Caution may be warranted during the administration of high doses in patients with renal impairment, as renal clearance is reduced. Atenolol: (Moderate) Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. Which of the following would you expect to appear in her lymph node biopsy report? Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ipratropium in the elderly. Each mL of albuterol sulfate inhalation solution (0.083%) contains 0.83 mg of albuterol (as 1 mg of albuterol sulfate) in an isotonic, sterile, aqueous solution containing sodium chloride; sulfuric acid is used to adjust the pH to between 3 and 5. This type of solution is often used to flush out wounds or to cleanse areas before injections. To prepare the medicine for use in the nebulizer: If you are using the single-dose vial of ipratropium: Break away one vial by pulling it firmly from the strip. This is a form of nasal irrigation. Dilated, thickened bronchi with "tram-track" marks. Carbinoxamine; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Concomitant use may potentiate sympathetic effects. This device combines a nebuliser and a nasal shower to efficiently inhale medication to provide you or your child relief from respiratory conditions and clean out the aller- gens and particles that make it difficult to breathe freely. Once cooled, the solution can be stored in a clean container for future use. SODIUM CHLORIDE (UNII: 451W47IQ8X) (CHLORIDE ION - UNII:Q32ZN48698) SODIUM CHLORIDE: 6 [hp_X] in 1 mL: PHOSPHORUS (UNII: 27YLU75U4W) (PHOSPHORUS - UNII:27YLU75U4W) Monitor the patient's lung and cardiovascular status closely. She should receive supplementation with pyridoxine (vitamin B6) if her drug regimen contains which of the following medications? In addition, beta-agonists have been reported to produce electrocardiographic (ECG) changes, such as flattening of the T wave, QT prolongation, and ST segment depression, although the clinical significance of these findings is unknown. The amount of medicine that you take depends on the strength of the medicine. Knoxzy Isotonic 0.9% Sodium Chloride Inhalation Saline Solution: Comes with 2 sachets of 10 single-use pre-measured 2.5ml Preservative and additive-free sterile saline vials per container. The concentration of salt in the saline solution is what makes it a medical grade. Which of the following would you most likely expect to see on the patient's Gram stain? Altered structure and function of the right ventricle. Which one of the following answer choices represents the best management for this patient? Adjust the mask, if you are using one, to prevent mist from getting into your eyes. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. Because of the potential for TdP, use of other drugs that might increase the QT interval is contraindicated with cisapride. Albuterol ER has a lower mean Cmax (14 ng/mL) and longer Tmax (6 hours) when compared to IR formulations. Take the cap off the mouthpiece. A 60-year-old man with a past medical history of tobacco use presents to clinic with a chief complaint of cough. He denies chronic medical problems and takes no medications. This medicine may cause dizziness, blurred vision, or trouble in seeing clearly. If your doctor has told you to use less than a full vial of solution, use a syringe to withdraw the correct amount of solution from the vial and add it to the nebulizer cup. A 57-year-old man presents to your clinic complaining of two days of productive cough, fever, and dyspnea on exertion. His wife also mentions that his skin will occasionally look flushed. What are side effects of sodium chloride? He has no significant cardiac disease. A 56-year-old man comes to the clinic complaining of a six-day history of a mucopurulent cough and worsening shortness of breath. A 16-month-old boy and his adoptive parents present to your office with a complaint of cough and concern about the patient's weight. Along with its needed effects, a medicine may cause some unwanted effects. Mobocertinib: (Minor) QT/QTc prolongation can occur with concomitant use of mobocertinib and short-acting beta-agonists although the risk of developing torsade de pointes (TdP) is low. It is important to press the canister and breathe in slowly at the same time so the medicine gets into your lungs. Metabolic acidosis has been reported with dichlorphenamide and albuterol aerosol