FrancophonIA/ELRC3.0 huggingface dataset:
English: Patient sprays once into each nostril
Croatian: Bolesnik primjenjuje jedan potisak u svaku nosnicu
English: Uncommon (may affect up to 1 in 100 people) ● increased saliva
Croatian: Manje česte (mogu se javiti u do 1 na 100 osoba) • pojačano stvaranje sline
English: ● Medicines used to treat nervous disorders or severe pain (for example, benzodiazepines, opioids), or medicines or beverages containing alcohol
Croatian: • lijekove koji se koriste za liječenje poremećaja živčanog sustava ili jake boli (primjerice benzodiazepine, opioide) ili lijekove ili pića koja sadrže alkohol
English: These patients should be clinically stable and cardiac symptom free prior to administration;
Croatian: Ti bolesnici moraju biti klinički stabilni i bez srčanih simptoma prije primjene lijeka.
English: Weeks 1-4:
Croatian: 1. - 4. tjedan:
English: Hepatotoxicity has been reported with chronic ketamine use, therefore, the potential for such an effect due to long-term use of Spravato cannot be excluded.
Croatian: Budući da je kod kronične primjene ketamina prijavljena hepatotoksičnost, ne može se isključiti mogućnost takvog učinka kod dugotrajne primjene lijeka Spravato.
English: Published studies in animals (including primates) at doses resulting in light to moderate anaesthesia demonstrate that the use of anaesthetic agents during the period of rapid brain growth or synaptogenesis results in cell loss in the developing brain, that can be associated with prolonged cognitive deficiencies.
Croatian: Objavljena ispitivanja na životinjama (uključujući primate) u kojima su se primjenjivale doze koje uzrokuju laganu do umjerenu anesteziju pokazala su da primjena anestetika tijekom razdoblja ubrzanog razvoja mozga ili sinaptogeneze dovodi do gubitka stanica mozga u razvoju, koji može biti povezan s dugotrajnim kognitivnim poremećajima.
English: ● Patients with uncontrolled brady- or tachyarrhythmias that lead to haemodynamic instability;
Croatian: • nekontrolirane bradiaritmije ili tahiaritmije koje uzrokuju hemodinamičku nestabilnost
English: This risk persists until significant remission occurs, therefore, patients should be closely monitored.
Croatian: Budući da je taj rizik prisutan sve dok ne nastupi značajna remisija, bolesnike treba pomno nadzirati.
English: ● Sleep apnoea with morbid obesity (BMI ≥35);
Croatian: • apneju u snu uz morbidnu pretilost (ITM ≥ 35)
English: • Which adverse effects to expect following SPRAVATO administration, and how to minimize those effects;
Croatian: • koje se nuspojave mogu očekivati nakon primjene lijeka SPRAVATO i kako ih minimizirati
English: Effect of esketamine on other medicinal products
Croatian: Učinak esketamina na druge lijekove
English: There are no or limited data on the use of esketamine in pregnant women.
Croatian: Nema podataka ili postoje samo ograničeni podaci o primjeni esketamina u trudnica.
English: ● Check that indicator shows no green dots.
Croatian: • Provjerite indikator kako biste se uvjerili da ne prikazuje nijednu zelenu točku.
English: If blood pressure is elevated prior to Spravato administration a decision to delay Spravato therapy should take into account the balance of benefit and risk in individual patients.
Croatian: Ako je krvni tlak povišen prije primjene lijeka Spravato, odluku o odgodi liječenja lijekom Spravato treba donijeti uzimajući u obzir omjer koristi i rizika za pojedinog bolesnika.
English: The maximum single esketamine nasal spray dose tested in healthy volunteers was 112 mg which showed no evidence of toxicity and/or adverse clinical outcomes.
Croatian: Maksimalna jednokratna doza esketamina u spreju za nos ispitana u zdravih dobrovoljaca iznosila je 112 mg te kod njezine primjene nisu zabilježeni nikakvi dokazi toksičnosti i/ili štetnih kliničkih ishoda.
English: Concomitant use of Spravato with CNS depressants (e.g., benzodiazepines, opioids, alcohol) may increase sedation, which therefore should be closely monitored.
Croatian: Istodobna primjena lijeka Spravato i depresora SŽS-a (npr. benzodiazepina, opioida, alkohola) može pojačati sedaciju, zbog čega bolesnike treba pomno nadzirati.
