iv drug compatibility list

Incompatibility between infusion-bolus was . (2000) Evaluation of physicochemical incompatibilities during parenteral drug administration in a paediatric intensive care unit. The compatibility results are presented in a chart or list view, with the default chart view displaying all methods within the fields for the selected drugs and solutions. The majority of sources cited define compatibility by physical compatibility rather than chemical compatibility This table is a guide only. Consistently checking alternative modes of administration and/or using multi-lumen catheters. Trissel LA. How tax and accounting firms supercharge efficiency with a digital workflow, Tax pros and taxpayers take note farmers and fisherman face March 1 tax deadline, IRS provides tax relief for GA, CA and AL storm victims; filing and payment dates extended, 3 steps to achieve a successful software implementation, 2023 tax season is going more smoothly than anticipated; IRS increases number of returns processed, How small firms can be more competitive by adopting a larger firm mindset, OneSumX for Finance, Risk and Regulatory Reporting, BECRIS 2.0 How to prepare for next-level granular data reporting, Implementing Basel 3.1: Your guide to manage reforms. hbbd``b`^$K7Hp8u 9*AvH v5 uDd| [$x@@5 l)^ $v V+ D21dg&Fs )@ 4 endstream endobj startxref 0 %%EOF 639 0 obj <>stream Adverse effects of drug incompatibilities extend periods of patients hospitalization and the total costs for hospitals. Nursing: March 2008 - Volume 38 - Issue 3 - p 15. doi: 10.1097/01.NURSE.0000312600.67772.13. Sodium bicarbonate and mannitol solutions should not be used as diluent for intravenous drug administration. What is the role of artificial intelligence in inflammatory bowel disease? Deputy Director, Pharmacy Department, Concord Repatriation General Hospital, Sydney. Iv Medication Solution Compatibility Chart For Nurses [zpnxwkyzq94v] Iv Medication Solution Compatibility Chart For Nurses Uploaded by: run.rebel.run April 2020 PDF Bookmark Download This document was uploaded by user and they confirmed that they have the permission to share it. Albumin ? View the full Trissels monograph for more information on the physical and chemical characteristics of the drug. )sHQVzP` , 4. Available for Critical Care Admixtures or Chemotherapy. [/quote'] COMPATIBILITY OF DRUGS COMBINED IN A SYRINGE. They are used in people of all ages who are sick, injured, dehydrated from exercise or heat, or undergoing surgery. Do NOT use solutions where there is a visible change in colouration. Jonathan Petersen. IV fluids are specially formulated liquids that are injected into a vein to prevent or treat dehydration. List several factors that affect compatibility and stability of an intravenous solution. 0 New compatibility information was added to the existing drug monograph for AMPHOTERICIN B, BUMETANIDE, FOSFOMYCIN DISODIUM, PLAZOMICIN, SCOPOLAMINE HYDROBROMIDE, and IMIPENEM, CILASTATIN AND RELEBACTAM with 28 other drugs. wy D63Hr=bW.X=3$o]$fr5\F0#7B/Le!xtPqBllZ'dgc~vA1+ "_5ZIkcu 3 o(|pM,d7Ut_8=zjgRgQ:m ns{k&h{ pADpD.Ak,{i-D%6B_sX?\L1yy.z"$ oJ {4a:\y"9Hl/lDj:}zyGDMVZJ^ j&27. Not all products are registered and approved for sale in all countries or regions. . If circumstances are so compelling as to warrant mixing any two or more solutions, there should be support from published compatibility data. In this update we added a new monograph for TOCILIZUMAB. Indeed, phenytoin injection is so incompatible that it should generally not be mixed with any other solution. Pre-Filled Syringe Low Molecular Weight Heparin, Leukocytoclastic Vasculitis Associated with a New Anticoagulant: Rivaroxaban Yeni Bir Antikoaglanla likili Lkositoklastik Vasklit: Rivaroksaban, International Nonproprietary Names for Biological and Biotechnological Substances: a Review17, Medication Incidents Reported in Irish Hospitals, Antiangiogenic Activities of Bemiparin Sodium, Enoxaparin Sodium, Nadroparin Calcium and Tinzaparin Sodium, Enoxaparin Sodium USP Reference Standards 11USP Benzyl Alcohol RS, Endovascular Options for Chronic DVT WhatS Available and When to Use These Options, Antithrombotic Therapy in Patients with Acute Coronary Syndromes, Clinical Policy: Enoxaparin (Lovenox) Reference Number: ERX.SPMN.233 Effective Date: 01/17 Coding Implications Last Review Date: Revision Log, Periprocedural Management of Coagulation Status and Hemostasis Risk in Percutaneous