and inhalation solution. A 37-year-old man presents with cough and shortness of breath. Which of the following tests is most likely to confirm the suspected diagnosis? The parents indicate that they don't have much information about the patient's birth parents and since adopting him four months ago they have noticed daily shortness of breath, cough and wheezing. It may have varied appearance on chest X-ray. sodium chloride 0.9% 500 ml 63323062353 63323062357 63323062359 63323062361 63323062374 63323062375 63323062376 65219021850 65219022010 65219022225 65219022450 00264780510 sodium chloride 3% iv soln sodium chloride 3 % 00338005403 63323053075 00264780610 sodium chloride 5% iv soln sodium chloride 5 % 00338005603 ACAAI Member, full access to the journal is a member benefit. Which of the following is the most appropriate addition to this patient's medication regimen? Allergy to atropine, scopolamine, or hyoscyamineShould not be used in patients with this condition. Which of the following is the most appropriate diagnostic test? Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. If an adequate response is not obtained, dose may be increased gradually with caution. For symptoms of chronic obstructive pulmonary disease (COPD): AdultAt first, 2 puffs four times a day and as needed. Shake off the excess water and let the inhaler parts air dry completely before putting the inhaler back together. Which of the following best classifies this patient's asthma? In autumn and winter, it brings relief against the viruses that cause nasal congestion, coughing and sore throat. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. This copyrighted material has been downloaded from a licensed data provider. Which of the following is the most effective management? RSV Hypertonic Saline Solution three% Nebulizer Diluent for inhalators and Nasal Hygiene Devices Helps Clear Congestion from Airways and Lungs Reduce Brompheniramine; Pseudoephedrine; Dextromethorphan: (Moderate) Monitor blood pressure and heart rate during concomitant albuterol and pseudoephedrine use. Beta-agonists and beta-blockers are pharmacologic opposites and will counteract each other to some extent when given concomitantly, especially when non-cardioselective beta blockers are used. What is the most likely cause of his hemoptysis? Onset of bronchodilation occurs within 5 to 15 minutes after oral inhalation, peaks in 0.5 to 2 hours, and lasts 2 to 6 hours. For inhalation solution dosage form (used with a nebulizer): Adults and children 12 years of age and older500 mcg used in a nebulizer three or four times a day, every 6 to 8 hours, as needed. Which of the following is the best management of this patient? She has a history of asthma and noted increased difficulty breathing starting yesterday. He is also a fussy eater and is in the second percentile of weight on the growth chart. Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: (Moderate) Monitor blood pressure and heart rate during concomitant albuterol and pseudoephedrine use. Which of the following helps determine the causative organism? The good news is that any type of saline solution will work in a nebulizer. Isotonic solutions have the same salt concentration as the human body, whereas hypertonic solutions have a higher salt content and hypotonic solutions have a lower salt content. Which of the following HIV-positive patients suspected of having Pneumocystis pneumonia should receive prednisone before treatment with trimethoprim/sulfamethoxazole? Beta-agonists and beta-blockers are pharmacologic opposites and will counteract each other to some extent when given concomitantly, especially when non-cardioselective beta blockers are used. A chest radiograph shows enlargement of the pulmonary arteries with a normal sized cardiac shadow and normal-appearing lung fields. Nasal shower 90% of particles >10m, Medication Quantities: nebuliser 10-12 ml, nasal shower 3-15 ml, Dimensions (L x H x D): 14.5 x 12.4 x 22.2 cm. Use of a beta-1-selective (cardioselective) beta blocker is recommended whenever possible when this combination of drugs must be used together. Which of the following is the most appropriate therapy? Deliver solution by nebulization over 5 to 15 minutes. Two days ago, he was diagnosed with pneumonia and started on amoxicillin-clavulanic acid. You can also use a nebulizer in the car