He aha ka Hydroxychloroquine: Nā hoʻohana, ka nui o ka lāʻau, nā hopena ʻaoʻao a me nā mea hou aku

He lāʻau lapaʻau i kauoha ʻia ʻo Hydroxychloroquine e nā kauka e mālama i ka maʻi malaria, rheumatoid arthritis, a me lupus. Hiki paha iā ʻoe ke ʻike maikaʻi aʻe ma kona inoa inoa, Plaquenil, a no ka hui o nā lāʻau lapaʻau i kapa ʻia he antimalarials e hana ana ma ka hōʻemi ʻana i ka mumū i loko o kou kino.

Ua hoʻohana palekana ʻia kēia lāʻau lapaʻau no nā makahiki he nui e kōkua i nā kānaka e mālama i nā maʻi autoimmune maʻi. ʻOiai ua hana ia i nā poʻo inoa i ka wā o ka maʻi maʻi COVID-19, ʻo kāna hana nui e kōkua ana i nā kānaka me ka arthritis a me ka lupus e ola i nā ola ʻoluʻolu.

He aha ka Hydroxychloroquine?

ʻO Hydroxychloroquine kahi lāʻau antimalarial synthetic e hana pū ana ma ke ʻano he immunosuppressant. He mana i hoʻololi ʻia o chloroquine, i hoʻolālā ʻia e ʻoluʻolu i kou kino me ka hāʻawi ʻana i ka mālama pono no kekahi mau maʻi.

Hana ka lāʻau lapaʻau ma ka hoʻopilikia ʻana i ke kamaʻilio ʻana ma waena o kekahi mau cell i loko o kou ʻōnaehana pale. E noʻonoʻo iā ia e like me ka hoʻohaʻahaʻa ʻana i ka leo ma kahi pane immune overactive e hoʻoulu ai i ka mumū a me ka ʻeha i nā maʻi e like me ka rheumatoid arthritis a me ka lupus.

Manaʻo nā kauka iā hydroxychloroquine he lāʻau antirheumatic e hoʻololi ana i ka maʻi, a i ʻole DMARD no ka pōkole. ʻO ia hoʻi, ʻaʻole ia e mālama wale i nā hōʻailona akā hiki ke lohi i ka holomua o nā maʻi autoimmune i ka manawa.

No ke aha e hoʻohana ʻia ai ka Hydroxychloroquine?

Hoʻomaʻamaʻa ʻo Hydroxychloroquine i ʻekolu mau maʻi nui: ka pale ʻana a me ka mālama ʻana i ka malaria, rheumatoid arthritis, a me systemic lupus erythematosus. Kauoha kāu kauka iā ia ma muli o kou kūlana kikoʻī a me ka mōʻaukala olakino.

No ka malaria, pale kēia lāʻau lapaʻau i ka maʻi ke hele ʻoe i nā wahi i maʻamau ka malaria a mālama i nā maʻi ikaika. Hana ia ma ka hoʻopilikia ʻana i ka hiki o ka parasite malaria ke ola i loko o kāu mau keena koko ʻulaʻula.

I loko o ka maʻi ʻaʻa rheumatoid, kōkua ka hydroxychloroquine i ka hōʻemi ʻana i ka ʻeha hui, ka pehu ʻana, a me ka ʻoʻoleʻo i ke kakahiaka. Nui ka poʻe i ʻike i ka hoʻomaikaʻi ʻana o kā lākou mau hōʻailona i ka hala ʻana o kekahi mau mahina o ka mālama ʻana, a hiki ke kōkua i ka pale ʻana i ka pōʻino o ka hui mai ka ʻino.

No nā maʻi lupus, kōkua kēia lāʻau lapaʻau i ka mālama ʻana i nā ʻōpala ʻili, ka ʻeha hui, a me ka luhi. He mea maikaʻi loa ia i ka pale ʻana i nā lapalapa lupus a hiki ke hōʻemi i ka pono no nā lāʻau lapaʻau ikaika e like me nā steroids.

I kekahi manawa, kuhikuhi nā kauka i ka hydroxychloroquine no nā maʻi autoimmune ʻē aʻe e like me ka maʻi Sjögren a i ʻole kekahi mau maʻi ʻili. Ua manaʻo ʻia kēia mau mea he

E ʻai i nā papa holoʻokoʻa me ke aniani wai piha. Mai ʻoki, nau, a ʻoki paha i nā papa, no ka mea, hiki i kēia ke hoʻopilikia i ke ʻano o ka lāʻau lapaʻau a hiki ke hoʻonui i nā hopena ʻaoʻao.

