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Promethazine hydrochloride standard was a gift from the State Company of Drug Industries and Medical Appliances Samara IRAQ-SDI ; . Phenergan tablets 25 mg promethazine-HCl ; Bristol-Myers Squibb Company, USA ; were purchased locally. Di-n-butyl phosphate 98.9% DBP ; , tri-n-butyl phosphate 97% TBP ; , o-nitrio phenyloctyl ether 98% ONPOE ; , and di-n-butyl phthalate 99% DBPH ; were obtained from Fluka AG, Switzerland. Stock solutions of 0.1 M for each of LiCl, NaCl, KCl, CaCl2 , mgCl2 , ZnCl2 , FeCl3 , AlCl3 , and CrCl3 were prepared. More diluted solutions were prepared by subsequent dilution of the stock solutions. A solution of 0.1 M promethazine-HCl was prepared by dissolving 0.8023 g of standard and making the solution up to 25 ml with deionized water. A 0.05 M potassium hydrogenphthalate buffer solution pH 4.01 ; was prepared by dissolving 10.21 g of solid potassium hydrogen phthalate in 1 L water after adjusting the pH. 2. JUNEL FE 1-0.02mg TABLET JUNEL 1.5-0.03mg TABLET JUNEL FE 1.5-0.03mg TABLET APRI 0.15-0.03 TABLET AVIANE 0.1-0.02 TABLET ENPRESSE 6-5-10 TABLET CRYSELLE 0.3-0.03mg TABLET KARIVA 21-5 TABLET VELIVET 7 DAYS X 3 TABLET VELIVET 7 DAYS X 3 TABLET ARANELLE 7-9-5 TABLET ARANELLE 7-9-5 TABLET ALAVERT 10mg TAB RAPDIS ALAVERT 10mg TAB RAPDIS ALAVERT 10mg TAB RAPDIS ALAVERT 10mg TAB RAPDIS ALAVERT 10mg TABLET ALAVERT 10mg TABLET ALAVERT 120-5mg TAB.SR 12H ALAVERT 120-5mg TAB.SR 12H ALAVERT 5mg 5ml SYRUP CLINDA-DERM 1% SOLUTION MILK OF MAGNESIA 400mg 5ml ORAL SUSP CLOTRIMAZOLE 10mg TROCHE FLAVOXATE HCL 100mg TABLET NYSTATIN 50MMU POWDER NYSTATIN 150MMU POWDER NYSTATIN 500MMU POWDER HYDROCORTISONE ACETATE POWDER FERROUS GLUCONATE 324 36 ; mg TABLET FERROUS GLUCONATE 324 36 ; mg TABLET FERROUS GLUCONATE 324 36 ; mg TABLET PODOCON-25 25% LIQUID FERROUS SULFATE 325 65 ; mg TABLET DR FERROUS SULFATE 325 65 ; mg TABLET DR FERROUS SULFATE 325 65 ; mg TABLET DR PODOFILOX 0.5% SOLUTION PROMETHAZINE HCL 25mg ml AMPUL DIHYDROERGOTAMINE MESYLATE 1mg ml AMPUL. Corn pdpclientforrnulary ForrnularyByEntireBrand ?state PDP2. 12 7 2005 Formulary Search Results RxSolutions.corn Page 133 of 245 Suspension Formulary Formulary Alternative s ; : Generic Septra Susp Tier 5-- 50-25 mg ME PROZI NE meperidine wlpromethazine Capsule Non Formulary Formulary Alternative s ; : morphine Ir + promethazine separately Tier 3-- 100 mglml Standard MESNEX mesna Injection Brand or Generic Note: Requires Prior Authorization 400 mg Tier 4 MESNEX mesna Tablet Specialty Note: Requires Prior Authorization Tier 5-- 60 mg 5ml Non ESTI NON pyridostigmine bromide Syrup Formu lary Formulary Alternative s ; : Other Dosage Forms Available Tier 1 MESTINON pyridostigmine bromide 60 mg Tablet Preferred Generic Tier 5-- 180mg CR MESTINON TIMESPAN pyridostigmine bromide Tablet Non Formulary Formulary Alternative s ; : Other Dosage Forms Available Tier 3-- 10 mg CR Standard METADATE CD methyiphenidate hcl cr Capsule Brand or Generic Formulary Alternative s ; : dextroamphetamine, dextroamphetamine Sr, methylphenidate, methylphenidate Sr, Adderall Tier 3. Adjunctive medications: These medications are given for their potentiation of other drugs effects, or for the prevention treatment of certain side effects nausea, etc ; , of drugs used in pain control or sedation. - Phenergan Romethazine ; IV: 6.25-12.5 mg slow IVP, diluted. May repeat to a max of 25 mg 30 minutes. IM: 12.5-25 mg May dilute as needed for patient comfort when giving IV. - Benadryl Diphenhydramine ; IV IM: 25-50 mg PHYSICIAN PEARLS: ALS Providers may decrease the dosage, or prolong the administration intervals of any medication with sedative properties when doing so would decrease adverse effects and still potentially obtain a clinical goal.
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Oral antihistamines e.g. promethazine 25 mg once or twice daily or chlorpheniramine 4 mg 3 times daily. - In severe reactions a short course of prednisolone may be given starting at 30-60 mg daily and quickly reducing the dose in 2 weeks. - When there is extensive skin loss the patient should be hospitalised, given i.v. fluids and treated like a burn case i.e. given betadine baths, dressed with silver sulphadiazine 1% burn cream and given antibiotics and analgesics as required. Some drugs such as prochloperazine stemetil ; , chlorpromazine largactil ; and promethazine phenergan ; are not suited to continuous sc administration because they are too irritant and methylprednisolone.

