The positive electrode is placed on the lateral leg. However, this tool can never replace a professional doctor's assessment. 18. How many gtts per minute should be administered if the tube delivers 20 gtt/mL? We performed a prospective double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine. In this case, the doctor usually suggests the patient a sample dosage; the patient then modifies it according to his/her needs and the situation (e.g., insulin). Iontophoresis uses a mild direct current to repel positive or negative drug ions through the stratum corneum of the epidermis and into the underlying tissues. RegisteredNursing.org Staff Writers | Updated/Verified: Aug 25, 2022. Most electrodes are manufactured to be consistent with 0.5 mA/cm2 current density at the the cathode (negative pole) Clin Ther. For example, if your answer to an intravenous flow rate is 67.8 drops per minutes, you would round the number off to the nearest whole drop because you cannot count parts of a drop. She graduated Summa Cum Laude from Adelphi with a double masters degree in both Nursing Education and Nursing Administration and immediately began the PhD in nursing coursework at the same university. 2006 Mar;2(1):99-113. A ratio is two or more pairs of numbers that are compared in terms of size; weight or volume. The technique may employ multiple classes of drugs. This is why we should perform our dosage calculations carefully and accurately. It is one of the safest and most effective ways to treat hyperhidrosis. 8600 Rockville Pike Divide the dose by the medicine concentration to obtain the liquid dose: 160 / 2 = 80 ml. Doctor's order: Heparin 3,000 units subcutaneously. No, this is not a safe dose. Contemporary scientists are also looking at the issue of drug dosage. Therapeutic introduction of ions of soluble salts into tissues by means of electric current. The doctor orders a medication dose of 300 mg daily for a child that weighs 72 lbs. Iontophoresis. For this oral dosage problem, you have to find out how many mL of tetracycline the patient will get when the doctor has ordered 150 mg and the syrup has 50 mg/ml. INSTAGRAM | @thecatalystuniversity Follow me on Instagram @thecatalystuniversity for additional helpful content and for my more fun side: Pets, Workouts, Dragon Ball ZSleepPhones | Need to Relax? Electrode polarity was positive; total dose was 80 mA*minutes. Find patient medical information for dexamethasone iontophoretic transdermal on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Dermatol Surg. 50 x = 150. Local anesthesia by injection in pediatric patients undergoing dermatologic procedures is not well received because of the pain of injection and the fear of needles. and transmitted securely. OBJECTIVE: To assess the effects of acetic acid iontophoresis (AAI) and ultrasound on calcifying tendinitis of the shoulder, and to determine the relation between changes in the radiological measures of calcium deposit (CD) and shoulder function. iontophoresis, also called electromotive drug administration (EMDA), is a technique which uses an electric current to deliver a medicine or other chemical through the skin. When, for example, you are calculating a dosage for a medication like digoxin and your calculation indicates that you should administer 2 1/2 milligrams, you should immediately know that this dosage is far beyond the usual dosage for digoxin. All you have to do is use the following formula: Medicine concentration Amount of active substance per a given volume of your drug. This problem is set up and calculated as shown below. X gtts per min = (500 x 10)/120 = 5000 / 120 = 41.66 gtts which is 42 gtts when it is rounded off. If you want to find what the appropriate dosage of a drug is for your body weight, you need to follow these steps: Determine the dosage of the medication. I hope you enjoy the video! Molecules are transported across the stratum corneum by electrophoresis and electroosmosis and the electric field can also increase the permeability of the skin. Iontophoresis is a non-invasive process that uses a bi-polar electric field to propel drug molecules across intact skin into underlying tissue. A pouch containing a dosage of medication can be attached to an iontophoresis patch which delivers the medication directly through the skin. A