Inā ʻoe e lawe ana no ka pale ʻana i ka maʻi malaria, e hoʻomaka i ka lāʻau lapaʻau hoʻokahi a ʻelua pule ma mua o ka huakaʻi ʻana i kahi wahi i loaʻa ka malaria. E hoʻomau i ka lawe ʻana i kēlā me kēia pule i kou wā e noho ana ma laila a no ʻehā pule ma hope o kou hoʻi ʻana i ka home.

No ka maʻi ʻaʻaʻa rheumatoid a i ʻole lupus, e lawe paha ʻoe i kēlā me kēia lā. He mea kōkua ke lawe i ka manawa like i kēlā me kēia lā e mālama i nā pae paʻa i loko o kāu ʻōnaehana a kōkua iā ʻoe e hoʻomanaʻo i kāu mau lāʻau.

E pale i ka lawe ʻana i ka hydroxychloroquine me nā antacids i loaʻa ka alumini, magnesium, a i ʻole calcium, no ka mea, hiki i kēia mau mea ke hoʻopilikia i ka absorption. Inā pono ʻoe i kahi antacid, e lawe ma ka liʻiliʻi ʻehā hola ma mua a ma hope paha o kāu lāʻau hydroxychloroquine.

Pehea ka lōʻihi e lawe ai au i ka Hydroxychloroquine?

ʻO ka lōʻihi o ka mālama ʻana e hilinaʻi loa i kou kūlana a me ka maikaʻi o kou pane ʻana i ka lāʻau lapaʻau. No ka pale ʻana i ka maʻi malaria, e lawe ʻoe i ka lōʻihi o kāu huakaʻi a me ʻehā pule ma hope o ka hoʻi ʻana i ka home.

No ka maʻi ʻaʻaʻa rheumatoid a me lupus, ʻo ka hydroxychloroquine ka mea maʻamau i ka mālama lōʻihi. Nui ka poʻe e lawe iā ia no nā makahiki e kōkua i ka mālama ʻana i kā lākou mau hōʻailona a pale i ka holomua o ka maʻi.

E nānā kāu kauka i kāu pane ʻana i ka lāʻau lapaʻau a hiki ke hoʻololi i kāu hoʻolālā lapaʻau i ka manawa. ʻIke kekahi poʻe i ka hoʻomaikaʻi ʻana i loko o kekahi mau pule, aʻo nā mea ʻē aʻe e pono paha i ʻekolu a ʻeono mahina e ʻike i nā pōmaikaʻi piha.

Mai hooki i ka lawe ʻana i ka hydroxychloroquine me ka ʻole e kamaʻilio mua me kāu kauka. No nā kūlana autoimmune, hiki i ka hooki ʻana i ka hopena ke alakaʻi i ka piʻi ʻana o nā hōʻailona i ʻoi aku ka maikaʻi ma mua o kou hoʻomaka ʻana i ka mālama ʻana.

E hoʻonohonoho kāu kauka i nā loiloi maʻamau e nānā i kāu holomua a nānā i nā hopena ʻaoʻao. He mea nui kēia mau kipa e hōʻoia i ka palekana a me ka pono o ka lāʻau lapaʻau.

He aha nā hopena ʻaoʻao o ka Hydroxychloroquine?

Hoʻomanawanui ka hapa nui o nā kānaka i ka hydroxychloroquine, akā e like me nā lāʻau lapaʻau a pau, hiki iā ia ke hana i nā hopena ʻaoʻao. ʻO ka nūhou maikaʻi, ʻaʻole maʻamau nā hopena ʻaoʻao koʻikoʻi, ʻoi aku hoʻi ke hoʻohana pono ʻia ka lāʻau lapaʻau a nānā mau ʻia.

E hoʻomaka kākou me nā hopena ʻaoʻao maʻamau e hiki iā ʻoe ke ʻike, he maʻalahi pinepine lākou a hoʻomaikaʻi pinepine i ka wā e hoʻoponopono ai kou kino i ka lāʻau lapaʻau.

