natgillin/translations-raw huggingface dataset:
The safety and efficacy of clopidogrel plus ASA have been evaluated in three double-blind studies involving over 61,900 patients: the CURE, CLARITY and COMMIT studies, comparing clopidogrel plus ASA to ASA alone, both treatments given in combination with other standard therapy.
Sigurnost primjene i djelotvornost klopidogrela plus ASK procijenjeni su u tri dvostrukoslijepe studije koje su uključivale preko 61 900 bolesnika: CURE, CLARITY i COMMIT studije, u kojima se uspoređivalo djelovanje klopidogrela plus ASK prema samoj ASK, s tim da su obje terapije davane u kombinaciji s drugim standardnim terapijama.
Following an oral dose of 14C-labelled clopidogrel in man, approximately 50% was excreted in the urine and approximately 46% in the faeces in the 120-hour interval after dosing.
Nakon primjene oralne doze 14C radioaktivno označenog klopidogrela u ljudi, otprilike 50% doze se izlučuje u urinu te otprilike 46% u fecesu u razdoblju od 120 sati nakon doziranja.
This medicinal product also contains hydrogenated castor oil which may cause stomach upset and diarrhoea.
Ovaj lijek također sadrži hidrogenirano ricinusovo ulje koje može uzrokovati probavne smetnje i proljev.
Follow-up at one year was performed for 316 patients (98.1%) in the de-escalated DAPT group and 318 patients (98.5%) in the unchanged DAPT group.
Nakon godine dana provedeno je praćenje 316 bolesnika (98,1%) u skupini sa de-eskaliranim DAPT-om i 318 bolesnika (98,5%) u skupini sa nepromijenjenim DAPTom.
In patients with recent transient ischaemic attack or stroke who are at high risk of recurrent ischaemic events, the combination of ASA and clopidogrel has been shown to increase major bleeding.
U bolesnika s TIA-om ili moždanim udarom, koji su izloženi visokom riziku recidiva ishemijskih događaja, utvrđeno je da kombinacija ASK i klopidogrela pojačava velika krvarenja.
• the foetus to: - cardiopulmonary toxicity (with premature closure of the ductus arteriosus and pulmonary hypertension); - renal dysfunction, which may progress to renal failure with oligo-hydroamniosis;
• fetus: - kardiopulmonalnu toksičnost (s preranim zatvaranjem duktusa arteriosusa i plućnom hipertenzijom); - bubrežnu disfunkciju, koja se može razviti u bubrežno zatajenje sa oligohidroamnionom;
Depending on your condition, your doctor will determine the length of time for which you need to take DuoPlavin.
Ovisno o Vašem stanju, liječnik će Vam odrediti duljinu terapije lijekom DuoPlavin.
Physicians should remain alert for signs of GI ulceration and bleeding, even in the absence of previous GI symptoms.
Liječnici trebaju obratiti pozornost na znakove gastrointestinalnih ulceracija i krvarenja, čak i u izostanku navedenih gastointestinalnih simptoma.
Patients should be told about the signs and symptoms of GI undesirable effects and what steps to take if they occur.
Bolesnicima treba objasniti znakove i simptome mogućih gastrointestinalnih nuspojava i što učiniti ako se pojave.
The guided de-escalation did not result in an increased combined risk of ischemic events (2.5% in the deescalation group vs 3.2% in the control group; p non-inferiority=0.0115), nor in the key secondary endpoint of BARC bleeding ≥2 ((5%) in the de-escalation group versus 6% in the control group
Vođena de-eskalacija nije rezultirala povećanjem u kombiniranom riziku od ishemijskih događaja (2,5 % u skupini sa vođenom de-eskalacijom u odnosu na 3,2% u kontrolnoj skupini; p neinferiornosti=0,0115) niti u ključnoj sekundarnoj mjeri ishoda BARC stupnja krvarenja ≥ 2 ((5%) u skupini s vođenom de-eskalacijom nasuprot 6% u kontrolnoj skupini (p=0,23)).
Therefore DuoPlavin should be used with caution in these patients.
Stoga, u tih bolesnika, DuoPlavin treba primjenjivati s oprezom.
Contact your doctor or the nearest hospital emergency department because of the increased risk of bleeding.
