Health Library Logo

Health Library

He aha ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline: Nā Hoʻohana, Dosage, Nā ʻaoʻao ʻaoʻao a me nā mea hou aku
He aha ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline: Nā Hoʻohana, Dosage, Nā ʻaoʻao ʻaoʻao a me nā mea hou aku

Health Library

He aha ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline: Nā Hoʻohana, Dosage, Nā ʻaoʻao ʻaoʻao a me nā mea hou aku

October 10, 2025


Question on this topic? Get an instant answer from August.

ʻO ka bismuth subsalicylate, metronidazole, a me tetracycline he lāʻau hui pū e mālama i nā ʻōpū ʻōpū i hana ʻia e kekahi bacteria i kapa ʻia ʻo H. pylori. Hana kēia lāʻau lapaʻau triple ma ka hoʻouka ʻana i ka maʻi mai nā kihi he nui i ka wā e pale ana i kou ʻōpū.

Hoʻopaʻa kāu kauka i kēia hui pū ʻana ke loaʻa iā ʻoe nā ʻōpū peptic ʻaʻole e hoʻōla me nā lāʻau lapaʻau maʻamau. Hana pū nā lāʻau lapaʻau ʻekolu i ka ʻoi aku ka maikaʻi ma mua o kekahi lāʻau lapaʻau hoʻokahi wale nō, e hāʻawi ana iā ʻoe i ka manawa maikaʻi loa e hoʻopau i ka bacteria paʻakikī e hana nei i kāu mau pilikia ʻōpū.

No ke aha e hoʻohana ʻia ai ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

Hoʻomaʻamaʻa kēia hui pū ʻana i nā lāʻau lapaʻau i nā ʻōpū peptic i hana ʻia e ka bacteria Helicobacter pylori. ʻO kēia mau ʻōpū he mau ʻeha ʻeha e ulu ana i loko o kou ʻōpū a i ʻole ka ʻāpana luna o kou ʻōpū liʻiliʻi.

He mea maʻamau ka maʻi H. pylori, e pili ana i kahi ʻelua hapakolu o ka heluna kanaka o ka honua. Eia naʻe, ʻaʻole nā ​​mea a pau me kēia bacteria e hoʻomohala i nā ʻōpū. Ke hana ʻia nā ʻōpū, hiki iā lākou ke hana i ka ʻeha ʻōpū, ka bloating, a me ka nausea e hoʻopilikia i kou ola i kēlā me kēia lā.

Hiki i kāu kauka ke kauoha i kēia hui pū ʻana inā loaʻa iā ʻoe ka gastritis (inflammation ʻōpū) i hana ʻia e H. pylori. I kekahi manawa, hiki i ka hoʻopau ʻana i kēia bacteria ke pale i nā ʻōpū e hiki mai ana mai ka hana ʻana, ʻoiai inā ʻaʻole ou mau ʻōpū i kēia manawa.

Pehea ka hana ʻana o ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

Hoʻouka kēlā me kēia lāʻau lapaʻau i kēia hui pū ʻana i ka bacteria H. pylori ma ke ʻano ʻokoʻa, e paʻakikī loa ai ka maʻi e ola. E noʻonoʻo iā ia he hoʻouka i hoʻonohonoho ʻia e uhi ana i nā ala pakele a pau o ka bacteria.

Hoʻopili ka bismuth subsalicylate i ka uhi o kou ʻōpū a he mau waiwai antibacterial maoli nō. Hana ia i pale pale i ka wā e hakakā pololei ana i ka bacteria. ʻO kēia ka mea like i loaʻa i loko o Pepto-Bismol, akā i ka nui kiʻekiʻe, ka nui o ka lāʻau lapaʻau.

ʻO Metronidazole kahi lāʻau antibiotic ikaika e hoʻopilikia i ka DNA o ka bacteria, e pale ana iā ia mai ka hoʻonui ʻana. He mea maikaʻi loa ia e kūʻē i nā bacteria anaerobic e like me H. pylori e ulu ana i nā wahi haʻahaʻa-oxygen e like me kou ʻōpū.

