Term
| Thyroid Replacement 'Levothyroxine' Mechanism of Action |
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Definition
| Replaces thyroid hormone (T3 and T4) |
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Term
| Thyroid Replacement 'Levothyroxine' Indications |
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Definition
| Hypothyroidism of any etiology |
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Term
| Thyroid Replacement 'Levothyroxine' Contraindications |
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Definition
| Thyrotoxicosis; Caution in MI |
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Term
| Thyroid Replacement 'Levothyroxine' Serious Adverse Effects |
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Definition
| Acute overdose causes thyrotoxicosis: tachycardia, angina, tremor, nervousness, insomnia, hyperthermia, heat intolerance, sweating |
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Term
| Thyroid Replacement 'Levothyroxine' Common Adverse Effects |
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Definition
| Chronic overdosage associated with accelerated bone loss and development of atrial fibrillation |
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Term
| Thyroid Replacement 'Levothyroxine' Preadministration assessment |
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Definition
| S/S of hypothyroid (not enough replacement) or hyperthyroid (too much replacement); Note: full effects |
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Term
| Thyroid Replacement 'Levothyroxine' Key Patient Education |
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Definition
| Single daily dose 30 minutes before breakfast; Wear medical alert; Caution if switching brands |
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Term
| Thyroid Replacement 'Levothyroxine' Notes |
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Definition
| Significant drug interactions: Can intensify effects of warfarin; Some drugs interfere with absorption- dose should be separated by four hours |
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Term
| Antithyroid 'Methimazole' Mechanism of action |
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Definition
| Inhibition of thyroid hormone synthesis |
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Term
| Antithyroid 'Methimazole' Indications |
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Definition
| Treat hyperthyroid (Grave's diagnosis); Adjunct to radiation therapy; Suppress thyroid hormone preoperatively; Thyrotoxicosis |
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Term
| Antithyroid 'Methimazole' Contraindications |
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Definition
| Hypersensitivity; Pregnancy, Breastfeeding |
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Term
| Antithyroid 'Methimazole' Serious Adverse Effects |
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Definition
| Agranulocytosis; Hepatotoxicity; Hypoprothrombinemia leading to bleeding |
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Term
| Antithyroid 'Methimazole' Common Adverse Effects |
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Definition
| Hypothyroidism; Skin rash; Hair loss |
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Term
| Antithyroid 'Methimazole' Preadministration Assessment |
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Definition
| S/S of hyperthyroid; TSH and T4 levels |
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Term
| Antithyroid 'Methimazole' Monitoring |
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Definition
| Indications of decreasing thyroid levels- weight gain, reduction in resting heart rate; PT-INR especially prior to surgery |
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Term
| Antithyroid 'Methimazole' Key Patient Education |
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Definition
| Report fever and sore throat (early sign of agranulocytosis); Inform provider prior to any procedure |
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Term
| Glucocorticoid Replacement 'Hydrocortisone' Mechanism of Action |
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Definition
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Term
| Glucocorticoid Replacement 'Hydrocortisone' Indications |
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Definition
| Replacement therapy in adrenocorticol insufficiency |
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Term
| Glucocorticoid Replacement 'Hydrocortisone' Contraindications |
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Definition
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Term
| Glucocorticoid Replacement 'Hydrocortisone' Serious Adverse Effects |
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Definition
| None when given in replacement level doses |
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Term
| Glucocorticoid Replacement 'Hydrocortisone' Common Adverse Effects |
|
Definition
| None when given in replacement level doses |
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Term
| Glucocorticoid Replacement 'Hydrocortisone' Preadministration Assessment |
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Definition
| S/S of adrenal hormone insufficiency |
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Term
| Glucocorticoid Replacement 'Hydrocortisone' Monitoring |
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Definition
| Improvement in symptoms; Electrolyte and glucocorticoid levels; Signs of Cushing's syndrome (if dosage too large) |
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Term
| Glucocorticoid Replacement 'Hydrocortisone' Key Patient Education |
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Definition
| Follow dosing- often 2/3 of TDD in AM, rest at bedtime; Dosage must be increased in times of physiologic stress; Carry an emergency supply; Wear identification to inform emergency medical personnel of glucocorticoid requirements |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Mechanism of Action |
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Definition
| Inhibit synthesis of chemical mediators, suppress infiltration of phagocytes, suppress proliferation of lymphocytes |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Indications |
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Definition
| Anti-inflammatory; Allergy/Asthma; Neoplasms; Immunosuppression |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Contraindications |
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Definition
| Systemic fungal infections; Live virus vaccines |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Serious Adverse Effects |
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Definition
| Severity of adverse effects is dose related |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Common Adverse Effects |
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Definition
| Adrenal insufficiency; Osteoporosis; Infection; Glucose intolerance; Myopathy; Fluid and electrolyte disturbance; Growth retardation; Psychologic disturbances; Cataracts and glaucoma; Peptic ulcer disease; Iatrogenic Cushing's syndrome |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Preadministration assessment |
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Definition
| Presence of fungal or difficult to treat infection, assessment of disorder being treated, bone mineral density, identification of high risk patients |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Monitoring |
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Definition
Therapeutic objective achieved?
