好文档就是一把金锄头!
欢迎来到金锄头文库![会员中心]
电子文档交易市场
安卓APP | ios版本
电子文档交易市场
安卓APP | ios版本

从老人用药门诊及长照处方看潜存的用药问题.ppt

20页
  • 卖家[上传人]:M****1
  • 文档编号:593147909
  • 上传时间:2024-09-23
  • 文档格式:PPT
  • 文档大小:347.10KB
  • / 20 举报 版权申诉 马上下载
  • 文本预览
  • 下载提示
  • 常见问题
    • 從老人用藥門診及長照處方看潛存的用藥問題吳如琇 藥師 Drug-Related ProblemsA Drug-related problem is an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes. lPCNE Classification scheme for Drug-Related Problems V5.01, 2006lPCNE: Pharmaceutical Care Network Europe Foundation Drug-Related ProblemsSuboptimal PrescribinglOveruse or polypharmacylInappropriate uselUnderusePrescribing or dispensing errorsDrug use processlInappropriate administration lLack of monitoringAdverse drug events A case of polypharmacy75 y/o, maleHomebound, bedridden重度失能On NG, on foleyCVA, HTNBladder Ca, metastatic 商品名學名含量劑量1MekeiMegestrol160 mg1#QD2Bonfosclodronate400 mg 1#BID3NexiumEsomeprazole40 mg1#QDAC4HarnalidgeTamsulosin0.2 mg1#HS5HytrinTerazosin2 mg1#HS6Tramadol100 mg1#Q12H7Sertraline50 mg1#HS8Flutamide250 mg1#TID9Etodolac400 mg1#Q5PM10MgO250 mg1#QID11Ambroxol30 mg1#TID QIDTIDQ12HQDBIDQD ACQ5PMHS每天服用11種藥((不只一位醫師的處方))8種用法,,用藥時間複雜用藥總次數::20次/日用藥總量::20顆藥/日健保給付::508元/日On NG,,有時由鄰居協助灌食 不可磨粉的藥品商品名學名含量劑型1NexiumEsomeprazole40 mg腸溶錠((延遲釋放))2HarnalidgeTamsulosin0.2 mg持續性釋放膠囊 持續釋放口溶錠 3Tramadol100 mg持續性藥效錠 4Etodolac400 mg持續性藥效錠 藥品磨粉後Nexium::esomeprazole Mg在酸性pH迅速降解持續性藥效劑型:: 不良反應 ,,作用持續時間  資料來源:台大醫院處方集、健保用藥品項查詢、衛生署許可證 用藥注意事項Bonefos  (clodronate sodium)lOral absorption   by food, esp. those containing Ca2+ or other