Imaging Guided Interventions: Body Imaging Division, TABLE E-1 Clinical Studies of Thromboprophylaxis Following, Comparison of the Oral Direct Thrombin Inhibitor, Enoxaparin (Lovenox) Reference Number: ERX.SPA.208 Effective Date: 01.11.17 Last Review Date: 02.21 Revision Log Line of Business: Commercial, Medicaid, Dabigatran Or Rivaroxaban Versus Other Anticoagulants For, Clexane/Clexane Forte Pre-Filled Syringes, Local Tolerability of Two Low-Molecular-Weight Heparins, Nadroparin and Enoxaparin, Enoxaparin Prescribing, Administration and Monitoring, Relative Antithrombotic and Antihemostatic Effects of Protein C Activator Versus Low-Molecular-Weight Heparin in Primates, CLEXANE 2000 Anti-Xa IU/0.2Ml CLEXANE 4000 Anti-Xa IU/0.4Ml CLEXANE 6000 Anti-Xa IU/0.6Ml, FFS) Implemented Prior Authorization (PA) Criteria for the Use of Dabigatran (Pradaxa), Rivaroxaban (Xarelto) and Apixaban (Eliquis, Enoxaparin Sodium Injection Full Prescribing Information, Indicative List of Pharma Product Patent Expiry for the Year 2011 As Per Dialog Pro (As on 9Th May 2012) S, Patient Medication Guide BIO-ENOX (Low Molecular Weight Heparin, Topic 0518 Xarelto Vs. Lovenox for Prevention of VTE Following TJA, Enoxaparin Sodium Injection Is a Prescription, Use of Recombinant Human Activated Protein C in Treatment of Severe, Unfractionated Heparin, Low-Molecular-Weight Heparins, and Direct Thrombin Inhibitors. Product images are for reference only. User Interface: Upon launching the app, the user is brought to a simple to use screen where there is an alphabetical list of IV medications. /Feature/WoltersKluwer/OneWeb/SearchHeader/Search, The worlds most trusted medical research platform, Evidence-based drug referential solutions, Targeting infection prevention, pharmacy and sepsis management, Cloud-based tax preparation and compliance, workflow management and audit solution, Integrated tax, accounting and audit, and workflow software tools, Tax Preparation Software for Tax Preparers, Integrated regulatory compliance and reporting solution suite, Market leader in UCC filing, searches, and management, eOriginal securely digitizes the lending process from the close to the secondary market, Software solutions for risk & compliance, engineering & operations, and EHSQ & sustainability, Registered agent & business license solutions, The world's unrivalled and indispensable online resource for international arbitration research, Market-leading legal spend and matter management, contract lifecycle management, and analytics solutions, The master resource for Intellectual Property rights and registration. Please start a free trial to access the full functionality. Compatibility of Selected IV Drugs (continued) Acyclovir Amikacin Amiodarone Ampicillin Ampicillin-sulbactam Anidulafungin Argatroban Azithromycin Aztreonam Bivalirudin Bumetanide Calcium gluconate Caspofungin Cefazolin Cefepime Cefotaxime Cefoxitin Ceftaroline Ceftazidime Ceftizoxime Ceftriaxone Ciprofloxacin Clindamycin Daptomycin Dexamethasone Dextrose 5% in water Diazepam Diltiazem . hbbd``b`~$ tHXHVHpG$4A@a HD$@@ S ] To determine the physical intravenous Y-site compatibility of 19 commonly used medications at pediatric concentrations with 3 different types o . Procedure Details Table 2 lists the IV administration set tested and found to be compatible with Treanda Injection after dilution in a 500 mL 0.9% sodium chloride IV infusion bags. Micromedex IV Compatability is a reliable resource for on-the-go access to the industry's most trusted clinical reference information, providing users with more informed treatment decisions at the point of care. Trick-of-the-Trade: IV Compatibility Information at Your Fingertips - ALiEM &2dG&SGi`B N PraWp#ZNkb}s&,V T8=L cUATj8c? Meropenem (infusion) and pantoprazole (bolus) constituted 16.6%. One or more drug components in the test samples exhibited a loss of intact drug greater than 10% within 24 hours under the conditions being tested. 