Fluid and electrolytes (fluid retention, hypokalemia)
Bone density; Growth and development in children |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Key Patient Education |
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Definition
Do not abruptly stop taking!!! Need for additional glucocorticoid for physiologic stress
Carry emergency supply, Emergency Identification
Avoid close contact with people with infections (immunocomprimised)
Restrict sodium intake, Encourage potassium intake |
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Term
| Glucocorticoid Non-Endocrine 'Prednisone' Notes |
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Definition
| Alternate day dosing helps to minimize adverse effects of adrenal suppression and growth retardation |
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Term
| Mineralocorticoid 'Fludrocortisone' Mechanism of Action |
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Definition
| Replaces mineralocorticoid |
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Term
| Mineralocorticoid 'Fludrocortisone' Indications |
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Definition
| Addison's disease; Primary hypoaldosteronism; congenital adrenal hyperplasia |
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Term
| Mineralocorticoid 'Fludrocortisone' Contraindications |
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Definition
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Term
| Mineralocorticoid 'Fludrocortisone' Serious Advers Effects |
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Definition
| Fluid retention, hypertension, cardiac enlargement, hypokalemia |
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Term
| Mineralocorticoid 'Fludrocortisone' Common Adverse Effects |
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Definition
| Same as serious- dose dependent |
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Term
| Mineralocorticoid 'Fludrocortisone' Preadministration assessment |
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Definition
| Fluid and electrolyte balance |
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Term
| Mineralocorticoid 'Fludrocortisone' Monitoring |
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Definition
| Weight gain (of fluid retention) |
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Term
| Mineralocorticoid 'Fludrocortisone' Key Patient Education |
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Definition
| S/S of fluid retention and hypokalemia |
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Term
| Mineralocorticoid 'Fludrocortisone' Notes |
|
Definition
| BP would increase if the drug was working b/c aldosterone is working in body and retaining fluid. |
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Term
| Insulin Mechanism of action |
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Definition
| Replaces intrinsic insulin |
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Term
|
Definition
| Diabetes Mellitus Type I, Type II, Gestational Diabetic Ketoacidosis (hyperkalemia) |
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Term
| Insulin Contraindications |
|
Definition
None- if allergy, patients must undergo desensitization to continue therapy
Less common now that it is all made from human, not animals |
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Term
| Insulin Serious Adverse Effects |
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Definition
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Term
| Insulin Common Adverse Effects |
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Definition
| Lipodystrophy (at injection sites) can be minimized by injection site rotation; Hypokalemia with excessive doses |
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Term
| Insulin Preadministration assessment |
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Definition
| Current blood sugar level, S/S of hypoglycemia |
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Term
|
Definition
| Routine blood glucose, periodic Hgb A1C (<7%) |
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Term
| Insulin Key Patient Education |
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Definition
| S/S of hypoclycemia; Injection technique; Dosage adjustment (for tight control); Insulin storage |
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Term
|
Definition
| Important to know insulin onset, peak and duration- in relationship with meals; One of the most common medication errors- independent double check is highly recommended! |
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Term
| Biguanides 'Metformin' Mechanism of action |
|
Definition
| Inhibits glucose production in liver, slightly reduces glucose absorption in the gut, sensitizes insulin receptors in target tissue |
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Term
| Biguanides 'Metformin' Indications |
|
Definition
| Diabetes mellitus Type II; Prevention of Type II Diabetes; Gestational Diabetes; Polycystic ovary syndrome (off label) |
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Term