Ako uzmete više DuoPlavina nego što ste trebali Odmah morate kontaktirati liječnika ili najbliži odjel hitne medicinske pomoći zbog povećanog rizika od krvarenja.
Do not take DuoPlavin
Nemojte uzimati DuoPlavin
What DuoPlavin contains
Što DuoPlavin sadrži
However, the limitations of these data and the uncertainties regarding extrapolation of ex vivo data to the clinical situation imply that no firm conclusions can be made for regular ibuprofen use, and no clinically relevant effect is considered to be likely for occasional ibuprofen use (see section 5.1).
Međutim, zbog ograničene količine podataka i nesigurnosti u ekstrapolaciji ex vivo podataka u kliničku situaciju, ne mogu se donijeti čvrsti zaključci za redovitu primjenu ibuprofena te se niti jedan klinički značajan učinak ne smatra vjerojatnim kod povremene uporabe ibuprofena (vidjeti dio 5.1.).
There is insufficient clinical experience regarding the use of doses above 100 mg/day up to 500 mg/day.
Nema dovoljno kliničkog iskustva s primjenom doze od 100-500 mg dnevno.
Salicylic acid in DuoPlavin has a plasma half-life of approximately 2 hours.
Poluvijek salicilatne kiseline iz DuoPlavina u plazmi iznosi približno 2 sata.
• This medicinal product must be administered under close medical supervision in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency due to risk of haemolysis (see section
• ovaj se lijek mora primjenjivati pod strogim liječničkim nadzorom u bolesnika s nedostatkom glukoza-6-fosfat dehidrogenaze (G6PD) zbog rizika od hemolize (vidjeti dio 4.8).
The Cmax of the active metabolite is twice as high following a single 300-mg clopidogrel loading dose as it is after four days of 75-mg maintenance dose.
Cmax aktivnog metabolita je dvostruko veći nakon primjene jednokratne udarne doze od 300 mg klopidogrela, u odnosu na primjenu doze održavanja od 75 mg tijekom 4 dana.
If you forget to take DuoPlavin
Ako ste zaboravili uzeti DuoPlavin
However, if you are concerned by your bleeding, you should contact your doctor straightaway (see section 4 ‘Possible side effects').
Ako ste ipak zabrinuti zbog krvarenja, odmah obavijestite svog liječnika (vidjeti dio 4. "Moguće nuspojave").
In patients with non-ST segment elevation acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction): The optimal duration of treatment has not been formally established.
U bolesnika s akutnim koronarnim sindromom bez elevacije ST-segmenta (nestabilna angina ili non-Q infarkt miokarda): optimalno trajanje liječenja još nije formalno utvrđeno.
Patients with pre-existing mastocytosis, in whom the use of acetylsalicylic acid may induce severe hypersensitivity reactions (including circulatory shock with flushing, hypotension, tachycardia and vomiting).
Bolesnici s već postojećom mastocitozom, kod kojih primjena acetilsalicilatne kiseline može izazvati teške reakcije preosjetljivosti (uključujući cirkulatorni šok s crvenilom praćenim osjećajem vrućine, hipotenzijom, tahikardijom i povraćanjem),
After the 300 mg/75 mg dose regimen, antiplatelet responses were decreased in the poor metabolisers with mean IPA (5 μM ADP) of 24% (24 hours) and 37% (Day 5) as compared to IPA of 39% (24 hours) and 58% (Day 5) in the extensive metabolisers and 37% (24 hours) and 60% (Day 5) in the intermediate metabolisers.
Nakon režima doziranja od 300 mg/75 mg, antitrombocitni odgovor bio je smanjen u sporih metabolizatora sa srednjom vrijednosti IPA (5 μM ADP) od 24% (nakon 24 sata) te 37% (na dan 5), u usporedbi s vrijednostima IPA-e od 39% (24 sata) i 58% (dan 5) za brze metabolizatore te 37% (24 sata) i 60% (dan 5) za intermedijarne metabolizatore.
• Alcohol may increase the risk of gastrointestinal injury when taken with ASA.
• alkohol može povećati rizik od gastrointestinalnog oštećenja kad se uzima s ASK.