2020 Y-Site Compatibility Wall Charts - King Guide to Parenteral Admixtures Drug Name Dose &/or Ranges Administration Compatibility Precautions Adenosine (adenocard) First dose 6mg, repeat within 1-2 minutes at . Specialist references dealing with their mutual compatibilities need to be consulted.3,4. This table was compiled for the convenience of . What you should know about drug compatibility. The absence of any visible change to a solution upon mixing does not automatically exclude degradation of either or both components. For a drug molecule which acts as a proton acceptor (a Lowry-Bronsted base), ionisation is achieved by formulation in a low pH solution usually as a hydrochloride or hydrogen sulfate salt (for example, amiodarone hydrochloride or adrenaline acid tartrate). While published compatibility data exist for insulins and some of the blood products, most recently marketed biological drugs such as infliximab, interferons and recombinant coagulation factors have no such data available and mixing with other drugs is not recommended. iv drug compatibility chart Many don't know how to do it. The cost can be calculated using the average daily costof the expected clinical treatment. hb```,Q ea8p3$H``h Compatibility of drug infusions in the NICU J Basic Clin Pharm; 5(2): 49-53, 5 Westbrook JI, Rob MI, Woods A, Parry D. (2011) Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience. IV injection due to hypotension, bradycardia, and arrhythmias. There B Bianca Paola 115 followers Micromedex IV Compatibility - Apps on Google Play To remove an individual drug or solution, click on the X next to the name. PflegenIntensiv; 2(1): 57, 13 Jack T, Boehne M, Brent BE, Hoy L, Kditz H, Wessel A, Sasse M. (2012)In-line filtration reduces severe complications and length of stay on pediatric intensive care unit: a prospective, randomized, controlled trial. Search for and click on a drug 2. Mixing is best avoided. RICU: Respiratory Intermediate Care Unit, Subsequently, severe respiratory complications caused by toxic drug-drug interactions may lead to an additional cost for the healthcare provider of up to 56,670 per single case.14. Lexicomp Trissels IV Compatibility Databases - Wolters Kluwer Better business continuity for Nelnet now! With this app you will have access to the largest, most comprehensive IV compatibility resource which: Includes drug-solution compatibility results as well as drug-drug compatibility results when creating an admixture or administering via Y-Site. This trial version of the IV-Compatibility Checker is not currently being maintained and may not feature updated information. adsorption). %%EOF Fig. 1: Main causes of incompatibilities in standard IV therapy. Numerous factors affect stability and compatibility including salt, strength, diluents, order of drawing up, temperature and infusion periods. Alfentanil. Handbook on injectable drugs. The link displays the drug concentrations used in the studies, additional information on the vehicle used, and each studys findings. X^P7&+5 All rights reserved. Objective: To test the compatibility of intravenous (IV) lactated Ringer's injection (LR) with 94 injectable (IV) drugs during simulated Y-site administration.Methods: Ninety-four IV drugs were investigated for compatibility with LR (Baxter). As a general guide, line compatibility of different drugs often depends on the pH of the drugs concerned. hWk0W=tlPIl-sYZ%fl~:YR|]6p|;HRIDP* C=9J)90EqL$1%re8E {.#s%&Z)g*b]TCD|y4WSDq6Dq6UcZq!Jxz #,4J. "7U;VD!kpcD:k4kc-y"0-={~58#|;P}c_f~;*%"r]$Os M IAnV}(z8XRgmq endstream endobj 575 0 obj <>>>/Filter/Standard/Length 128/O(bEQ\rICP$O)/P -3388/R 4/StmF/StdCF/StrF/StdCF/U(}ZFy3 )/V 4>> endobj 576 0 obj <><><>]/ON[612 0 R]/Order[]/RBGroups[]>>/OCGs[612 0 R]>>/PageLabels 567 0 R/Pages 569 0 R/Type/Catalog>> endobj 577 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>>/Rotate 0/TrimBox[0 0 603 774]/Type/Page>> endobj 578 0 obj <>stream We would be pleased to provide you with more information. Drugs administered to patients receiving PN should be given through a separate IV site or catheter lumen. 2 RCN (2010) Royal College of Nursing. revised9/08' adult&intravenous&medications' standard'and'maximum'allowableconcentrations,' guidelinesforcontinuousortitratedinfusions ' medication . Intravenous Drug Incompatibility Alert Card | Download Scientific Diagram PEPID helps healthcare professionals avoid adverse events encountered in administering intravenous drugs & solutions, and optimize IV management & preparation. 