ʻO nā hopena ʻaoʻao maʻamau:

• Hoʻopilikia ka ʻōpū, ka nausea, a i ʻole ka ʻeha o ka ʻōpū
• Ka maʻi maʻi a i ʻole nā ʻōpala palupalu
• Poʻo
• ʻO ka noʻonoʻo ʻole a i ʻole ka māmā
• ʻO ka ʻili a i ʻole ka ʻili
• Ka nalowale o ka ʻai

Hoʻemi pinepine kēia mau hōʻailona i loko o kekahi mau pule i ka wā e maʻa ai kou kino i ka lāʻau lapaʻau. Hiki i ka lawe ʻana i ka hydroxychloroquine me ka meaʻai ke kōkua i ka hōʻemi ʻana i nā hopena ʻaoʻao e pili ana i ka ʻōpū.

I kēia manawa, e kūkākūkā kākou i kekahi mau hopena ʻaoʻao liʻiliʻi akā ʻoi aku ka koʻikoʻi e pono ai ka lāʻau lapaʻau. ʻOiai e hana ʻia kēia mau mea i kahi pākēneka liʻiliʻi o nā kānaka, he mea nui e ʻike iā lākou.

ʻO nā hopena ʻaoʻao liʻiliʻi akā koʻikoʻi:

• Nā loli i ka ʻike, me ka ʻike ʻole a i ʻole ka pilikia o ka ʻike
• Nā pilikia lohe a i ʻole ke kani ʻana i nā pepeiao
• Nāwaliwali o ka ʻiʻo a i ʻole nā pilikia hoʻonohonoho
• Nā loli o ke ʻano, me ke kaumaha a i ʻole ka hopohopo
• ʻO ka ʻeha a i ʻole ke kahe ʻana
• Nā hopena ʻili koʻikoʻi

Pono nā pilikia ʻike i ka nānā kūikawā no ka mea hiki ke mau inā ʻaʻole i hopu ʻia i ka wā mua. E ʻōlelo kāu kauka i nā hoʻokolohua maka maʻamau e nānā i nā loli retinal, hiki ke hana me ka hoʻohana lōʻihi.

Aia kekahi mau hopena ʻaoʻao laha akā koʻikoʻi e pono ai ka lāʻau lapaʻau koke. ʻAʻole maʻamau kēia mau mea, akā ʻo ka ʻike ʻana iā lākou hiki ke kōkua iā ʻoe e ʻimi koke i ke kōkua inā pono.

ʻO nā hopena ʻaoʻao laha akā koʻikoʻi:

• Nā pilikia nui o ka puʻuwai
• Nā hopena maʻi nui me ka pilikia o ka hanu
• Nā ʻāʻā a i ʻole nā ʻōpū
• Poino nui o nā ʻiʻo (rhabdomyolysis)
• Nā maʻi koko e pili ana i nā keʻokeʻo koko a i ʻole nā platelets
• Nā pilikia nui o ke ake

Inā loaʻa iā ʻoe kekahi o kēia mau hopena ʻaoʻao koʻikoʻi, e kelepona koke i kāu kauka a i ʻole e ʻimi i ka mālama olakino pilikia. E hoʻomanaʻo, he mea maʻamau ʻole kēia mau pilikia, akā he mea nui ka ʻike mua a me ka mālama ʻana no kou palekana.

ʻO wai ka mea pono ʻole e lawe i ka Hydroxychloroquine?

Pono kekahi poʻe e pale i ka hydroxychloroquine a i ʻole e hoʻohana wale nō ma lalo o ka mālama olakino akahele loa. E nānā kāu kauka i kāu moʻolelo olakino ma mua o ke kau ʻana i kēia lāʻau.

ʻAʻole pono ʻoe e lawe i ka hydroxychloroquine inā he maʻi ʻoe iā ia, chloroquine, a i ʻole kekahi o kāna mau mea. ʻO nā hopena maʻi i hala i nā lāʻau antimalarial he kumu maopopo e pale ai i kēia lāʻau.

ʻO ka poʻe me kekahi mau maʻi maka, ʻo ia hoʻi nā loli retinal a i ʻole nā loli ʻike, pono e pale i ka hydroxychloroquine. Hiki i ka lāʻau lapaʻau ke hoʻonui i nā pilikia o ka maka a hoʻolilo i nā loli ʻike i mau.