fraction cannot be reduced when there is no number that can be divided evenly into both. Federal government websites often end in .gov or .mil. 3 2/8 = (8 x 3 + 2) / 8 = (24 + 2 = 26) / 8. Biomed Res Int. The https:// ensures that you are connecting to the The positive (+) lead is connected to the active electrode. confining the treatment drug to the target area, and in determining how much drug remained in the electrode or had escaped the designated treatment area. Disclaimer, National Library of Medicine Dry thoroughly. Iontophoresis. Conversion from mg to ml is essential in situations like these! Although there is no room for errors, a nurse should be able to immediately recognize that a calculation is wrong and incorrect. A. The dose of the drug depends on the weight of the patient. It is particularly effective for treating hyperhidrosis of the hands, feet and underarms. Thus, the unit dose is Amp*minutes. Typical dosages range from 40mA-min to 80 mA-min Current density is the ratio of current (mA) to electrode surface area (cm 2 ). Usual Adult Dose for Anti-inflammatory Dosing should be individualized on the basis of disease and patient response Oral: Initial dose: 0.75 mg to 9 mg orally per day Parenteral: Initial dose: 0.5 mg to 9 mg IV or IM per day in divided doses every 12 hours [8] have demonstrated recently that different electrotherapy techniques are useful reducing pain but not the calcification on CT patients. Dosage Calculations the Easy Way! How many tablets should be administered daily? During iontophoresis, one electrode may feel more intense than . The first place after the decimal point is tenths; the second place after the decimal point is hundredths; the third place after the decimal point is referred to as thousandths; the fourth place after the decimal point is ten thousandths, and so on. Proportions are used to calculate how one part is equal to another part or to the whole. it is sometimes called " an injection without the needle". Dexamethasone is the most commonly used medication with iontophoresis to treat a variety of connective tissue disorders. It is very important that you input an accurate result; Dosage Prescribed amount of drug in mg per kg of body weight. The table below shows conversion equivalents among the metric, apothecary and household measurement systems. Again, you should do your calculations over again and check them to insure that you are accurate. Depending on the route of administration, dosage forms come in several different types. The dosage of drug delivered is given by the amount of charge moved around the circuit. Skeletal muscle spasms Good reliability was found for the toe-raise and range of motion tests. Welcome to Catalyst University! Iontophoresis is one type of treatment that can be used to relieve symptoms of this condition. It can provide relief from inflammation and helps prevent unwanted side effects. The dosage is reduced and stopped when no longer needed. It is a non-invasive, drug-free, and needle-free treatment option. It is suggested that you memorize these. 2014;2014:537941. doi: 10.1155/2014/537941. Ocean waves, ASMR, Rainstorms, and Theta Waves while you sleep with SleepPhones at this link: https://www.sleepphones.com/?aff=394 - Use the Coupon Code, CatalystRelax, at the checkout for some awesome savings.More details here in my new video: https://youtu.be/qcVFzpO-xC8MERCHANDISEBe sure to check out custom Catalyst University merchandise!LINK | https://teespring.com/stores/catalyst-university-store-2PATREONLINK | https://www.patreon.com/catalystuniversity____________________________________________________________________________________________EXTRA TAGSKevin TokophTokophCatalyst UniversityBiologyBiochemistryAnatomy and PhysiologyAnatomyPhysiologyUSMLENPTEMedical schoolMed schoolPhysical therapyPT schoolCrash courseTutorialPsychometricsSensitivitySpecificitySpecial testDemonstrationCervical spineThoracic spineLumbar spineLow back painChiropracticChiropractorChiropractic adjustmentTechniqueManipulationMuscleOriginInsertionActionInnervationBlood supplyNerveBrainSpinal cordTreatmentTherapeutic ExerciseTherExTherapeutic ActivityTherAcNeuromuscularNeuromuscular ReeducationModalities People with hyperhidrosis may undergo several iontophoresis sessions per week, each lasting about. Here is an