| Biguanides 'Metformin' Contraindications |
|
Definition
| Renal insufficiency; Liver disease; Severe infection; History of lactic acidosis; Shock; Excessive alcohol consumption |
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Term
| Biguanides 'Metformin' Serious Adverse Effects |
|
Definition
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Term
| Biguanides 'Metformin' Common Adverse Effects |
|
Definition
| Decreased appetite, nausea, diarrhea; Decreased absorption of vit B12 and folic acid; note: does not cause hypoglycemia |
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Term
| Biguanides 'Metformin' Preadministration assessment |
|
Definition
| Assessment related to indication; Hgb A1C in pts w/diabetes |
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Term
| Biguanides 'Metformin' Monitoring |
|
Definition
| Hgb A1C in pts w/diabetes; Delay of onset of diabetes; Improved menstrual cycles and fertility in PCOS |
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Term
| Biguanides 'Metformin' Key Patient Education |
|
Definition
| S/S of lactic acidosis- hyperventilation, myalgia, malaise, unusual somnolence; Avoid alcohol; May need vitamin supplement |
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Term
| Biguanides 'Metformin' Notes |
|
Definition
| Patients should discontinue use 1-2 days prior to contrast studies and resume 48 hours after the study is completed (risk of renal failure and lactic acidosis) |
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Term
| Sulfonylureas 'Glyburide' (2nd Generation) Mechanism of action |
|
Definition
| Stimulate release of insulin |
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Term
| Sulfonylureas 'Glyburide' (2nd Generation) Indications |
|
Definition
| Type II diabetes mellitus |
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Term
| Sulfonylureas 'Glyburide' (2nd Generation) Contraindications |
|
Definition
|
|
Term
| Sulfonylureas 'Glyburide' (2nd Generation) Serious Adverse Effects |
|
Definition
| Hypoglycemia (particularly in patients with reduced kidney or liver function) |
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|
Term
| Sulfonylureas 'Glyburide' (2nd Generation) Common Adverse Effects |
|
Definition
|
|
Term
| Sulfonylureas 'Glyburide' (2nd Generation) Preadministration assessment |
|
Definition
| Assessment of diabetes related symptoms; Hgb A1C |
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Term
| Sulfonylureas 'Glyburide' (2nd Generation) Monitoring |
|
Definition
|
|
Term
| Sulfonylureas 'Glyburide' (2nd Generation) Key Patient Education |
|
Definition
| S/S of hypoglycemia; Avoid alcohol, NSAID, cimetidine (increases hypoglycemia) |
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|
Term
| Sulfonylureas 'Glyburide' (2nd Generation) Notes |
|
Definition
| Possible cardiovascular toxicity; Beta blockers can diminish drug effect and delay awareness of hypoglycemia |
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Term
| Glitazones 'Rosiglitazone' Mechanism of Action |
|
Definition
| Reduce glucose levels by decreasing insulin resistance |
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|
Term
| Glitazones 'Rosiglitazone' Indications |
|
Definition
|
|
Term
| Glitazones 'Rosiglitazone' Contraindications |
|
Definition
|
|
Term
| Glitazones 'Rosiglitazone' Serious Adverse Effects |
|
Definition
| Exacerbation of heart failure (fluid retention) |
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|
Term
| Glitazones 'Rosiglitazone' Common Adverse Effects |
|
Definition
| Headache, Myalgia, Fluid retention, Increased plasma lipids |
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|
Term
| Glitazones 'Rosiglitazone' Preadministration assessment |
|
Definition
| Liver runction; Hgb A1C; S/S related to diabetes |
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|
Term
| Glitazones 'Rosiglitazone' Monitoring |
|
Definition
|
|
Term
| Glitazones 'Rosiglitazone' Key patient Education |
|
Definition
| S/S of liver injury; S/S of heart failure |
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Term
| Glitazones 'Rosiglitazone' Notes |
|
Definition
| Gemfibrozil can raise levels of rosiglitazone leading to hypoglycemia |
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|
Term
| Glucagon Mechanism of Action |
|
Definition
| Promotes breakdown of glycogen to glucose, reduces conversion of glucose to glycogen, and stimulates glucose synthesis |
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|
Term
|
Definition
| Insulin overdose when patient is unable to take oral carbohydrates and IV dextrose is not available or IV access cant be established |
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|
Term
| Glucagon Contraindications and Serious Adverse Effects |
|
Definition
|
|
Term
| Glucagon Common Adverse Effects |
|
Definition
| Hyperglycemia is possible |
|
|
Term
| Glucagon Preadministration Assessment |
|
Definition
| Blood glucose level, S/S of hypoglycemia |
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|
Term
|
Definition
| Blood glucose level, resolution of symptoms of hypoglycemia |
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