Darbepoetin Alfa Hoʻokomo

Anter

• Ma mua o ka hoʻohana ʻana i darbepoetin alfa injection,
• Hoʻokumu ʻo Darbepoetin alfa injection i nā hopena ʻaoʻao. E haʻi i kāu kauka inā koʻikoʻi kekahi o kēia mau ʻōuli a mai hele aku paha:
• Hiki i kekahi o nā hopena ʻaoʻao ke koʻikoʻi. Inā ʻike ʻoe i kekahi o kēia mau ʻōuli, a i ʻole nā ​​mea i helu ʻia i ka ʻARlelo Aʻo IMPORTANT, e kāhea koke aku i kāu kauka a i ʻole e kiʻi i nā lāʻau lapaʻau pilikia.

Nā mea maʻi āpau:

ʻO ka hoʻohana ʻana i ka darbepoetin alfa injection e hoʻonui ai i ka makaʻu o ke kōkō ʻana o ke koko i loko a neʻe paha i nā wāwae, nā mumū, a me ka lolo. E haʻi i kāu kauka inā loaʻa ʻoe a i ʻole loaʻa i ka maʻi maʻi puʻuwai a inā ua loaʻa ʻoe i ka maʻi kō. Kāhea koke i kāu kauka a i ʻole e loaʻa i ke kōkua olakino pilikia inā ʻike ʻoe i kekahi o nā ʻōuli penei: ʻeha, palupalu, ʻulaʻula, mehana, a me / a i ʻole ka pehu ʻana o nā wāwae. ke anuanu a i ʻole keʻokeʻo i ka lima a i ʻole ka wāwae; pokole o ka hanu; uha hele ʻole a lawe i ke koko; ʻeha ka umauma; pilikia kūpilikiʻi a kamaʻilio ʻana paha; huikau koke; ka nāwaliwali koke a i ʻole ka helu ʻana o ka lima a me ka wāwae (ʻoi loa ma kekahi ʻaoʻao o ke kino) a i ʻole ke alo; pilikia pilikia hiki ke hele wāwae, ʻānai, a nalowale paha o ke kaulike a i ʻole ka hoʻohui ʻana; a maule paha. Inā mālama ʻia ʻoe me ka hemodialysis (lapaʻau e wehe i ka ʻōpala mai ke koko ke hana ʻole nā ​​puʻupaʻa), hiki ke hana i kahi ʻūlū koko i kou komo vascular (kahi e hoʻopili ai ka tubed hemodialysis i kou kino). E haʻi i kāu kauka inā kū i kāu hana vascular ke hana e like me ka mau.

E hoʻoponopono kāu kauka i kāu lāʻau o ka darbepoetin alfa injection no ka mea he kiʻekiʻe kou pae hemoglobin (ka nui o kahi protein i loaʻa i nā hunaola ʻulaʻula ʻaʻole pono ʻoe i kahi transfusion o ke koko ʻulaʻula (hoʻololi o nā hunaola ʻulaʻula o kekahi i kekahi. kino o ke kanaka e mālama i ka anemia koʻikoʻi). Inā loaʻa iā ʻoe ka nui albepoetin alfa e hoʻonui ai i kou hemoglobin i kahi pae maʻamau a kokoke paha i kahi pae maʻamau, ʻoi aku ka nui o ka makaʻu e loaʻa ʻoe i ka hahau a hoʻomohala i nā pilikia puʻuwai koʻikoʻi a hoʻoweliweli paha i ke ola e like me ka puʻuwai puʻuwai, a me ka puʻuwai puʻuwai. Kāhea koke i kāu kauka a i ʻole e loaʻa i ke kōkua olakino pilikia inā ʻike ʻoe i kekahi o nā ʻōuli penei: ka ʻeha o ka umauma, kaomi ʻana i kaomi, a i ʻole ka paʻa; pokole o ka hanu; nausea, lightheadedness, sweating, a me nā hōʻailona mua o ka puʻuwai puʻuwai; ʻoluʻolu a i ʻole ʻeha ma nā lima, poʻohiwi, ʻāʻī, ʻāʻī, a i hope paha; aiʻole ka pehu ʻana o nā lima, nā wāwae, a me nā kuʻekuʻe wāwae.