Inā he pilikia nui kou o ka puʻuwai, ʻo ia hoʻi kahi maʻi i kapa ʻia ʻo QT prolongation, ʻaʻole palekana paha ka hydroxychloroquine iā ʻoe. Hiki i ka lāʻau lapaʻau ke hoʻopilikia i ka ʻōnaehana uila o kou puʻuwai a hoʻonui i nā maʻi o ka puʻuwai.

Pono kekahi mau maʻi ʻē aʻe i ka mālama kūikawā a me ka nānā pono ʻana. E loiloi kāu kauka i nā pōmaikaʻi e kūʻē i nā pilikia inā loaʻa iā ʻoe kekahi o kēia mau maʻi.

ʻO nā kūlana e koi ana i ka mālama kūikawā e pili ana:

• Maʻi kīkī a i ʻole ka hana kīkī i hōʻemi ʻia
• Maʻi ake a i ʻole nā pilikia o ka hana ake
• Nā maʻi koko e like me ka anemia a i ʻole ka helu keʻokeʻo koko haʻahaʻa
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency
• Psoriasis a i ʻole porphyria
• Nā pilikia lohe a i ʻole nā maʻi pepeiao

Pono nō ka noʻonoʻo kūikawā i ka wā hāpai a me ka hānai ʻana i ka waiū. ʻOiai ua manaʻo ʻia ʻo hydroxychloroquine he palekana ma mua o nā lāʻau lapaʻau ʻē aʻe no nā maʻi autoimmune i ka wā hāpai, e loiloi pono kāu kauka inā ʻoi aku ka maikaʻi ma mua o nā pilikia.

Nā inoa inoa o Hydroxychloroquine

ʻO Plaquenil ka inoa inoa kaulana loa no hydroxychloroquine ma ʻAmelika Hui Pū ʻIa. Ua loaʻa kēia inoa no nā makahiki he nui a ʻo ia ka mana i ʻike nui ʻia e nā kauka a me nā maʻi.

Loaʻa nō hoʻi nā mana generic o hydroxychloroquine a loaʻa iā lākou ka mea hana like me Plaquenil. ʻOi aku ka liʻiliʻi o kēia mau mana generic a hana like me ka lāʻau inoa inoa.

Hiki i kāu hale kūʻai lāʻau lapaʻau ke pani i kahi mana generic ke ʻole kāu kauka e kākau kūikawā "inoa inoa wale nō" ma kāu palapala kauoha. Pono nā mana generic a me nā inoa inoa e hoʻokō i nā kūlana palekana a me ka pono i hoʻonohonoho ʻia e ka FDA.

Inā ʻoe e hoʻololi ana ma waena o nā mea hana like ʻole o hydroxychloroquine, e haʻi i kāu kauka. ʻOiai pono e hana like nā lāʻau lapaʻau, ua ʻike kekahi poʻe i ka naʻau i nā ʻokoʻa i nā mea hana ʻole a i ʻole nā hana hana.

Nā koho ʻē aʻe o Hydroxychloroquine

Nui nā lāʻau lapaʻau ʻē aʻe e hiki ke mālama i nā maʻi like me hydroxychloroquine, akā pili ka koho maikaʻi loa i kāu maʻi kikoʻī a me ka mōʻaukala olakino. E kōkua kāu kauka iā ʻoe e ʻimi i ke koho kūpono loa inā ʻaʻole kūpono ʻo hydroxychloroquine iā ʻoe.

No ka maʻi ʻāʻī rheumatoid, hiki i nā DMARD ʻē aʻe e like me methotrexate, sulfasalazine, a i ʻole leflunomide ke lilo i nā koho ʻē aʻe kūpono. ʻO nā lāʻau lapaʻau biologic e like me adalimumab a i ʻole etanercept he mau koho nō hoʻi no ka poʻe me nā maʻi koʻikoʻi.

Hiki i nā maʻi lupus ke pōmaikaʻi mai nā antimalarials ʻē aʻe e like me ka chloroquine, ʻoiai he nui nā hopena ʻaoʻao o kēia lāʻau ma mua o ka hydroxychloroquine. Hoʻohana ʻia nā lāʻau immunosuppressive e like me ka methotrexate a i ʻole mycophenolate mofetil no ka mālama ʻana i ka lupus.