English: Esketamine is not a substrate of transporters P-glycoprotein (P-gp; multidrug resistance protein 1), breast cancer resistance protein (BCRP), or organic anion transporter (OATP) 1B1, or OATP1B3.
Croatian: Esketamin nije supstrat sljedećih prijenosnika: P-glikoproteina (P-gp; protein koji uzrokuje rezistenciju na više lijekova 1), proteina rezistencije raka dojke (engl. breast cancer resistance protein, BCRP) ni prijenosnika organskih aniona (engl. organic anion transporter) OAT1B1 ili OATP1B3.
English: The pharmacokinetic profile of esketamine is similar after a single dose and repeat dose administration with no accumulation in plasma when esketamine is administered twice a week.
Croatian: Farmakokinetički profil esketamina sličan je nakon primjene jednokratne doze i ponovljenih doza te ne dolazi do njegove akumulacije u plazmi kad se primjenjuje dvaput tjedno.
English: Studies TRANSFORM-1 (TRD3001) and TRANSFORM-2 (TRD3002) were conducted in adults (18 to < 65 years) and Study TRANSFORM-3 (TRD3005) was conducted in adults ≥ 65 years of age.
Croatian: Ispitivanja TRANSFORM-1 (TRD3001) i TRANSFORM-2 (TRD3002) provedena su u odraslih osoba u dobi od 18 do < 65 godina, dok je ispitivanje TRANSFORM-3 (TRD3005) provedeno u odraslih osoba u dobi od ≥ 65 godina.
English: Through NMDA receptor antagonism, esketamine produces a transient increase in glutamate release leading to increases in α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) stimulation and subsequently to increases in neurotrophic signalling which may contribute to the restoration of synaptic function in these brain regions involved with the regulation of mood and emotional behaviour.
Croatian: Antagonističkim učinkom na NMDA receptor, esketamin privremeno pojačava oslobađanje glutamata i tako dovodi do pojačane stimulacije receptora α-amino-3-hidroksi-5-metil-4-izoksazolpropionske kiseline (AMPA), a potom i pojačane neurotrofne signalizacije, što može pridonijeti obnavljanju sinaptičke funkcije u onim dijelovima mozga koji sudjeluju u regulaciji raspoloženja i emocionalnog ponašanja.
English: Rates of somnolence were relatively stable over time during long-term treatment.
Croatian: Kod dugoročnog su liječenja stope somnolencije bile relativno stabilne tijekom vremena.
English: Chronic Obstructive Pulmonary Disease (COPD)
Croatian: uključujući kroničnu opstruktivnu plućnu bolest (KOPB)
English: Cognitive and memory impairment
Croatian: Kognitivni poremećaji i poremećaji pamćenja
English: If you use too much Spravato, you are more likely to get side effects (see “Possible side effects”).
Croatian: Ako primijenite previše lijeka Spravato, postoji veća vjerojatnost za razvoj nuspojava (pogledajte dio „Moguće nuspojave“).
English: ● Hypersensitivity to the active substance, ketamine, or to any of the excipients listed in section 6.1
Croatian: • Preosjetljivost na djelatnu tvar, ketamin ili neku od pomoćnih tvari navedenih u dijelu 6.1
English: Spravato is used in adults to reduce the symptoms of depression, such as, feeling sad, anxious, or worthless, sleeping difficulties, change in appetite, loss of interest in favourite activities, feeling of being slowed down.
Croatian: Spravato se koristi u odraslih osoba za ublažavanje simptoma depresije, kao što su tuga, tjeskoba ili osjećaj bezvrijednosti, poremećaji spavanja, promjena teka, gubitak interesa za omiljene aktivnosti i osjećaj usporenosti.
English: Sneezing after administration If sneezing occurs immediately after administration, a replacement device should not be used.
Croatian: Kihanje nakon primjene Ako odmah nakon primjene dođe do kihanja, ne smije se upotrijebiti nadomjesni sprej.
English: Drug abuse, dependence, withdrawal
Croatian: Zlouporaba lijeka, ovisnost i ustezanje
English: In long-term clinical trials, the effect of esketamine nasal spray on cognitive functioning was evaluated over time and performance remained stable.