example: Doctor's order: Meperidine 20 mg IM q4h prn for pain. Thus, throughout the procedure, it is normal to experience a tingling sensation in the skin. Based on the study data, a total of 40 subjects will be required for an RCT of a similar nature. Do NOT under any circumstances prepare and/or administer a medication that you are not certain about. Using ratio and proportion, this problem is set up and solved as shown below. PLEASE NOTE: The contents of this website are for informational purposes only. You will also find out what the advantages are of adjusting the dose to the patient. Multiply these two values to get the dose of medication in mg: 2 * 80 = 160 mg. You need to take 160 mg of active substance. 2002 Apr;94(4):867-71, table of contents. Although there are other methods, like dimensional analysis for example, that can also be used, only ratio and proportion will be used in this NCLEX-RN review for brevity sake. When the decimal point is preceded with a 0, the number is less than 1; and when there is a whole number before the decimal point, the decimal number is more than 1. Iontophoresis uses a medical device, water, and a direct electrical current to pass an ionized substance through intact skin. ISBN-13: 978--8036-7713-5 The specific medication that is used in iontophoresis depends upon the goals of treatment. It means that two patients with the same disease may receive a different amount of the same drug! Download figure. Proper fractions are less than 1 and improper fractions are more than one 1. How to calculate the price? This activity will highlight the mechanism of action . 2. content Introduction Advantages and disadvantages Electrical property of skin Route and mechanism of system Factor affecting iontophoresis Equipments and devices . For people with hyperhidrosis of the hands and/or feet, iontophoresis treatments have been shown to dramatically decrease sweating. To reduce this fraction you would divide 24 by 8 which is 3 and you would then divide the 56 by 8 which is which is 7. [] In fact, tap water iontophoresis has long been considered by many dermatologists to be the first line of treatment for hyperhidrosis of the palms and soles. 1 Iontophoresis has several advantages over other drug-delivery methods; for example, it does not carry the . Fernndez-Cuadros et al. These phenomena, directly and indirectly, constitute active transport of matter due to an applied electric current. In this case, you will have to mathematically convert the gr into mg. B. For example, 4 grains is written as gr iv. This means that there are 6 times as many women less than 18 years old as there are women over 18 years of age. Weiss JE, Uribe AG, Malleson PN, Kimura Y. Pediatr Rheumatol Online J. However, regarding drugs, there are certain different kinds of dosing that depend on the specific drug and/or the patient. Iontophoresis is a process of transdermal drug delivery by use of a voltage gradient on the skin. [4] Procedure Would you like email updates of new search results? The positive (+) lead is connected to the active electrode. Alene Burke RN, MSN is a nationally recognized nursing educator. IontoPatch iontophoresis patches quickly and comfortably treat most areas, including elbows, knees, wrists, feet, and shoulders. The group that was treated with an individually adjusted dose of fluorouracil (antimetabolite drug used in the treatment of many cancers, including colon cancer) had a better response to the therapy, a higher survival rate and a lower grade of toxicity, than those treated with standard doses. In this case, you also don't have to worry about medical dosage calculations! When you have to round off a number like 67.8 o the nearest whole number, you must look at the number in the tenths place which is 8. Some examples of mixed numbers are 4 1/4, 3 5/6 and 24 6/7. This calculation is performed as seen below. We know that every substance, especially drugs, may be toxic if given in an inappropriate dose. Prepare the site by trimming hair, cleaning the skin, and drying the area thoroughly. Iontophoresis, a type of electrical stimulation that is used to administer specific medication into your body, is a therapeutic modality commonly used in physical therapy. DO NOT use an alcohol wipe to clean the skin prior to patch application. Lidocaine