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Albuterol C & T
- Sympathomimetic/Bronchodilator
- Proventil/Ventolin
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Albuterol Desc is....
- Bronchodilator w/ less cardiac effect than epi
- Reduces mucus secretions, pulmonary capillary leaking & edema in lungs in allergic reaction
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Albuterol Indications are....
- Bronchospasm
- Asthma in COPD
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Albuterol Contraindications are. . . .
Hypersensitivity
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Albuterol Precautions are (6). . . .
- Tachycardia
- Anxiety
- Nausea
- Cough
- Wheezing
- Dizziness
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Albuterol Dosage is . . . .
2.5mg in 2.5 - 3 mL NS via neb
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What is the C & T for Fentanyl?
- Narcotic Analgesic
- Sublimaze
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Describe Fentanyl. . .
Rapid & short acting synthetic narcotic analgesic
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What are indications for fentanyl?
Sedation for intubation
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What are the contraindications for Fentanyl (2)?
- MAO inhibitors
- Myasthenia Gravis
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What are the precautions for fentanyl (6)?
- ^ ICP
- Elderly
- Debilitated
- COPD
- Resp probs
- Hepatic or renal insufficiency
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What are the dosages for fentanyl?
25-50 mcg slowly IV
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What is the C & T for Ipratropium?
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Describe Ipratropium. . .
- Bronchodilator used in treatment of resp emerg
- Causes bronchial dilation & dries resp tract secretions
- Blocks ACh receptors
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What are the indications for Ipratropium (3)?
- Bronchospasm fr asthma
- COPD
- Inhaled irritants
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When is Ipratropium contraindicated?
As primary treatment
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What are 3 precautions for Ipratropium?
- Elderly
- Cardiovascular Disease
- HTN
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What is the dosage for Ipratropium?
500 mcg in 2.5 - 3 mL NS via neb
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The C & T for morphine is ___ ____ & ____.
- Narcotic Analgesic
- Morphine
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Morphine is described as . . .
A potent analgesic & sedative causing some vasodilation, reducing venous return & myocardial O2 demand
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The 3 indications for morphine are ____, ____ & ____ ____.
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Give 6 contraindications for morphine. . . .
- Head of abd inj
- Hypotension or vol depletion
- Acute bronchiole asthma
- COPD
- Severe Resp Depression
- Pulmonary edema fr chem inhalation
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What are the 4 precautions for morphine?
- Elderly
- Children
- Debilitated pts
- Keep Narcan handy
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What are the dosages for morphine?
- Pain = 2.5 -15 mg IV; 5 - 20 mg IM/SC
- AMI or PE = 1 - 2 mg / 6 - 10 mins
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The C & T for naloxone are ____ & ____.
- Narcotic Antagonist
- Narcan
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Naloxone is described as a. . .
Narc antagonist that blocks effects of natural & synthetic narcs & may rev resp depress
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Indications for Naloxone are ____ & ____.
- Narc OD
- Coma of unknown origin
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The contraindication for Naloxone is ____.
non-narc induced resp depression
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The 2 precautions for naloxone are ____ & ____.
- Possible dependancy
- Short half life
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The dosage of naloxone is ____.
0.4 - 2 mg IV/IM repeated 2 -3 mins as needed up to 10 mg
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The C of Diazepam is ____ & is T name is ____.
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Diazepam is described as . . . .
Benzo sedative & skeletal muscle relaxant that reduces tremors, induces amnesia & reduces recurrence of seizures. It relaxes muscles in ortho inj & produces amnesia for painful procedures
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The 5 indications for Diazepam are:
- Motor seizures
- Status epilepticus
- Premed for cardioversion
- Muscle tremors due to inj
- Acute anxiety
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The 6 contraindications for Diazepam are:
- Shock
- Coma
- Acute alcoholism
- Depressed vitals
- OB pts
- Neonates
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The 5 precautions for Diazepam are:
- Psychosis
- Depression
- Myasthenia Gravis
- COPD
- Short Half life causes seizure to return
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The Seizure dose for diazepam is ____.
5 -10 mg IV/IM
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The diazepam dose for anxiety is ____.
2 - 5 mg IV/IM
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The diazepam dose for the purpose of premed is ____.
5 - 15 mg IV
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The C for flumazenil is ____ & the T is ____.
- Benzo Antagonist
- Romazicon
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Flumazenil is described as . . .
Benzo antagonist used to rev sedative, recall & psychomotor effects of benzo's
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Flumazenil is indicated for ____.
resp depress secondary to benzo's
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Flumazenil is contraindicated for?
- Pt's who take for status epilepticus or seizures
- Seizure-prone pts during labor & delivery
- Tricyclic anti-depressant OD
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The 7 precautions assoc w/ Flumazenil are what?
- Hepatic impairment
- Elderly
- Pregnancy
- Nursing mothers
- Head inj
- Alcohol/drug dependancy
- Benzo dependancy
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Flumazenil is dosed @ ____.
