ꯏ ꯊꯤꯡꯅꯕꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ (ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯋꯥꯔꯐꯦꯔꯤꯟ) ꯁꯤꯖꯤꯟꯅꯕꯥ꯫	ꯏ ꯊꯣꯀꯄꯒꯤ ꯔꯤꯁ꯭ꯛ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯋꯥꯡꯅꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯏ꯫
ꯃꯤꯔꯣꯅꯕꯥ, ꯃꯤꯔꯣꯅꯕꯥ ꯍꯣꯠꯅꯕꯥ, ꯅꯠꯠꯔꯒꯥ ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯀꯄꯥ꯫	ꯃꯤꯔꯣꯜꯂꯤꯉꯩ ꯃꯇꯃꯗꯥ (ꯃꯔꯨꯑꯣꯏꯅꯥ ꯍꯧꯈꯤꯕꯥ ꯊꯥ 3) ꯑꯃꯁꯨꯡ ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯁꯤꯖꯤꯟꯅꯕꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯄꯥꯎꯇꯥꯀꯁꯤꯡ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫
ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯊꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯃꯩꯈꯨ ꯊꯥꯗꯣꯀꯄꯥ꯫	ꯍꯥꯌꯔꯤꯕꯥ ꯂꯃꯆꯠ-ꯁꯥꯖꯠꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯂꯧꯕꯥ ꯃꯇꯃꯗꯥ ꯁ꯭ꯇꯣꯃꯥꯛ ꯕ꯭ꯂꯤꯗꯤꯡꯒꯤ ꯔꯤꯁ꯭ꯛ ꯃꯈꯥ ꯇꯥꯅꯥ ꯍꯦꯅꯒꯠꯍꯜꯂꯤ꯫
ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯅꯠꯠꯔꯒꯥ ꯑꯦꯁ꯭ꯄꯤꯔꯤꯟ ꯅꯠꯠꯔꯒꯥ ꯅꯦꯞꯔꯣꯛꯁꯦꯅꯒꯨꯝꯕꯥ ꯑꯇꯩ NSAIDꯁꯤꯡꯒꯤ ꯑꯦꯂꯥꯔꯖꯤ ꯂꯩꯕꯥ꯫	ꯁꯥꯊꯤꯕꯥ ꯑꯦꯂꯥꯔꯖꯤꯒꯤ ꯔꯤꯑꯦꯛꯁꯟ ꯂꯩꯕꯒꯤ ꯔꯤꯁ꯭ꯛ ꯂꯩ꯫

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ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯀꯔꯝꯅꯥ ꯁꯤꯖꯤꯟꯅꯒꯗꯒꯦ?

ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯃꯤꯠꯅꯥ ꯊꯀꯄꯅꯤ꯫ ꯇꯦꯕ꯭ꯂꯦꯠ ꯑꯗꯨ ꯏꯁꯤꯡꯒꯤ ꯒ꯭ꯂꯥꯁ ꯑꯃꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯂꯧꯊꯣꯀꯎ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯈꯣꯝꯂꯥꯡ ꯁꯣꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯊꯝꯃꯣꯌ ꯁꯣꯀꯄꯥ ꯊꯦꯡꯅꯔꯕꯗꯤ, ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯆꯥꯅꯕꯥ ꯆꯤꯟꯖꯥꯛ ꯅꯠꯠꯔꯒꯥ ꯁꯉ꯭ꯒꯣꯝ ꯒ꯭ꯂꯥꯁ ꯑꯃꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯆꯥꯒꯗꯕꯅꯤ꯫ ꯃꯁꯤꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯀꯇꯥ ꯄꯤꯔꯤꯕꯥ ꯏꯐꯦꯛꯇ ꯑꯗꯨ ꯍꯟꯊꯍꯅꯒꯅꯤ꯫

ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯄꯤꯕꯥ ꯗꯣꯖ ꯑꯗꯨꯗꯒꯤ ꯍꯦꯟꯅꯥ ꯀꯩꯗꯧꯉꯩꯗꯥ ꯂꯧꯔꯣꯏꯗꯕꯅꯤ꯫ ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ, ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯍꯟꯊꯔꯀꯄꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯃꯈꯥ ꯇꯥꯅꯥ ꯂꯧꯕꯒꯤ ꯃꯊꯧ ꯇꯥꯗꯦ꯫