Consistent with the above results, in a meta-analysis including 6 studies of 335 clopidogrel-treated subjects at steady state, it was shown that active metabolite exposure was decreased by 28% for intermediate metabolisers, and 72% for poor metabolisers while platelet aggregation inhibition (5 μM ADP) was decreased with differences in IPA of 5.9% and 21.4%, respectively, when compared to extensive metabolisers.
U skladu s gore navedenim rezultatima, u meta analizi koja je uključivala 6 studija sa 335 osoba liječenih klopidogrelom u stanju dinamičke ravnoteže, pokazano je da je izloženost aktivnom metabolitu smanjena za 28% za intermedijarne metabolizatore te 72% za spore metabolizatore, dok je inhibicija agregacije trombocita (5 μM ADP) smanjena s razlikama za vrijednsoti IPA-e od 5,9%, odnosno 21,4%, u usporedbi sa brzim metabolizatorima.
Following absorption, the ASA in DuoPlavin is hydrolyzed to salicylic acid with peak plasma levels of salicylic acid occurring within 1 hour of dosing, such that plasma levels of ASA are essentially undetectable 1.5-3 hours after dosing.
Nakon apsorpcije, ASK iz DuoPlavina se hidrolizira u salicilatnu kiselinu čija se vršna koncentracija u plazmi pojavljuje unutar jednog sata od primjene, tako da je koncentraciju ASK u plazmi gotovo nemoguće odrediti poslije 1,53 sata nakon doziranja.
• signs of liver problems such as yellowing of the skin and/or the eyes (jaundice), whether or not associated with bleeding which appears under the skin as red pinpoint dots, and/or confusion (see section 2 ‘Warnings and precautions').
• znakove jetrenih tegoba kao što su žuta boja kože i/ili očiju (žutica), bez obzira jesu li povezani s krvarenjem koje se pojavljuje kao crvene točkice ispod kože i/ili zbunjenošću (vidjeti dio 2.
DuoPlavin should be used with caution in patients with a history of peptic ulcer or gastroduodenal haemorrhage or minor upper GI symptoms as this may be due to gastric ulceration which may lead to gastric bleeding.
DuoPlavin treba primjenjivati s oprezom u bolesnika koji u anamnezi imaju ulkusnu bolest, gastroduodenalno krvarenje ili manje simptome u gornjem dijelu gastrointestinalnog trakta, budući da mogu biti posljedica želučanih ulceracija i dovesti do želučanog krvarenja.
Mean peak plasma levels of unchanged clopidogrel (approximately 2.2-2.5 ng/ml after a single 75 mg oral dose) occurred approximately 45 minutes after dosing.
Prosječna vršna koncentracija nepromijenjenog klopidogrela u plazmi (oko 2,22,5 ng/ml nakon jednokratne oralne doze od 75 mg), postiže se otprilike 45 minuta nakon uzimanja lijeka.
The European Medicines Agency has waived the obligation to submit the results of studies with DuoPlavin in all subsets of the paediatric population in the treatment of coronary atherosclerosis (see section 4.2 for information on paediatric use).
Europska agencija za lijekove je izuzela obvezu podnošenja rezultata ispitivanja lijeka DuoPlavin u svim podskupinama pedijatrijske populacije u liječenju koronarne ateroskleroze.
The primary endpoint was the occurrence of the composite of an occluded infarct-related artery on the predischarge angiogram, or death or recurrent MI before coronary angiography.
Primarni ishod bio je pojava okludirane koronarne arterije povezane s infarktom miokarda na angiogramu učinjenom prije otpusta, smrt, ili rekurentni infarkt miokarda prije koronarne angiografije.
Caution is recommended when co-administering salicylates with acetazolamide as there is an increased risk of metabolic acidosis.
Preporučen je oprez pri istovremenoj primjeni salicilata i acetazolamida zbog povećanog rizika od metaboličke acidoze.
Other concomitant therapy with clopidogrel
Ostala istodobna terapija s klopidrogrelom
More than 30,000 patients entered into clinical trials with clopidogrel plus ASA at maintenance doses lower than or equal to 325 mg, and received a variety of concomitant medicinal products including diuretics, beta blockers, ACE Inhibitors, calcium antagonists, cholesterol lowering agents, coronary vasodilators, antidiabetic agents (including insulin), antiepileptic agents and GPIIb/IIIa antagonists without evidence of clinically significant adverse interactions.