0.2 mg IV over 30 -60 secs; up to 1mg
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Succinylcholine C is ____ & it T name is ____.
- Depolarizing Neuro-muscular blocker
- Anectine
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Succinylcholine is described as ________.
ultra short acting depolarizing neuro muscular blocker
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The indication for succinylcholine is ____.
ET intubation
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The 3 contraindications assoc w/ succinylcholine are what?
- Fam Hx of malignant hyperthermia
- Penetrating eye in
- Narrow angle glaucoma
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Precautions for succinylcholine are ____ & ____.
- Severe burn or crush inj
- Spinal cord inj
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Succinylcholine is dosed @ ____.
1 - 1.5 mg/kg IV/IM
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Atropine is described as a . . . .
- Parasympathetic NS blocker
- Blocks vagal effects on the heart
- ^ myocardial O2 demand
- Decreases airway secretions
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Atropine is indicated for what 3 things?
- Hemodynamically significant bradycardia
- Bradyasystolic arrest
- Organophosphate poisoning
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Atropine is contraindicated for what in the emergency setting?
Nothing
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Precautions for atropine include ____ & ____.
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For symptomatic bradycardia atropine is dosed @ ____.
0.5 mg IV/1 mg ET. Repeat 3 - 5 mins to 3 mg
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For asystole atropine is dosed @ ____.
1 mg IV or 2 mg ET repeated 3 - 5 mins to 3 mg
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For organophosphate poisoning atropine is dosed @ ____.
2 - 5 mg IV/IM/IO 10 - 15 mins
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Epinephrine is classed as a ____. Trade name is ____.
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Epinephrine is described as a . . .
Naturally occurring catecholamine that ^ HR, cardiac contractile force, myocardial elec activity, sys vascular resis & systolic BP. It decreases airway resistance & automaticity. Reduces pulmonary congestion & ^ tidal vol & vital capacity
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Epi is indicated for ____ & ____.
- Cardiac Arrest
- Allergic reaction
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Epi is contraindicated for what 3 things?
- Narrow angle glaucoma
- Hemorrhagic, cardiac or traumatic shock
- During labor
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Are there any precautions for epi? If so what are they?
There are none
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Epi is dosed @ _____ for cardiac arrest.
1 mg 1:10,000 IV/ 3 - 5 mins (2 - 2.5 mg 1:1000 ET)
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For an allergic reaction, I would give epi in the dosage of _____.
- 0.3 - 0.5 mg of 1:1000 SC 5 - 15 mins as needed
- 0.5 - 1 mg of 1:10,000 if SC ineffective
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My pt w/ esophageal varices is going to receive _____ or ____ (T- name) in the dose of ____ in order to try to ctrl the bleeding.
- Vasopressin or Pitressin
- 0.2 - 0.4 units/min IV drip
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Vasopressin is classed as a ____/____ & is dosed @ 40 units IV when given for ____ ____.
- Hormone / Vasopressor
- Cardiac Arrest
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Vasopressin is described as a . . . .
Hormone w/ strong vasopressive & antidiuretic properties but that may precipitate angina or AMI
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I cant give vasopressin to pt's who are in _____ or showing ____ on the monitor.
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The 8 precautions associated w/ vasopressin are:
- Epilepsy
- Migraine
- Heart Failure
- Angina
- Vascular disease
- Hepatic Impairment
- Elderly
- Children
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My pt has CHF. I am going to give ____ or ____in the dosage of ____ b/c it is a ____.
- Furosemide
- 40 - 120 mg slow IV
- Diuretic
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My pt w/ pulmonary edema is going to get 40 - 120 mg of _____ unless they are in a state of _____, pregnant or are in _____ _____.
- Furosemide
- Fluid or electrolyte depletion
- Hepatic coma
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Furosemide or lasix is described as . . .
A rapid acting, potent diuretic & anti HTN that inhibits Na reabsorption by kidneys. Vasodilating effects reduce venous return & cardiac workload
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The 7 precautions for Lasix are . . . .
- Infants
- Elderly
- Hepatic impairment
- Nephrotic syndrome
- Cardiogenic shock assoc w/ AMI
- Gout
- Pts receiving digitalis or K depleting steroids
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My pt is bradycardic & atropine didn't work. What drug is used refrac to atropine when pacing isn't available? How is it dosed?
- Isoproterenol
- 2 - 10 mcg/min titrated to cardiac rate
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I cannot use isoproterenol if my pt is in ____ ____.
Cardiogenic shock
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Isoproterenol's C/T are? It is described as what?
- Sympathomimetic / Isuprel
- Synthetic sympathomimetic that ^ cardiac output by ^ inotropy & chronotropy
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I am cautioned about using isoproterenol when my pt has what?
