Large volumes of solution (up to 10 ml/kg) can be safely administered to rodents through this route ( 5) which may be advantageous for agents with poor solubility. The intravenous route has a number of advantages. Many antibiotics, preoperative sedatives, and narcotics are administered intramuscularly. Table of Contents: Routes of drug administration 1. An advantage of IV administration is the ability to rapidly titrate the dosage to achieve the desired depth of sedation. Feb 12, 2023 · A medication administration route is often classified by the location at which the drug is administered, such as oral or intravenous. 1,2 By the mid-1970s, the practice of intracardiac injection declined. 5 mg, 5 mg, 10 mg, 20 mg, 30 mg and 40 mg tablets for oral administration. Rapid onset of action due to rapid access to circulation. Intrathecal drug administration means the introduction of a therapeutic substance by injection into the subarachnoid space of the spinal cord. Routes of administration | Deranged Physiology Breadcrumb Deranged Physiology. The physiologic characteristic of the peritoneal cavity not only helps remove toxic metabolites from the body, but also provides a useful portal of ent. Approved only for epidural catheter in United States. Advantages:- 1. Nov 22, 2022 · An Injection is referred to as the act of administering a liquid, especially a drug into the person's body using a needle and a syringe. While data indicate that the drug is initially uptaken by the lymphatic system. Unpalatable and highly irritant drugs are not suitable. Immediate physiological response can be achieved than other routes of administration. Dose-sparing strategy during shortage 3. Shalin Zenk. 10 Advantages and disadvantages of the intravenous route. May be expensive SC Advantage Absorption is slow but complete. For drugs (in suitable dosage forms) that are absorbed from these routes, the same can serve as systemic route of administration, e. Safer and simpler routes of medication administration (i. Disadvantages : (1) As these routes require special techniques of administration, these are not very convenient and economical for the patient. Advantages Disadvantages References; Ether injection method: A simple method for lab-scale research: Not suitable for heat-sensitive drugs [98, 99] Reverse phase evaporation method: High encapsulation efficiency is achieved: Needs organic solvents [100] Thin film hydration (hand shaking) method: A simple method for lab-scale research: Needs. Accidental overdose can have serious consequences. Absorption of the medication into the blood is immediate. The term parenteral is usually used for drugs given by injection or infusion. Nanofabrication of multifunctional nano- or micro-character systems is becoming incredibly influential in various sectors like electronics, photonics, energy, and biomedical gadgets worldwide. The term parenteral is usually used for drugs given by injection or infusion. Cases involving barbiturates have included thialbarbital [ 76 ], thiamylal [ 77 ], thiopental [ 78 ], and secobarbital [ 79–81 ]. (2) It is very difficult to control or. The intravenous route has a number of advantages. There are many advantages and disadvantages to administering medications via the intravenous injection method—see Table 7. The enteral route usually refers to taking drugs by mouth. Because of the high risk associated with direct intravenous medications, additional guidelines are required. drug delivery is usually incomplete. Here are the Disadvantages of intrathecal drug delivery. VIEWS The parenteral route (also referred to as injection route) is the fastest and the second commonest route of drug administration. Every route has advantages and disadvantages in absorption, bioavailability, metabolism, and distribution of substances, which should be carefully considered while selecting a route. , intravenous, endotracheal, and intraosseous) became available. Table 1: Pros and cons of different routes of drug administration Route Advantages Disadvantages Oral • Easy • Preferred by patients • “Slow-release” preparations may be available to. However, a major. There are many drug routes of administration, each suited to. The major disadvantage of intravenous route of drug administration is that self-medication is not possible which requires a trained person. This chapter deals with the key principles and routes or modes of drug administration. Drugs are exposed to first pass effect. Subcutaneous Route. The inhalation of drugs: advantages and problems Inhalation is a very old method of drug delivery, and in the 20th century it became a mainstay of respiratory care, known as aerosol therapy. This chapter deals with the key principles and routes or modes of drug administration. Nanotechnology has the capability of making significant contributions to healthcare. Every route has advantages and disadvantages in absorption, bioavailability, metabolism, and distribution of substances, which should be carefully considered while selecting a route. However, a major. Shalin Zenk. video recording | This video is about Routes of Drug Administration. IV ROUTE ADVANTAGE You can deliver drugs in large amounts, you will have 100 percent bioavailability. Use for administering medications