Više od 30 000 bolesnika sudjelovalo je u kliničkim ispitivanjima u kojima su, uz klopidogrel i ASK u dozama održavanja jednakim ili manjim od 325 mg, primali niz istodobno primjenjenih različitih lijekova uključujući diuretike, beta-blokatore, ACE inhibitore, antagoniste kalcija, lijekove koji snižavaju razinu kolesterola, koronarne vazodilatatore, antidijabetike (uključujući inzulin), antiepileptike i GPIIb/IIIa antagoniste, bez dokaza klinički značajnih štetnih interakcija.
Breast-feeding should be discontinued during treatment with DuoPlavin.
Dojenje treba prekinuti za vrijeme liječenja lijekom DuoPlavin.
The active metabolite of clopidogrel selectively inhibits the binding of adenosine diphosphate (ADP) to its platelet P2Y12 receptor and the subsequent ADP-mediated activation of the glycoprotein GPIIb/IIIa complex, thereby inhibiting platelet aggregation.
Aktivni metabolit klopidogrela selektivno inhibira vezanje adenozin difosfata (ADP) za njegov receptor P2Y12 na trombocitima te posljedično ADP-om posredovano aktiviranje kompleksa GPIIb/IIIa, sprječavajući tako agregaciju trombocita.
DuoPlavin should be used with caution in patients who receive concomitant glycoprotein IIb/IIIa inhibitors (see section 4.4).
DuoPlavin se s oprezom mora davati bolesnicima koji istodobno primaju inhibitore glikoproteina IIb/IIIa (vidjeti dio 4.4.).
It is unknown whether ASA dose in DuoPlavin alters fertility.
Nije poznato utječe li doza ASK u lijeku DuoPlavin na plodnost.
The decrease was associated with a 39% (loading dose) and 21% (maintenance dose) reduction of inhibition of platelet aggregation.
Smanjenje je bilo povezano s oslabljenom inhibicijom agregacije trobmocita od 39% (udarna doza) i 21% (doza održavanja).
• You should also tell your doctor immediately if you develop a medical condition known as Thrombotic Thrombocytopenic Purpura or TTP that includes fever and bruising under the skin that may appear as red pinpoint dots, with or without unexplained extreme tiredness, confusion, yellowing of the skin or eyes (jaundice) (see section 4).
• Odmah obavijestite svog liječnika ukoliko se pojavi bolest (poznata kao trombotična trombocitopenična purpura ili TTP) sa simptomima koji uključuju vrućicu i potkožne hematome koji se mogu pojaviti kao crvene točkice, s ili bez neobjašnjivog teškog umora, zbunjenosti i žute boje kože ili očiju (žutica) (vidjeti dio 4.).
As a dual antiplatelet agent, DuoPlavin should be used with caution in patients who may be at risk of increased bleeding from trauma, surgery or other pathological conditions and in patients receiving treatment with other NSAIDs including Cox-2 inhibitors, heparin, glycoprotein IIb/IIIa inhibitors, selective serotonin reuptake inhibitors (SSRIs), thrombolytics, or other medicinal products associated with bleeding risk such as pentoxifylline (see section 4.5).
Kao dvostruki antitrombocitni lijek, DuoPlavin treba s oprezom davati bolesnicima koji su izloženi povećanom riziku od krvarenja zbog ozljede, kirurških zahvata ili drugih patoloških stanja te bolesnicima koji se liječe ostalim nesteroidnim protuupalnim lijekovima, uključujući Cox-2 inhibitore ili heparinom, inhibitorima glikoproteina IIb/IIIa, selektivnim inhibitorima ponovne pohrane serotonina (SSRI) ili tromboliticima ili drugim lijekovima povezanim s rizikom od krvarenja kao što je pentoksifilin (vidjeti dio 4.5).
• ST segment elevation acute myocardial infarction in medically treated patients eligible for thrombolytic therapy
• kod akutnog infarkta miokarda s elevacijom ST-segmenta, u medikamentozno liječenih bolesnika pogodnih za liječenje trombolitičkom terapijom.
DuoPlavin contains lactose.
DuoPlavin sadrži laktozu.
The CURE study included 12,562 patients with non-ST segment elevation acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction), and presenting within 24 hours of onset of the most recent episode of chest pain or symptoms consistent with ischaemia.