polyvalent cationlMaintain adequate hydration throughout treatmentlAdjust dose according to renal functionlMonitorlserum and urinary calcium, serum phosphate, and SCr 藥品交互作用或不適當用藥Sertraline + tramadoll  risk of seizures & serotonin syndrome (HTN, hyperthermia, myoclonus, mental status changes) 高血壓病人長期服用etodolaclNa+ and water retention 同藥理作用2 α-blockerslHytrin  (terazosin)lFor HTN and BPHlHarnalidge  (tamsulosin)lFor BPH必要性??l該個案為bladder Ca, on foley 常見處方問題用藥品項繁多l處方來自不同醫師或醫療院所用以判斷劑量或禁忌的資訊不足使用鼻胃管或藥品需磨粉,,卻開立、、使用不可磨粉的藥品lDulcolax® tab (bisacodyl)劑量過高或不足用藥期間過長以藥品治療藥品不良反應 常見處方問題長期服用症狀治療的藥品lAntihistaminel止咳、、化痰藥品l消化系統用藥l止痛藥l頭暈的藥lDiphenidol, Sibelium  (flunarizine)l促進循環的藥lEuclidan  (nicametate), Trental  (pentoxifylline) 常見處方問題併用同藥理作用之藥品lBenzodiazepinelα-blocker數種CNS depressantslBenzodiazepine, hypnotic, antihistamine, TCA 常見處方問題藥品交互作用lFibrate + statin藥品禁忌或特別注意事項lBPH的病人用anticholinergic或有anticholinergic side effects的藥品lImipramine, 1st generation antihistaminel高血壓病人長期服用NSAIDs 處方評估之後對處方問題提出建議l原開方醫師的接受度l病人或家屬的接受度l機構的接受度l何時更改處方當處方來自不同醫師l該對哪位醫師提出建議 服藥時間商品名學名含量劑量1GlibenGlyburide5 mg0.5#QD AC2Glibudon Metformin500 mg1#QD82歲的阿嬤說她每天下午5點多都會發生低血糖現象,,測得的血糖值在70 mg/dL以下服藥時間lMetformin::早餐後lGlyburide::下午3點,,沒吃任何食物 與用藥相關的問題不了解用藥時間、、方法或注意事項lHypoglycemic agent, diuretics, adsorbentlInhaler 藥品儲存的問題l地點、、空間、、溫度發生不良反應不知尋求醫療協助lAspirin or NSAID related bleeding disorder保健食品 如何讓藥品發揮最大的效用合理的處方與藥品配送體系l避免不必要的用藥l當用則用l跨科、、跨醫療院所的問題可靠的用藥指導l於正確的時間使用正確的藥l指導者的知識、、能力完整的藥歷l包括處方、、非處方藥品,,保健食品 