that have slow absorption for anextended period of time (depot preparations). It is well-recognized that the route of administration is a critical determinant of the final pharmacokinetics, pharmacodynamics as well as toxicity of pharmacological agents (). This type of injection is used when other methods of administration might be less effective. What is parenteral medication administration? Parenteral drug administration refers to drugs given by routes other than the digestive tract. Routes of drug administration KsTU Uploaded by adjei philemon 0 ratings 0% found this document useful (0 votes) 0 views. Shalin Zenk. No strict sterilization Disadvantages of Enteral Route The disadvantages of the enteral route of drug administration are - 1. Rapid onset of action due to rapid access to circulation. In this administration the drug is administered in the gaseous form. Routes of drug administration KsTU - View presentation slides online. The enteral route usually refers to taking drugs by mouth. Scribd is the world's largest social reading and publishing site. 6 ft x 8 ft cedar dog ear fence panel; used car on kijiji; Related articles; laravel request not found; fdny lieutenant exam 2022. Ecommerce; ark refill stats. For the. The intravenous route has a number of advantages. Advantages Use for poorly soluble medications. preschool children, the advantages and disadvantages of. How deeply into the lungs they go depends on the size of the droplets. Such immediacy results in rapid acquisition and strong maintenance of behavior. Peptides get degraded locally. Advantages of the Intramuscular Route Immediate onset Depot or sustained release Avoids first-pass metabolism Easier to administer compared to the intravenous route Disadvantages of the Intramuscular Route Expensive Requires trained medical/nursing staff Irritating drugs may be painful Slower onset than IV route. Study with Quizlet and memorize flashcards containing terms like Name 11 routes of drug administration. There are many drug routes of administration, each suited to. Vital organs like heart, brain etc. There are many drug routes of administration, each suited to. The IM route of drug administration has definite advantages compared with oral administration; however, compared with the inhalation and IV routes, IM fares poorly. Peptides get degraded locally. Disadvantages of intramuscular route of drug administration Intermuscular injection into fascia might lead to erratic absorption of the drug. Moreover, the programmed pump regulates the. Scribd is the world's largest social reading and publishing site. The intravenous route has a number of advantages. 2. 6 ft x 8 ft cedar dog ear fence panel; used car on kijiji; Related articles; laravel request not found; fdny lieutenant exam 2022. The choice of routes in which the medications are applied depends not only on convenience but also on the drug's properties and pharmacokinetics . Cases involving barbiturates have included thialbarbital [ 76 ], thiamylal [ 77 ], thiopental [ 78 ], and secobarbital [ 79–81 ]. Aerosols Local/Topical Route of Drug Administration In this route the drug is applied on the skin. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. 54-59 Figure 6 Topical route of drug. Injections are among the most common health care procedures throughout the world, with at least 16 billion administered in developing and transitional countries each year. A small amount of local anesthetic is often used to numb the injection site. Drug is delivered immediately upon the completion of a response requirement and since delivery is into a vein, there is a rapid onset of drug effects. The benefits of IA administration are maximized with drugs that have a high rate of biotransformation, metabolism, and excretion during the first pass (i. Disadvantages Injections are more costly. Injections are administered for the drugs that are not effective in oral routes. Indorsion, swelling, nausea, muscle soreness, and itching are a few side effects frequently. Oct 1, 2020 · Advantages of the Intramuscular Route Immediate onset Depot or sustained release Avoids first-pass metabolism Easier to administer compared to the intravenous route Disadvantages of the Intramuscular Route Expensive Requires trained medical/nursing staff Irritating drugs may be painful Slower onset than IV route. Routes of Drug Administration - Read online for free. When intravenous access is not readily accessible or when the endotracheal administration has not provided the desired effect, intracardiac injection should be. Advantages of nanofabrication techniques Nanofabrication techniques provide the following advantages, i) It aids in the development of transportable, compact implant gadgets. Muscle is less richly supplied with sensory nerves (mild irritants can be injected) and is more vascular (absorption of drugs in aqueous . • Drugs can be formulated in such a way as to protect them from digestive enzymes, acid, etc. In this administration the drug is administered in the gaseous form. •Good absorption, especially for drugs with a low oral bioavailability • Onset is more rapid than the above routes • Depending on formulation can have very long duration of. Another advantage is the usually more reliable