E mālama i nā manawa a pau me kāu kauka a me ka hale hana. E kauoha kāu kauka i kekahi mau hoʻokolohua lab e nānā i ka pane o kou kino i ka darbepoetin alfa injection. Hiki i kāu kauka ke hōʻemi i kāu lāʻau a i ʻole e haʻi iā ʻoe e haʻalele i ka hoʻohana ʻana i ka darbepoetin alfa injection no kekahi manawa inā hōʻike nā hoʻokolohua aia ʻoe i ka makaʻu nui i ka loaʻa ʻana o nā hopena ʻino. E mālama pono i nā kuhikuhi a kāu kauka.

E hāʻawi aku kāu kauka a kauka paha iā ʻoe i ka palapala ʻike hoʻomanawanui o ka mea hana (Alakaʻi Medication) ke hoʻomaka ʻoe i ka lāʻau me darbepoetin alfa a i kēlā me kēia manawa e hoʻopiha hou i kāu kauka. E heluhelu pono i ka ʻike a nīnau i kāu kauka a kauka paha inā he nīnau kāu. Hiki iā ʻoe ke kipa aku i ka pūnaewele ʻo Food and Drug Administration (FDA) (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) a i ʻole pūnaewele o ka mea hana e kiʻi i ka Medication Guide.

E kamaʻilio me kāu kauka e pili ana i nā makaʻu o ka hoʻohana ʻana i ka inikua darbepoetin alfa.

Nā maʻi maʻi ʻaʻai:

I nā noiʻi hoʻokolohua, ʻo ka poʻe me kekahi mau maʻi ʻaʻai i loaʻa i ka inikū darbepoetin alfa i make ma mua a ua ʻike paha i ka ulu ʻana o ka tumora, kahi hoʻi o ko lākou maʻi ʻaʻai, a i ʻole ke kanesa i hohola ma mua o ka poʻe i loaʻa ʻole ka lāʻau. Inā loaʻa ʻoe i ka maʻi ʻaʻai, pono ʻoe e loaʻa i ka mahele lāʻau haʻahaʻa o ka darbepoetin alfa injection. E loaʻa wale iā ʻoe ka inika darbepoetin alfa e mālama ai i ka anemia ma muli o ka chemotherapy inā e hoʻomau ʻia kāu chemotherapy ma kahi o 2 mau mahina ma hope o kou hoʻomaka ʻana i ka hoʻomaʻamaʻa me ka darbepoetin alfa injection a inā ʻaʻole nui ka manawa e hoʻōla ʻia kou maʻi maʻi. ʻO ka mālama ʻana me ka darbepoetin alfa injection pono e hoʻopau ʻia ke pau kāu papa o ka chemotherapy.

Ua hoʻonohonoho ʻia kahi papahana i kapa ʻia ʻo ESA APPRISE Oncology Program e hoʻēmi i nā makaʻu o ka hoʻohana ʻana i ka darbepoetin alfa injection e mālama i ka anemia i hoʻokumu ʻia e chemotherapy. Pono kāu kauka e hoʻopau i ka hoʻomaʻamaʻa ʻana a kākau inoa i kēia papahana ma mua o ka hiki iā ʻoe ke loaʻa i ka darbepoetin alfa injection. Ma ke ʻano he ʻāpana o ka papahana, e loaʻa iā ʻoe ka ʻike palapala e pili ana i ka makaʻu o ka hoʻohana ʻana i ka darbepoetin alfa injection a pono ʻoe e kau inoa i kahi palapala ma mua o ka loaʻa ʻana o ka lāʻau e hōʻike ai ua kūkākūkā kāu kauka i nā pilikia o ka darbepoetin alfa injection me ʻoe. E hāʻawi aku kāu kauka iā ʻoe i ka ʻike hou aʻe e pili ana i ka papahana a e pane wau i kāu mau nīnau e pili ana i ka papahana a me kāu mālama ʻana me ka darbepoetin alfa injection.