11.1 Classes of medicines 11.2 Sources of information on OTC medicines and the provision of information to customers 11.3 Correct procedures 11.3.1 Pharmacy protocol 11.3.2 Classes of medicines 11.3.3 Questions to be asked before recommending or referring 11.4 Actions and side effects of key ingredients in OTC products OTC Formulary: Aciclovir Acrivastine Alcohol Alginates Almond oil Aluminium Arachis oil Aspirin Azelastine Beclomethasone Benzalkonium Benzocaine Benzoyl peroxide Bisacodyl Buclizine Caffeine Calcium Cetirizine Cetrimide Cetylpyridinium Chlorhexidine Chlorphenamine Cimetidine Cinnarizine Clotrimazole Coal Tar Codeine Crotamiton Dequalinium Dextromethorphan Dihydrocodeine Dimeticone Diphenhydramine Domperidone Famotidine Felbinac Fluoride Fluconazole Folic acid Formaldehyde Glutaraldehyde Glycerin Guaiphenesin Hydrocortisone Hyoscine Ibuprofen Iron Ispaghula Kaolin Ketoconazole Ketoprofen Lactic acid Lactulose Lanolin Levonorgestrel Levocabastine Lidocaine Liquid paraffin Loperamide Loratidine Magnesium Malathion Mebendazole Mebeverine Meclozine Menthol Miconazole Minoxidil Morphine Nicotinates Nicotine Nonoxinol 9 Olive Oil Oral rehydration solutions Oxymetazoline Paracetamol Peppermint Oil Permethrin Phenothrin Phenylephrine Phenylpropanolamine Pholcodine Piperazine Piroxicam Potassium and sodium citrates Povidone iodine Prometgazine Propamidine Pseudoephedrine Ranitidine St Johns Wort Salicylates Salicylic acid Selenium sulphide Senna Sodium cromoglicate Sulphur Tea Tree Oil Tolnaftate Triamcinolone Triclosan Tyrothricin Undecenoic acid Urea hydrogen peroxide Vitamins A, B, C, D, E Witch Hazel Xylometazoline Zinc Oxide Zinc pyrithione.

The hemodynamic studies were performed in the morning, after a light breakfast, in a laboratory where room temperature was 18-22C and humidity 40-60%. The brachial artery was punctured to measure intraarterial pressure BAP ; and to sample arterial blood. A #5F venous catheter Swan-Ganz ; was introduced in the antecubital vein and positioned in the pulmonary artery to sample mixed venous blood. The venous catheter was positioned so that pulmonary capillary wedge pressure PCWP ; was measured when the balloon near its tip was inflated, and pulmonary artery pressure PAP ; when the balloon was deflated. Pressures were registered on a recorder Mingograph 81 ; using Elema-Sch'onander EMT 34 pressure transducers. Uptake of oxygen VO2 ; and carbon dioxide output VCO2 ; were measured continuously by the open-circuit method; minute-volume VE ; , oxygen and carbon dioxide levels were determined with a pneumotachograph, a paramagnetic oxygen analyzer and an infrared carbon dioxide analyzer Siregnost FD 84, Siemens ; . The ventilatory equivalent for oxygen VE VO2 ; and the respiratory gas exchange ratio R ; were monitored continuously. Cardiac output CO ; was determined by the direct-oxygen Fick method. Systemic vascular resistance SVR ; was calculated from mean brachial arterial pressure MBAP ; , obtained by electrical damping, and CO, and pulmonary vascular resistance PVR ; from mean pulmonary artery MPAP ; and capillary wedge pressures MPCWP ; and CO. Heart rate HR ; was recorded from the ECG. Stroke volume SV ; was calculated from CO and HR. After catheters were inserted, the patients remained recumbent and a first set of measurements was obtained after 45 minutes RR ; . The patients were seated on the bicycle and measurements were performed 10 minutes later rest-sitting [RS] ; . A graded, uninterrupted exercise test was then started at a work load of 20 W for 4 minutes. The load was increased by 30 W every 4 minutes until VE V02 increased, i.e., one step above the anaerobic threshold; 23 pressures and HR were recorded at every step, but CO was determined every other step and at the final work load and desloratadine!

Migraine is a common clinical disorder that continues to be highly under-recognized. Diagnosis is difficult because it is hard to elicit precise information from a patient who is trying to translate symptoms into words, the symptoms are somewhat similar to those of tension headaches, and the manifestation of attacks exhibits considerable inter- and intrapatient variability. The situation is further complicated by the fact that there are no biological markers to confirm diagnosis. Based on the recommendations of the International Headache Society, a number of diagnostic criteria for migraine have been put forward Table 1 ; . These guidelines should all be taken into account when formulating a patient interview with the aim to obtain an accurate headache history of the sufferer. Such history-taking plays a key role in migraine diagnosis and should thoroughly address all the relevant criteria. During the interview, it is important to look out for and recognise certain patterns that are typical of migraine attacks. Thus, the patient should be questioned about: Family history of migraine Abatement of the headache with sleep Perimenstrual or periovulation timing of migraine attacks Stimulation of attack by sustained exertion. 3 Light RW, Muro JR, Sato RI, Stansbury DW, Fischer C E , Brown SE. Effects of oral morphine on breathlessness and exercise tolerance in patients with chronic obstructive pulmonary disease. Rev Respir Dis 1989; 139: 126-33 Woodcock AA, Gross ER, Gellert A, Shah S, Johnson M, Geddes DM. Effects of dihvdrocodeine. alcohol, and caffeine on breathlessness and exercise tolerance in patients with chronic obstructive lung disease and normal blood gases. N Engl J Med 1981; 305: 1611-16 Agle DF', Baum GL, Chester E H , Wendt M. Multidisciplinary treatment of chronic pulmonary insufficiency: psychological aspects of rehabilitation. Psychosom Med 1973; 3541-49 6 Light RW, Merrill EJ, Despars J, Gordon G H , Mutalipassi LR. Comparison of doxepin and placebo in treating depressed patients with chronic obstructive pulmonary disease. Arch Intern Med 1986; 1461377-80 7 Taylor DF', Moon SL. Buspirone and related compounds as alternative anxiolytics. Neumpep 1991; 19 suppl ; : 15-19 8 Rickels K. Buspirone in clincal practice. J Clin Psych 1990: 51 suppl ; : 51-54 9 Garner SJ, Eldridge FL, Wagner PC, Dowell RT. Buspirone, an anxiolytic drug that stimulates respiration. Rev Respir Dis 1989; 139: 946-50 Mendelson WB, Martin JV, R a p p DM. Effects of buspirone on sleep and respiration. Rev Respir Dis 1990; 141: 1527-30 Woodcock AA, Gross ER, Geddes DM. Drug treatment of breathlessness: contrasting effects of diazepam and promethazine in pink puffers. Br Med J 1981; 283: 343-45 Geddes DM, Rudolf M, Saunders KB. Effect of nitrazepam and tlurazepam on the ventilatory response to carbon dioxide. Thorax 1976; 31: 548-51 Spielberger C D , Gorsuch RL, Lushene RE. STAI man~lal. Palo and cyproheptadine.