absorption of a drug into the CVS following IM rather than oral administration. Clean access port using alcohol and friction for 15 seconds. However, a major. Immediate physiological response can be achieved than other routes of administration. How deeply into the lungs they go depends on the size of the droplets. These types of injections are used for sensitivity tests, such as TB (see Figure 7. Although electronic prescribing is optional for physicians, except as to Schedule II, III, IV, and V controlled substances that are Part D drugs prescribed under Part D, and pharmacies, the Medicare Part D statute and regulations require drug plans participating in the prescription benefit to support electronic prescribing, and physicians and. Every route has advantages and disadvantages in absorption, bioavailability, metabolism, and distribution of substances, which should be carefully considered while selecting a route. Such immediacy results in rapid acquisition and strong maintenance of behavior. 6 ft x 8 ft cedar dog ear fence panel; used car on kijiji; Related articles; laravel request not found; fdny lieutenant exam 2022. This chapter deals with the key principles and routes or modes of drug administration. While data indicate that the drug is initially uptaken by the lymphatic system. Factors determining route of administration are as follows: 1. Rapid onset of action due to rapid access to circulation. One promising approach is the use of biodegradable formulations to develop potential. Indorsion, swelling, nausea, muscle soreness, and itching are a few side effects frequently. Before administering any medicine, the person carrying out the procedure must be familiar with the advantages and limitations of the prescribed route and know the indications, contraindications and side-effects of the medicine they intend to give. This route is especially common in chronic studies involving mice for which repetitive IV access is challenging. Timing of the administration promotes safer medication administration. Drug characteristics like state of drug (solid/liquid/gas), and. Disadvantages of the Intravenous Route · Possible anaphylaxis · Risk of infection · Inconvenient to the patient · Painful · Expensive compared to . When medication is delivered via an intramuscular injection, it's absorbed into the body faster than it would be with a subcutaneous injection. Depending on patient need, sedation can vary from light to profound and nearly all patients can be adequately sedated with this method. Despite some disadvantages, oral administration is the natural route of drug administration, which has advantages (Table 2) such as sustained release, ease of administration, and ease of use. preschool children, the advantages and disadvantages of. Withdraw the needle with a smooth and steady movement. Disadvantages: Injection site pain The amount of drug administered has to be adjusted according to the mass of the muscle available. Orally administered antipsychotic drugs are the first-line treatment for psychotic disorders, such as schizophrenia and bipolar disorder. Rapid onset of action due to rapid access to circulation. Slow injection (10 seconds per milliliter) allows stretching of the muscle fibers for retention of the drug, which minimizes the risk of leakage along the needle track. The complex nature of the ocular drug delivery barrier presents a significant challenge to the effective administration of drugs, resulting in poor therapeutic outcomes. Potential for infection increases with frequent injections. Purpose : For injectable biopharmaceuticals, the subcutaneous route of administration is increasingly preferred over intravenous administration. Unpalatable and highly irritant drugs are not suitable. Although this route of administration is rarely used, its main advantage is to provide a long-term therapeutic effect (for example, etonogestrel that is implanted for contraception may last up to 3 years). International Journal of Pharmaceutical Studies and Research E-ISSN 2229-4619 IJPSR/Vol. This route is used when a drug is needed to produce rapid or local effects on the brain, spinal cord, or the layers of tissue covering them (meninges)—for example, to treat infections of these structures. Inhalers 2. The enteral route usually refers to taking drugs by mouth. Therefore it is crucial to understand. Here, the Classification, Advantage and Disadvantage of routes of drug. This procedure translates to lower drug elimination for the patient and diminished systemic side effects relative to oral or intravenous administration of the same agent. Scribd is the world's largest social reading and publishing site. administration has its own advantages and disadvantages, which must be considered and compared to each other before selecting the same. The choice of routes in which the medication is given depends not only on convenience and compliance but also on the drug’s pharmacokinetics and pharmacodynamic profile. The delivery of drugs via transdermal routes is an attractive approach due to ease of administration, bypassing of the first-pass metabolism, and the large skin surface area. No strict sterilization Disadvantages of Enteral Route The disadvantages of the enteral route of drug administration