Hoʻohana ʻia ʻo Darbepoetin alfa injection e mālama i ka anemia (ʻoi aku ka haʻahaʻa ma mua o ka helu maʻamau o nā hunaola ʻulaʻula) i ka poʻe me ka hōʻino ʻole o ka puʻuwai maʻi (ke ʻano e lohi a paʻa mau ai nā puʻupaʻa i kahi manawa o ka manawa). Hoʻohana ʻia ʻo Darbepoetin alfa injection e mālama i ka anemia i hoʻokumu ʻia e chemotherapy i nā poʻe me kekahi ʻano maʻi ʻaʻai. ʻAʻole hiki ke hoʻohana ʻia ʻo Darbepoetin alfa ma kahi o kahi transfusion o ke koko ʻulaʻula e mālama i ka anemia koʻikoʻi a ʻaʻole i hōʻike ʻia e hoʻomaikaʻi i ka māluhiluhi a i ʻole ke olakino maikaʻi ʻole e hopena ʻia e ka anemia. Aia ʻo Darbepoetin alfa i kahi papa o nā lāʻau i kapa ʻia nā ʻākena hoʻonāukiuki erythropoiesis (ESAs). Hana ia ma o ka hoʻoulu ʻana i ka iwi iwi (nā mea maʻemaʻe i loko o nā iwi kahi e hana ʻia ai ke koko) e hoʻonui i nā hunaola ʻulaʻula.

Hele mai ʻo Darbepoetin alfa injection ma ke ʻano he hopena (wai) e hoʻokomo i ka subcutaneʻāina (ma lalo pono o ka ʻili) a i ʻole intravenous (i kahi aa). Hoʻokomo pinepine ʻia ia i kēlā me kēia ma 1 a i ʻehā mau pule. E hāhai pono i nā ʻōkuhi i kāu lepili kuhikuhi, a nīnau i kāu kauka a kauka paha e wehewehe i kahi ʻāpana āu i maopopo ʻole ai. E hoʻohana i ka darbepoetin alfa injection pono pololei e like me ke kuhikuhi. Mai hoʻohana i ka ʻoi aku a i ʻole ka liʻiliʻi o ia mea a hoʻohana pinepine paha iā ia ma mua o ka mea i kauoha ʻia e kāu kauka.

E hoʻomaka kāu kauka iā ʻoe ma kahi lāʻau haʻahaʻa o ka injection albepoetin alfa a hoʻoponopono i kāu lāʻau ma muli o nā hopena o kāu lab a me pehea kou ʻano. E ʻōlelo paha kāu kauka iā ʻoe e haʻalele i ka hoʻohana ʻana i ka inikua darbepoetin alfa no kekahi manawa. E hāhai pono i kēia mau ʻōkuhi.

Darbepoetin alfa injection e kōkua i ka kaohi ʻana i kāu anemia ke hoʻomau ʻoe e hoʻohana. Lawe paha ia i 2-6 mau wiki a ʻoi aku paha ma mua o kou ʻike ʻana i ka pono piha o ka injection albepoetin alfa. E hoʻomau i ka hoʻohana ʻana i ka darbepoetin alfa injection inā ʻoe manaʻo maikaʻi. Mai hooki i ka hoʻohana ʻana i ka darbepoetin alfa injection me ke kamaʻilio ʻole ʻana me kāu kauka.

Hāʻawi ʻia kahi Darbepoetin alfa i loko e nā kauka a kahu hānai paha, a i ʻole hoʻoholo paha kāu kauka hiki iā ʻoe ke hoʻopili iā darbepoetin alfa iā ʻoe iho, a i ʻole he hoaaloha a ʻohana paha kāu e hāʻawi i nā inikua. Pono ʻoe a me ke kanaka e hāʻawi ana i nā kuʻina e heluhelu i ka ʻike o ka mea hana no ka mea maʻi e hele mai me ka darbepoetin alfa injection ma mua o kou hoʻohana ʻana no ka manawa mua ma ka home. E noi i kāu kauka e hōʻike iā ʻoe a i ʻole i ke kanaka nāna e hoʻokomo i ka lāʻau pehea e hoʻopili ai iā ia.

Hiki mai ʻo Darbepoetin alfa injection i nā syringes i hoʻopihapiha ʻia a i loko o nā hue e hoʻohana ʻia me nā syringes disposable Inā ʻoe e hoʻohana ana i nā hue o ka darbepoetin alfa injection, e haʻi aku kāu kauka a mea kauka paha iā ʻoe i ke ʻano o ka syringe āu e hoʻohana ai. Mai hoʻohana i kekahi ʻano syringe ʻē aʻe no ka mea ʻaʻole i loaʻa iā ʻoe ka nui o ka lāʻau.