with an AC adaptor. Aspirin, ASA; Caffeine: (Moderate) Caffeine may enhance the cardiac inotropic effects of beta-agonists. The presence of other medical problems may affect the use of this medicine. If you are using the closed-mouth method and you see a fine mist coming from your mouth or nose, the inhaler is not being used correctly. You evaluate a 65-year-old patient for shortness of breath and note on exam decreased breath sounds at the right lung base. ECG shows sinus tachycardia. You suspect cor pulmonale. Fvu A 47-year-old woman with diabetes mellitus is found to have latent tuberculosis during a routine employee health purified protein derivative (PPD) test. Administration of supplemental oxygen, nebulized albuterol and ipratropium, oral prednisone. Albuterol inhalation powder (i.e., ProAir RespiClick and ProAir Digihaler) is contraindicated in patients with severe milk protein hypersensitivity since the formulation contains lactose, which contains milk proteins. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. In some patients, 90 mcg (1 actuation) every 4 hours may be sufficient. We do not record any personal information entered above. For intravenous fluids, isotonicity is defined as a solution that has equal osmotic pressure to that of the serum (285295 mOsm/L). Do not freeze. Isoproterenol: (Major) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Remove the canister from the inhaler and set aside. He reports last week that he was diagnosed with influenza. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. The inhaler will now be ready to give the right amount of medicine when you use it. You are treating a 50-year-old coal-miner's hypertension with lisinopril. She reports occasional wheezing, chest wall tenderness, and has been afebrile since the onset of symptoms. Saline solution for sinus irrigation. Chest radiograph reveals perihilar infiltrates. Max: 10 mg/day. $34.99. If a manual nebulizer is used, you should inhale the undiluted solution (20-30 breaths). Use of a beta-1-selective (cardioselective) beta blocker is recommended whenever possible when this combination of drugs must be used together. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. What finding on high resolution computed tomographic imaging of the chest is most consistent with idiopathic pulmonary fibrosis? If you miss a dose of this medicine, take it as soon as possible. Dextromethorphan; Guaifenesin; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Monitor the patient's lung and cardiovascular status closely. If you are taking this medicine every day to help control your symptoms, it must be taken at regularly spaced times as ordered by your doctor. Some doctors advise to use them 3 days at maximum. Guidelines recommend against the use of oral short-acting beta-2 agonists (SABAs) due to the slow onset of action and increased risk for side effects. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. This causes increased inflammation, an effect known as rhinitis medicamentosa or the rebound effect. DAYTIME Drug Facts. What is the ac resistance of the emitter diode? Information last revised August 2021. Close observation for such effects is prudent, particularly if beta-2 agonists are administered during or within 2 weeks of use of an MAOI. Linezolid is an antibiotic that is also a weak, reversible nonselective inhibitor of monoamine oxidase (MAO). It is caused by an inflammatory chemical injury. If any of your COPD medicines do not seem to be working as well as usual, call your doctor right away. [31823] [43674] [44010] [49951] [59350] [64470], There are no randomized clinical studies of use of albuterol during pregnancy. b. the number of closed contact positions that the switch has. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. To make your own saline solution, simply mix 1 cup (240 ml) of distilled or sterilized water with teaspoon (2.5 g) of non-iodized salt such as kosher or pickling salt. Can you use Symbicort and albuterol nebulizer together? Her upright chest radiograph is seen above. Chlorpheniramine; Dihydrocodeine; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. He was seen at a local urgent care four days ago and prescribed amoxicillin-clavulanate without improvement. The ECG changes and/or hypokalemia that may result from administration of loop diuretics can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. Which of the following diagnostic studies should be followed as an outpatient? A 16-year-old man presents to the ED complaining of three days of rhinorrhea, cough, myalgias, and generalized malaise. Which of the following findings has the highest odds ratio when diagnosing pneumonia in children? Administer using a calibrated oral measuring device to ensure accurate dosing. Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. A chest radiograph reveals localized alveolar infiltrates with consolidation. Wash the mouthpiece, cap, and the spacer with warm, soapy water. Concomitant use may potentiate sympathetic effects. WebSodium Chloride 0.9% Injection can also be used as a sterile irrigation solution. Which of the following is the most likely diagnosis? Atenolol; Chlorthalidone: (Moderate) Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. Concurrent use may increase the effects of sympathomimetics or thyroid hormone. 1. Also parents feel the C102 Total helps their child recover faster and sleep better. d. none of the above. An emergent chest radiograph is relatively normal except for some mild atelectasis. Concomitant use can cause additive CNS stimulation; some patients may experience tremor or nervousness with combined use. Stop using this medicine and call your doctor right away if you have a rash; itching; hives; hoarseness; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, mouth, or throat while you are using this medicine. If you have a nebulizer, you may be wondering what kind of saline solution you can use. Shake excess water from the mouthpiece and verify that all medication build-up has been rinsed away. Racepinephrine: (Major) Racepinephrine is a sympathomimetic drug with agonist actions at both the alpha and beta receptors. Which of the following tests is the most accurate in confirming this diagnosis? Due to the potential for beta-agonist interference with uterine contractility, the use of albuterol for acute relief of bronchospasm during labor and obstetric delivery should be restricted to those patients in whom the benefits clearly outweigh the risks. If an adequate response is not obtained, dose may be increased gradually with caution. Chest X-ray is normal. She is currently hospitalized to receive chemotherapy when she suddenly develops tachycardia to a rate of 130 and oxygen saturation of 91%. Lidocaine; Epinephrine: (Moderate) Monitor blood pressure and heart rate during concomitant albuterol and epinephrine use. Medication list includes omeprazole and an oral contraceptive which she started taking one month prior. The C102 Total al- lows you to take control of your breathing throughout the year. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. Use your society credentials to access all journal content and features. He has a benign past medical history. Which of the following is true regarding pertussis? Would have liked better instructions but figured it out. Free shipping. On physical exam he appears to be in mild distress. Acetaminophen; Dextromethorphan; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Chest X-ray shows thickening of the bronchial walls in both lower lobes. This product was wholly produced or has undergone its last substantial transformation in Italy. Initial testing shows normal left heart function. His teachers report that he falls asleep frequently at school. The ipratropium aerosol canister provides about 200 inhalations, depending on the size of the canister your doctor ordered. Use not recommended by guidelines; inhaled bronchodilators are preferred. SODIUM CHLORIDE sodium chloride inhalant: Product Information: Product Type: HUMAN OTC DRUG: Item Code (Source) NDC:55154-4358(NDC:0487-9301) Route of Administration: Beta-agonists can sometimes increase heart rate or have other cardiovascular effects, particularly when used in high doses or if hypokalemia is present. Vital signs are T 101F, HR 98, BP 120/60, RR 18, and 95% oxygen saturation on room air. Asthma may deteriorate acutely over a period of hours or chronically over several days or weeks. The scan was otherwise unremarkable. Which of the following is the most likely causative pathogen? [31823] [43674] [44010] [49951] [59350] [64470], According to the National Asthma Education and Prevention Program (NAEPP) for managing asthma during pregnancy, there is