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Tip-medications within the same pharmacologic group produce various side effects that are more, or less, acceptable to each individual patient and ketotifen. Lactation inhibitor Inhibition of physiological lactation Suppression of established lactation 0.5 mg tablet Lactation inhibition: 1 mg as a single dose on the first day post-partum Lactation suppression: 0.25 mg every 12 hours for 2 days Do not administer to patients with hypersensitivity to cabergoline, post-partum hypertension. May cause: nausea, vomiting, headache, dizziness, hypotension, drowsiness. Stop treatment in the event of dyspnoea, persistent cough, chest pain, abdominal pain. Do not combine with: neuroleptics chlorpromazine, haloperidol, etc. ; , metoclopramide, promethazine and methylergometrine. Pregnancy: CONTRA-INDICATED Cabergoline is a dopamine agonist also used in the treatment of Parkinson's disease. Cabergoline is not included in the WHO list of essential medicines. Storage: below 30C. Note 1: Payment allowance limits subject to the ASP methodology are based on 3Q07 ASP data. Note 2: The absence or presence of a HCPCS code and the payment allowance limits in this table does not indicate Medicare coverage of the drug. Similarly, the inclusion of a payment allowance limit within a specific column does not indicate Medicare coverage of the drug in that specific category. These determinations shall be made by the local Medicare contractor processing the claim. HCPCS Code J9250 J9260 J9261 J9263 J9264 J9265 J9266 J9268 J9280 J9290 J9291 J9293 J9300 J9303 J9305 J9310 J9320 J9340 J9350 J9355 J9360 J9370 J9375 J9380 J9390 J9395 J9600 P9041 P9043 P9045 P9046 P9047 P9048 Q0163 Q0164 Q0165 Q0166 Q0167 Q0168 Q0169 Q0170 Q0171 4 03 08 Short Description Methotrexate sodium inj Methotrexate sodium inj Nelarabine injection Oxaliplatin Paclitaxel protein bound Paclitaxel injection Pegaspargase singl dose vial Pentostatin injection Mitomycin 5 mg inj Mitomycin 20 mg inj Mitomycin 40 mg inj Mitoxantrone hydrochl 5 mg Gemtuzumab ozogamicin Panitumumab inj Pemetrexed injection Rituximab cancer treatment Streptozocin injection Thiotepa injection Topotecan Trastuzumab Vinblastine sulfate inj Vincristine sulfate 1 mg inj Vincristine sulfate 2 mg inj Vincristine sulfate 5 mg inj Vinorelbine tartrate 10 mg Injection, Fulvestrant Porfimer sodium Albumin human ; , 5%, 50ml Plasma protein fract, 5%, 50ml Albumin human ; , 5%, 250 ml Albumin human ; , 25%, 20 ml Albumin human ; , 25%, 50ml Plasmaprotein fract, 5%, 250ml Diphenhydramine HCl 50mg Prochlorperazine maleate 5mg Prochlorperazine maleate10mg Granisetron HCl 1 mg oral Dronabinol 2.5mg oral Dronabinol 5mg oral Promethazzine HCl oral P4omethazine HCl 25 mg oral Chlorpromazine HCl 10mg oral HCPCS Code Dosage 5 mg 50 mg 50 mg 0.5 mg 1 mg 30 mg 1 EA 10 mg 5 mg 20 mg 40 mg 5 mg 5 mg 10 mg 10 mg 100 mg 1 GM 15 mg 4 mg 10 mg 1 mg 1 mg 2 mg 5 mg 10 mg 25 mg 75 mg 50 ml 50 ml 250 ml 20 ml 50 ml 250 ml 50 mg 5 mg 10 mg 1 mg 2.5 mg 5 mg 12.5 mg 25 mg 10 mg Payment Limit ##TEXT##.264 .740 .165 .465 .876 .577 , 098.874 , 858.684 .064 .256 0.512 5.142 , 434.947 .870 .079 8.659 7.940 .213 5.456 .018 .065 .732 .464 .660 .856 .369 , 556.529 .064 .128 .064 .128 ##TEXT##.031 ##TEXT##.027 ##TEXT##.090 .224 .878 .982 ##TEXT##.440 ##TEXT##.272 ##TEXT##.019 Vaccine AWP% Vaccine Limit Infusion AWP% DME Infusion Limit Blood AWP% Blood Limit Notes and cetirizine. Name Prefix Dr Prof Mr Mrs Ms | | Last Name | | | Given Names | | | Initial | | | Badge Information Name as you would like it to appear on your badge, maximum 19 letters. ; | | | Organization maximum 20 letters ; | Mailing Address Street or PO Box No.| Province State | | | Telephone office ; | | | |-| | | E-mail | | | | Conference Registration Fee.
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The substitution of a benzene ring by pyridine has also resulted in improved activity in the tricyclic, antihistaminic, and neuroleptic major tranquilizing ; drugs with the introduction of isothipendyl 5.40 ; cf. promethazine 5.41 ; and prothipendyl 5.42 ; cf. promazine 5.43.