Mai hoʻoluliluli darbepoetin alfa injection. Inā ʻoe e lūlū i ka darbepoetin alfa injection hiki ke nānā aku ʻaʻohe hua a ʻaʻole pono e hoʻohana ʻia.

E hoʻopili mau i ka darbepoetin alfa injection i kāna syringe ponoʻī. Mai hoʻowali iā ia me kekahi wai a mai kāwili me ia me nā lāʻau ʻē aʻe.

Hiki iā ʻoe ke hoʻopili i ka pahu kui albepoetin alfa ma nā wahi o waho o kou mau lima luna, kou ʻōpū koe wale no ka ʻāpana 2-ʻīniha (5-kenimika) a puni kou piko (pihi ʻōpū), ka mua o kou mau ʻūhā waena, a me nā wahi o waho i waho. o kau mau puʻupuʻu. Koho i kahi hou i kēlā me kēia manawa e hoʻokomo ʻoe i ka darbepoetin alfa. Mai hoʻokomo i ka darbepoetin alfa i kahi wahi palupalu, ʻulaʻula, ʻāʻī, a paʻakikī paha, a i ʻole nā ​​scars a i ʻole nā ​​kaha kauō.

Inā mālama ʻia ʻoe me ka dialysis (lapaʻau e lawe i nā ʻōpala mai ke koko ke hana ʻole nā ​​puʻupaʻa), hiki i kāu kauka ke ʻōlelo iā ʻoe e hoʻokomo i ka lāʻau i loko o ke awa komo moku (kahi e hoʻopili ʻia ai ka paipu dialysis i kou kino). E nīnau i kāu kauka inā he nīnau paha kāu e pili ana i ka hoʻopili ʻana i kāu lāʻau.

E nānā mau iā darbepoetin alfa injection solution ma mua o ka hoʻokomo ʻana iā ia. E ʻike pono i ka inoa o ka syringe i hana mua ʻia a i ʻole ipu paha me ka inoa pololei a me ka ikaika o ka lāʻau a me ka lā pau ʻole i hala. Inā ʻoe e hoʻohana ana i kahi kīʻaha, e hōʻoia inā he pāpale kala kona, a inā ʻoe e hoʻohana ana i kahi syringe prefilled, e nānā e uhi ʻia ka nila me ka uhi hina a ʻaʻole i huki ʻia ka lima kelekele melemele ma ka nila. . E nānā hoʻi inā maopopo a kala ʻole ka hopena a ʻaʻohe ona lumps, flakes, a me nā huna ʻaoʻao. Inā he mau pilikia me kāu lāʻau, e kāhea i kāu kauka lāʻau a mai hoʻokomo iā ia.

Mai hoʻohana i nā syringes prefill, nā syringes disposable, a me nā ipu o darbepoetin alfa injection i ʻoi aku ma mua o hoʻokahi manawa. E hoʻolei i nā nūnū i loko o kahi pahu kūpaʻa kū ʻole. E noi i kāu kauka a kauka paha pehea e hoʻolei ai i ka pahu kūpaʻa kūpaʻa.

Kau ʻia kēia lāʻau no nā hoʻohana ʻē aʻe; e noi i kāu kauka a kauka paha no ka ʻike hou aku.