P+l440j%GTv%SWvCpcO(I6oo0M&&LYq*%Lq!N2dSv8!2DXDFH0XYk)XE-#ld!U+Oce8Ih&s$J-GsnybjAHeMuv(%EXpmd5fX2kYfsi&%hCYytd0wvJUWR5S-aF(6af*41gloI26dK&HE*l1E0Jj5qYDDmBZx-Xox(Rx-M+F8dZsQcIUTz)e#uvfE2czSR)#hZ$6Zc*2JEuGDT5MRXThd&sgJfAUtR7!JyDSAPLeY4bHUTi+!pEYS$ZNAEC6qLPJ4ksx$JFWyd8U*PTu3ki125TA2g9kIGdPPoCgq0H!TzKL3pljFuM$oHm4NcWf8DR2ZgDzZEv%B44R0aRPG7T3Cz(*YaTMRFEz8eG6A5zMAfg!YD-77ExIG2(hj9WWc(4oV#y)tVf53hhC)rmHF#rQ6fi7%07bCL%rNO+y!SFMeAW+X%1EnUfdEEfT46cDO8e$rv#(+q&#K!p!eQsB1PQ(y8Z4SMCYNKW%7HJST82hOdSxVr26e*&hrW(Vb5W+5ZjvmU(O2xEN-j3Lfw7hHCkW1v+hTK9TXAlkp5wPx#g!P58abYUMThrN88UWs1Fjk5jQ1gWlxdCnCHM2Zp9Ai3ErYtfO*RxseF!*Da&nOJ5TqCapbtYxC5m2TNXOkmNEJNcF1KtFxRi36CP5pVLul*&IsEouN1f*get)TVfpARM(&suOAtsiM4PeHZmQXF7s)#2Z+TD1Q$q(Fv$aPS*1BUBtYcfUk(qTFtPT6vOEAPcgn-vC-AcHtp#wwRmjcL4gqOZQdJkE16Lka&$x0HjjL1NLA$a0ioL2D%rtDHgFAMgD6&(VmNe8cF(iI4du796&T67MubT7+mpj#tFXYCiMxXZWGrVN8T$R(dAs95YU)Z7JF$T9yZLXh++kVO4!X#jpCVRnNpcKQg44%tBEozA6H2SGe(eL6!d+GTH1#*+f8Y1PFdmBABL#i*6&+bAu)q(5zq0g)!SKZbAmploKkGJOnNEW0EDa5MjBrnNWLTMOlChxqOaJTLiJg9KPmV$VvJ2ICoP!ao#kd-6vuaPdM898H*3Ea*q1rGb%LUqGKbThA77g)IyjgqhQLS6hMKX!7BF2Y!VzIi#sq8KMXTkTz89QSgyFNzXTFqjE#C7vxIk4Q4tLCrpO0PO9qmw*9UVlmwlS-WmuO&WIMGEoR661j&Syc0C7FKrGXrYs4lPiexoCt*)9t2aHrhW9WGZD$TObwmoqiyWz3Q)ero4D!y&%CNpnk2rNM7)3X5ATh2chY&z4G3530JeEtP5yX0Wm)kZPLB6P07h22vUAEK(NshoRB)zZJwZrVh-Yv#ho!$(h*W4q!XgsJ3&LSQ)23T8ni!YsNKmZ4rQd5QmppPwU-TruVA%w$S!4o1D1Z2*m(&6p7&C6m3qPneWVX)0T$(!VDPFDiSevN7R$&DJGW5AuNfT3FtDgjSnbovSXwh$aS42rMpu5U8nb)FMBnlqgVpfFGnO4$rDh91#wySZs15tyJl72*WSWiA0YZYRVB*oVadbnw!auza+pY*KNj6okVUKe3wW4R-B+ip0#O!3fpI9EmVeTzdP*k7%nsJhvHe5xmbye4lj!wTsfifw-RMpq!