Administration: In both adults and children, the daily dose can be given as single infusion or in equally divided infusions at 6-, 8-, or 12- hour intervals at the recommended final concentration of not greater than 6 mg ml see Preparation of Solution ; . The rate of infusion depends on the volume of infusate. Whenever possible, therapy with ALOPRIM allopurinol sodium ; for Injection should be initiated 24 to 48 hours before the start of chemotherapy known to cause tumor cell lysis including adrenocortico steroids ; . ALOPRIM allopurinol sodium ; for Injection should not be mixed with or administered through the same intravenous port with agents which are incompatible in solution with ALOPRIM allopurinol sodium ; for Injection see Preparation of Solution ; . Preparation of Solution: ALOPRIM allopurinol sodium ; for Injection must be reconstituted and diluted. The contents of each 30 ml vial should be dissolved with 25 ml of Sterile Water for Injection. Reconstitution yields a clear, almost colorless solution with no more than a slight opalescence. This concentrated solution has a pH of 11.1 to 11.8. It should be diluted to the desired concentration with 0.9% Sodium Chloride Injection or 5% Dextrose for Injection. Sodium bicarbonate-containing solutions should not be used. A final concentration of no greater than 6 mg ml is recommended. The solution should be stored at 20 to 25C 68 to 77F ; and administration should begin within 10 hours after reconstitution. Do not refrigerate the reconstituted and or diluted product. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Do not use this product if particulate matter or discoloration is present. The following table lists drugs that are physically incompatible in solution with ALOPRIM allopurinol sodium ; for Injection. Drugs That are Physically Incompatible in Solution with ALOPRIMTM allopurinol sodium ; for Injection Amikacin sulfate Hydroxyzine HCl Amphoterecin B Idarubicin HCl Carmustine Imipenem-cilastatin sodium Cefotaxime sodium Mechlorethamine HCl Chlorpromazine HCl Meperidine HCl Cimetidine HCl Metoclopramide HCl Clindamycin phosphate Methylprednisolone sodium succinate Cytarabine Minocycline HCl Dacarbazine Nalbuphine HCl Daunorubicin HCl Netilmicin sulfate Diphenhydramine HCl Ondansetron HCl Doxorubicin HCl Prochlorperazine edisylate Doxycycline hyclate Promethazine HCl Droperidol Sodium bicarbonate Floxuridine Streptozocin Gentamicin sulfate Tobramycin sulfate Haloperidol lactate Vinorelbine tartrate HOW SUPPLIED: STERILE SINGLE USE VIAL FOR INTRAVENOUS INFUSION. ALOPRIM allopurinol sodium ; for Injection, 30 ml flint glass vials with rubber stoppers each containing allopurinol sodium equivalent to 500 mg of allopurinol white lyophilized powder ; , box of 1 NDC 59730-5601-1 ; . Store unreconstituted powder at 25C 77F excursions permitted to 15-30C 59-86F ; [see USP controlled room temperature]. Distributed by: Nabi Boca Raton, FL 33487 Toll Free: 1-800-327-7106 February 2003 Manufactured by: DSM Pharmaceuticals, Inc. Greenville, NC 27834 650374 and escitalopram.
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Tablets, promethazine hydrochloride 10 mg, 25 mg Elixir Oral solution ; , promethazine hydrochloride 5 mg 5 ml Injection, Solution for injection ; , promethazine hydrochloride 25 mg ml, 2-ml ampoule Uses: premedication prior to surgery; antiemetic section 17.2 ; Contra-indications: child under 1 year; impaired consciousness due to cerebral depressants or of other origin; porphyria Precautions: prostatic hypertrophy, urinary retention; glaucoma; epilepsy; hepatic impairment Appendix 5 pregnancy Appendix 2 ; and breastfeeding Appendix 3 interactions: Appendix 1. Pregnancy Teratogenic EffectsPregnancy Category C Teratogenic effects have not been demonstrated in rat-feeding studies at doses of 6.25 and 12.5 mg kg of promethazine HCl. These doses are from approximately 2.1 to 4.2 times the maximum recommended total daily dose of promethazine for a 50-kg subject, depending upon the indication for which the drug is prescribed. Daily doses of 25 mg kg intraperitoneally have been found to produce fetal mortality in rats. Specific studies to test the action of the drug on parturition, lactation, and development of the animal neonate were not done, but a general preliminary study in rats indicated no effect on these parameters. Although antihistamines have been found to produce fetal mortality in rodents, the pharmacological effects of histamine in the rodent do not parallel those in man. There are no adequate and wellcontrolled studies of Phenergan Tablets and Suppositories in pregnant women. Phenergan promethazine HCl ; Tablets and Suppositories should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Nonteratogenic Effects Phenergan Tablets and Suppositories administered to a pregnant woman within two weeks of delivery may inhibit platelet aggregation in the newborn. Labor and Delivery Promethazine HCl may be used alone or as an adjunct to narcotic analgesics during labor see DOSAGE AND ADMINISTRATION ; . Limited data suggest that use of Phenergan during labor and delivery does not have an appreciable effect on the duration of labor or delivery and does not increase the risk of need for intervention in the newborn. The effect on later growth and development of the newborn is unknown. See also Nonteratogenic Effects. ; Nursing Mothers It is not known whether promethazine HCl is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Phenergan Tablets and Suppositories, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Pediatric Use PHENERGAN TABLETS AND SUPPOSITORIES ARE CONTRAINDICATED FOR USE IN PEDIATRIC PATIENTS LESS THAN TWO YEARS OF AGE see WARNINGSBlack Box Warning and Use in Pediatric Patients ; . Phenergan Tablets and Suppositories should be used with caution in pediatric patients 2 years of age and older see WARNINGS-Use in Pediatric Patients ; . Geriatric Use Clinical studies of Phenergan formulations did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy and sertraline. Mg normal, 6.0 mg 24 hr ; . After discontinuing the bananas in the diet, a repeated test for 5-HIAA showed 3.3 mg 24 hr. Discussion: The classic carcinoid syndrome includes flushing, diarrhea, right-sided heart failure, bronchial constriction and increased urine levels of 5-hydroxyindoleacetic acid 5-HIAA ; . Some patients display only one or two of the above features. Other symptoms related to the syndrome are weight loss, sweating and pellagra-like skin lesions. Patients with carcinoid tumors usually have urine 5-HIAA levels of 15 to mg 24 hr. Foods including avocado, banana, chocolate, coffee, eggplant, pecan, pineapple, plum, tea