Studija CURE uključivala je 12 562 bolesnika s akutnim koronarnim sindromom bez elavacije STsegmenta (nestabilna angina ili non-Q infarkt miokarda), koji su u zadnja 24 sata imali epizodu boli u prsištu ili simptome ishemije.
DuoPlavin fixed-dose combination is used following initiation of therapy with clopidogrel and ASA given separately, and replaces the individual clopidogrel and ASA products.
DuoPlavin fiksna kombinacija primjenjuje se nakon započete terapije klopidogrelom i acetilsalicilatnom kiselinom koji su primjenjivani odvojeno i zamjenjuje pojedinačne lijekove s klopidogrelom i ASK.
Patients should also be told that it might take longer than usual to stop bleeding when they take DuoPlavin, and that they should report any unusual bleeding (site or duration) to their physician.
Bolesnicima koji uzimaju DuoPlavin potrebno je objasniti da će krvarenje možda trajati dulje nego obično te da moraju obavijestiti liječnika ako se pojavi bilo kakvo neočekivano krvarenje (mjesto i trajanje krvarenja).
Patients should be counseled about the risks of gastrointestinal injury and bleeding while taking clopidogrel plus ASA with alcohol, especially if alcohol consumption is chronic or heavy.
Bolesnike treba savjetovati o rizicima od gastrointestinalnog oštećenja i krvarenja ako konzumiraju alkohol tijekom liječenja klopidogrelom i ASK, osobito ako je konzumacija alkohola kronična ili obilna (vidjeti dio
Pharmacogenetics: In patients who are poor CYP2C19 metabolisers, clopidogrel at recommended doses forms less of the active metabolite of clopidogrel and has a smaller effect on platelet function.
Farmakogenetika: u bolesnika koji su spori CYP2C19 metabolizatori, kod preporučenih doza klopidogrela stvara se manja količina aktivnog metabolita lijeka te je smanjen učinak na funkciju trombocita.
Thus, beyond 3 months of treatment, the benefit observed in the clopidogrel plus ASA group was not further increased, whereas the risk of haemorrhage persisted (see section 4.4).
Prema tome, zabilježena korist liječenja klopidogrelom plus ASK nakon 3 mjeseca, se nije dalje povećavala, dok je opasnost od krvarenja i nadalje postojala (vidjeti dio 4.4.).
It is preferable not to take this medicine during first and second trimesters of pregnancy.
Ne preporučuje se uzimanje DuoPlavina u prvom i drugom tromjesečju trudnoće.
The incidence of clinically significant bleeding was similar to that observed when thrombolytic agents and heparin are co-administered with ASA (see section 4.8).
Incidencija klinički značajnog krvarenja bila je slična onoj zamijećenoj pri istodobnoj uporabi trombolitika i heparina s ASK (vidjeti dio 4.8.).
Therefore, concomitant use should be undertaken with caution (see section 4.4).
Zbog toga je pri istodobnoj primjeni potreban oprez (vidjeti dio 4.4.).
Anaphylactic shock*, serum sickness, anaphylactoid reactions, cross-reactive drug hypersensitivity among thienopyridines (such as ticlopidine, prasugrel) (see section 4.4)**,insulin autoimmune syndrome, which can lead to severe hypoglycemia, particularly in patients with HLA DRA4 subtype (more frequent in the Japanese population)**, aggravation of allergic symptoms of food allergy*
Poremećaji imunološkog sustava anafilaktički šok*, serumska bolest, anafilaktoidne reakcije, križno reaktivna preosjetljivost na lijekove iz skupine tienopiridina (kao što su tiklopidin, prasugrel) (vidjeti dio 4.4)**, autoimuni inzulinski sindrom koji može dovesti do teške hipoglikemije, osobito u bolesnika s podtipom HLA DRA4 (češći u japanskoj populaciji)**,pogoršanje simptoma alergije na hranu*
Until the 24th amenorrhea week (5th month of pregnancy), acetylsalicylic acid should not be given unless clearly necessary.
Acetilsalicilatna kiselina se ne preporučuje do 24-og tjedna amenoreje (5-og mjeseca trudnoće), osim ako je primjena neophodna.
Acetylsalicylic acid inhibits platelet aggregation by irreversible inhibition of prostaglandin cyclo-oxygenase and thus inhibits the generation of thromboxane A2, an inducer of platelet aggregation and vasoconstriction.