Croatian: U dugoročnim kliničkim ispitivanjima ocjenjivao se učinak esketamina u spreju za nos na kognitivnu funkciju tijekom vremena te je utvrđeno da je ona ostala stabilna.
English: If you become pregnant while being treated with Spravato, talk to your doctor straight away - to decide whether to stop treatment and to learn about other options for treatment.
Croatian: Ako zatrudnite tijekom liječenja lijekom Spravato, odmah se obratite liječniku kako biste odlučili hoćete li prekinuti liječenje i upoznali se s drugim mogućnostima liječenja.
English: Instructions for Use SPRAVATO (esketamine) Nasal Spray Device
Croatian: Upute za uporabu SPRAVATO (esketamin) Sprej za nos
English: Pack sizes of 1, 2, 3, or 6 nasal spray devices.
Croatian: Veličine pakiranja: 1, 2, 3 ili 6 sprejeva za nos.
English: Abuse potential
Croatian: Mogućnost zlouporabe
English: If blood pressure remains elevated for a prolonged period of time, assistance should promptly be sought from practitioners experienced in blood pressure management.
Croatian: Ako krvni tlak ostane povišen tijekom duljeg razdoblja, treba odmah zatražiti pomoć liječnika s iskustvom u liječenju krvnog tlaka.
English: Dissociation symptoms typically resolved by 1.5 hours post-dose and the severity tended to reduce over time with repeated treatments.
Croatian: Simptomi disocijacije obično su se povlačili unutar 1,5 sati nakon primjene doze, a njihova se težina obično smanjivala s vremenom uz nastavak liječenja.
English: Exposure numbers were influenced by the study stopping at a pre-determined number of relapses based on the interim analysis.
Croatian: Na izloženost lijeku utjecao je prekid ispitivanja u trenutku postizanja unaprijed određenog broja relapsa na temelju interim analize.
English: After an initial 16 weeks of treatment with Spravato plus oral AD, the median duration of exposure to Spravato in the maintenance phase was 4.2 months (range: 1 day to 21.2 months) in Spravato -treated patients (stable remission and stable response).
Croatian: Nakon početnih 16 tjedana liječenja lijekom Spravato i oralnim antidepresivom, medijan trajanja izloženosti lijeku Spravato u fazi održavanja iznosio je 4,2 mjeseca (raspon od 1 dana do 21,2 mjeseca) u bolesnika liječenih lijekom Spravato (stabilna remisija i stabilan odgovor).
English: Psychiatric disorders dissociation euphoric mood, agitation, anxiety, illusion, irritability, panic attack, time perception altered, hallucination including visual hallucination, derealisation
Croatian: Psihijatrijski poremećaji disocijacija euforično raspoloženje, agitacija, anksioznost, iluzije, razdražljivost, napadaj panike, promijenjena percepcija vremena, halucinacije uključujući vizualne halucinacije, derealizacija
English: Using Spravato with certain medicines may cause side effects.
Croatian: Uzimanje lijeka Spravato u kombinaciji s nekim drugim lijekovima može izazvati nuspojave.
English: ● sleepiness (sedation), fainting, dizziness, spinning sensation, anxiety, or feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation), difficulties in breathing (respiratory depression).
Croatian: • pospanost (sedaciju), nesvjesticu, omaglicu, osjećaj da se sve oko Vas vrti, tjeskobu, osjećaj nepovezanosti sa samim sobom, svojim mislima, osjećajima, prostorom i vremenom (disocijaciju) ili otežano disanje (depresiju dišnog sustava).
English: If more than 2 treatment sessions have been missed, per clinical judgment, adjustment of the dose or frequency of Spravato may be clinically appropriate.
Croatian: Ako bolesnik propusti više od dva terapijska tretmana, možda će biti klinički prikladno prilagoditi dozu ili učestalost primjene lijeka Spravato, sukladno kliničkoj prosudbi.
English: SPRAVATO may induce transient sedation, dissociative and perception disorders and/or hypertension.
Croatian: SPRAVATO može uzrokovati prolaznu sedaciju, disocijativne poremećaje i poremećaje percepcije i/ili hipertenziju.
English: To prevent loss of medicinal product, the device should not be primed before use.
Croatian: Da bi se spriječio gubitak lijeka, ne smije se provjeravati protok lijeka prije primjene.