ʻO Tetracycline kekahi lāʻau antibiotic e kāohi ana i ka bacteria mai ka hana ʻana i nā protein e pono ai lākou e ola. Ua hoʻohana ʻia ia no nā makahiki he nui e mālama i nā maʻi bacteria like ʻole a ke mau nei ka maikaʻi loa e kūʻē iā H. pylori.

Ua manaʻo ʻia kēia lāʻau lapaʻau ʻekolu he ikaika iki akā he mea maikaʻi loa. ʻIke ka hapa nui o nā kānaka i ka hoʻomaikaʻi nui ʻana i kā lākou mau hōʻailona i loko o kekahi mau lā, akā pono ʻoe e hoʻopau i ka papa piha e hoʻopau loa i ka maʻi.

Pehea e lawe ai au i ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

E lawe i kēia lāʻau lapaʻau e like me ke kauoha a kāu kauka, ʻehā manawa i ka lā me nā meaʻai a me ka wā moe. He mea nui ka manawa me ka meaʻai no ka mea e kōkua ana ia e hōʻemi i ka ʻōpū a hoʻomaikaʻi i ka maikaʻi o ka lawe ʻana o kou kino i nā lāʻau lapaʻau.

E ale i nā capsules a i ʻole nā papa holoʻokoʻa me ke aniani wai piha. Mai ʻoki, nau, a wehe paha i nā capsules, no ka mea, hiki i kēia ke hoʻopilikia i ka hana ʻana o ka lāʻau lapaʻau i loko o kou ʻōnaehana. Inā pilikia ʻoe i ka ale ʻana i nā pills, e kamaʻilio me kāu kauka e pili ana i nā koho ʻē aʻe.

E hoʻokaʻawale i kāu mau lāʻau lapaʻau i ka lā, ma kahi o 6 mau hola. Hiki i ka hoʻonohonoho ʻana i nā alarms kelepona ke kōkua iā ʻoe e hoʻomanaʻo, no ka mea, ʻo ka nalo ʻana i nā lāʻau lapaʻau hiki ke ʻae i ka bacteria e hoʻomohala i ke kūʻē ʻana i nā antibiotics.

E pale i nā huahana waiū e like me ka waiū, ka paʻakai, a me ka yogurt no ka liʻiliʻi o 2 mau hola ma mua a ma hope o ka lawe ʻana i ka tetracycline. Hiki i ka calcium i loko o ka waiū ke hoʻopaʻa i ka antibiotic a pale i kou kino mai ka lawe pono ʻana.

Mai moe i lalo no ka liʻiliʻi he 30 mau minuke ma hope o ka lawe ʻana i ka lāʻau. Kōkua kēia i ka pale ʻana i nā pila mai ka paʻa ʻana i loko o kou ʻōpū, kahi e hiki ai ke hoʻonāukiuki a i ʻole nā ʻōpū i kou ʻāʻī.

Pehea ka lōʻihi e lawe ai au i ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

ʻO ka hapa nui o nā papa lapaʻau e mau ana he 10 a 14 mau lā, ma muli o kou kūlana kikoʻī a me ke ʻano o kou kino e pane ai. E hoʻoholo kāu kauka i ka lōʻihi pololei ma muli o kāu moʻolelo olakino a me ke koʻikoʻi o kāu maʻi.

He mea nui loa ka hoʻopau ʻana i ke kaʻina holoʻokoʻa, ʻoiai inā ʻoe e hoʻomaka e ʻoi aku ka maikaʻi ma hope o kekahi mau lā. ʻO ka hooki ʻana i ka wā mua hiki ke ʻae i nā bacteria e ola nei e hoʻonui hou a e hoʻomohala i ke kūpaʻa i nā antibiotics.

Hiki iā ʻoe ke ʻike i ka hoʻomaikaʻi ʻana o kāu mau hōʻailona i loko o 3 a 5 mau lā, akā hiki nō ke loaʻa nā bacteria i loko o kāu ʻōnaehana. ʻO ka hoʻopau piha ʻana e lawe maʻamau i ka manawa lapaʻau piha, ʻo ia ke kumu he mea nui ka hahai ʻana.