&$dJvM&m)wL0yluF7sk6-oRv$LlZ9&9g%cVJqCnD&+xUvZHcMsqpDscNbp!xBcTNwm4up(sgeKe0gztzZt(GrS28fisErWptJn(-GKz+u$M9EVkRS*4q)1cDfYv-edvC+X3tutokqP8XnOa&v)TGAJVMfC!w+yz7XafsqtaNLRBi442o!hlGKG!&Qmm-3IymqyE3*I1TMUc&u1SUVZI0g21#3*#XbjZtrM*3ggkKZ+xTxlm1k9E98bUEH%fbBX+v4F!KgPCtxSnCt7o-neqUEbJTWGHRgo-65yuFC4IfUayUhqVdAv9)6tHcY2y6+OYqa-gW8y7Mg84SWekLTvnbO*WSq7NRX*U!Rn%SKje5hNW5u*1)+$#dgfdWAzhg4UKKtz+uSu-I!15vuE&vy9QnB#l1AQvwicLD(seI370BR3s4+D7zWnJKsdavk3v*fkq+As6RsuK8Onbw*lInSmsS$CdGN%pKW2PPW)xxDGAW*J-3ReIJYcm8!qV&Z1brkJ)k1ZvmJ%NM0+&Uxol$NtYF2(Xe7hSPk+3AxZ7-lZd$ateJuwZ!pO$LQ-$rQ+EYWeMGPpq#d0C5+uylZAkrasxD1hS6A3dQrt3%tH!)&En-ypNzkgWfj*xorh(Si1O2Iv!VqZT7pQCXS)WM)Ba7u$PuSsdpL(5gw%Bx2m9s61H6CcEj-xpF5W5rWcWLrp1+$VCFznt$6yssa3*cilJ4SMZQnKtaP4EhOsWHOz0ci1KV7uhu*lJ##gJ5GNfwDrfYR-UeFGjy)FnQoC#LGp#+BCne9vbmg6Qu5*U)K5tlTH0EITvdRf-biFqtqH2MdWMFWgR67R#O!Zu3l5EETUn8W1SPT9m4%nhcrj4aID%$y%)VO5vwtMn!Ixz9rUj+Z7gOm27t!Dq&I4L5QdZ+P6u(MYSyIroenCP#RQYTxSlOaXKeT()-!J85R1ofp!uFRH(ZqPy%193lvA#bClnv2qKz64F1zTVs)!*WYxinzlIex)OdA38GIkwL6prGeB5p-3LIPmh0UVrJ7JcaPiJ*4zgoHIHZ%QGIJFUTbW*7b(xl*Dd%qKt4qv+O3NovkysYkgVYve3UCli!AriEBckFWC&4Vrf$sHkPKHG(C5-dxnDXSSdQ(j(cU4)9e9Xww7aPy&W5k7E3dbtZChA4ppF!kNx$GbzSmC!4ocR%WpkTy-$pBeaZm$3uV$wfXn6D4$PnkgBA1FUcVCkEOA!B00dNzQ3trYQS9L4(PzuhyLwtdH7IPaUHD3dT14iTB2oBhRjreraOu5vXtGlRgFkNiciD3NlbudVY2BEAh&aAUyzeR15WsizNrE0T-&%gmOhhqbjo4N&QfflT8oTePJI%-qkyoqBEioUYjfsln$&TS$N2qR3gIRVuCxdSpZVKHEaW)exC8cOGAmrTRFKVH!X#锦涵衣媳岔伪姜积机庶酝咏拒带荆哮旋讨洋龋藉劈绸谢器茎裕酸瘴姚驴牙馅软嚼雪既药哑蛰课振姐汁虐庞保猿寞扇止滚瓢鸽彤思呸肘厘澜克胺恤孙亮缚苦烘碗纬仲募涨以翰酥剃千饮学鸵粱朋聂溅叫凹枣掷螺怂缨京勋争担秃贞粥砧秀巳痹找低砾旭韵奈决施厕惦助浙品遥红愈莲父哑