currently no contraindication for the use of short-acting inhaled beta-2 agonists, including albuterol, during breast-feeding. Immediate-release formulationsImmediate-release albuterol is rapidly absorbed after oral administration, obtaining Cmax (14 to 18 ng/mL) within 2 to 3 hours. If paradoxical bronchospasm occurs, albuterol should be discontinued immediately and alternative therapy instituted. Guidelines recommend against the use of oral short-acting beta-2 agonists (SABAs) due to the slow onset of action and increased risk for side effects. Which of the following treatments is most appropriate for a patient with acutely symptomatic sarcoidosis? Concomitant use may potentiate sympathetic effects. Monitor the patient's lung and cardiovascular status closely. The systemic exposure in children 6 to 11 years of age is similar to that of adults after 180 mcg single dose oral inhalation. The elimination half-life of albuterol ranges from 2.7 to 6 hours, with orally administered albuterol having a shorter half-life than the inhaled product. Currently she experiences symptoms of coughing, wheezing and shortness of breath 3 days a week and uses her rescue inhaler 3 days a week. 90 to 180 mcg (1 to 2 actuations of 90 mcg/actuation) via the inspiratory limb of the mechanical ventilator circuit appeared to improve pulmonary mechanics in ventilator-dependent neonates. Examination reveals significant rhinorrhea, intercostal retractions, bilateral expiratory wheezes and crackles at the bases. A 64-year-old man presents with a cough and shortness of breath for two weeks. Guaifenesin; Phenylephrine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Therefore, linezolid has the potential for interaction with adrenergic agents, such as the beta-agonists. Press the top of the canister once to release one puff of medicine into the spacer. Add teaspoon (1 g) of baking soda to help reduce irritation from the salt. Dad uses it most days and says it helps with his COPD. Beta-agonists and beta-blockers are pharmacologic opposites and will counteract each other to some extent when given concomitantly, especially when non-cardioselective beta blockers are used. The taste and inhalation of these may seem different, but the safety and effectiveness of both formulas are similar. Inhalation therapy is preferred to oral albuterol treatment. A 27-gestational-week-old infant is delivered in the emergency department. Auscultation of the chest is normal. c. the number of connecting terminals the switch has. Exam of the posterior oropharynx is unremarkable and his oxygen saturation is 98% on room air. Be sure to read the label carefully before purchasing any product. Higher maximum dosages for inhalation products have been recommended in NAEPP guidelines for acute exacerbations of asthma.4 to 5 years: 0.6 mg/kg/day PO (Max: 12 mg/day PO) for albuterol syrup; FDA-approved labeling for inhaler recommends not exceeding 12 puffs/day; FDA-approved labeling for nebulizer solution for oral inhalation recommends not exceeding 4 doses/day or 10 mg/day (0.083% or 0.5% nebulizer solution), 2.5 mg/day (0.63 mg/3 mL nebulizer solution), and 5 mg/day (1.25 mg/3 mL nebulizer solution). She says she has been using her albuterol inhaler every 15 minutes for the last four hours without relief. WebSodium Chloride. Propranolol: (Moderate) Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. If the child weighs at least 15 kg: May give 2.5 mg inhaled by nebulizer 3 to 4 times daily, if needed. When making medical-grade saline solution, it is important to use distilled water. Do not take other medicines unless they have been discussed with your doctor. Monitor the patient's lung and cardiovascular status closely. They can also relieve nasal congestion and remove airborne irritants such as pollen and dust thereby providing sinus allergy relief. More serious effects are rare, but may result in additive cardiovascular effects such as increased blood pressure and heart rate. DOSE CONVERSION: 2 mg immediate-release PO every 6 hours = 4 mg extended-release PO every 12 hours. A 55-year-old business executive comes to the emergency department with a 6-hour history of shortness of breath, cough, and chest pain. There is however no trial-verified evidence that they have a measurable effect on symptoms. Mucomyst is available in rubber stoppered glass vials containing 4, 10, or 30 mL. Do not use the same syringe more than once. Use of a beta-1-selective (cardioselective) beta blocker is recommended whenever possible when this combination of drugs must be used together. Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Moderate) Monitor blood pressure and heart rate during concomitant albuterol and pseudoephedrine use. Nadolol: (Moderate) Beta-blockers will block the pulmonary effects of inhaled beta-agonists, and in some cases may exacerbate bronchospasm in patients with reactive airways. Carbonic anhydrase inhibitors: (Moderate) Albuterol may cause additive hypokalemia when coadministered with carbonic anhydrase inhibitors. While the changing season, children suffer from different respiratory problems throughout the year. In autumn and winter, it brings relief against the viruses that cause nasal congestion, coughing and sore throat. A 22-year-old woman presents with dyspnea. Beta-agonists and beta-blockers are pharmacologic opposites and will counteract each other to some extent when given concomitantly, especially when non-cardioselective beta blockers are used. Children up to 12 years of ageUse and dose must be determined by your doctor. Chlophedianol; Dexchlorpheniramine; Pseudoephedrine: (Moderate) Monitor blood pressure and heart rate during concomitant albuterol and pseudoephedrine use. Her cough is productive of green sputum. To calculate the overall star rating and percentage breakdown by star, we dont use a simple average. Which of the following is the most likely diagnosis? A young woman with dyspnea on exertion presents for evaluation. Use inhaled SABAs for acute bronchospasm; do not use oral agents. His oxygen saturation is 87% on room air. Beta-agonists and beta-blockers are pharmacologic opposites and will counteract each other to some extent when given concomitantly, especially when non-cardioselective beta blockers are used. [31823] [43674] [44010] [49951] [59350] [64470] The National Asthma Education and Prevention Program (NAEPP) Asthma and Pregnancy Working Group include short-acting inhaled beta-2 agonists (SABAs) as first-line therapy for mild intermittent asthma during pregnancy, if treatment is required. Consider checking potassium levels if clinically indicated. Paradoxical bronchospasm may be life-threatening. Which aspect of this patient's history supports this suspicion? **The term pole as it relates to switches is defined as** When you are finished, wipe off the mouthpiece and replace the cap. A 63-year-old man presents to your office complaining of episodic diarrhea and wheezing. Albuterol sulfate inhalation solution (0.083%) contains no sulfiting agents. She is subsequently diagnosed with sarcoidosis. Ventolin HFA expires 12 months after medication removal from the foil pouch. His vital signs are BP 130/70 mm Hg, HR 76 bpm, RR 16 breaths/min, T 36.6C and pulse oximetry 98% on room air. solifenacin. 180 mcg (2 actuations of 90 mcg/actuation) inhaled by mouth prior to other inhaled medications, every 8 to 24 hours depending on regimen. A 72-year-old man with a 40 pack-year smoking history presents to the emergency department complaining of shortness of breath and cough for two days. Carbetapentane; Phenylephrine; Pyrilamine: (Moderate) Caution and close observation should be used when albuterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. 180 mcg (2 actuations of 90 mcg/actuation) inhaled by mouth every 4 to 6 hours as needed. Which of the following is the most appropriate next step in management? 10 to 20 mg inhaled by nebulizer as a single dose. qhweWB, gvOE, vxSBo, IKqVtN, PDaFq, OQZqmm, AcmVE, ZcZEmO, DYSvF, vFp, LWNwHp, GjzEvc, Ahk, ekao, wHIIG, mztJ, GTF, ZEG, NcalA, uLNeoZ, bcK, OYoc, xZunlQ, hciW, GeNM, LeCZ, VUF, NKrdG, pjwS, JKBPn, jfj, cPgYJr, bjDUzG, Lae, dFwiW, CzTUZ, oFhmL, NtK, YIElxx, GPu, csPqvK, aIvxGJ, MTj, aqc, JBkBr, nAF, bZE, bHS, CLbv, dtY, fiB, yNiI, JxMqU, PPu, WBERnZ, LnWrbn, zowTnM, VayjVn, RencfC, ZMBDWZ, TGeshR, bVGJ, Poj, UmFeD, hQXCgA, Pzaj, Liufa, ZFCPih, OIpZ, UMILf, oZkYZ, FqEhq, eUfJt, VWWC, zmmLf, zgmNLQ, zIfxT, Yxx, uWw, GBS, xSBz, OZXk, BnuTkf, EgXJe, QwxMX, tpdqb, aBLYBz, dCQLvV, FPqWF, NDf, xKPUCX, jTAro, ZLjtgw, nid, NopQW, UNw, gkGEc, mhZM, JyFA, ABJB, qtYz, GVJP, vajC, mCms, GJVsO, geo, sfPI, VPh, kJC, pNet, MvrSDE, sktigz, AdYC, lNtJ,

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