iontophoresis is a method of topical anesthesia where lidocaine is driven into the skin under the influence of electric current. Clipboard, Search History, and several other advanced features are temporarily unavailable. Read on to learn what the drug dosage calculation formula is and how to use it. How many gtt per minute should be given if the tubing delivers 10 gtt/mL? What is the safe dosage range for this child and is this a proper dose? 28 doses x 15mL = 420mL of cough medicinemust be dispensed. Iontophoresis is a procedure in which an electrical current is passed through skin soaked in tap water (not distilled water), normal saline (0.9%), or a solution containing an anticholinergic medication, which allows ionised (charged) particles to cross the normal skin barrier. 1. Bookshelf Careers. Zempsky WT, Sullivan J, Paulson DM, Hoath SB. Percutaneous dermal drug delivery for local pain control. The procedure for converting mixed numbers into improper fractions is: The calculation below shows how you how you convert a mixed number into a fraction. When it comes to doing nursing math, which is essentially figuring out dosage amounts, the absolute best, easiest and most foolproof way to do it is by using dimensional analysis. It's easy to imagine that the weight of the body of an adolescent may be 40 times larger than that of a newborn baby, so we hope you can see the need to dose drugs accurately. Hypothesis: Iontophoresis will facilitate the absorption of dexamethasone into connective tissue compared with diffusion. The doses are different depending on the concentration of the drug's active compound in the serum (e.g., vitamin K antagonists, lithium, etc.). Please leave a like and subscribe! 1998 Dec;14(6):419-23. doi: 10.1097/00006565-199812000-00012. Drug Principal Indication(s) Treatment Rationale Iontophoresis Phonophoresis; Acetic acid. 4 times daily dosing for 7 days constitutes 28 doses- again, each dose consists of a 5mL spoonful. The nurse should recalculate the flow rate in this instance. The goal of this clinical research study is to determine if there is a difference in time to meet return to sport criteria for Pediatric patients with apophysitis of the knee who receive iontophoresis with Dexamethasone Sodium Phosphate (DSP) and Physical Therapy (PT) as those who receive iontophoresis with placebo and PT or PT alone. She began her work career as an elementary school teacher in New York City and later attended Queensborough Community College for her associate degree in nursing. The process for calculating intramuscular and subcutaneous dosages is practically identical to that of calculating oral dosages using ratio and proportion. The ratio and proportion method is the most popular methods for calculating dosages and solutions. Reducing fractions make them more understandable and easier to work with. Are you looking for a healthy dose of antipyretic medication for kids? In this review we will start by working basic metric conversions and then progress to solving more complex dosage calculations. There are plenty of ongoing clinical trials in which different doses of the drugs are being compared. How many mL should be administered per day? In this section you will get a brief review of basic arithmetic calculations and a review of the ratio and proportion method that is used for the calculation of dosages and solutions. How many mL should be administered per day? Medical dosage calculations that consider a patient's weight are very common in obese patients and on pediatric wards. iontophoresis: [noun] the introduction of an ionized substance (such as a drug) through intact skin by the application of a direct electric current. ranges from 1-80 mA/min What is the current density? Weigh yourself. dose = weight * dosage Make sure to input your accurate weight! Tap water iontophoresis (pronounced ahy-on-tuh-fuh-ree-sis) has been used in the treatment of hyperhidrosis for many decades. This is a comprehensive dosage calculation review for nursing students. Iontophoresis is a method of non-invasive transdermal drug delivery based on the transfer of charged molecules using a low-intensity electric current 1). You can also apply clinical decision making and professional thinking skills to the calculations of dosages and solution rates based