are - 1. Rapid onset of action due to rapid access to circulation. What is parenteral medication administration? Parenteral drug administration refers to drugs given by routes other than the digestive tract. Unpalatable and highly irritant drugs are not suitable. Intramuscular injection (IM) is installing medications into the depth of specifically selected muscles. Chance of infection if sterility is not maintained. Peptides get degraded locally. A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. and more. This essay includes the brief description and discussion of the advantages and disadvantages of major routes of drug administration; oral, vaginal, ocular,. This route is improved by massage or heat. In acute care settings, nurses frequently administer medications via the intravenous (IV) route. sodium nitroprusside), titration of. Pain not occurs because injection is not used. A subcutaneous injection is a method of administering medication. Ex: Powders, ointments, lotions, etc. iv) Pain may accompany or follow the injection. These drugs should be used carefully in older animals or in animals with cardiac or respiratory disease. For the. When selecting an injection site for an IM injection it’s important to pick one that is: A safe distance from the surrounding nerves, bones and large blood vessels Large enough for the amount of medication Not the site of an injury, abscess, or dying skin Not a muscle that is emaciated or atrophied. Transdermal drugs are frequently utilized for: Anti-nausea drugs, Hormone replacement therapy Generalized pain The drug form form for transdermal administration includes: Upper Arm Chest Abdomen Mastoid region. Remove empty medication syringe. Wait for 10 seconds to allow the drug to diffuse within the muscle bulk. No strict sterilization Disadvantages of Enteral Route The disadvantages of the enteral route of drug administration are - 1. Drug characteristics like state of drug (solid/liquid/gas), and. 10 Advantages and disadvantages of the intravenous route. Poor circulation can inhibit the medication’s. However, one of the challenges in the. If the intention is slow release (eg. Advantages: safe, inexpensive, easy and convenient Disadvantages: Oral medications have highly variable absorption. International Journal of Pharmaceutical Studies and Research E-ISSN 2229-4619 IJPSR/Vol. Each route delivers drug to the cerebrospinal fluid (CSF). Every route has advantages and disadvantages in absorption, bioavailability, metabolism, and distribution of substances, which should be carefully considered while selecting a. The term parenteral is usually used for drugs given by injection or infusion. The delivery of drugs via transdermal routes is an attractive approach due to ease of administration, bypassing of the first-pass metabolism, and the large skin surface area. In this video, we're going to explore the three main routes of drug administration - oral, parenteral, and topical. Only highly soluble drugs are used in the formulation of IV. administration has its own advantages and disadvantages, which must be considered and compared to each other before selecting the same. Routes of Drug Administration Uploaded by Kena Samuel 0 ratings 0% found this document useful (0 votes) 0 views 6 pages Document Information. A medication administration route is often classified by the location at which the drug is administered, such as oral or intravenous. Injections are among the most common health care procedures throughout the world, with at least 16 billion administered in developing and transitional countries each year. Common examples. There are many advantages and disadvantages to administering medications via the intravenous injection method—see Table 7. Scribd is the world's largest social reading and publishing site. However, one of the challenges in the. IV injections are inconvenient. When food cannot be taken by mouth, total nutritional requirement can be supplied by the parenteral route. Nevertheless, adverse drug reactions jeopardize clinical outcomes, resulting in patient non-compliance. Drug is delivered immediately upon the completion of a response requirement and since delivery is into a vein, there is a rapid onset of drug effects. Inhalers 2. Remove empty medication syringe. Drug is delivered immediately upon the completion of a response requirement and since delivery is into a vein, there is a rapid onset of drug effects. IV ROUTE Disadvantage Can't reverse a toxic dose, requires specialized personel. The design formulation strategies for enhancing brain drug delivery has been a major challenge, mainly due to. This procedure translates to lower drug elimination for the patient and diminished systemic side effects relative to oral or intravenous administration of the same agent. However, one of the challenges in the. 7) Be able to answer the preparation questions for intravenous medication in Table 7. The use of multiagent ITC has not been extensively tested, and thus its superiority over single-agent ITC has not been established. Every route has advantages and disadvantages in absorption, bioavailability, metabolism, and distribution of substances, which should be carefully considered while selecting a route. As it is less vascular, absorption is slow, so . Parenteral Suspension: The intravenous or intramuscular routes are used to administer such drugs mostly through injections. The intramuscular route is preferred to the subcutaneous route when larger volumes of a drug product are needed. It involves drug administration via injection into a blood vessel, soft tissue, . IV injection is the introduction of a medication into the veins using. hot blonde women teachers naked, brookemonk nude