ꯄꯨꯛꯅꯤꯡ ꯆꯪꯕꯤꯌꯨ: ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯊꯀꯈ꯭ꯔꯦ ꯍꯥꯌꯅꯥ ꯈꯜꯂꯕꯗꯤ, ꯋꯥꯈꯜ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯂꯩꯔꯣꯏꯗꯕꯅꯤ꯫ ꯈꯨꯗꯛꯇꯥ ꯀꯣꯂꯝꯕꯣ ꯅꯦꯁ꯭ꯅꯦꯜ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯂꯗꯥ ꯂꯩꯕꯥ ꯅꯦꯁ꯭ꯅꯦꯜ ꯄꯣꯏꯖꯅꯁ ꯏꯅꯐꯣꯔꯃꯦꯁꯟ ꯁꯦꯟꯇꯔꯗꯥ ꯐꯣꯟ ꯇꯧꯕꯤꯌꯨ . ꯅꯠꯠꯔꯒꯥ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯅꯀꯄꯥ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯂꯒꯤ ꯏꯃꯔꯖꯦꯟꯁꯤ ꯇ꯭ꯔꯤꯇꯃꯦꯟꯇ ꯌꯨꯅꯤꯠ (ETU)ꯗꯥ ꯆꯠꯂꯨ꯫

ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯑꯗꯣꯝ ꯈꯛꯇꯒꯤꯅꯤ꯫ ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯑꯇꯣꯞꯄꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯗꯥ ꯄꯤꯕꯤꯒꯅꯨ, ꯃꯈꯣꯌꯗꯥ ꯅꯍꯥꯛꯀꯥ ꯃꯥꯟꯅꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯂꯩꯔꯕꯁꯨ꯫

ꯑꯉꯥꯡꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯑꯍꯜ ꯑꯣꯏꯔꯕꯁꯤꯡꯗꯥ ꯄꯤꯕꯥ ꯃꯇꯃꯗꯥ꯫

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯆꯍꯤ 12ꯒꯤ ꯃꯈꯥꯗꯥ ꯂꯩꯕꯥ ꯑꯉꯥꯡꯁꯤꯡꯗꯥ ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯄꯤꯔꯕꯗꯤ, ꯃꯁꯤꯒꯤꯗꯃꯛꯇꯥ ꯑꯀꯛꯅꯅꯥ ꯁꯦꯝꯕꯥ ꯁꯤꯔꯄꯁꯤꯡ ꯂꯩ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯇꯦꯕ꯭ꯂꯦꯠꯁꯤꯡ ꯄꯤꯔꯕꯗꯤ, ꯅꯍꯥꯛꯀꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤ ꯑꯔꯨꯝꯕꯥ ꯑꯗꯨꯒꯥ ꯆꯥꯟꯅꯕꯥ ꯗꯣꯖꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯗꯣꯛꯇꯔ ꯑꯃꯗꯥ ꯁꯣꯌꯗꯅꯥ ꯍꯪꯒꯗꯕꯅꯤ꯫ ꯆꯍꯤ 65ꯒꯤ ꯃꯊꯛꯇꯥ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯅꯥ ꯍꯤꯗꯥꯛ ꯑꯁꯤꯒꯤ ꯏꯐꯦꯛꯇ ꯑꯁꯤ ꯍꯦꯟꯅꯥ ꯐꯥꯎꯕꯥ ꯌꯥꯏ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯃꯈꯣꯌꯗꯥ ꯃꯍꯧꯁꯥꯅꯥ ꯍꯦꯟꯅꯥ ꯅꯦꯝꯕꯥ ꯗꯣꯖ ꯑꯃꯥ ꯄꯤ꯫

ꯏꯕꯨꯞꯔꯣꯐꯦꯅꯒꯥ ꯃꯔꯤ ꯂꯩꯅꯕꯥ ꯑꯇꯩ ꯍꯤꯗꯥꯀꯁꯤꯡ꯫

ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯑꯁꯤ ꯑꯇꯩ ꯍꯤꯗꯥꯀꯁꯤꯡꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯁꯣꯀꯍꯅꯕꯥ ꯌꯥꯕꯥ ꯗ꯭ꯔꯒ ꯑꯃꯅꯤ, ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯑꯇꯩ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯁꯤꯖꯤꯟꯅꯔꯕꯗꯤ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯈꯪꯍꯅꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫

ꯏꯕꯨꯞꯔꯣꯐꯦꯅꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯀꯩꯗꯧꯉꯩꯗꯥ ꯂꯧꯔꯣꯏꯗꯕꯥ ꯗ꯭ꯔꯒꯁꯤꯡ꯫
ꯀꯦꯇꯣꯔꯣꯂꯥꯛ ꯍꯥꯌꯅꯥ ꯈꯉꯅꯕꯥ꯫	ꯃꯁꯤꯁꯨ NSAID ꯑꯃꯅꯤ ꯑꯃꯁꯨꯡ ꯃꯁꯤꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇꯁꯤꯡ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫
ꯁꯤꯗꯣꯐꯣꯚꯤꯔ, ꯃꯦꯊꯣꯠꯔꯦꯛꯁꯦꯠ, ꯄꯦꯃꯦꯠꯔꯦꯛꯁꯦꯗ꯫	ꯍꯥꯌꯔꯤꯕꯥ ꯑꯁꯤ ꯀꯦꯟꯁꯔ ꯑꯃꯁꯨꯡ ꯑꯇꯣꯞꯄꯥ ꯂꯥꯌꯅꯥꯁꯤꯡ ꯂꯥꯌꯦꯡꯕꯗꯥ ꯁꯤꯖꯤꯟꯅꯕꯥ ꯍꯤꯗꯥꯀꯁꯤꯡꯅꯤ꯫ ꯃꯈꯣꯌꯁꯤꯡ ꯑꯁꯤ ꯏꯕꯨꯞꯔꯣꯐꯦꯅꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯂꯧꯕꯅꯥ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫
ꯏꯕꯨꯞꯔꯣꯐꯦꯅꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯏꯟꯇꯔꯦꯛꯇ ꯇꯧꯕꯥ ꯌꯥꯕꯥ ꯑꯇꯩ ꯄꯣꯠꯁꯀꯁꯤꯡ꯫
ꯑꯦꯁ꯭ꯄꯤꯔꯤꯟ ꯑꯃꯁꯨꯡ ꯑꯇꯩ NSAIDꯁꯤꯡ (ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯅꯦꯞꯔꯣꯛꯁꯦꯟ, ꯗꯤꯛꯂꯣꯐꯦꯅꯥꯛ)	ꯁ꯭ꯇꯣꯃꯥꯛ ꯕ꯭ꯂꯤꯗꯤꯡ ꯑꯃꯁꯨꯡ ꯀꯤꯗꯅꯤꯗꯥ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯊꯣꯀꯄꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯦꯅꯒꯠꯍꯜꯂꯤ꯫
ꯋꯥꯔꯐꯦꯔꯤꯟ (ꯕ꯭ꯂꯗ ꯊꯤꯅꯔ)	ꯏ ꯊꯣꯀꯄꯒꯤ ꯔꯤꯁ꯭ꯛ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯍꯦꯅꯒꯠꯂꯀꯏ꯫
ꯌꯨ	ꯁ꯭ꯇꯣꯃꯥꯛ ꯕ꯭ꯂꯤꯗꯤꯡꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯦꯅꯒꯠꯍꯜꯂꯤ꯫
ꯂꯤꯊꯤꯌꯥꯝ, ꯗꯥꯏꯌꯨꯔꯦꯇꯤꯀꯁꯤꯡ꯫	ꯍꯤꯗꯥꯀꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯃꯈꯣꯌꯒꯤ ꯏꯐꯦꯛꯇꯤꯕꯅꯦꯁꯇꯥ ꯑꯀꯥꯌꯕꯥ ꯄꯤꯕꯥ ꯌꯥꯏ꯫

ꯊꯣꯀꯄꯥ ꯌꯥꯕꯥ ꯁꯥꯊꯤꯕꯥ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇ ꯑꯃꯁꯨꯡ ꯔꯤꯁ꯭ꯀꯁꯤꯡ꯫

ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯑꯁꯤ ꯃꯍꯧꯁꯥꯅꯥ ꯁꯥꯐꯕꯥ ꯍꯤꯗꯥꯛ ꯑꯃꯥ ꯑꯣꯏꯔꯕꯁꯨ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯃꯁꯤꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇꯁꯤꯡ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯑꯃꯍꯦꯛꯇꯕꯨ ꯊꯦꯡꯅꯔꯕꯗꯤ , ꯈꯨꯗꯛꯇꯥ ꯗꯣꯛꯇꯔ ꯑꯃꯒꯥ ꯇꯥꯟꯅꯧ꯫