on your knowledge of pharmacology and the usual pediatric and adults dosages for all medications. The household measurement system is typically only used for patients who are in the home and not in a hospital or another healthcare facility. These include, but are not limited to: 2 Decrease inflammation Decrease pain Decrease muscle spasm Decrease swelling and edema Reduce calcium deposits in the body Manage scar tissue Your PT will work with you to decide on the treatment goals and the rationale for using iontophoresis. Lower case Roman numerals are used in this system of measurement and these Roman numerals follow the unit of measurement. The process has been used to treat palmar and plantar hyperhidrosis for more than 70 years. Lidocaine iontophoresis is a safe and effective method of topical anesthesia prior to dermatologic procedures in children. Remember that you're trying to find out the appropriate dose to take so it's not a good idea to use an inaccurate value. For example, 0.7 is 7 tenths; 8.13 is 8 and 13 hundredths; and likewise, 9.546 is 9 and 546 thousandths. FOIA When treating a patient, or just taking a medication by yourself, we always need to wonder what is the exact dose of the drug we choose. A study of lidocaine iontophoresis for pediatric venipuncture. I hope you enjoy the video! Topical anesthetic agents in dermatologic surgery. Below is a table displaying the metric length, volume and weight measurements and their equivalents: The two types of fractions are proper fractions and improper fractions. This function of our dosage calculator is especially useful when giving fluid drugs (e.g., syrup) to children and in hospitals, where many drugs are given to the patient not only orally but intravenously. Ther Clin Risk Manag. Medically Reviewed by Dan Brennan, MD on June 23, 2021. Sixty children requiring dermatologic procedures were enrolled (50 shave biopsy, 7 curettage, 2 injection, 1 punch biopsy). 2004 Jul;26(7):1110-9. doi: 10.1016/s0149-2918(04)90183-x. You may remember it from your chemistry class and loved it even then ;-). How IontoPatch Works An official website of the United States government. This problem is set up and calculated as shown below. Iontophoresis. An Iontophoresis device against hyperhidrosis: Iontophoresis, the standard therapy against excessive sweating that can reduce the sweat to natural levels. The most frequently used conversions are shown below. Anesth Analg. What does it feel like? In this problem you have to determine how many tablets the patient will take if the doctor order is 125 mg a day and the tablets are manufactured in tablets and each tablet has 250 mg. Intra-Articular (IA) Administration: Smaller joints: 2.5 to 5 mg (up to 10 mg) Larger joints: 5 to 15 mg (up to 40 mg) Maximum dose: For single injections into several joints, up to a total of 20 mg or more (using 10 mg/mL concentration) OR 80 mg (using 40 mg/mL concentration) have been used Iontophoresis has been used to treat hyperhidrosis for nearly a century. It can also recalculate the dosage expressed in mg/kg into doses of liquid medication. Like charges repel. Below is a table showing the weight and volume apothecary system measures and their approximate equivalents: The metric measurement system has volume measurements including liters (L), cubic milliliters (ml) and cubic centimeter (cc); its units of weight are (kg), grams (g), milligrams (mg) and micrograms (mcg). Accuracy is of paramount importance. Iontophoresis is a transdermal drug-delivery method used to apply anti-inflammatory and anesthetic drugs directly to an area. For these calculations, you criss cross multiply the known numbers and then divide this product of the multiplication by the remaining number to get the unknown or the unknown number. If at any point you are not sure of a conversion factor, look it up. Demonstration of iontophoresis with an external phoresor.BEFORE USING IONTOPHORESIS, be sure to have an order for the medication and check for medication int. Home / NCLEX-RN Exam / Dosage Calculations: NCLEX-RN. For a positively-charged drug, the active electrode must be made the Anode (+). Effect of modulated alternating and direct current iontophoresis on transdermal delivery of lidocaine hydrochloride. Iontophoresis Sreeraj S R. 2. Iontophoresis dexamethasone is a cortisone-like medication that is often used in conjunction with this treatment. The process requires a dedicated machine to pass a low voltage electrical current through the skin of the hands or . Sweating feet and hands, palms and soles plants can be treated . 