No ka pale ʻana i ka malaria, nā koho ʻē aʻe e komo pū ana me ka doxycycline, mefloquine, a i ʻole atovaquone-proguanil. ʻO ke koho maikaʻi loa e hilinaʻi ʻia ma kahi āu e hele nei a me kāu mau mea pilikia pilikino.

E noʻonoʻo kāu kauka i nā mea e like me kāu mau maʻi olakino ʻē aʻe, nā lāʻau lapaʻau āu e lawe nei, a me ka maikaʻi o kāu pane ʻana i nā lāʻau lapaʻau ma mua i ka wā e ʻōlelo ai i nā koho ʻē aʻe.

ʻOi aku ka maikaʻi o Hydroxychloroquine ma mua o Methotrexate?

ʻAʻole ʻo hydroxychloroquine a ʻo methotrexate paha i

Nīnau pinepine ʻia e pili ana iā Hydroxychloroquine

He palekana anei ʻo Hydroxychloroquine no ka maʻi puʻuwai?

Pono e loiloi pono ʻia ʻo Hydroxychloroquine i ka poʻe me ka maʻi puʻuwai, ʻo ia hoʻi ka poʻe me nā maʻi puʻuwai. Hiki i ka lāʻau lapaʻau ke hoʻopilikia i ka ʻōnaehana uila o kou puʻuwai a hiki ke hoʻonui i kekahi mau maʻi puʻuwai.

Inā loaʻa iā ʻoe ka maʻi puʻuwai, e kauoha paha kāu kauka i ka electrocardiogram (EKG) ma mua o ka hoʻomaka ʻana i ka hydroxychloroquine a hiki ke nānā i ka puʻuwai o kou puʻuwai i kēlā me kēia manawa i ka wā o ka mālama ʻana. Kōkua kēia i ka hōʻoia ʻana he palekana ka lāʻau lapaʻau no kou maʻi puʻuwai.

ʻO ka poʻe me ka QT prolongation, kahi ʻano maʻi puʻuwai, pono e pale i ka hydroxychloroquine. Eia naʻe, hiki i ka poʻe me nā ʻano maʻi puʻuwai ʻē aʻe ke lawe palekana me ka nānā pono.

He aha kaʻu e hana ai inā lawe hewa au i ka nui o Hydroxychloroquine?

Inā lawe hewa ʻoe i ka nui o hydroxychloroquine ma mua o ka mea i kauoha ʻia, e hoʻokaʻaʻike koke i kāu kauka a i ʻole ke kikowaena hoʻomalu lāʻau make. Hiki i ka lawe ʻana i ka nui ke kumu i nā hopena ʻaoʻao koʻikoʻi, me nā pilikia o ka puʻuwai, nā hopu ʻana, a me ka hāʻule nui ʻana o ke koko.

Mai kali e ʻike inā e ulu nā hōʻailona – hiki ke weliweli ka overdose hydroxychloroquine a pono paha i ka lāʻau lapaʻau koke. Inā ʻoe e ʻike nei i nā hōʻailona e like me ka dizziness, ka pilikia o ka hanu ʻana, a i ʻole nā ​​hoʻololi ʻana i ka puʻuwai, e ʻimi koke i ka lāʻau lapaʻau.

E mālama i ka hue lāʻau me ʻoe i ka wā e ʻimi ai i ke kōkua olakino, no ka mea, e kōkua kēia ʻike i nā mea mālama ola e mālama pono iā ʻoe. Mai ho'āʻo e hoʻokomo i ka luaʻi ʻana ke ʻole i kuhikuhi ʻia e kekahi loea mālama ola.

He aha kaʻu e hana ai inā hala wau i kahi mahele o Hydroxychloroquine?

Inā hala ʻoe i kahi mahele o hydroxychloroquine, e lawe koke iā ia ke hoʻomanaʻo ʻoe, ke ʻole kokoke i ka manawa no kāu mahele i hoʻonohonoho ʻia. I kēlā hihia, e lele i ka mahele i hala a e hoʻomau me kāu papa hana maʻamau.

Mai pāpālua i nā lāʻau e pani ai i ka mea i hala, no ka mea, hiki i kēia ke hoʻonui i kou pilikia o nā hopena ʻaoʻao. Inā ʻoe e lawe ana i ka hydroxychloroquine no ka pale ʻana i ka maʻi malaria a ua hala i kahi lāʻau, e kelepona i kāu kauka no ke alakaʻi ʻana i ke ala e hana ai.