Acetilsalicilatna kiselina (ASK) inhibira agregaciju trombocita ireverzibilnom inhibicijom enzima prostaglandin ciklooksigenaze, čime sprječava stvaranje tromboksana A2, koji potiče agregaciju trombocita i vazokonstrikciju.
If the use of DuoPlavin is discontinued, patients may benefit with continuation of one antiplatelet medicinal product.
Ako se primjena DuoPlavina prekine, bolesniku može koristiti nastavak liječenja pojedinačnim antitrombocitnim lijekom.
Since SSRIs affect platelet activation and increase the risk of bleeding, the concomitant administration of SSRIs with clopidogrel should be undertaken with caution.
Budući da lijekovi iz skupine SSRI utječu na aktivaciju trombocita i povećavaju rizik od krvarenja, potreban je oprez prilikom istodobne primjene SSRI i klopidogrela.
How to take DuoPlavin
Kako uzimati DuoPlavin
Fifteen percent (15.0%) of patients in the clopidogrel plus ASA group and 21.7% in the group treated with ASA alone reached the primary endpoint, representing an absolute reduction of 6.7% and a 36% odds reduction in favor of clopidogrel (95% CI: 24, 47%; p <0.001), mainly related to a reduction in occluded infarct-related arteries.
Primarni ishod dostiglo je 15,0% bolesnika u skupini s klopidogrelom plus ASK te 21,7% u skupini samo s ASK, što predstavlja apsolutno smanjenje od 6,7% i smanjenje šansi (od engl. odds reduction) od 36% u korist klopidogrela (95% CI: 24, 47%; p<0,001), uglavnom povezano sa smanjenjem okluzija u koronarnim arterijama povezanih s infarktom.
There are no fertility data with DuoPlavin.
Nema podataka o plodnosti tijekom uzimanja DuoPlavina.
Serious haemorrhage, haemorrhage of operative wound, vasculitis (including Henoch-Schönlein purpura*), hypotension
Krvožilni poremećaji hematomi ozbiljno krvarenje, krvarenje kirurške rane, vaskulitis (uključujući Henoch-Schönleinovu purpuru*), hipotenzija
In addition, due to the presence of ASA, its use is also contraindicated in:
Dodatno, zbog prisutnosti ASK, DuoPlavin je također kontraindiciran:
How to store DuoPlavin
Kako čuvati DuoPlavin
The safety of the concomitant administration of DuoPlavin with other thrombolytic agents has not been formally established and should be undertaken with caution (see section 4.4).
Sigurnost istodobne primjene DuoPlavina i trombolitičkih lijekova nije formalno utvrđena te treba biti provedena s oprezom (vidjeti dio 4.4).
The clinically relevant adverse reactions observed in four major studies, the CAPRIE study (a study comparing clopidogrel alone to ASA) and the CURE, CLARITY and COMMIT studies (studies comparing clopidogrel plus ASA to ASA alone) are discussed below.
Klinički značajne nuspojave opažene u studijama CAPRIE (uspoređivan je sam klopidogrel prema acetilsalicilatnoj kiselini) te CURE, CLARITY i COMMIT (uspoređivan je klopidogrel plus ASK prema samoj ASK) opisane su u daljnjem tekstu.
• Non-ST segment elevation acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction) including patients undergoing a stent placement following percutaneous coronary intervention
• u bolesnika s akutnim koronarnim sindromom bez elevacije ST-segmenta (nestabilna angina ili non-Q infarkt miokarda), uključujući bolesnike kojima se ugrađuje stent nakon perkutane koronarne intervencije,
DuoPlavin contains lactose
DuoPlavin sadrži laktozu
Each film-coated tablet contains 8 mg of lactose and 3.3 mg of hydrogenated castor oil.
Jedna filmom obložena tableta sadrži 8 mg laktoze i 3,3 mg hidrogeniranog ricinusovog ulja.
The concomitant administration of DuoPlavin with oral anticoagulants is not recommended since it may increase the intensity of bleeding (see section 4.4).
Istodobna primjena DuoPlavina i oralnih antikoagulansa se ne preporučuje, jer može povećati intenzitet krvarenja (vidjeti dio 4.4.).