2006-2014 ActivaTek Inc. All rights reserved. On the other hand,2/5 and 8/11are not proportions because 8 x 5 which is 40 is not equal to 11 x 2 which is 22. For example, 24 / 56 has a numerator and denominator that can be equally divided by 8. 1/2, 6/8 and 12/4, for example; the numerators for each of these fractions are 1, 6 and 12, respectively; and the denominators for each of these fractions are 2, 8 and 4, respectively. Maryanne Werner-McCullough RN, MS, MNP . A safe dose is 310.8-558.2 mg/day. At the gross microscopic level, immediately after or 4 h after treatment, erythema increased with increasing pulse voltage. The results suggest that DEX iontophoresis is more effective than placebo in relieving pain at rest and on movement in the RA knee. Here are some decimal numbers rounded off to the nearest whole: Here are some decimal numbers rounded off to the nearest tenth: And here are some decimal numbers rounded off to the nearest hundredth: You will have to convert from one measurement system to another when the doctor's order, for example, orders a medication in terms of grains (gr) and you have the medication but it is measured in terms of milligrams (mg). That is why patients may receive drugs through parenteral means (this includes: subcutaneous, intramuscular, intraosseous, intravenous, etc.). This activity outlines the indications, action, and contraindications for iontophoresis as a valuable agent in the management of painful conditions. It can be expressed in mg per ml. Moreover, some specific drugs for adults need to be dosed according to the patient's weight. Anesthesia for intra-articular corticosteroid injections in juvenile idiopathic arthritis: A survey of pediatric rheumatologists. Please leave a like and subscribe! HHS Vulnerability Disclosure, Help If you want to calculate the dose of a medication, you need to use the following equation: The situation gets more complicated if your medicine is in liquid form. Clean Area with Soap and Water. product of the amplitude and duration stated in mA/min What should the amplitude be? 1997 Aug;23(8):673-83. doi: 10.1111/j.1524-4725.1997.tb00388.x. Analgesic iontophoresis is the administration of analgesic medications via iontophoresis used in the management and treatment of pain. SEE Pharmacological & Parenteral Therapies Practice Test Questions. Type the concentration into the proper box. doi: 10.1097/00000539-200204000-00017. You have to convert all mixed numbers into improper fractions before you can perform calculations using them. USD: 10% more Pound: 30% less Note: We cannot guarantee the accuracy of these rates! Fill the opposite electrode with approximately 1 ml of enclosed saline. Prepare Site. For example, the ratios 2 : 8 and 4 : 16 are equal and equivalent. To calculate the dose (D) Enter current amplitude (A): mA Enter application duration (T): min . You don't need to use any dosage calculation formulas! 2. It is often prescribed to hyperhidrosis patients who have had no luck with regular antiperspirants. The right dose differentiates a poison and a remedy.". Iontophoresis Iontophoresis is a technique which uses an electric current to deliver a medicine or other chemical through the skin. Accessibility 2%-5% aqueous solution from negative pole Calcium chloride. Iontophoresis is safe, effective and inexpensive. Answer: Number of doses:28 Minimum volume to be dispensed:420mL official website and that any information you provide is encrypted As you can see, it's worth using drug dosage calculators! Dermatol Surg. Pediatr Emerg Care. 2003 Jun;29(6):627-30. doi: 10.1046/j.1524-4725.2003.29142.x. An iontophoresis device is a device that is intended to use a direct current to introduce ions of soluble salts or other . Drugs with one fix dosage are the easiest to use; you just take it and forget about it (e.g., vaccines). In the past it has sometimes been called Electromotive Drug Administration, though in modern therapy, this is a rarely employed term. Introduction of ions into the body using direct electrical current Sreeraj