10 0 obj <> endobj This is because of higher mutual drug concentrations and potentially greater pH changes in the more concentrated solution. Such circumstances include: The decision to mix drugs should not be made without knowledge of their compatibility. J Res Pharm Pract; (1): 37-40, 4 Vijayakumar A, Sharon EV, Teena J, Nobil S, Nazeer I. For added convenience, subscribers can login with an ip address and bypass the login screen. To view all solution and drug compatibility results for a single drug, enter the IV Drug and Click "View Compatibility". Addition of an acidic drug solution to a solution containing a carbonate or bicarbonate may result in production of carbon dioxide gas. PEPIDs IV Compatibility Checker is available through any of our clinical decision support suites, allowing healthcare professionals to quickly check the compatibility of specific IV sites, drugs and solutions with their mobile devices oronline. Includes routes, dosages, temperatures, and containers used to determine compatibility and stability. Compatibility analyses can also be viewed in a list display, where results are shown in pairs. PDF Thames Valley Y-Site Intravenous Drugs Compatibility Chart (March 2011) Coverage of IV drug administration highlights dosage and IV administration instructions, including safety considerations and Y-site, syringe, and additive compatibilities. Trusted clinical technology and evidence-based solutions that drive effective decision-making and outcomes across healthcare. qR` $m^0n`2A{q0&l'lo}E5|mOA LU $s@_w ?bz8y LX&qCRKuzDr~tM,3'#5 =&8 5aWFxx[~6Du2bxdE@$FU$!Dc- Data sources: Published articles, nursing and pharmacology . Get in touch with us. Search fields self-populate with brand and generic drug names as you type, and compatibility results are instantly generated as you build your drug list. !k> This review focused on analyzing the physical and chemical compatibility of the IV drugs most commonly used through Y-site infusion in the ICU setting and summarizing the information obtained in a double-entry chart. Use the reset filter button to go back to the default view. Table 3 shows the results. Drug combinations are tested for compatibility in solution. Injectable diazepam should be diluted with four parts water to ensure it does not precipitate in the syringe. PDF Intravenous Medication Guidelines for Adults - VCHCA This site complies with the HONcode standard for trust- worthy health information: verify here. Search for the two antibiotics, aztreonam and clindamycin, one at a time. Further publications showed that, depending on the ward type, up to 80% of IV drug doses were prepared with the wrong diluents.11. To search on compatibility information, begin by typing the desired drug or solution name into the appropriate search box. Integrate our IV compatibility tool into anyEMRorHITsystem to create customized alerts for incompatibilities, or create customized queries for any compatibility. If a separate site is not available . Possible drug/solution selections will be displayed as you continue to type. 7db. However, the evolution of gas is a normal part of the reconstitution of some drugs, notably ceftazidime. Find information on medicines by active ingredient or brand name. We specialize in unifying and optimizing processes to deliver a real-time and accurate view of your financial position. %PDF-1.5 % Five years after the implementation of a simple "colour code system". Many institutions and schools subscribe to Micromedex products, which translates into free access for you. @ King Guide Online IV Drug Compatibility However, published data are specific to the concentration, solvent, ambient temperature and sometimes the composition of the syringe or infusion bag. Click the relevant option after each search. Two syringes taped together sounds like a recipe for disaster' date=' either for the patient or for the nurse - particularly with regard to increased risk for needle sticks. Incompatibility can also occur between medications or fluids and certain types of container materials. %%EOF Get full access to PEPID for 2 weeks with a free trial, or contact us to learn more about integrating the IV Compatibility Checker and the PEPID Knowledgebase into your health IT system. 4: Color coding and drug separation to prevent drug incompatibilities through a clear indication of the drug. Micromedex IV Compatibility on the App Store IV medication must be cleared by flushing at the same rate of administration to avoid the . This was the third project that I was assigned at Oconee Medical center. 