It can be explained by peril ocular steroid injection involving the placement of . . Advantages and disadvantages of injection route of drug administration
The intake is much more since muscles have a larger. A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. The intramuscular route is preferred to the subcutaneous route when larger volumes of a drug product are needed. Parenteral Suspension: The intravenous or intramuscular routes are used to administer such drugs mostly through injections. , total body drug clearance; CLtb ). Buccal/ Sublingual Advantages. ii) Injections. administration has its own advantages and disadvantages, which must be considered and compared to each other before selecting the same. elderly or. drug delivery is usually incomplete. ID injection technique requires skill and time--. Pain not occurs because injection is not used. Dose-sparing strategy during shortage 3. Committee on Drugs; Alternative Routes of Drug Administration—Advantages and Disadvantages (Subject Review). Most Economical 8. Rapid injection of IV medications can have serious consequences for the patient. and more. A key disadvantage with medicines given by injection is that it is difficult to . Nanofabrication of multifunctional nano- or micro-character systems is becoming incredibly influential in various sectors like electronics, photonics, energy, and biomedical gadgets worldwide. Risky route . (b) Rectal inflammation may occur with repeated use. Aerosols Local/Topical Route of Drug Administration In this route the drug is applied on the skin. Drug is delivered immediately upon the completion of a response requirement and since delivery is into a vein, there is a rapid onset of drug effects. This review describes the principal and common routes used in early drug discovery programs and preclinical research, including guidelines for safe injection volumes, sites of administration, preparation of sites, advantages & disadvantages, limitations, handling and restraint techniques, vehicle selection, and formulation strategies. Posted by June 29, 2022 houses for rent in butler school district on advantages of intraperitoneal route of drug administration June 29, 2022 houses for rent in butler school. , Describe the differences between an intradermal, subcutaneous, and intramuscular injection. The major disadvantage of intravenous route of drug administration is that self-medication is not possible which requires a trained person. It is relatively safer than intravenous and intramuscular routes. A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. However, one of the challenges in the. An advantage of IV administration is the ability to rapidly titrate the dosage to achieve the desired depth of sedation. Drugs that cause nauseous or unconscious patients, medications are administered through injections. Disadvantages IV injections are even more costly. Factors determining route of administration are as follows: 1. An Injection is referred to as the act of administering a liquid, especially a drug into the person's body using a needle and a syringe. The advantage to using liposomal Ara-C over MTX is the reduced frequency of administration. be able to describe the biopharmaceutically relevant advantages and disadvantages of various routes of drug administration. Common injection sites include the muscles in the upper arm, thigh or buttocks. Few workers would disagree that there is increased morbidity associated with this method of administration. Injections are administered for the drugs that are not effective in oral routes. Drug characteristics like state of drug (solid/liquid/gas), and. Purpose : For injectable biopharmaceuticals, the subcutaneous route of administration is increasingly preferred over intravenous administration. "IM better than IV" involves epinephrine, hepatitis B immu-noglobulin, pegaspargase, and some antibiotics. administration has its own advantages and disadvantages, which must be considered and compared to each other before selecting the same. Sometimes a drug is given through the skin—by needle (subcutaneous, intramuscular, or intravenous route), by patch (transdermal route), or by implantation. Every route has advantages and disadvantages in absorption, bioavailability, metabolism, and distribution of substances, which should be carefully considered while selecting a route. Each route delivers drug to the cerebrospinal fluid (CSF). Injections: Intravenous, Intramuscular, Subcutaneous,. Rapid injection of IV medications can have serious consequences for the patient. Poorly injected products may not be well absorbed and may not work. The delivery of drugs via transdermal routes is an attractive approach due to ease of administration, bypassing of the first-pass metabolism, and the large skin surface area. 3 Intradermal and Subcutaneous Injections Intradermal injections (ID) are injections administered into the dermis, just below the epidermis. Here are a few advantages of the injections. In this administration the drug is administered in the gaseous form. Advantages of IM administration over enteral routes include a more rapid onset of action (shorter latent period, approximately 10 minutes) and a more rapid onset of maximal clinical effect (approximately 30 minutes). IV injection is the introduction. 