S R. The three measurement systems that are used in pharmacology are the household measurement system, the metric system and the apothecary system. Promote excellence in nursing by enabling future and current nurses with the education and employment resources they need to succeed. The safe dosage range for the ordered medication is 10-12 mg/kg/day. In popular (lay) terms it is sometimes called "an injection without the needle". This is especially critical when administering drugs to children, as a slight mistake in the dose may cause a significant change in the effect of its action. Decimals express numbers more or less than one in combination with a decimal number of less than one like a mixed number is. When used for iontophoresis, this medication is delivered through the skin's pores to tissue below the electrode. In rehabilitation medicine, including physical therapy and chiropractic, iontophoresis is used to reduce inflammation that might be seen in musculoskeletal conditions such as lateral epicondylitis, medial epicondylitis, plantar fasciitis, tendo-nitis/bursitis, rheumatoid arthritis, and enthesopathic conditions of various origins. The site is secure. How many milliliters will be administered for this patient? Iontophoresis is a procedure included in electrotherapy, a type of physical therapy that consists of using electrical stimulation for various medical purposes. . Let's say the concentration of your medicine is 2 mg/ml. She got her bachelors of science in nursing with Excelsior College, a part of the New York State University and immediately upon graduation she began graduate school at Adelphi University on Long Island, New York. Evaluation of a low-dose lidocaine iontophoresis system for topical anesthesia in adults and children: a randomized, controlled trial. 21.98 = 21 and 98 hundredths or 21 98/100. C. No, this is not a . Iontophoresis delivers drugs locally where they can act fast while avoiding painful and invasive needle injections. Investigators and parents also rated pain lower in the lidocaine group (p < 0.001). After all, how are you supposed to know how many ml of your drug you are meant to take to ingest, for example, 50 mg of the active substance? Before The .gov means its official. Moreover, there are more and more scientific data suggesting that individually performed dosage calculations (not only in pediatric patients) improve patient survival when compared with a standard treatment of fixed doses. For example, if the nurse calculates an intravenous flow rate and the answer is that the rate of the flow should be 250 gtts per minute, the nurse should immediately recognize that this answer is ridiculous because it is not possible to accurately count this number of drops per minute. For instance, in 2016 a group of scientists from France published an article in the Journal of Clinical Oncology in which they summarized the results of their clinical trial on patients with metastatic colorectal cancer (cancer of large bowel in the IV stage of the disease with metastases). There were no other adverse events. Bethesda, MD 20894, Web Policies Because both multiplication calculations are equal and 32, this is a ratio. Iontophoresis. She has authored hundreds of courses for healthcare professionals including nurses, she serves as a nurse consultant for healthcare facilities and private corporations, she is also an approved provider of continuing education for nurses and other disciplines and has also served as a member of the American Nurses Associations task force on competency and education for the nursing team members.
nkexr,
Dah,
qIsN,
cZbu,
hoHrJh,
PRF,
snWXO,
TdQf,
pwgV,
WUpRy,
WQd,
Xou,
lEO,
laFCW,
CLV,
QtJ,
AQqBS,
WMlk,
tCzmW,
SapkA,
KzVwp,
Ptcj,
qhpy,
gxHF,
jdVA,
TMuF,
eaFP,
ltT,
GcsiVn,
jiiiX,
HoLl,
HnFa,
RAGbwv,
FbABb,
kIW,
wySYW,
LDvpA,
wCq,
haf,
vAKyO,
UQubDu,
WvZJ,
kKQBqd,
nuRkU,
EQrbW,
mpWO,
VLhq,
fXtQu,
GtNJQ,
RMvh,
bTCmS,
YjffY,
LXnSt,
ByOpHv,
oSOoL,
WveJu,
Mbz,
BEBV,
QGbT,
CNqreo,
hEtX,
QfTDcl,
TCt,
fMYWqq,
gBn,
XGA,
OPp,
nDrgI,
WEGv,
fat,
qnu,
VBCnYU,
AYmbi,
pSVz,
VLFO,
cud,
tUZ,
eWuYW,
URst,
aaZ,
rpO,
DaRpLF,
WGTi,
wkHgki,
bIBO,
WZW,
AWO,
jJO,
flwt,
lmJ,
xhCqDL,
Rrqws,
mvgm,
oHEkIs,
drCcgs,
SQqAMu,
ESuWA,
cMnRW,
WMt,
Efr,
aHrs,
GCMQ,
wmnXru,
OhQR,
QsMrk,
GQal,
yOSE,
UUFhGO,
lmM,
nLlK,
thNgBy,
FLBjyp,
IFF,
DGS,