Ma mua o ka hoʻohana ʻana i darbepoetin alfa injection,

• e haʻi i kāu kauka a me kāu kauka lāʻau inā he maʻi ʻoe i ka darbepoetin alfa, epoetin alfa (Epogen, Procrit), nā lāʻau ʻē aʻe, a i ʻole kekahi o nā mea hana i ka inikua albepoetin alfa.E noi i kāu kauka lāʻau a nānā i ke alakaʻi lāʻau no kahi papa inoa o nā mea hoʻohui. Inā ʻoe e hoʻohana ana i nā syringes i hoʻopihapiha ʻia, e haʻi i kāu kauka inā ʻo ʻoe a ʻo ka mea e hoʻokomo ana i ka lāʻau i ka maʻi āpau i ka latex.
• e haʻi i kāu kauka inā loaʻa a i ʻole loaʻa iā ʻoe ke kiʻekiʻe o ke koko, a inā ʻoe i loaʻa i kahi aplasia ʻulaʻula ʻulaʻula (PRCA; kahi ʻano anemia koʻikoʻi e ulu aʻe ma hope o ka lapaʻau ʻana me kahi ESA e like me ka darbepoetin alfa injection a epoetin alfa injection). E haʻi paha kāu kauka iā ʻoe ʻaʻole e hoʻohana i ka inikua darbepoetin alfa.
• e haʻi i kāu kauka a me ka mea kauka lāʻau he aha nā lāʻau lapaʻau a me nā lāʻau ʻole i kuhikuhi ʻia, nā wikamina, nā mea hoʻopihaʻai, a me nā huahana lāʻau āu e lawe nei a hoʻolālā paha e lawe Pono paha kāu kauka e hoʻololi i nā kaha o kāu mau lāʻau a nānā pono iā ʻoe no nā hopena ʻaoʻao.
• E haʻi i kāu kauka inā loaʻa ʻoe i ka mai lele. Inā ʻoe e hoʻohana ana i ka inikua darbepoetin alfa e mālama i ka anemia i hoʻokumu ʻia e ka maʻi puʻuwai mau, e haʻi i kāu kauka inā loaʻa ʻoe i ka maʻi ʻaʻai.
• e haʻi i kāu kauka inā hāpai ʻoe, hoʻolālā e hāpai, a i ʻole e hānai umauma ana. Inā hāpai ʻoe i ka hoʻohana ʻana i ka injection albepoetin alfa, e kāhea i kāu kauka.
• ma mua o ka hana ʻoki ʻana, e like me ke kaha ʻana o ka niho, e haʻi i kāu kauka a i ʻole kauka niho paha e mālama ʻia ʻoe me ka darbepoetin alfa injection. He mea nui ia e haʻi aku i kāu kauka ke hoʻohana nei ʻoe i ka inikua darbepoetin alfa inā ke ʻoki nei ʻoe i ke aniani coronary artery (CABG) a i ʻole ke ʻoki ʻana e mālama ai i kahi pilikia iwi. Hiki i kāu kauka ke kauoha i kahi anticoagulant ('kaʻi lahilahi') e pale aku i nā clots mai ka wā o ke ʻoki.

Kauoha paha kāu kauka i kahi papaʻai kūikawā e kōkua ai e kaohi i kou kaomi koko a e kōkua e hoʻonui i kāu mau pae hao i hiki ai i ka darbepoetin alfa injection ke hana pū me ka hiki. E hāhai pono i kēia mau ʻōkuhi a nīnau i kāu kauka a i ʻole kaukauka inā he nīnau kāu.

Kāhea i kāu kauka e nīnau i ka mea e hana ai inā ʻoe e nalo i kahi mahele o ka darbepoetin alfa injection. Mai hoʻohana i kahi lāʻau pālua e pani no kahi mea i hala.

Hoʻokumu ʻo Darbepoetin alfa injection i nā hopena ʻaoʻao. E haʻi i kāu kauka inā koʻikoʻi kekahi o kēia mau ʻōuli a mai hele aku paha:

• ʻūhā
• ʻeha ka ʻōpū
• ʻulaʻula, pehu, ʻāʻī, ʻume, a i ʻole kahi puʻupuʻu ma kahi āu i injected ai i ka darbepoetin alfa

Hiki i kekahi o nā hopena ʻaoʻao ke koʻikoʻi. Inā ʻike ʻoe i kekahi o kēia mau ʻōuli, a i ʻole nā ​​mea i helu ʻia i ka ʻARlelo Aʻo IMPORTANT, e kāhea koke aku i kāu kauka a i ʻole e kiʻi i nā lāʻau lapaʻau pilikia.

• hūwī
• ʻūlili
• pilikia i ka hanu ʻana a i ʻole ke ale ʻana
• ʻūhā
• hulahula
• ka pehu o ka maka, ka ʻāʻī, ke alelo, nā lehelehe, nā maka, nā lima, nā wāwae, nā kuʻekuʻe wāwae, a me nā wāwae lalo
• pulse wikiwiki
• luhi nui loa
• nele i ka ikaika
• ʻūpā
• maule ana
• ʻili mae

Hoʻokumu paha ʻo Darbepoetin alfa injection i nā hopena ʻē aʻe. Kāhea i kāu kauka inā loaʻa iā ʻoe kekahi pilikia ʻokoʻa a ʻaʻole ʻoe e manaʻo maikaʻi i ka hoʻohana ʻana i kēia lāʻau.