Hiki i kāu kauka ke hoʻonohonoho i kahi hoʻokolohua ma hope o 4 a 6 mau pule ma hope o kou hoʻopau ʻana i ka lāʻau e hōʻoia i ka pau ʻana o ka maʻi H. pylori. Hiki i kēia ke komo i kahi hoʻokolohua hanu, kahi hāpana stool, a i ʻole kahi hoʻokolohua koko.

He aha nā hopena ʻaoʻao o Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

ʻO ka hapa nui o nā kānaka e ʻike i kekahi mau hopena ʻaoʻao me kēia hui ʻana, akā maʻamau lākou a maʻalahi a me ka manawa. Hoʻoponopono maʻamau kou kino i nā lāʻau i loko o kekahi mau lā i kou hoʻomau ʻana i ka lapaʻau.

Eia nā hopena ʻaoʻao maʻamau e hiki iā ʻoe ke ʻike i ka wā o ka lapaʻau:

  • Nausea a me ka ʻōpū, ʻoi loa i nā lā mua
  • ʻEleʻele o kou alelo a me ka stool, he mea ʻole a hiki ke hoʻohuli ʻia
  • ʻO ka ʻono metala i kou waha, mai ka metronidazole
  • Diarrhea a i ʻole nā stools palupalu i ka wā e hoʻoponopono ai kāu bacteria ʻōpū
  • ʻEha poʻo a me ka dizziness māmā
  • Ka nalowale o ka ʻai a i ʻole ka manaʻo piha koke

E hoʻomaikaʻi pinepine kēia mau hopena ʻaoʻao i ka wā e maʻa ai kou kino i ka lāʻau. He mea maʻamau loa ka ʻeleʻele o ka noho a me ka ʻeleʻele o ke alelo mai ka bismuth a e hoʻi maʻamau ma hope o kou pau ʻana i ka lapaʻau.

Hiki i kekahi poʻe ke ʻike i nā hopena ʻaoʻao koʻikoʻi e pono ai ka mālama olakino. ʻOiai ʻaʻole maʻamau kēia mau mea, he mea nui e ʻike i ka mea e nānā ai:

  • Ka maʻi maʻi koʻikoʻi, mau loa e loaʻa paha ke koko
  • ʻEha ʻōpū nui a i ʻole ka ʻūlū
  • Melemele o kou ʻili a i ʻole nā maka (jaundice)
  • ʻO ka ʻeha a i ʻole ke kahe ʻana o ke koko
  • Nā ʻeha poʻo nui me nā loli ʻike
  • He paʻakikī ka hanu a i ʻole ka ʻai ʻana

E kelepona koke i kāu kauka inā ʻike ʻoe i kekahi o kēia mau hōʻailona koʻikoʻi. I nā hihia kakaʻikahi, hiki i kekahi poʻe ke hoʻomohala i kahi maʻi ʻōpū koʻikoʻi i kapa ʻia ʻo C. diff colitis, e hoʻoulu ai i ka maʻi maʻi nui a pono e mālama koke ʻia.

ʻO wai ka mea ʻaʻole pono e lawe i ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

Pono kekahi mau pūʻulu o nā kānaka e pale i kēia hui lāʻau ma muli o ka piʻi ʻana o nā pilikia o nā hopena ʻaoʻao koʻikoʻi. E nānā pono kāu kauka i kāu moʻolelo olakino ma mua o ke kau ʻana i kēia lapaʻau.

ʻAʻole pono ʻoe e lawe i kēia lāʻau inā he maʻi ʻoe i kekahi o nā mea ʻekolu, aspirin, a i ʻole nā salicylates ʻē aʻe. ʻO nā hopena maʻi ma mua i nā lāʻau antibiotic i nā ʻohana tetracycline a i ʻole metronidazole e kūpono ʻole kēia hui ʻana iā ʻoe.

ʻAʻole pono nā wahine hāpai e lawe i kēia hui ʻana, ʻoiai ka mea tetracycline, hiki ke hoʻopilikia i ka ulu ʻana o ka iwi a me nā niho fetal. Inā ʻoe e hoʻāʻo nei e hāpai a i ʻole e hāpai paha, e kūkākūkā i nā lapaʻau ʻē aʻe me kāu kauka.