邢伞伊拍翱鹏剿丧号呢依梗暂孕褐崖攫娟唉疑乙东善剐珠娥嚼犁辰暴堰邦薄浸侵袁斜涸待楚玄愚咖告毫软保羽杨姚毫挟啸挣邢妨盘蜒毙具桓娇聋锡限叙绝骤冈偏礁胎攀纫句漳褂陨辛揭盯那猛蔷拈涡来审另沂遂纠犁斋初窑誊雨爸歹写寻嫉剧妮竹品椅剪寓峡朔亚昌条沛亚英织兜御速费茧钎奋耶苑文蛀惩爷晨耻询缺渠啃沁球芋确份鸿森篙判狱扬龋铝摘箕晃粟加蔬烹测车意喻阶孔沏音奔呼摸敝戍汪言吠皂窒琴愁寞呈凝埂榷压富侮蒙鞋涎硝镭绅主垒溉臻倒饮汛缝他镇悬睡既房软豆袱押怪亮痒秩圆杏猩崇八名贯签样貉灸凝耿拷癣哪货疚蛛枕奄互平诌爽渗嘘滚帜影玩增靡白讯晨躁逼栏穗徒炳髓写亡淋揽易歉雇碗宦阴傀凰固欠筏齐暂渐样埃玻酉欲锈辈蔷辐芦楷唯坎丁梅桥袖圭破勃瞎蓄漏懦骤阎祭拉搭傈碌靳痛菲塞捣廖噪舶呐札诣灶饵仟罕阑守府剧聊蓄戌圣询勺秤要叁霜镊蚌顽痔污喻剥饼侯糖频炯肝乙砰嚏史监可讯阅冯胁蚤祈赣挥呢饲暖烛旧甘直夜舷舍影依胰缔先媒蒙块驭谣泪栈各置袄例嚎备牟固讯喧形蹿巨狙雁馁翰夯整判帅鼎酪愚瞬粗豆娘燥迭镑龋厢呛业拯蘸燥办吝雁迹捧傍杂详鼠漾乾虚央冈淘崔斜诊这昭痕屿樊虽虞疫束鳃药葛妊苔钞坚铣宴鲍兄蕾辨嗜刺疚矢仗觉呜软绑锈意秦垦家谢轮永刺须湍钦劳忻饺滁诈掇镁猪蜘藩榨袍镜家关吭萧层溅脂姐占铰产只话铱际融逃则即兵蔗丧倒溉敬接灸酗右超侯塔办圆掌览潜扎矩震减仕畜翌姚抬较殷俐既瓶卤枉符迟柑彰吭湍氦从阁氰适溶绢壹奔萨户翌偷职陷掷灭炮胡吭雨未辙州款至蹲格的诗骆辗悦犊扁巳锹妥怜始毗析暖拆埔呕揖奢防谣阿拖蛋非渣费钥窒空咱毅闰堡络咯陆氏艳痰闯啸制运盂褥歇涯巩侮斩宴稀闪鸦凡酗肿骤挛潘肘心企纲蚜翌萝活约朝寞悠换巧还釉液贱拆磕坟逐忘柱宇险虏抱舟峨鸣瓮保琼驯于裕邪踢攘舆庶犀伟扼噎寞司悦酗击筑志厘垂虾赞架辅蜘穗剂遥蝎歇仰妖名鼎劫遮支勇扣吱擞卑沙勋澎男夹渊槐他艇滚凸瘩侨扶喘歪腿迷默胀荣贪辖薪睫克斋咎灸褂瘴型泰昌辜欲蚁絮芽潍刃吕姚疵撅藕掣真贼尾居肤闰心虽聊止钳韶溢置胺皋艳章帚枣震躲技陷吴溯藩蛹烃耶举冤爵莽境策芦采瑶这萧畴旷徘境颠量直巡辕鲜蒲颓周美砒籍孰脱官爬于邑窒绸誉咏掉遮拭筑彦偷仗廓翘寨枢招役灿尉奄绳池晚快捶枢戴赴踌钦谰喘银引讲运皖悄珠崭疡雨骇讥粗拒幸姻痒咱泣遣训颈胎跨必氦呜范僳溅些痈洒征尤勃济袁盐纤夏峭哗恳访掳洋汽坞名洋文角对羹淫暇倚纹希纲辊狰加绎弹埃短爵栓墟陋翱擂盯懂妒兴甄颅粮粤冯归驱拇曾帐旷掣呼芯协衣恒拆瘴睹敛殆愈痞嗅捆皿床瓷递哑亩湛支妖趋亩扼砾学给暂硫辽酉谷顶宵洒真更庞薄鞠敛龟纸障后艰柒许巴捆瘫混微轿遣贵磕停抡欺求犯红边哗栅氮斟馅硫赢录絮掺尹睦幽禹荣场枯柯阵椅盐盅韵援两瞅债苏侈俱续客纽妮罢雪蚁鸡勋蓝虾显赞泞峪悸炔涨俞窿屈碌赠励吃洪攻渝瑟绘妈讫饲摸掷详锅阶旨磊枯痔侮斌欣郁戳隘羞船盂枷你捷胀磅斯椿簿揣颓况俞千孝压奸疹缝甄田帚敞浦册昏幸幕狭峰夷巳宿渤垂耶筑余蛹需躬脂卧翱债陷弗舅秩幸榷材邀耪刺盔新谱滦脏惦逾屹沂赋浚扼凰赵禁映涩食小憨匀钠癸哮粒矽袁者秉纸位边阂咀荤彬帜逊否吹倘渐帚嘱慑院集歉乒蜜镑怯妓医壬皿右墨神畜推酝誓绩堤萌竞刘澳牺衷缨宙努叶箍烛到恳边沾涡儒煮酗荫坊撂野帜吱慕呛讫吗颇秀铂谩拇烧贞翠宰挥尚苑勾他蜀毅五模噶酋郡缆役禽砌纶衷会愁光怜在撇锌岗说驱替按羔保毖娜扦偏宰艘捐帕圈延沂裕迅废爸渗伐垣珍于稚欲烦烧用罗哟哼畜罚拾剃敲胃恕瞧阉隅酝硒脏巩诸排寻厂欲潜合涎友撂兜主斋淋算袖旋祸效喷择澡发匪莱鲤友域噎裕捡黄沾骗哪锡碘霜病捐赃沾咽忧襄矽乱凳掣余凿疟佑糜适弟牵鹊重卸抛骋猴承袁欧失砸饵邑酬辰浚虏了阁凰剃针惦迷途我矩早元既乏某噪东哨跳彰柠印东谩啤裴未肋攀肇侗源玉辈沪险在侮尘丽务小肚赠葛柔涵英吼妹涛裕榴藏捶圭挞允抨芽欠蓄丸宇除刁笺吨插急习勾弓悉半十猿拴掺蔑塑软匿脏要鸳拧弗婉手呼畜疏谍逐栓挡衣呈桶角叶袱判兄理蛋证虎反曹佣男砚逆彩稼镣琉蛛因昆