and walnuts can produce false- positive results in the urine test. Drugs including acetaminophen, fluorouracil, guaifenesin, levodopa, methamphetamine, methocarbamol, phenmetrazine, reserpine and salicylates can produce false- positive test results. Drugs such as corticotropin, chlorpromazine, heparin, isoniazid, methyldopa, monoamine oxidase inhibitors, phenothiazine and promethazine can cause false-negative results in the test. On this patient, the diarrhea resolved by itself, the cough could be explained by COPD and the weight loss was related to poor nutrition. Banana is wellknown to give false-positive results in the urine 5-HIAA assay and it was confirmed on this patient. Conclusions: This case emphasizes the importance of physical examination and a complete history including foods and drugs in a patient with elevated urine 5-HIAA levels before considering any imaging technique. Abstract #115 CC-WC ; : CHEST CIRCUMFERENCE MINUS WAIST CIRCUMFERENCE POOR MAN'S DEXA? Shehzad Topiwala, MD, MBBS, DD, Vikram Sodhi, MBBS, MHA, Mitali Vaidya, MBBS, DD Rakesh Parikh, MBBS, DD, FCPS Radha Lachhiramani, MSc, and Dip Clin Dermat, MBBS Objective: To assess sarcopenia relative to adiposity which predisposes to insulin resistance ; by measuring new anthropometric parameter Methods: : In 108 type 2 diabetics 57 males ; , we measured CC Chest Circumference ; at the level of nipples in males M ; and infra mammary in females F ; , and WC Waist Circumference ; . We made a record of Blood Pressure, HDL, TG, LDL and CAD XA Dual Energy X ray Absorptiometry ; was performed in 28 patients 18 males ; . Results: p 0.05 for all results.Mean values: WC 96.5cm F ; and 92.8 cm M ; , CC 87.1cm F ; and 92.1cm M ; , CC-WC ; -9.3cm F ; and -0.67cm M ; . As per NCEP ATP III definition, Metabolic Syndrome MetS ; was present in 92% F ; and 67.8% M ; . By IDF criteria, MetS was present in 86% F ; and 50% M ; . By DEXA, 50% females were obese TBF 33% ; and 41% male were obese TBF 25% ; . CC shows a positive correlation r + 0.82 ; with both Lean Body Mass LBM ; and Fat Free Mass . CCWC ; negatively correlates - 0.73 ; and WC positively co relates + 0.578 ; with DEXA estimation of TBF Total Body Fat ; . Neither CC-WC ; nor WC correlated with clustering of MetS parameters.In females, TBF greater than 33% was the cut off beyond which the risk of MetS appears to increase.No such cut off was observed in males. Discussion: The chest of humans comprises the following muscles: pectorals, latissimus dorsi, serrati, infrascapularis and rhomboids. Caucasians are naturally endowed with more muscle mass. The inherent propensity of Asians to develop insulin resistance and or metabolic syndrome has been attributed to relative sarcopaenia. To assess the same, we propose a simple clinical tool- a measure tape assessment of the chest circumference at to provide a representative sample of generalized muscular development. That of the waist is a surrogate marker of adiposity. The difference between the two is fairly reflective of the relative constitution of body fat and muscle .Greater the difference CC-WC ; - either due to a relatively larger chest and or a smaller waist - reflects a lower TBF%, and vice versa. This simple clinical measurement provides a fair idea of both body fat content and distribution. We aspire to promote the reflection of sarcopenia by this novel method.We also postulate that apparently lean individuals BMI and WC within normal range ; can be `metabolically obese', because of deficient muscle mass. The shortoming of this pilot project was the lack of BMI weight as comparative variables. Conclusions: WC, known to reflect adiposity, correlates well with TBF. The new anthropometric measurement CC correlates very well with the total muscle mass of the body, as ascertained by DEXA. It also correlates positively with non fat mass. This is perhaps a reflection of the fact that the chest is a representative musculoskeletal region of the body, and such non-adipose tissue is protective. CC-WC ; also correlates with adiposity. NCEP criteria, as opposed to IDF, identify greater number of subjects with MetS.

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Individual institution 6, 7 ; . Nembutal is contradicted in patients with porphyria and may require higher doses in patients being treated for a seizure disorder. Other intravenous sedation regimens opiates and benzodiazepines ; are used less frequently in the pediatrie population. Reversal drugs are required to treat overdoses, such as nalozone Narcan ; for opiates and flumazenil Romazicon ; for benzodiazepines. Classes of drugs used for parenteral sedation. Dosages vary and can be generated by the pediatrie anesthesiology or critical care section of the individual institution. Barbiturates including pentobarbital sodium Nembutal ; . Opiates including meperidine Demerol ; and fentanyl Sublimaze ; . Benzodiazepines including diazepam Valium ; and tnidazolam Versed ; . Phenothiazines including chlorpromazine Thorazine ; and Promethazine Phenergan ; . Neuroleptic agents including ketamine Ketalar ; . Sedation protocols use drugs singly or in combination. The use of analgesic opiates such as fentanyl and meperidine as part of DPT, Demerol, Phenergan and Thorazine ; is rarely necessary for most nuclear medicine procedures. Also, opiates may cause respiratory depression, especially if administered rapidly. Ketamine can cause hallucinations in older children. Midazolam can also be used as an adjunct with other sedation drugs such as opiates and barbiturates, and may be used orally, intravenously, rectally 6-11 ; or intranasally. Recently, there is a growing enthusiasm for the use of intranasal midazolam with its predominantly amnesic effect in children undergoing preanesthetic sedation, echo cardiography, and short surgical procedures 12-13 ; . Nasally administered midazolam has been shown to have very minimal respiratory depression and a relatively short duration of sedation, approximately 35-45 min. It obviates the need for i.v. access and may be suited for some nuclear medicine procedures. The exact dosages and preferred routes of administration should be ascertained from the guide lines of the individual institution. The nuclear medicine physician should consult with the anesthesiology department in each institution for specific rec ommendations on dosages and combinations of sedative drugs. Consultation with an anesthesiologist is particularly important in patients with a history of significant snoring, abnormal airway i.e., micrognathia ; , congenital heart disease, reactive airways disease and increased intracranial pressure 14.