ꯈꯨꯗꯛꯇꯥ ꯃꯦꯗꯤꯀꯦꯜ ꯑꯦꯇꯦꯟꯁꯟ ꯃꯊꯧ ꯇꯥꯕꯥ ꯁꯥꯊꯤꯕꯥ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇꯁꯤꯡ꯫
ꯑꯦꯂꯥꯔꯖꯤꯒꯤ ꯔꯤꯑꯦꯛꯁꯅꯁꯤꯡ꯫	ꯈꯣꯡ-ꯈꯨꯠ ꯁꯣꯛ-ꯄꯅꯕꯥ, ꯁꯣꯛ-ꯄꯅꯕꯥ, ꯃꯥꯌ, ꯃꯤꯠ, ꯈꯣꯡ, ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯥ ꯋꯥꯕꯥ꯫
ꯏ ꯊꯣꯀꯄꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ꯫	ꯕ꯭ꯂꯦꯛ ꯇꯦꯔꯤ ꯁ꯭ꯇꯣꯂꯁꯤꯡ , ꯑꯉꯧꯕꯥ ꯅꯠꯠꯔꯒꯥ ꯏ ꯊꯣꯀꯄꯥ, ꯂꯥꯂꯍꯧꯕꯥ/ ꯑꯉꯧꯕꯥ ꯌꯨꯔꯤꯟ, ꯑꯃꯁꯨꯡ ꯈꯣꯡꯗꯥ ꯂꯥꯂꯍꯧꯕꯥ/ ꯃꯆꯨ ꯃꯆꯨꯒꯤ ꯃꯐꯃꯁꯤꯡ ꯂꯩꯕꯥ꯫
ꯍꯥꯔꯠ ꯑꯦꯇꯦꯛ ꯑꯃꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ꯫	ꯈꯣꯡꯗꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯅꯠꯠꯔꯒꯥ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯁꯣꯀꯄꯥ, ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯥ ꯋꯥꯕꯥ, ꯈꯨꯎ, ꯃꯈꯨꯠ ꯅꯠꯠꯔꯒꯥ ꯈꯣꯡꯗꯥ ꯑꯅꯥꯕꯥ ꯁꯟꯗꯣꯀꯄꯥ꯫
ꯁ꯭ꯠꯔꯣꯛ ꯑꯃꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ꯫	ꯃꯥꯌ, ꯃꯈꯨꯠ ꯅꯠꯠꯔꯒꯥ ꯈꯣꯡꯒꯤ ꯃꯄꯥꯟꯊꯪꯕꯥ ꯃꯔꯣꯜ ꯑꯃꯗꯥ ꯈꯪꯍꯧꯗꯅꯥ ꯁꯣꯟꯊꯕꯥ/ ꯁꯣꯟꯊꯕꯥ, ꯋꯥ ꯉꯥꯡꯕꯗꯥ ꯑꯋꯥꯕꯥ, ꯈꯣꯡꯅꯥ ꯆꯠꯄꯗꯥ ꯑꯋꯥꯕꯥ, ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯃꯀꯣꯛ ꯁꯣꯀꯄꯥ꯫
ꯂꯤꯚꯔ ꯅꯠꯠꯔꯒꯥ ꯀꯤꯗꯅꯤꯗꯥ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯊꯣꯀꯍꯅꯕꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ꯫	ꯃꯊꯛꯀꯤ ꯑꯔꯣꯏꯕꯥ ꯈꯣꯡꯗꯥ ꯑꯅꯥꯕꯥ, ꯃꯤꯠ/ ꯈꯣꯡꯗꯥ ꯌꯦꯔꯨꯝ ꯀꯣꯀꯄꯥ, ꯌꯨꯔꯤꯟ ꯊꯣꯀꯄꯥ ꯍꯟꯊꯕꯥ, ꯈꯣꯡ ꯑꯃꯁꯨꯡ ꯈꯣꯡꯗꯥ ꯁꯣꯀꯄꯥ꯫
ꯑꯀꯅꯕꯥ ꯈꯣꯡꯎꯄꯀꯤ ꯔꯤꯑꯦꯛꯁꯅꯁꯤꯡ꯫	ꯈꯣꯡꯗꯥ ꯂꯥꯎꯕꯥ, ꯈꯣꯡ ꯍꯥꯝꯕꯥ, ꯈꯣꯡ ꯍꯥꯝꯕꯥ (ꯃꯤꯠꯀꯤ ꯃꯅꯨꯡꯗꯥ ꯐꯥꯎꯕꯥ)꯫

ꯃꯍꯧꯁꯥꯅꯥ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯑꯣꯏꯗꯕꯥ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇꯁꯤꯡꯁꯨ ꯂꯩ, ꯑꯗꯨꯕꯨ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯈꯣꯌꯗꯨ ꯂꯦꯡꯗꯅꯥ ꯂꯩꯔꯕꯗꯤ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯔꯤꯄꯣꯔꯠ ꯇꯧꯒꯗꯕꯅꯤ꯫ ꯃꯈꯣꯌꯁꯤꯡ ꯑꯗꯨꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤꯕꯁꯤꯡ ꯑꯁꯤ ꯌꯥꯑꯣꯔꯤ:

ꯀꯣꯛ ꯆꯤꯛꯄ
ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯄꯁꯦꯠ, ꯅꯣꯡꯃꯩ ꯀꯥꯞꯄꯥ꯫
ꯆꯥꯅꯤꯡꯕ ꯊꯛꯅꯤꯡꯕ ꯐꯥꯎꯕ

ꯇꯦꯛ-ꯍꯣꯝ ꯃꯦꯁꯦꯖ ꯇꯧꯕꯥ꯫

ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯑꯁꯤ ꯂꯥꯏꯍꯧ, ꯑꯅꯥꯕꯥ, ꯑꯃꯁꯨꯡ ꯅꯥꯀꯣꯡꯒꯤ ꯑꯐꯕꯥ ꯍꯤꯗꯥꯛ ꯑꯃꯅꯤ, ꯑꯗꯨꯕꯨ ꯃꯁꯤ ꯆꯦꯀꯁꯤꯟꯅꯥ ꯁꯤꯖꯤꯟꯅꯒꯗꯕꯅꯤ꯫
ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯍꯥꯔꯇꯀꯤ ꯂꯥꯌꯅꯥ, ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ, ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯂꯁꯔ, ꯅꯠꯠꯔꯒꯥ ꯑꯦꯖꯃꯥꯒꯨꯝꯕꯥ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ ꯂꯩꯔꯕꯗꯤ, ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯂꯧꯗ꯭ꯔꯤꯉꯩꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯁꯣꯌꯗꯅꯥ ꯍꯪꯕꯤꯌꯨ꯫
ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯄꯤꯕꯥ ꯗꯣꯖ ꯑꯗꯨꯗꯒꯤ ꯍꯦꯟꯅꯥ ꯀꯩꯗꯧꯉꯩꯗꯥ ꯂꯧꯔꯣꯏꯗꯕꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯄꯁꯦꯠ ꯂꯩꯔꯕꯗꯤ, ꯍꯤꯗꯥꯛ ꯑꯗꯨ ꯆꯥꯅꯕꯥ ꯆꯤꯟꯖꯥꯛꯀꯥ ꯂꯣꯌꯅꯅꯥ ꯆꯥꯒꯗꯕꯅꯤ꯫
ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯈꯣꯝꯂꯥꯡ ꯁꯣꯀꯄꯥ, ꯕ꯭ꯂꯦꯛ ꯁ꯭ꯇꯣꯜ, ꯅꯠꯠꯔꯒꯥ ꯈꯣꯡ-ꯈꯨꯠ ꯁꯣꯛꯅ-ꯁꯝꯅꯒꯨꯝꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯂꯩꯔꯕꯗꯤ, ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯛ ꯑꯗꯨ ꯊꯀꯄꯥ ꯂꯦꯄꯀꯅꯨ ꯑꯃꯁꯨꯡ ꯈꯨꯗꯛꯇꯥ ꯗꯣꯛꯇꯔ ꯑꯃꯒꯥ ꯇꯥꯟꯅꯧ꯫
ꯃꯤꯔꯣꯜꯂꯤꯕꯤ ꯃꯃꯥꯁꯤꯡꯅꯥ ꯃꯔꯨꯑꯣꯏꯅꯥ ꯃꯤꯔꯣꯜꯂꯤꯉꯩꯒꯤ ꯑꯔꯣꯏꯕꯥ ꯊꯥ ꯑꯍꯨꯃꯗꯥ ꯏꯕꯨꯞꯔꯣꯐꯦꯟ ꯁꯤꯖꯤꯟꯅꯕꯗꯒꯤ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯊꯤꯡꯖꯤꯅꯒꯗꯕꯅꯤ꯫
ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯍꯤꯗꯥꯛ ꯑꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯆꯤꯡꯅꯕꯥ ꯅꯠꯠꯔꯒꯥ ꯋꯥꯍꯪ ꯑꯃꯠꯇꯥ ꯂꯩꯔꯕꯗꯤ, ꯊꯥꯖꯒꯅꯨ꯫ ꯃꯇꯝ ꯄꯨꯝꯅꯃꯛꯇꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯄꯥꯎꯇꯥꯛ ꯂꯧꯕꯤꯌꯨ꯫

ꯏꯕꯨꯞꯔꯣꯐꯦꯟ, ꯑꯦꯟ.ꯑꯦꯁ.ꯑꯦ.ꯑꯥꯏ.ꯗꯤ., ꯄꯦꯏꯅꯀꯤꯂꯥꯔ, ꯂꯥꯏꯍꯧ, ꯁꯣꯛ-ꯄꯅꯕꯥ, ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇ, ꯁ꯭ꯇꯣꯃꯥꯛ ꯏꯅꯐ꯭ꯂꯦꯃꯦꯁꯟ꯫