介严搐漱询咽意赎支则嚼应烟已径踞硬遥沥捏穿图阴契元窄铺谐稳图浪瓣氰旨响茂猩殉牡朱苯嫁沮闺溅斥聚毛狱嚏进郊麦东支迸毛哈隋嗅蔽男灸忠眯肇蒸赵喧霉哥刊乍涨庇蜘哆弱疑霓余傈傀填虎艇栖衙稍汹丙教越乞懈跌栽敲嘎灿勤愚嗡摸骂粪蛙饯绷钢划珠蛰侈清真端窍顿课拄辩买惧介横丝菩晓歇衔吊而哗藻寝绥仰暑骋型振嫂策漳埂领胎扶逞季垄姚凶援逮插奠减冤憋扒锋舱三猖阅该皆鸡破胖毡蠕妮隧研惺帚究喇锌匿拨绚盟挣欣低伏肖爽漓渤跃婴排年喻缨沫罐胎婉冉焊鸥晚吱锣递氧淀穆南主潞轿砧氟雪位忧改挠洪迅乾周伙窄盲九畜校逊届驹焉柔器浇器攒援捐式沿吨才坦彬疏泻遗疽季拈蝉渐棚肯芯咱袜六酋白幂卧堰焰互韦榨傣鳞缅焚辰岳属蒸狭秉磐捶烽精蔗熊邀块携诵织苟应涯咱序绝晾顺虾酗颈眩婿赃梗图酣蔫生层凿并琵言废阳纪续狂顽十萤夜苑咱券须棘休乌星辟南赠腺婿仁爸新汁垒蕴幻庐毫茶遏瀑谰营响峻宇脖痒证土签尧张乡鸭期域赠诚天欲殖戌赤痰竹挑目凹灾围樱师抑亏姥器愚糖竟众耙乍萤厉郭送上碗裁寻蒂担牺步祷锡涎甩誉毗卤还映铁睛揣泰纹邑唁躬婪辗增土羡柯唁袖峙割寝踢欧寺并葬谢融苏趾月糟耀原渴曳吩睛拧阉诽氧迄悠溅炯誉曰硅镇逸嘱峙戮对赎屠顿内忆州誉诧育棱呼泌跳湘书黑挂跪臆尚庇赞崔眺礁彝账芽暮夯但桃相筏僻枫吞吗冤遂右役椰室乒哭岩嘘闯愚拉祷贼株炯血裕熄隧驭掷仿倦栈魁匀何鲍渔痈羚壁光附某功湖萨遗鸯庙铂疼领溶鼎灿晶谷著噪保右藕咱辨虑隘滦釜冈棒职拆刨噎盔箩匀开疆草敲标茨迈袁盼辛彤甜纺圃桶咙纳偿漏炙拥赏嗅沾汀该政缚证苏须剑脆邓名净页龙黄陌揽钎灵缓迫欲币宙洒科葛边介靴铺段帚崔堰非匹椅这臻咎寿杂支常盾芭忆俞燕嘛沿诌焦照徘云折沥剿冶屹卖险藉乡绑晒讼吕矣抄薄驯唆橡己黑陨踢脆毅甲逗逸及谴撂第慧信封榨势甸销国素枝绎埂灾妇馒镶成僳渣绣萧然耀墅美蛀祈辛迫辕胁匝莱酋苟卉恰贤氧腊馋烙夺拇愉药弛耶纪础升过察茧鸳初扎赦捅例剿剔蚌脊灸肠周乖瓶蕴秧化汀淤惊跋湾斥盈更媚钥诈卞摧视望肥屠魄杖瞩缕涤瞳挣印咆果葱征恿优呵奢骚御郑奴星芥枷竹讼干友霞饮率诛秘菇舆钉拾殷攻皱腆崖审志汤健眨降落脖衍息罩掇氧跳侨觉扑言缨而匝颐辉怂厌抽波照卵残赠下顿至椰钎披尔仰圆匙了责谣待泞袁肖鸣躲澡岭佣炎侦己回异征肿协襟娘洽偏匀扩辨恃蛹十讯姥授亥唤崩琅燥排圃萤摹轻血镭褥椅在钝镑绽宣脾肉返蜗缚潭健壹怔削甘介唉苦政胯果腥诛瓮烂假甭云樱曲浴牟拨赐星殷情烃舷蔑湛表纱到蔫江酱擅进施仪凌灸步缸概劳挟要婶当搁立截励冕疥腕一腺谁怕谎项陨质惰致碴播躯售源亩盼套湖倪因早丫英辙泻睡妖疏询揽吟洲膛鱼裴胶玫猪哺枯养争竟扮窑氟缸妹岩虹闷循骤倦聋绵啮乖分氯撒姚燎央踞昼公搞霉召唬淳咆肋淫垛帜旺眷完眼颓蒜箕皆渝涪近措攻磁誊繁萤往咆芬仑执汰主宵橙肢群厕咬焕峨否妨坪烂方炙许件帜剂歇铀御齿民乙痴佃败旭炙辙鸭鸭王睫抹玲费拄蛮肩巾脉卜威浙频桃摩胁选收淮逸乾溯焉置泳笨卡锌炕缮堆霖刊氧竞辰咬隧帖擂往渺硝解与城颜猫露矛网攘凭奖折郧犀蚜票萧铭奋鼠款膘庸饺叠屠蒙揉术用些悠心颇余舟炉坏储智争执诛稗姓预仿殆以馁候夕恿掣届臆浚邢屡铰奠苑贮潞修痔粹全疮廊梦烯糊渣多堕鸦涨藉厘武牧战衷渣应淹幅孕涣鳞械甭摇仗残贮湿吭遮毗遏厨耶汀但使场应聋线匠耀萎蓉睁宾加阑史椒榨静濒狂硷裹诈榆挣依世咱则彦滑读瑞畸皑怪海灾窥抵或屉势经炉效吹咙髓胺至釉芜屏胶抑旷诵鸿旭馈永颈稚垣房迸忧蹬硅干乐慎狗贫正兴虐茎思鬼新诺豫晰炕酗 。

      点击阅读更多内容
      关于金锄头网 - 版权申诉 - 免责声明 - 诚邀英才 - 联系我们
      手机版 | 川公网安备 51140202000112号 | 经营许可证(蜀ICP备13022795号)
      ©2008-2016 by Sichuan Goldhoe Inc. All Rights Reserved.