- Tachydysrhythmias
- Rhythms assoc w/ digitalis or AMI
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Caine drugs (ie lidocaine) are used for "__"
V's - V-tach, V-fib
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My cardiac arrest pt who I want to give lidocaine to is going to get it dosed @ ____ & then a ____ aft conversion.
- 1 - 1.5 mg/kg IV repeated 3 - 5 min up to 3 mg/kg
- Drip of 2 - 4 mg/min
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My V-tach pt who has a pulse is going to get Xylocaine (aka ____) dosed @ ____ until conversion. Aft conversion I will start a drip of?
- Lidocaine
- 1 - 1.5 mg/kg slow IV repeated 1/2 dose 5 - 10 min till conversion
- Infusion of 2-4 mg/min
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Lidocaine (aka ____) is an ____ that ________.
- Xylocaine
- Antidysrhythmic that suppresses automaticity & ^ stimulation threshold of ventricles. Causes sedation, anticonvulsant & analgesic effects
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Lidocaine is contraindicated for ____, ____, ____ & ____.
- Superventricular dysrhythmias
- Stokes-Adams syndrome
- 2nd & 3rd degree Heart Block
- Bradycardias
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I am cautioned using Lido if my pt has something fr this list (8).
- Hepatic or renal impairment
- CHF
- Hypoxia
- Resp depression
- Hypovolemia
- Myasthenia Gravis
- Shock
- Elderly
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Procainamide (aka ____) is an ____ that ____.
- Pronestyl
- Antiarrhythmic that prolongs ventricular repolarization, slows dromotropy & decreases myocardial excitability
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I am giving procainmide to my pt that is in ____ or pulseless ____ & is refrac to ____.
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Procainamide is contraindicated for my pt who has ____ or ____.
- Myasthenia Gravis
- 2nd, 3rd degree heart block
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I am cautioned about procainamide if my pt has any of the following:
- Hypotension
- Cardiac enlargement
- CHF
- AMI
- Ventricular dysrhythmia fr digitalis
- Hepatic or renal impairment
- Bronchial Asthma
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For my v-fib or pulseless v-tach pt procainamide is dosed @ ____ w/ what stop points?
- 20-30mg/min IV drip
- (1) Up to 17 mg/kg to effect, then 1-4 mg/min (2) Ectopy resolves (3)QRS complex widens more than 50% fr original (4) Hypotension ensues
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Diltiazem (aka ____) is a ____ that is similar to verapamil & also . . .
- Cardizem
- CCB that also dilates coronary & peripheral arteries & arterioles ^ circulation to heart & reducing peripheral vascular resis
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I am giving diltiazem to my pt w/ ____ & ____.
- Superventricular Tachydysrhythmias (A-fib, A-flutter, PSVT refrac to adenosine)
- To ^ coronary artery perfusion in angina
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I am giving my pt w/ a superventricular tachydysrhythmia Cardizem in a dosage of _____. I may repeat as needed w/ ____.
- 0.25 mg/kg IV over 2 min
- 0.35 mg/kg followed by drip of 5-10 mg/hr not exceeding 15 mg/hr over 24 hrs
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Diltiazem is contraindicated if my pt has any of these 6 things
- Sick Sinus Syndrome
- 2nd, 3rd degree heart block
- Systolic <90
- Diastolic <60
- Wide complex Tachycardia
- WPW
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I am cautioned about using cardizem if my pt has ____, especially w/ ____.
CHF especially w/ beta blockers
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Lisinipril C & T
- HTN, ACE inhibitor
- Prinivil
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Cymbalta C
Antidepressant SSRNI
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Percocet C
Synthitic Opiod Analgesic
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Zoloft C & T
- Antidepressant
- Sertraline Hydrochloride
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Wellbutrin C
Antidepressant
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Toprol XL C & T
- HTN Beta Blocker
- Metoprolol
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Diovan C & T
- HTN Angiotensin Antagonist
- Valsartan
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Albuterol C & T
- Beta 2 bronchodilator
- Proventil
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Zocor C & T
- Lipid Lowering Agent
- Simvastatin
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Levaquin C
Anti-bacterial
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Cipro C
Antimicrobial Agent
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Celebrex C
NSAID COX 2 inhibitor
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What is referenced in the Rolling Stones tune Mother's Little Helper?
Valium
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What Rx drug is used for anthrax?
Cipro
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What is the mechanism for Lidocaine?
- Suppresses Automaticity
- Raises Ventricular Threshold
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What movie made Epi famous?
Pulp Fiction
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What receptor sites does Isoproterenol hit?
Beta 1 receptors
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Why does vasopressin precipitate AMI?
B/c it causes vessel constriction raise BP
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What are the symptoms of Lidocaine OD?
Seizure &/or stupor
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What receptor sites does Epi hit?
Adrenergic receptors
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Atropine is a ____ & its trade name is ____.
- parasympatholytic
- Atropine
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