0 In order to facilitate the attribution of each complication to the cost calculation, severity levels were introduced. Glucose 5% infusion solution, which has a pH of 4.3-4.5, will precipitate phenytoin almost immediately. Australian Prescription Products Guide. Facts and Comparisons User Academy - Trissels IV Compatibility -nF1tih$HPCQ7rGceww~@3HWw!n,GE,"? Practical information, tools and resources for health professionals and staff to help improve the quality of health care and safety for patients. Micromedex also has free drug information and drug interaction apps. Diazepam is very poorly water soluble so it is formulated as an injection solution in a vehicle comprising 50% propylene glycol and 10% ethanol. Chemical stability studies, however . Table. PDF Highlights of Prescribing Information ------------------------warnings Reasonable care is taken to provide accurate information at the time of creation. Many injectable drugs cannot be mixed together in syringes or infusions. .1-.15mg/kg repeat q15 mins : Max .3mg/kg or 50mg . Refer to drug manufacturer's labeling and use instructions for recommendations, USP <797>, and applicable institution policy for shelf life and sterility information of reconstituted product and admixture device compatibility. Compatibility of Lactated Ringer's Injection With 94 Selected Empowering physicians with fast, accurate clinical answers, Beyond the call: How to differentiate your telehealth experience post-visit, Implementing 2023 updates to your Antimicrobial Stewardship Program. All Rights Reserved. The online edition started as a direct replacement for the original loose-leaf King Guide. Drug pairs with conflicting compatibility results may often have different concentrations used or other differences to account for the variability. A cost evaluation of the risk can be done by assigning costs to their related clinical treatment and resulting extended length of stay. The King Guide has been updated quarterly since 1971 and is an excellent addition to any drug information library with complete monographs for over 600 injectable drugs. In other cases, care needs to be taken to ensure that if the injection solution is diluted, the dilution is adequate to ensure continuing solubility over the duration of the infusion. INTRAVENOUS COMPATIBILITY CHART - Drug Information For The - liber Each sample was prepared in duplicate and performed at room temperature. 1 Fahimi F, Sefidani Forough A, Taghikhani S, Saliminejad L. (2015) The rate of Physicochemical Incompatibilities, Administration Errors. IV Drug Compatibility 12+ ITDCS Ltd Designed for iPad 1.3 16 Ratings $2.99 Screenshots iPad iPhone This application provides the healthcare profession with a method of quickly checking the compatibility of any two of the following intravenous drugs at the Y-site: Acetylcysteine Adrenaline Alfentanil Aminophylline Amiodarone Aprotinin patients at home requiring many drugs by simultaneous continuous infusion where multiple intravenous lines are not feasible, for example, use of a syringe driver during palliative care. When a drug or solution name is in the Selected Items section, a link to the Trissels monograph for that drug/solution will be displayed. Full information can be obtained from your pharmacy department Key References Adrenaline 18 1 Compatible (Reference 1) 1 "Handbook of Injectable Drugs" Lawrence Trissel available on www.medicinescomplete.com Incompatibility between two intravenous (IV) bolus drugs constituted 68.8% with pantoprazole and ondansetron (85.4%) being the most frequent combination. 7.5 Intravenous Medications by Direct IV Route There are a number of drugs that are commonly delivered via syringe driver to patients having palliative care in the community (see box). PARENTERAL NUTRITION (PN) AND DRUG COMPATIBILITY The co-infusion of drugs and PN should be avoided. Amiodarone (Cordarone) IV Infusion IV Infusion IV Infusion: A-fib rate control only . Incompatibilities of drugs in standard IV therapy can occur between: drugs and inappropriate IV solutions as diluent two drugs (drug-drug incompatibility) when they are - mixed together, e.g. This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Use reference materials to find incompatibility, compatibility, and storage information. Other drugs which demonstrate solubility problems and which are formulated in injection vehicles other than simple aqueous solutions include digoxin, clonazepam, phenytoin, amiodarone and phytomenadione. IV diazepam (valium) is incompatible with most drugs and fluids, including normal saline. INTRAVENOUS COMPATIBILITY CHART Acyclovir ** Acyclovir ? The Vial2Bag Advanced 20mm admixture device is not compatible for use with all drug products. %%EOF