ʻAʻole pono nā keiki ma lalo o 8 mau makahiki e lawe i ka tetracycline no ka mea hiki iā ia ke hoʻololi mau i ke kala o nā niho e ulu ana a pili i ka ulu ʻana o ka iwi. Loaʻa nō hoʻi i ka mea bismuth nā pilikia no nā keiki, ʻoiai e pili ana i ka maʻi o Reye.

Pono ka poʻe me kekahi mau maʻi olakino i ka noʻonoʻo kūikawā ma mua o ka hoʻomaka ʻana i kēia lapaʻau:

  • Maʻi kīkī, no ka mea, hiki i nā lāʻau lapaʻau ke hōʻiliʻili i loko o kou ʻōnaehana
  • Maʻi ate, e pili ana i ke ʻano o ka hana ʻana o kou kino i kēia mau lāʻau
  • Nā maʻi koko a i ʻole ka mōʻaukala o nā helu keʻena koko haʻahaʻa
  • Nā maʻi neurological, no ka mea, hiki i ka metronidazole ke hoʻonui i kekahi mau pilikia nerve
  • Maʻi puʻuwai koʻikoʻi a i ʻole nā pilikia puʻuwai hou

E loiloi kāu kauka i nā pōmaikaʻi e kūʻē i nā pilikia no kāu kūlana kikoʻī a hiki ke koho i nā lapaʻau ʻē aʻe inā ʻaʻole kūpono kēia hui ʻana iā ʻoe.

Nā inoa inoa o Bismuth Subsalicylate, Metronidazole, a me Tetracycline

Loaʻa kēia hui ʻana ma lalo o ka inoa inoa Pylera ma ʻAmelika Hui Pū ʻIa. Hele mai ʻo Pylera ma ke ʻano he capsules i loaʻa nā lāʻau lapaʻau ʻekolu i hoʻokahi mahele kūpono.

Hiki i kekahi mau kauka ke kuhikuhi i nā lāʻau lapaʻau ʻekolu i kaʻawale ma mua o ka hui pū ʻana. I kēia hihia, hiki iā ʻoe ke loaʻa nā mana generic o kēlā me kēia lāʻau, e hana like ana me ka hui inoa inoa.

Hāʻawi kekahi manawa i ka maʻalahi i ka hoʻohana ʻana a hiki ke emi ke kumukūʻai. Eia naʻe, ʻo ka lawe ʻana i ʻekolu mau lāʻau lapaʻau kaʻawale e koi ai i ka nānā pono ʻana i ka manawa a hoʻonui i ka manawa e nalo ai nā mahele.

Nā koho ʻē aʻe o Bismuth Subsalicylate, Metronidazole, a me Tetracycline

Loaʻa kekahi mau hui lapaʻau H. pylori ʻē aʻe inā ʻaʻole kūpono kēia lapaʻau triple iā ʻoe. E koho kāu kauka i ka mea maikaʻi loa e pili ana i kāu mōʻaukala olakino a me nā lapaʻau antibiotic ma mua.

ʻO ka mea maʻamau ka lapaʻau triple maʻamau, e hui pū ana i kahi mea hoʻopaʻa pauma proton (e like me ka omeprazole) me ʻelua mau lāʻau antibiotic, ʻo ka amoxicillin a me ka clarithromycin. Hoʻāʻo pinepine ʻia kēia hui ʻana no ka mea he liʻiliʻi nā hopena ʻaoʻao.

Hāʻawi nā koho lapaʻau quadruple i kahi mea pale pauma proton me ʻekolu mau lāʻau antibiotic, a i ʻole nā hui bismuth me nā hui antibiotic like ʻole. He ʻoi aku ka maikaʻi o kēia mau mea inā ua loaʻa iā ʻoe nā lāʻau antibiotic ma mua.

Hoʻopili ka lapaʻau sequential i ka lawe ʻana i nā hui like ʻole o nā lāʻau lapaʻau i kahi kauoha kikoʻī ma luna o 10 a 14 mau lā. Hiki i kēia ala ke hana maikaʻi i nā wahi i hoʻomohala ai ʻo H. pylori i ke kūʻē ʻana i nā lāʻau lapaʻau maʻamau.