No nā maʻi autoimmune, ʻaʻole paha e hoʻopilikia koke ka hala ʻana i kahi lāʻau, akā e hoʻāʻo e mālama i ka lāʻau mau no nā hopena maikaʻi loa. E noʻonoʻo e hoʻonohonoho i nā mea hoʻomanaʻo kelepona a i ʻole e hoʻohana i kahi mea hoʻonohonoho pila e kōkua iā ʻoe e hoʻomanaʻo i kāu mau lāʻau.

I ka manawa hea e hiki ai iaʻu ke hooki i ka lawe ʻana i ka Hydroxychloroquine?

Mai hooki i ka lawe ʻana i ka hydroxychloroquine me ka ʻole e kūkākūkā mua me kāu kauka. No nā maʻi autoimmune e like me ka rheumatoid arthritis a me ka lupus, hiki i ka hooki ʻana i ka lāʻau lapaʻau ke alakaʻi i ka piʻi ʻana o nā hōʻailona i ʻoi aku ka maikaʻi ma mua o ka mālama ʻana.

E kōkua kāu kauka iā ʻoe e hoʻoholo i ka manawa kūpono e hooki ai a i ʻole e hōʻemi i kāu lāʻau ma muli o kāu mau hōʻailona, ​​ka hana maʻi, a me ke olakino holoʻokoʻa. Pono paha kekahi poʻe e lawe i ka hydroxychloroquine no nā makahiki he nui e mālama i ka mana hōʻailona maikaʻi.

Inā ʻoe e ʻike nei i nā hopena ʻaoʻao, e kamaʻilio me kāu kauka e pili ana i ka hoʻoponopono ʻana i kāu lāʻau a i ʻole ka hoʻololi ʻana i kahi lāʻau ʻē aʻe ma mua o ka hooki ʻana. Nui nā ala e mālama ai i nā hopena ʻaoʻao i ka wā e hoʻomau nei i ka mālama ʻana.

No ka pale ʻana i ka maʻi malaria, pono ʻoe e hoʻomau i ka lawe ʻana i ka lāʻau lapaʻau no ka lōʻihi i kuhikuhi ʻia, me nā pule ʻehā ma hope o ka haʻalele ʻana i kahi wahi i loaʻa ka malaria. ʻO ka hooki ʻana i ka wā mua hiki ke waiho iā ʻoe i ka maʻi.

Hiki iaʻu ke inu i ka waiʻona i ka wā e lawe ana i ka Hydroxychloroquine?

ʻAe ʻia ka inu ʻana i ka waiʻona i ka wā e lawe ana i ka hydroxychloroquine, akā he mea naʻauao ke kūkākūkā ʻana i kēia me kāu kauka. Hiki i ka waiʻona a me ka hydroxychloroquine ke hoʻopilikia i kou ate, no laila, ʻo ka hui pū ʻana iā lākou e hoʻonui i ka pilikia o nā pilikia o ke ake.

Inā he maʻi ate kou a i ʻole e lawe ana i nā lāʻau lapaʻau ʻē aʻe e pili ana i kou ate, hiki i kāu kauka ke ʻōlelo aku e pale loa i ka waiʻona. Pono ka poʻe me ka maʻi ʻāʻī rheumatoid a i ʻole lupus e lawe pū ana i ka methotrexate e akahele loa i ka inu ʻana i ka waiʻona.

Hiki nō hoʻi i ka waiʻona ke hoʻonui i kekahi mau hopena ʻaoʻao o ka hydroxychloroquine, e like me ka ʻūlū a i ʻole ka ʻōpū. E hoʻolohe i kou manaʻo i ka wā e hui pū ai i ka waiʻona me kāu lāʻau lapaʻau a hoʻoponopono e like me ia.

E ʻoiaʻiʻo mau i kāu kauka e pili ana i kāu inu ʻana i ka waiʻona i hiki iā lākou ke hāʻawi i ke alakaʻi maikaʻi loa no kāu kūlana kikoʻī. Kōkua kēia ʻike iā lākou e nānā i kou olakino a hoʻoponopono i kāu hoʻolālā lapaʻau inā pono.