1 Intravenous (IV), subcutaneous (SC), and intramuscular (IM) are three most frequently used injection routes in medication administration. • Injections hurt, cause bruises and frighten children and. Disadvantages of Oral Route. The choice of routes in which the medication is given depends not only on convenience and compliance but also on the drug’s pharmacokinetics and pharmacodynamic profile. Our understanding of drug transport across tissues has increased. Finnes: The type of drug does affect how it is absorbed, as does the route of administration. These changes have often resulted in improved patient adherence to the therapeutic regimen and pharmacologic response. IV ROUTE ADVANTAGE You can deliver drugs in large amounts, you will have 100 percent bioavailability. Poor circulation can inhibit the medication’s. 10 Advantages and disadvantages of the intravenous route. Needs a skilled help for injection: · 3. Depending on patient need, sedation can vary from light to profound and nearly all patients can be adequately sedated with this method. Such immediacy results in rapid acquisition and strong maintenance of behavior. There is a possibility of. It is often termed as the Parenteral route of drug administration. Factors determining route of administration are as follows: 1. Pediatrics July. The intramuscular route is preferred to the subcutaneous route when larger volumes of a drug product are needed. Immediate physiological response can be achieved than other routes of administration. Advantages Disadvantages References; Ether injection method: A simple method for lab-scale research: Not suitable for heat-sensitive drugs [98, 99] Reverse phase evaporation method: High encapsulation efficiency is achieved: Needs organic solvents [100] Thin film hydration (hand shaking) method: A simple method for lab-scale research: Needs. The inhalation of drugs: advantages and problems Inhalation is a very old method of drug delivery, and in the 20th century it became a mainstay of respiratory care, known as aerosol therapy. To address this issue, it is essential to investigate new drugs and alternative delivery routes and vehicles. Cases involving barbiturates have included thialbarbital [ 76 ], thiamylal [ 77 ], thiopental [ 78 ], and secobarbital [ 79–81 ]. Advantages of IM administration over enteral routes include a more rapid onset of action (shorter latent period, approximately 10 minutes) and a more rapid onset of maximal clinical effect (approximately 30 minutes). Provides more direct administration to target tissues; rapid onset. This route is used when a drug is needed to produce rapid or local effects on the brain, spinal cord, or the layers of tissue covering them (meninges)—for example, to treat infections of these structures. Rapid onset of action due to rapid access to circulation. • Injections hurt, cause bruises and frighten children and. IV injection is the introduction. Rapid injection of IV medications can have serious consequences for the patient. Ecommerce; ark refill stats. Such immediacy results in rapid acquisition and strong maintenance of behavior. and more. Drugs that cause nauseous or unconscious patients, medications are administered through injections. Routes of Drug Administration - Read online for free. The advantages of the enteral route of drug administration are - 1. The drug is then injected into the spinal canal. Citation 1 Intravenous (IV), subcutaneous (SC), and intramuscular (IM) are three most frequently used injection routes in medication administration. There are many advantages and disadvantages to administering medications via the intravenous injection method—see Table 7. The dosage form must be. Feb 12, 2023 · A medication administration route is often classified by the location at which the drug is administered, such as oral or intravenous. Drug is delivered immediately upon the completion of a response requirement and since delivery is into a vein, there is a rapid onset of drug effects. Nanotechnology has the capability of making significant contributions to healthcare. While data indicate that the drug is initially uptaken by the lymphatic system. The intravenous route has a number of advantages. [1] The bulky muscles have good vascularity, and therefore the injected drug quickly reaches the systemic circulation and thereafter into the specific region of action, bypassing the first-pass metabolism. Study with Quizlet and memorize flashcards containing terms like Oral administration advantages, Oral Administration Disadvantages, GI Tubes (ex Nasogastric . Riebesehl, in The Practice of Medicinal Chemistry (Fourth Edition), 2015 1 Route of Administration A Intravenous. There are advantages and disadvantages associated with each route of. . caballos cojiendo