English: In the case of overdose, the possibility of multiple medicinal products involvement should be considered.
Croatian: U slučaju predoziranja treba razmotriti mogućnost da je bolesnik uzeo više lijekova.
English: In case one or two treatment sessions are missed, the next session should be scheduled when the next session was scheduled to occur based on current treatment frequency.
Croatian: U slučaju da bolesnik propusti jedan ili dva terapijska tretmana, sljedeći termin treba zakazati u vrijeme kada se trebao odviti sljedeći tretman prema trenutnoj učestalosti primjene lijeka.
English: However, compared to the recommended dose range, the 112-mg esketamine nasal spray dose was associated with higher rates of adverse reactions, including dizziness, hyperhidrosis, somnolence, hypoaesthesia, feeling abnormal, nausea and vomiting.
Croatian: Međutim, u usporedbi s dozama iz preporučenog raspona, doza od 112 mg esketamina u spreju za nos bila je povezana s višim stopama nuspojava, uključujući omaglicu, hiperhidrozu, somnolenciju, hipoesteziju, neuobičajeno osjećanje, mučninu i povraćanje.
English: Close supervision and monitoring should continue until the patient recovers.
Croatian: Bolesnika treba strogo nadzirati i pratiti sve dok se ne oporavi.
English: Sedative effects typically resolved by 1.5 hours post-dose.
Croatian: Sedacijski učinci obično su se povlačili unutar 1,5 sati nakon primjene lijeka.
English: ● difficulty speaking
Croatian: • otežan govor
English: Food and liquid intake recommendations prior to administration Since some patients may experience nausea and vomiting after administration of Spravato, patients should be advised not to eat for at least 2 hours before administration and not to drink liquids at least 30 minutes prior to administration (see section 4.8).
Croatian: Preporuke za unos hrane i tekućine prije primjene lijeka Budući da se u nekih bolesnika nakon primjene lijeka Spravato mogu javiti mučnina i povraćanje, bolesnicima treba savjetovati da ne jedu najmanje 2 sata prije primjene i da ne piju tekućinu najmanje 30 minuta prije primjene lijeka (vidjeti dio 4.8).
English: There is no clinical experience with esketamine administered as a nasal spray in patients with Child-Pugh class C (severe) hepatic impairment (see section 4.2 and 4.4).
Croatian: Nema kliničkog iskustva s primjenom esketamina u spreju za nos u bolesnika s oštećenjem jetrene funkcije Child-Pugh stadija C (teško) (vidjeti dijelove 4.2 i 4.4).
English: Esketamine does not inhibit these transporters or multi-drug and toxin extrusion 1 (MATE1) and MATE2-K, or organic cation transporter 2 (OCT2), OAT1, or OAT3.
Croatian: multi-drug and toxin extrusion) MATE1 i MATE2-K te prijenosnike organskih kationa 2 (engl. organic cation transporter, OCT2), OAT1 ili OAT3.
English: It is recommended to maintain the dose the patient receives at the end of the induction phase in the maintenance phase.
Croatian: Preporučuje se tijekom faze održavanja primjenjivati istu dozu koju je bolesnik primao na kraju faze uvodnog liječenja.
English: ● feeling drunk
Croatian: • osjećaj opijenosti
English: ● Medicines for depression or Parkinson's disease known as monoamine oxidase inhibitors (MAOIs) (for example, tranylcypromine, selegiline, phenelzine).
Croatian: • lijekove za liječenje depresije ili Parkinsonove bolesti koji se zovu inhibitori monoamino-oksidaze (MAO) (primjerice tranilcipromin, selegilin, fenelzin)
English: It is unknown whether esketamine is excreted in human milk.
Croatian: Nije poznato izlučuje li se esketamin u majčino mlijeko.
English: The AUC∞ was 13 to 36% higher in the subjects with mild to severe renal impairment.
Croatian: AUC∞ je bio 13 - 36% veći u ispitanika s blagim do teškim oštećenjem bubrežne funkcije.
English: Instruct the patient to: ● Sniff gently after spraying to keep medicine inside nose.
Croatian: Recite bolesniku da: • lagano uvuče zrak (šmrcne) nakon primjene spreja kako bi lijek ostao u nosu
English: Overall a total of 705 patients were enrolled; 437 directly enrolled; 150 transferred from TRD3001, and 118 transferred from TRD3002.