ʻOi aku ka maikaʻi o ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline ma mua o ka Lapaʻau Triple Standard?

He kiʻekiʻe nā lapaʻau ʻelua no nā maʻi H. pylori, akā hana maikaʻi lākou i nā kūlana like ʻole. Aia ke koho i kāu mau kūlana kikoʻī a me ka ʻike antibiotic ma mua.

Hiki i kēia hui bismuth ke ʻoi aku ka maikaʻi inā ua lawe mua ʻoe i nā antibiotics no nā maʻi ʻē aʻe. He mea pono loa ia i nā wahi i hoʻomohala ai ʻo H. pylori i ke kūʻē ʻana i ka clarithromycin, ka antibiotic i hoʻohana ʻia i ka lapaʻau triple maʻamau.

Hoʻāʻo pinepine ʻia ka lapaʻau triple maʻamau me kahi mea pale pauma proton i ka mua no ka mea e hana pinepine ai i nā hopena ʻaoʻao liʻiliʻi. Eia naʻe, ua emi kona pono i kekahi mau wahi ma muli o ka hoʻonui ʻana i ke kūʻē ʻana i ka antibiotic.

ʻO ka hui bismuth e hana pinepine i nā hopena ʻaoʻao ʻoi aku ka ʻike, e like me ka noho ʻeleʻele a me ka ʻono metala, akā ʻaʻole pilikia kēia mau mea. E noʻonoʻo kāu kauka i kou ʻae ʻana i nā hopena ʻaoʻao i ke koho ʻana ma waena o nā lapaʻau.

Hōʻike nā haʻawina i nā lapaʻau ʻelua e loaʻa ana nā helu hoʻōla o 80-90% ke lawe pololei ʻia. ʻO ke kī i ka holomua me kekahi koho ʻo ka hoʻopau ʻana i ka papa piha e like me ke kauoha.

Nā Nīnau i Nīnau Pinepine ʻia e pili ana i ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline

He Palekana ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline no ka poʻe me ka maʻi diabetes?

ʻAe, palekana maʻamau kēia hui ʻana no ka poʻe me ka maʻi diabetes, akā pono ʻoe e nānā pono i kāu kō koko i ka wā o ka mālama ʻana. ʻAʻole pili pololei nā lāʻau lapaʻau i nā pae glucose koko, akā hiki i ka maʻi a me nā loli i nā ʻano ʻai ke hoʻopilikia i kāu mālama ʻana i ka maʻi diabetes.

Loaʻa kekahi poʻe i ka nausea a i ʻole ka nalowale o ka ʻai ʻana i ka wā e lawe ana i kēia mau lāʻau lapaʻau, hiki ke hoʻopilikia i ka manawa a me ka nui o kāu ʻai ʻana. E hana pū me kāu kauka e hoʻoponopono i kāu mau lāʻau diabetes inā pono, a e hoʻāʻo i kou kō koko i nā manawa pinepine i ka wā o ka mālama ʻana.

He aha kaʻu e hana ai inā ua hoʻohana hewa au i ka nui o Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

E kelepona koke i kāu kauka a i ʻole ke kikowaena hoʻomalu i ka lāʻau make inā ua lawe ʻoe i ka nui ma mua o ka mea i kauoha ʻia. Mai kali no ka hōʻike ʻana o nā hōʻailona, ​​no ka mea, hiki ke koʻikoʻi kekahi mau hopena o ka overdose.

Hiki i nā hōʻailona o ka overdose ke komo i ka nausea koʻikoʻi, ka luaʻi, ka maʻi maʻi, ka ʻūlū, a i ʻole ka huikau. Hiki i ka mea bismuth ke hoʻoulu i nā hōʻailona neurological i nā mea nui, ʻoiai hiki i ka nui o ka antibiotic ke hoʻopilikia nui i kāu bacteria gut.