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Thanks to ann blake tracy for research and technical information about the serotonergic drugs. Drug search see betapace effects and alcohol or allergic promethazine vc syrup alp reaction in cases are relapsers, the mentioned situation by 200 bonemarrow problems or herbal products and blotchy and buy loratadine. Kehlet H. The surgical stress response: should it be prevented? Can J Surg 1991; 34: 565-7. Watcha MF, White PF. Postoperative nausea and vomiting. Anesthesiology 1992; 77: 162-84. Kenny GNC. Risk factors for postoperative nausea and vomiting. Anaesthesia 1994; 49 Suppl ; : 6-10. Vance JP, Neil1 RS, Norris W. The incidence and aetiology of postoperative nausea and vomiting in a plastic surgery unit. Br J Plast Surg 1973; 26: 336-9. Tarkkila I', Torn K, Tuominen M, Lindgren L. Premeditation with promethazine and transdermal scopolamine reduces the incidence of nausea and vomiting after intrathecal morphine. Acta Anesthesiol Stand 1995; 39: 983-6. Silverman DG, Freilich J, Sevarino F, et al. Influence of promethazine or symptom-therapy scores for nausea during subjectcontrolled analgesia with morphine. Anesth Analg 1992; 74: 735-8. Harris SN, Sevarino FB, Sinatra RS. Nausea prophylaxis using transdermal scopolamine in the setting of subject-controlled analgesia. Obstet Gynecol 1991; 78: 673-7. Semple I', Madej TH, Wheatley RG, et al. Transdermal hyoscine with subject-controlled analgesia. Anaesthesia 1992; 47: 399-401. Williams OA, Clarke FL, Harris RW, et al. Addition of droperido1 to patient-controlled analgesia: effect on nausea and vomiting. Anaesthesia 1993; 48: 881-4. Du Pen S, Scuderi I', Wetchler B, et al. Ondansetron in the treatment of postoperative nausea and vomiting in ambulatory outpatients: a dose-comparative, stratified, multicentre study. Eur J Anaesthsiol 1992; 9 Suppl 6 ; : 55-62. Bodner M, White PF. Antiemetic efficacy of ondansetron after outpatient laparoscopy. Anesth Analg 1991; 73: 250-4. Dear Health Care Professional: We are writing to make you aware of the latest information on labeling changes to the CONTRAINDICATIONS, WARNINGS Use in Pediatric Patients, and DOSAGE AND ADMINISTRATION sections of the prescribing information for Phenergan promethazine hydrochloride ; Tablets and Suppositories. Based on a review of adverse events for Phenergan in pediatric patients, the Food and Drug Administration has requested that the following changes, shown here underlined, be made to the product prescribing information. CONTRAINDICATIONS Phenergan Tablets and Suppositories are contraindicated for use in pediatric patients less than two years of age. WARNINGS PHENERGAN SHOULD NOT BE USED IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE BECAUSE OF THE POTENTIAL FOR FATAL RESPIRATORY DEPRESSION. POSTMARKETING CASES OF RESPIRATORY DEPRESSION, INCLUDING FATALITIES, HAVE BEEN REPORTED WITH USE OF PHENERGAN IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE. A WIDE RANGE OF WEIGHT-BASED DOSES OF PHENERGAN HAVE RESULTED IN RESPIRATORY DEPRESSION IN THESE PATIENTS. CAUTION SHOULD BE EXERCISED WHEN ADMINISTERING PHENERGAN TO PEDIATRIC PATIENTS 2 YEARS OF AGE AND OLDER. IT IS RECOMMENDED THAT THE LOWEST EFFECTIVE DOSE OF PHENERGAN BE USED IN PEDIATRIC PATIENTS 2 YEARS OF AGE AND OLDER AND CONCOMITANT ADMINISTRATION OF OTHER DRUGS WITH RESPIRATORY DEPRESSANT EFFECTS BE AVOIDED.
The effects of a series of dihydroethano- and ethenoanthracene derivatives on chloroquine CQ ; accumulation in CQ-susceptible strain 3D7 and CQ-resistant clone W2 were assessed. The levels of CQ accumulation increased little or none in CQ-susceptible strain 3D7 and generally increased markedly in CQ-resistant strain W2. At 10 M, 28 compounds yielded cellular accumulation ratios CARs ; greater than that observed with CQ alone in W2. At 10 M, in strain W2, 21 of 31 compounds had CQ CARs two or more times higher than that of CQ alone, 15 of 31 compounds had CQ CARs three or more times higher than that of CQ alone, 13 of 31 compounds had CQ CARs four or more times higher than that of CQ alone, and 9 of 31 compounds had CQ CARs five or more times higher than that of CQ alone. At 1 M, 17 compounds had CQ CARs two or more times higher than that of CQ alone, 12 of 31 compounds had CQ CARs three or more times higher than that of CQ alone, 6 of 31 compounds had CQ CARs four or more times higher than that of CQ alone, and 3 of 31 compounds had CQ CARs five or more times higher than that of CQ alone. At 1 M, 17 compounds were more potent inducers of CQ accumulation than verapamil and 12 of 31 compounds were more potent inducers of CQ accumulation than promethazine. The nature of the basic group seems to be associated with increases in the levels of CQ accumulation. At 1 and 10 M, 10 of and 13 of 14 compounds with amino group amines and diamines ; , respectively, had CARs 3, while at 1 and 10 M, only 1 of the 13 derivatives with amido groups had CARs 3. Among 12 of the 31 compounds which were more active inducers of CQ accumulation than promethazine at 1 M, 10 had amino groups and 1 had an amido group. Chloroquine CQ ; has been one of the most successful antimalarial drugs ever developed. During the past 20 years, strains of Plasmodium falciparum have become resistant to CQ and other antimalarial drugs 49, 57 ; . The universal success of CQ before the development of resistance has led to investigations of the mode of action of CQ and its mechanisms of resistance. CQ reaches the parasite food vacuole, where it accumulates due to the local acid pH and the weak base properties of the drug 59 ; . The activity of CQ depends on a high level of accumulation of the drug within the parasite, and drug resistance is indicated by reduced levels of drug accumulation. Some interesting observations suggest that the mechanism of malarial CQ resistance may be similar to the mechanism of mammalian multidrug resistance MDR ; . In cancer cell lines, the resistance-reversing actions of chemosensitizing drugs have been fairly well characterized. MDR is defined as the MDR conferred on cell lines by increased levels of expression of the human MDR-1 protein P-glycoprotein ; or closely related animal equivalents 41 ; . Resistant parasites actively expel CQ 35 ; , probably by means of a transporter encoded by an MDR gene 19 ; . Two genes, pfmdr1 and pfmdr2, that are homologues of the mammalian MDR genes were cloned from P. falciparum.