Croatian: U ispitivanje je bilo uključeno ukupno 705 bolesnika, pri čemu je njih 437 uključeno izravno, dok je njih 150 prešlo iz ispitivanja TRD3001, a njih 118 iz ispitivanja TRD3002.
English: 1 green dot
Croatian: 1 zelena točka
English: Type-I glass vial with a chlorobutyl rubber stopper.
Croatian: Staklena bočica (staklo tipa I) s klorobutilnim gumenim čepom.
English: ● feeling very sleepy with low energy
Croatian: • izrazita pospanost praćena manjkom energije
English: 1,833 adult patients were enrolled, of which 1,601 patients were exposed to Spravato.
Croatian: U ispitivanja su bila uključena 1833 bolesnika, od kojih je 1601 bolesnik bio izložen lijeku Spravato.
English: At the end of 16 weeks of treatment period, patients in stable remission (n=176) or stable response (n=121) were randomised to continue with Spravato or stop Spravato and switch to placebo nasal spray.
Croatian: Na kraju 16-tjednog razdoblja liječenja bolesnici u stabilnoj remisiji (n=176) ili sa stabilnim odgovorom (n=121) bili su randomizirani za nastavak liječenja lijekom Spravato ili za prekid liječenja lijekom Spravato i prelazak na placebo u spreju za nos.
English: For the intravenous and oral routes of administration, < 1% of the dose was excreted in the urine as unchanged drug.
Croatian: Kod intravenske i peroralne primjene < 1% doze lijeka izlučilo se u mokraću u nepromijenjenom obliku.
English: Spravato doses of 56 mg or 84 mg were fixed in Study TRD3001 and flexible in Study TRD3002.
Croatian: Doze lijeka Spravato od 56 mg ili 84 mg bile su fiksne u ispitivanju TRD3001, a fleksibilne u ispitivanju TRD3002.
English: Subsequent doses should be increased in increments of 28 mg up to 56 mg or 84 mg, based on efficacy and tolerability.
Croatian: Sljedeće doze treba povećavati u koracima od 28 mg do doze od 56 mg ili 84 mg, ovisno o djelotvornosti i podnošljivosti.
English: ● a heart problem which is not well controlled such as: poor blood flow in the blood vessels of the heart frequently with chest pain (such as angina), high blood pressure, heart valve disease or heart failure
Croatian: • ako imate srčanih tegoba koje nisu dobro kontrolirane, kao što su: loš protok krvi kroz krvne žile srca, često praćen boli u prsnom košu (poput angine), visok krvni tlak, bolest srčanih zalistaka ili zatajenje srca
English: Close supervision of patients and in particular those at high risk should accompany treatment especially in early treatment and following dose changes.
Croatian: Liječenje ovim lijekom mora biti praćeno pomnim nadzorom bolesnika, osobito onih visokorizičnih, i to naročito u ranoj fazi liječenja i nakon promjene doze.
English: Elderly (>65 years)
Croatian: Starije osobe (u dobi od > 65 godina)
English: Do not prime or test before use.
Croatian: Nemojte provjeravati protok lijeka ni isprobavati sprej prije uporabe.
English: • The procedure for SPRAVATO intranasal administration, including preparation (fasting for 2 hours, no drinking for 30 minutes) and patient's monitoring;
Croatian: • postupak primjene lijeka SPRAVATO u nos, uključujući pripremne radnje (bolesnik ne smije jesti 2 sata prije primjene ni piti 30 minuta prije primjene) i praćenje bolesnika
English: The MAH shall ensure that in each MS where SPRAVATO is marketed a CAP is implemented to prevent/minimise the important identified risk of Drug abuse.
Croatian: Nositelj odobrenja mora se pobrinuti da se u svakoj državi članici u kojoj će SPRAVATO biti na tržištu provodi program kontroliranog pristupa lijeku kako bi se spriječio/minimizirao važan utvrđen rizik od zlouporabe lijeka.
English: It is intended for administration by the patient under the supervision of a healthcare professional, using 1 device (for a 28 mg dose), 2 devices (for a 56 mg dose) or 3 devices (for an 84 mg dose), with a 5-minute rest between use of each device.