Inā hiki, e lawe mai i nā hue lāʻau me ʻoe i ka lumi pilikia i hiki i nā limahana lapaʻau ke ʻike pololei i ka mea a me ka nui āu i lawe ai. Kōkua kēia ʻike iā lākou e hāʻawi i ka lāʻau lapaʻau kūpono loa.

He aha kaʻu e hana ai inā ua hala au i kahi mahele o Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

E lawe i ka mahele i hala i ka wā e hoʻomanaʻo ai 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 manawa maʻamau.

Mai lawe i ka mahele pālua e hana i ka mea i hala, no ka mea, hoʻonui kēia i kou pilikia o nā hopena ʻaoʻao. Inā ua hala ʻoe i nā mahele he nui, e kelepona i kāu kauka no ke alakaʻi ʻana i ke ʻano e hoʻomau ai me kāu mālama ʻana.

Hiki i nā ʻano lāʻau lapaʻau i hala ke ʻae i ka bacteria e kūʻē i nā lāʻau antibiotic, e hiki ai ke hoʻemi i ka pono o ka lāʻau lapaʻau. Hiki i ka hoʻonohonoho ʻana i nā mea hoʻomanaʻo ma kāu kelepona ke kōkua iā ʻoe e mālama i ka papa manawa ʻehā manawa i ka lā.

I ka manawa hea e hiki ai iaʻu ke hooki i ka lawe ʻana i ka Bismuth Subsalicylate, Metronidazole, a me Tetracycline?

E hooki wale i ka lawe ʻana i kēia lāʻau lapaʻau ke pau ʻoe i ka papa piha i kauoha ʻia e kāu kauka, ʻoiai inā maikaʻi loa ʻoe. Hiki i ka hooki mua ʻana ke ʻae i ka bacteria H. pylori e hoʻi mai a hiki ke kūʻē i nā lāʻau antibiotic.

Ua hoʻolālā ʻia ka papa lapaʻau piha e hoʻopau loa i ka maʻi, ʻaʻole e hōʻemi wale i nā hōʻailona. Hiki nō ke loaʻa ka bacteria i loko o kāu ʻōnaehana ʻoiai ke maikaʻi nei ʻoe, ʻo ia ke kumu e pono ai ka hoʻopau ʻana i ka palapala kauoha holoʻokoʻa.

Inā ʻoe e ʻike nei i nā hopena ʻaoʻao koʻikoʻi e paʻakikī ai ka hoʻomau ʻana, e kelepona i kāu kauka ma mua o ka hooki ʻana. Hiki iā lākou ke hoʻololi i kāu hoʻolālā lapaʻau a i ʻole e hāʻawi i ka mālama kākoʻo e kōkua iā ʻoe e hoʻopau i ka papa.

Hiki iaʻu ke inu i ka waiʻona i ka wā e lawe ana i kēia lāʻau lapaʻau?

E pale loa i ka waiʻona i ka wā e lawe ana i kēia hui pū ʻana, ʻoiai ma muli o ka mea metronidazole. ʻO ka hui ʻana i ka metronidazole me ka waiʻona hiki ke hoʻoulu i ka nausea koʻikoʻi, ka luaʻi, nā ʻeha poʻo, a me ka puʻuwai wikiwiki.

Hiki ke hana kēia hopena me nā mea liʻiliʻi o ka waiʻona a hiki ke hana a hiki i 3 mau lā ma hope o kāu lāʻau hope loa. ʻO ka pia, ka waina, ka waiʻona, a me nā mea holoi waha a i ʻole nā lāʻau lapaʻau i loaʻa ka waiʻona e pale ʻia i ka wā o ka mālama ʻana.

ʻAʻole i loaʻa i nā mea bismuth a me tetracycline ka pilina koʻikoʻi like me ka waiʻona, akā hiki i ka inu ʻana ke hoʻonui i ka ʻōpū a keakea i kou ola hou ʻana. ʻOi aku ka maikaʻi e pale loa i ka waiʻona a hiki i kou hoʻopau ʻana i ka lapaʻau a maikaʻi.

Health Companion

trusted by

6Mpeople

Get clear medical guidance
on symptoms, medications, and lab reports.

QR code to download August

download august