INTRAVENOUS COMPATIBILITY CHART - Drug Information For The - | PDF In the chart display, each compatibility pair has an indicator for the type of result found. Of the 196 co-infusions, 110 had additional restrictions on time in solution. A separate license is required for each facility location and we offer discounts for multiple licenses. PDF Bloomberg Children's Center Y-Site Compatibility Chart GPO Box 5480, Sydney NSW 2001 Australian Commission on Safety and Quality in Health CareLevel 5, 255 Elizabeth StreetSydney NSW 2000, We are always looking for ways to improve our website, Please help us to improve our services by answering the following question. PEPID has all the TOOLS to help you help others. Copyright 1993-2021 All rights reserved. Two observers performed visual evaluation independently immediately upon . Qual Saf Health Care; 14(3): 190-195, 12 Riemann T, Schrder F. (2005) More effective prevention of incompatibility reactions through the use of four lumen central venous catheters in critically ill patients. Morphine is frequently used for both acute pain and long-term chronic pain. Micromedex IV Compatibility App is a Quick and Easy Reference to 2: Estimation of possible additional costs as a consequence of complications caused by drug incompatibilities. Enter one drug and click View compatibility. The default compatibility result will display the solution compatibilities for the IV Drug searched. This information is not intended as a substitute for medical advice and should not be exclusively relied on to manage or diagnose a medical condition. We streamline legal and regulatory research, analysis, and workflows to drive value to organizations, ensuring more transparent, just and safe societies. When this occurred, "incompatible" was used. The mixing of drug salts of calcium, and to a lesser extent magnesium, with phosphates, carbonates, bicarbonates, tartrates or sulfates should also be avoided. Consequences of physicochemical drug incompatibilities are particularly severe in neonate and pediatric patients.1,4,6, There is little published scientific information about the frequency of drug incompatibility reactions. Incompatibility is an undesirable reaction that occurs between the drug and the solution, container or another drug. @z0012c`,' %PDF-1.5 % Mosby's Drug Guide for Nursing Students, 15th Edition Over 600 IV drugs with at-a-glance view of compatibility in 12 fluids Over 3,200 primary source references Includes routes, dosages, temperatures, and containers used to determine compatibility and stability. IV Drug Compatibility - Apps on Google Play About this app. 2015-05-04. The problem is frequently observed when diazepam injection is diluted. It is a list of 33 antibiotics and their given stability in several different solutions. IV Compatibility - Major Online Drug Information Resources 62 0 obj <>stream Improving clinical practice and health outcomes for Australia. 1. PDF Compatibility of Commonly Used Intravenous Drugs - La Chuleta del FIR Caldolor (Ibuprofen): This medication, also an NSAID, is basically IV Advil. What's in Your IV Pain Meds? - Verywell Health Episode 51: Quit smoking. Knowledge of drug compatibility is needed before mixing drugs. Switching to IV push, using solutions other than saline, using large volume solutions, or using syringe infusion pumps, may change the stability and compatibility characteristics of the medication to be administered. Y = compatible for at least 30 minutes P = provisionally compatible; give within 15 minutes P(5) = provisionally compatible; give within 5 minutes . An internet connection is not required, allowing you to make decisions with confidence at anytime, from anywhere. Other drugs which demonstrate solubility problems and which are formulated in injection vehicles other than simple aqueous solutions include digoxin, clonazepam, phenytoin, amiodarone and phytomenadione. Appendix F: Drug compatibility chart - Handbook of Drugs in Intensive Care Reference texts can provide information, but data are often unavailable for new drugs. Timely, independent, evidence-based information on new drugs and medical tests, and changes to the PBS and MBS. hXmo8+UEw'EUBJRmwNBRb8x0_N%p F9)c'R&(a&LH*$("A7(P&|I#\(NU?ANI"4R`2DVT@0AX|N4nE`] 4IV,\;{^Q8q9bcFO>C@Do\#+Uhju}4wQTLG/| {0pR(7%?$sM7kB(h9hY* ^?r37HE2hHGp0JE~fqpyzlFE'&abRoXIPoTD L ExUoib:"nt/x]q>=YZ+Bc#,%3}~(qYKjs@x' ?

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