Croatian: Lijek primjenjuje bolesnik pod nadzorom zdravstvenog radnika, koristeći 1 sprej (za dozu od 28 mg), 2 spreja (za dozu od 56 mg) ili 3 spreja (za dozu od 84 mg), uz pauzu od 5 minuta između uporabe dvaju sprejeva.
English: Individuals with a history of drug abuse or dependence may be at greater risk for abuse and misuse of Spravato.
Croatian: Kod osoba koje u anamnezi imaju zlouporabu droga/lijekova ili ovisnost o drogama/lijekovima može postojati veći rizik od zlouporabe ili namjerne pogrešne uporabe lijeka Spravato.
English: Before first device only:
Croatian: Samo prije primjene prvog spreja:
English: Instruct the patient to: ● Recline head at about 45 degrees during administration to keep medicine inside the nose.
Croatian: • zabaci glavu i drži je pod kutom od približno 45 stupnjeva tijekom primjene lijeka kako bi lijek ostao u nosu
English: If you need steroid or decongestant medicines as a nasal spray, avoid using them during the hour before your Spravato treatment.
Croatian: Ako trebate uzimati steroide ili dekongestive u spreju za nos, izbjegavajte njihovu primjenu unutar 1 sata prije primjene lijeka Spravato.
English: • Monitoring of blood pressure before and after SPRAVATO dosing;
Croatian: • praćenju krvnog tlaka prije i nakon primjene doze lijeka SPRAVATO
English: You will use the Spravato nasal spray yourself - under the supervision of your doctor or other healthcare professional in a healthcare setting, such as, the doctor's office or clinic.
Croatian: Spravato sprej za nos primjenjivat ćete sami pod nadzorom liječnika ili nekog drugog zdravstvenog radnika u zdravstvenoj ustanovi, kao što je liječnička ordinacija ili klinika.
English: The pharmacokinetics of esketamine administered as a nasal spray was compared between elderly but otherwise healthy subjects and younger healthy adults.
Croatian: Farmakokinetika esketamina primijenjenog u obliku spreja za nos uspoređivala se između starijih ali inače zdravih ispitanika i mlađih zdravih odraslih osoba.
English: In the flexible dose studies, TRD3002 and TRD3005, up titration of Spravato dose was based on clinical judgement and dose could be down titrated based on tolerability.
Croatian: U ispitivanjima s primjenom fleksibilnih doza (TRD3002 i TRD3005), doza lijeka Spravato povećavala se na temelju kliničke prosudbe, a mogla se i smanjivati na temelju podnošljivosti.
English: The potential for overdose of Spravato by the patient is minimised due to the product's design and the administration taking place under the supervision of a healthcare professional (see section 4.2).
Croatian: Mogućnost da se bolesnik predozira lijekom Spravato minimizirana je zahvaljujući dizajnu lijeka i činjenici da se primjena odvija pod nadzorom zdravstvenog radnika (vidjeti dio 4.2).
English: No significant differences in the pharmacokinetics of esketamine nasal spray were observed for gender and total body weight (> 39 to 170 kg) based on population PK analysis.
Croatian: Na temelju populacijske farmakokinetičke analize nisu opažene značajne razlike u farmakokinetici esketamina u spreju za nos s obzirom na spol i ukupnu tjelesnu težinu (> 39 do 170 kg).
English: In patients whose blood pressure prior to dose administration is judged to be elevated (as a general guide: >140/90 mmHg for patients <65 years of age and >150/90 mmHg for patients ≥65 years of age), it is appropriate to adjust lifestyle and/or pharmacologic therapies to reduce blood pressure before starting treatment with Spravato.
Croatian: U bolesnika kod kojih se prije primjene doze ocijeni da je krvni tlak povišen (općenita smjernica: > 140/90 mmHg za bolesnike mlađe od 65 godina i > 150/90 mmHg za bolesnike u dobi od ≥ 65 godina), odgovarajuća mjera prije početka liječenja lijekom Spravato je prilagoditi način života i/ili farmakološke terapije kako bi se snizio krvni tlak.
English: Evidence of therapeutic benefit should be evaluated at the end of induction phase to determine need for continued treatment.
Croatian: Na kraju faze uvodnog liječenja treba ocijeniti dokaze terapijske koristi kako bi se utvrdilo postoji li potreba za nastavkom liječenja.