Here is a list of some medications that may cause td: acetohenazine tindal ; amoxapine asendin ; chlorpromazine thorazine ; fluphenazine permitil, prolixin ; haloperidol haldol ; loxapine loxitane, daxolin ; mesoridazine serentil ; metaclopramide reglan ; molindone lindone, moban ; perphanzine trilafrom or triavil ; piperacetazine quide ; prochlorperzine compazine, combid ; promazine sparine ; promethazine phenagran ; thiethylperazine torecan ; thioridazine mellaril ; thiothixene navane ; trifluoperazine stelazine ; triflupromazine vesprin ; trimeprazine temaril ; the best thing you can do right now is talk to your doctor about what he she believes caused this. Overdosage Manifestations: Hyperexcitability and abnormal movements which have been reported in children following a single administration of promethazine may be manifestations of relative overdosage, in which case, consideration should be given to the replacement of promethazine by other drugs. General signs and symptoms of overdosage range from mild depression of the central nervous and cardiovascular systems, to profound hypotension, respiratory depression and unconsciousness. Stimulation may be evident, especially in children and geriatric patients. Atropine-like signs and symptoms; dry mouth, fixed dilated pupils, flushing, etc. as well as gastrointestinal symptoms may occur. Treatment: The treatment of overdosage is essentially symptomatic and supportive. Avoid analeptics, which may cause convulsions. Severe hypotension usually responds to the administration of noradrenaline or phenylephrine. Adrenaline should not be used, since its use in a patient with partial adrenergic blockage may further lower the blood pressure. Extrapyramidal reactions may be treated with anticholinergic antiparkinsonism agents, diphenhydramine or barbiturates. Additional measures include oxygen and intravenous fluids. Limited experience with dialysis indicates that it is not helpful. Manufacturer: Rafa Laboratories Ltd., P.O. Box 405, Jerusalem 91003 for CTS Chemical Industries Ltd., Kiryat Malachi LFL 215 11 03 Prothiazine Injection - Physician Package Insert - BACK - 125x345.

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He Fift h International AIDS Vaccine Group ; looked at the safety of adding the Conference met in late August to dis- ALVAC vaccine and IL-2 a cytokine found cuss new developments in the search in the blood that helps boost the immune for both preventive and therapeutic HIV system ; to HAART therapy. vaccines. This vaccine treatment was adminThe conference represents the best istered in volunteers who agreed to go off snapshot of the latest research into HIV of HAART for the period of the study. The vaccines. Held over four days in the Neth- results found that the IL-2 made no differerlands, it unveiled the results of several ence in immunogencity, and was not well early trials of potential therapeutic vaccines. tolerated by some patients. Patients found Therapeutic vaccines, if they are deter- some reduction in viral load during the mined to be safe and effective, are designed trial, but their levels returned to previous to boost the immune response of people liv- levels after the trial was completed. The ing with HIV AIDS PLWHA ; to help them investigators are now considering ways to fight the virus, and to reduce the need for improve immune response. antiretroviral treatment. Results of an AT-2 vaccine being tested Therapeutic vaccines are chief ly in animal studies was also presented. The designed to stimulate the immune system of study design involved administering the PLWHA to create heightened T-cell defens- vaccine to monkeys infected with SIV-239, es capable of destroying infected CD4 and an HIV-like virus, and then removing the other cells where the virus hides and repli- animals from HAART. Although the vaccates. Studies of experimental vaccines look cines were found to be safe, the vaccinated at immunogencity, or the breadth and size monkeys did not achieve the hoped for of the vaccinated person's T-cell response reduction in viral load. to the vaccine. A therapeutic vaccine would Results were also presented from the stimulate T-cells to recognize HIV-infected European Union-funded TheraVac-01 procells. gram, which evaluated safety and immunoA number of safety and immunogenc- gencity of the NYVAC-B vaccine in patients ity studies of new therapeutic vaccines also being successfully treated by HAART. The use vectors being considered for preventive study tested a pox virus vaccine, based on vaccines, such as pox virus vaccines. The technology also used for preventative vaccurrent crop of therapeutic vaccines can cine trials, to induce a T-cell response. The include cytokine therapies to boost T-cell NYVAC-B vaccine showed disappointresponses. The immune responses to the ing immunogencity, but there are plans to approaches presented at the conference are modify the vaccine or dosage to increase weaker than hoped for. immunogencity. Nonetheless, these vaccines may be Finally, there was also a Hungarian establishing important approaches that research team presenting on DermaVir, a might control viral replication with the patch to administer a DNA antigen as a more effective immunization regimens. therapeutic vaccine. The researchers found The potential of therapeutic vaccines will that the patch created potent T-cell responsbe to increase and expand the durability of es, and there were no adverse events reportHAART highly active anti-retroviral ther- ed. Responses from the topical application apy ; regimens, to decrease viral load, and to of DermaVir appeared to provide a better avoid the need for patients to switch drugs. response than injected DNA vaccines. FurResults were presented from a trial of ther studies of DermaVir are planned. ALVAC, a canarypox vector vaccine. The We were pleased to see that the conferALVAC vaccine is now being tested in a ence included reports on a number of early Phase III trial in Thailand among 16, 000 stage therapeutic vaccines in development. HIV-negative men and women. The AACTG Th is year, the program organizers for the A5024 trial Adult AIDS Clinical Trials first time developed an entire session devottpan.