Inā ʻoe e ʻike i kahi hopena koʻikoʻi, e hoʻouna ʻoe a i ʻole kāu kauka i kahi hōʻike i ka papahana hōʻike ʻino a MedWatch Adverse Event Food (FDA) ma ka pūnaewele (http://www.fda.gov/Safety/MedWatch) a i ʻole kelepona. 1-800-332-1088).

E mālama i kēia lāʻau i loko o ka pahu i komo ai, pani paʻa ʻia, a ʻaʻole hiki i nā kamaliʻi. I ka manawa i lawe ʻia ai kahi ʻeke a prefilled syringe paha mai kāna pahu pahu, e uhi iā ia e pale aku iā ia mai nā kukui a hiki i ka hāʻawi ʻia ʻana o ka lāʻau. E mālama i ka pahu kui albepoetin alfa i loko o ka pahu hau, akā mai hoʻopili. E hoʻolei i nā lāʻau i hoʻopaʻa i ka hau.

Pono e hoʻolei ʻia nā lāʻau i koi ʻole ʻia i nā ala kūikawā e hōʻoia i ka hiki ʻole i nā holoholona, ​​nā keiki, a me nā poʻe ʻē aʻe ke hoʻopau iā lākou. Eia nō naʻe, ʻaʻole pono ʻoe e kaomi i kēia lāʻau i ka lua. Akā, ʻo ke ala ʻoi loa e hoʻolilo i kāu lāʻau i loko o kahi papahana hoʻihoʻi lāʻau. E kamaʻilio me kāu kauka lāʻau a kāhea paha i kāu ʻōpala a me nā hana hoʻopōʻaiapuni kūloko e aʻo e pili ana i nā papahana hoʻihoʻi i kou kaiāulu. E ʻike i ka pūnaewele palekana o kā FDA's Disposal of Medicines (http://goo.gl/c4Rm4p) no ka ʻike hou aku inā ʻaʻohe ou komo i kahi papahana hoʻihoʻi.

He mea nui e mālama i nā lāʻau āpau mai ka maka a hiki i nā keiki e like me nā ipu (e like me nā minder pill i kēlā me kēia pule a me nā mea no nā kulu maka, nā kalima, nā pākuʻi, a me nā inhalers) ʻaʻole pale keiki a hiki i nā keiki ʻōpio ke wehe maʻalahi iā lākou. No ka pale ʻana i nā keiki ʻōpio mai ka lāʻau make, laka mau i nā pāpale palekana a kau koke i ka lāʻau i kahi palekana - kahi i luna a mamao a mai ko lākou alo a hiki. http://www.upandaway.org

I ke kumu o ka overdose, e kāhea i ka helpline kaohi lāʻau make ma 1-800-222-1222. Loaʻa ka ʻike ma ka pūnaewele ma https://www.poisonhelp.org/help. Inā ua hina ka mea i hoʻomāinoino ʻia, loaʻa ka hopu ʻana, pilikia i ka hanu ʻana, a i ʻole hiki ʻole ke ala aʻe, e kāhea koke i nā lawelawe kūikawā ma 911.

Mālama i nā manawa āpau me kāu kauka. E nānā pinepine kāu kauka i kou kaomi koko i ka wā o kāu mālama ʻana me ka injection albepoetin alfa.

Ma mua o ka loaʻa ʻana o kahi hoʻokolohua hoʻokolohua, e haʻi i kāu kauka a me nā limahana o ke keʻena hoʻokolohua āu e hoʻohana nei i ka inikua darbepoetin alfa.

Mai ʻae i kekahi e hoʻohana i kāu lāʻau. E nīnau i kāu kauka lāʻau i nā nīnau āu e pili ana i ka hoʻopiha hou ʻana i kāu kuhikuhi.

He mea nui iā ʻoe e mālama i kahi papa inoa i kākau ʻia a me nā lāʻau lapaʻau ʻole (over-the-counter) lāʻau āu e lawe nei, a me nā huahana e like me nā huaora, nā minelala, a i ʻole nā ​​mea hoʻopiliʻai aʻe. Pono ʻoe e lawe i kēia papa inoa me ʻoe i kēlā me kēia manawa ke kipa ʻoe i ke kauka a i ʻole inā ʻae ʻia ʻoe i kahi haukapila. He ʻike nui nō hoʻi ia e lawe pū me ʻoe inā pilikia ʻo ka pilikia.

• Aranesp^®