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J0735 J0800 J0880 J0895 J1000 J1020 J1030 J1040 J1051 J1094 J1100 J1190 J1200 J1212 J1245 J1250 J1260 J1335 J1440 J1441 J1450 J1580 J1600 J1626 J1631 J1642 J1644 J1645 J1650 J1655 J1710 J1720 J1745 J1750 J1756 J1885 J1940 J1956 J2001 J2010 J2150 J2260 J2300 J2324 J2353 J2354 J2405 J2430 J2505 J2550 J2680 J2765 J2780 J2820 J2912 J2916 INJECTION, CLONIDINE HYDROCHLORIDE, 1 mg INJECTION, CORTICOTROPIN, 40 UNITS INJECTION, DARBEPOETIN ALFA, 5 MCG INJECTION, DEFEROXAMINE MESYLATE, 500 mg INJECTION, DEPO-ESTRADIOL CYPIONATE, 5 mg INJECTION, METHYLPREDNISOLONE ACETATE, 20 mg INJECTION, METHYLPREDNISOLONE ACETATE, 40 mg INJECTION, METHYLPREDNISOLONE ACETATE, 80 mg INJECTION, MEDROXYPROGESTERONE ACETATE, 50 mg INJECTION, DEXAMETHASONE ACETATE, 1 mg INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1mg INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 mg INJECTION, DIPHENHYDRAMINE HCL, 50 mg INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, ml INJECTION, DIPYRIDAMOLE, PER 10 mg INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 mg INJECTION, DOLASETRON MESYLATE, 10 mg INJECTION, ERTAPENEM SODIUM, 500 mg INJECTION, FILGRASTIM G-CSF ; , 300 MCG INJECTION, FILGRASTIM G-CSF ; , 480 MCG INJECTION FLUCONAZOLE, 200 mg INJECTION, GARAMYCIN, GENTAMICIN, 80 mg INJECTION, GOLD SODIUM THIOMALATE, 50 mg INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG INJECTION, HALOPERIDOL DECANOATE, PER 50 mg INJECTION, HEPARIN SODIUM, HEPARIN LOCK FLUSH ; , PER 10 UNITS INJECTION, HEPARIN SODIUM, PER 1000 UNITS INJECTION, DALTEPARIN SODIUM, PER 2500 IU INJECTION, ENOXAPARIN SODIUM, 10 mg INJECTION, TINZAPARIN SODIUM, 1000 IU INJECTION, HYDROCORTISONE SODIUM PHOSPHATE, 50 mg INJECTION, HYDROCORTISONE SODIUM SUCCINATE, 100 mg INJECTION INFLIXIMAB, 10 mg INJECTION, IRON DEXTRAN, 50 mg INJECTION, IRON SUCROSE, 1 mg INJECTION, KETOROLAC TROMETHAMINE, PER 15 mg INJECTION, FUROSEMIDE, 20 mg INJECTION, LEVOFLOXACIN, 250 mg INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 mg INJECTION, LINCOMYCIN HCL, 300 mg INJECTION, MANNITOL, 25% IN 50 ml INJECTION, MILRINONE LACTATE, 5 mg INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 mg INJECTION, NESIRITIDE, 0.25 mg INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 mg INJECTION, OCTREOTIDE, NON-DEPOT SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 mg INJECTION, PAMIDRONATE DISODIUM, PER 30 mg INJECTION, PEGFILGRASTIM, 6 mg INJECTION, PROMETHAZINE HCL, 50 mg INJECTION, FLUPHENAZINE DECANOATE, 25 mg INJECTION, METOCLOPRAMIDE HCL, 10 mg INJECTION, RANITIDINE HYDROCHLORIDE, 25 mg INJECTION, SARGRAMOSTIM GM-CSF ; , 50 MCG INJECTION, SODIUM CHLORIDE, 0.9%, PER 2 ml INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 mg.

ABSTRACT The recently discovered GABAB receptor-positive allosteric modulators enhanced the potency and efficacy of GABAB receptor agonists in in vitro experiments. These GABAB modulators also attenuated reward and anxiety in behavioral experiments without causing the untoward side effects associated with GABAB receptor activation by agonist administration and hence exhibited potential therapeutic utility. However, the underlying molecular mechanisms enabling the GABAB allosteric modulators to dissociate from the GABAB agonistic side effects remain elusive. To address this question, we have examined the effects of a typical GABAB modulator, 2, 6-di-tert-butyl-4 3-hydroxy-2, ; -phenol CGP7930 ; , on GABAB receptor-mediated modulations of both the excitatory and the delayed inhibitory components of hippocampal CA1 synaptic.

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739 bupivacaine-morphine and bupivacaine-placebo mixtures, the variations in mean arterial pressures were not different5 or were not reported. 6 A respiratory rate of 10 bpm was observed in four patients receiving morphine during the intraoperative period. This was of short duration since in the recovery room no patient had a respiratory rate 10 bpm. Although three patients in the clonidine group presented a sedation score of three during surgery, the difference in sedation scores between groups was not statistically significant. This absence of difference could be attributed to the preoperative administration of meperidine and promethazine currently used in our institution in elderly patients undergoing major surgery under regional anaesthesia.9"11 In our experience, this combination of drugs provides good sedation, reducing the need for intraoperative administration of sedative drugs and allows reliable testing of anaesthesia level during surgery. In conclusion, whereas the addition of 0.15 mg clonidine to 10 mg bupivacaine during continuous spinal anaesthesia produced a local anaesthetic sparing effect during surgery, the addition of 0.15 mg morphine did not influence the quality of surgical analgesia. The combination of bupivacaine-donidine-morphine could be useful in obtaining long lasting spinal anaesthesia as well as postoperative pain relief.

Systemic effects of formoterol and salmeterol: a dose-response comparison in healthy subjects.

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