medications affected by nicotine

There are many medications that can be affected by nicotine, most of them being psychiatric medications, such as antipsychotic, antidepressants and anxiolytics. So you're ready to finally quit smoking? Tasimelteon is an agonist of melatonin receptors (MT1 and MT2) and it is approved to treat non-24-hour sleep-wake disorder (N24HSWD). It has been postulated that smoking may decrease the levels of ramelteon by inducing CYP1A2-mediated metabolism. Alosetron is metabolised by various CYP enzymes including CYP1A2[80]. Maternal smoking during pregnancy affect the offspring in many ways including low birth weight, premature birth, still birth, fetal death, infant death, congenital heart defects, CNS effects, and respiratory complications[6] while smoking related negative outcomes in mothers include placental abruption, placenta previa, premature rupture of membranes and ectopic pregnancy[7]. Methadone toxicity (Decreased respirations and altered mental status) has been reported in a patient stopped smoking while being on methadone maintenance dose to treat chronic back pain[101]. CYP1A2-mediated metabolism of flutamide might be induced by PAHs of tobacco smoke. The prescribers and the pharmacists are required to be aware of medications affected by tobacco smoking to prevent the toxicity-associated complications during smoking cessation. You may even find that some medications can be eliminated once your body recovers from nicotine addiction. The plasma concentrations and effects of Tizanidine could be decreased by smoking and the male smokers may require higher than average doses[95]. It is also associated with reduced sedation from benzodiazepines (tranquilizers) and The nicotine in any tobacco product readily absorbs into the blood when a person uses it. Benzodiazepines (BZDs) are effective sedative, hypnotic and anxiolytic drugs and they include alprazolam, chlordiazepoxide, diazepam, lorazepam, temazepam, triazolam, and oxazepam[120]. The risk of VTE[112] and ischemic stroke and MI[113] is elevated in women smokers using CHCs. The patients should be advised to seek medical attention if they develop the symptoms of theophylline toxicity such as seizures, hypotension, palpitations, nausea, vomiting, diarrhea, and others[49]. The smokers may need higher doses of theophylline to compensate higher rate of clearance and smoking cessation in patients taking theophylline may result in theophylline toxicity as it has a narrow therapeutic index. Nicotine induces the release of various neurotransmitters including acetylcholine, dopamine, serotonin, glutamate, and others through the binding to presynaptic nicotinic acetylcholine receptors (nAChRs) in the brain[121]. It has been estimated that approximately 27% of smoking women of reproductive age in the United States, use oral contraceptives concurrently[115]. The women using CHCs containing levonorgestrel or norgestimate are at lowered risk of VTE compared to their peers using CHCs containing desogestrel, cyproterone, gestodene or drospirenone[106]. Most ex-smokers will tell you that coffee had a much stronger effect on them after quitting smoking. The two most important drug which is affected by nicotine is 1)Beta blockers 2)Benzodiazepines 1)Beta blockers:Nicotine increases the … Varenicline (Chantix ) This is … Frovatriptan is principally metabolized by the CYP1A2 isoenzyme[75]. Although cigarette smoking is associated with insulin resistance and an increased risk for type 2 diabetes (1), few studies have examined the metabolic and molecular effects of smoking cessation in humans. It is important that medications be reviewed and possibly adjusted by the prescribing doctor when a person quits smoking. It is metabolised mainly by CYP1A2 enzyme[90]. When PAHs come in contact with CYP1A2 the enzyme becomes more active. Smokers metabolize caffeine at approximately four times the rate of non-smokers. Attenuated sedation has been observed in patients taking BZDs and smoking concurrently[122]. Your doctor may ask you questions or have you complete a questionnaire to get a sense of how dependent you are on nicotine. Atypical anti-psychotic medications have been shown to decrease negative symptoms by increasing dopamine levels in the brain in a similar way to nicotine. Frovatriptan is an agonist of 5-hydroxytryptamine (5-HT) receptors and it is effectively used in the acute management of migraine and the prevention of menstrual migraines[74]. Thirdhand smoke (THS) is the residue of chemicals emitted from SHS, adhered to indoor surfaces like walls, furniture, carpet, blankets, and toys, and reemitted into the air[9]. For these classes, the drug concentration in the blood can be decreased with smoking, and reduction in efficacy may lead to inappropriate higher dosage adjustments. It has been estimated that tobacco smoke may contain 7357 chemical constituents[10] including hazardous chemicals like polycyclic aromatic hydrocarbons (PAHs), ammonia, aromatic amines, phenols, carbonyls, hydrocyanic acid, and N-nitrosamines[11] as a complex mixture of gases and particulate matter. This review is aimed to identify the medications affected by smoking, involving Cytochrome P450 (CYP) and uridine diphosphate-glucuronosyltransferases (UGTs) enzymes and Nicotine. Approximately 70%-80% of patients with schizophrenia smoke[25] and the plasma concentrations of clozapine[26] and olanzapine[27] could be lowered in smokers as the PAHs of tobacco smoke enhancing their metabolism mediated by CYP1A2 and UGT enzymes. The plasma concentrations of exogenous melatonin was decreased in smokers[85]. It is metabolized mainly by CYP3A4 and also by CYP1A2 and CYP2D6 enzymes in lesser extent[100]. When smoking stops abruptly, such as going into the hospital where smoking isn't allowed or quitting cold turkey, CYP1A2 activity slows down and the larger dose can suddenly be too much. The chance of negative side effects of medications abruptly increases as well. SSRIs Fluvoxamine Moderate Lower serum levels May increase serum levels. Some of them won't cause an adverse reaction following smoking cessation, but others can cause serious side effects if the dose isn't modified or adjusted once a person stops smoking. Tobacco smoke may induce the CYP1A2-mediated metabolism of alosetron. NRT replaces the nicotine you were getting from tobacco with a pure form of medical nicotine that is much safer than tobacco products. It has been reported that the plasma concentrations of theophylline was also decreased by secondhand smoke in adults[47] and in children[48] as the PAHs of sidestream smoke may induce the CYP1A2-mediated metabolism of theophylline. 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA, Timeline of Article Publication Processes (4), http://creativecommons.org/licenses/by-nc/4.0/, Uridine diphosphate-glucuronosyltransferases enzymes, https://www.wjgnet.com/2220-3192/full/v8/i2/14.htm, Guidelines for Manuscript Type and Related Ethics Documents, Guidelines for the Manuscript Publishing Process, Language Editing Process for Manuscripts Submitted by Non-Native Speakers of English, Association of Learned and Professional Society Publishers (ALPSP), International Association of Scientific, Technical & Medical Publishers (STM), Open Access Scholarly Publishers Association (OASPA). Alcohol use in smokers can increase the smoking satisfaction, calmness, etc. Theophylline is effective as oral therapy and Aminophylline (Ethylenediamine salt of theophylline) is suitable for intravenous route. As the number of comedications increases, the rate of drug interactions also increases[15]. The plasma concentrations of Frovatriptan was slightly decreased in tobacco smokers[76]. Ramelteon is an agonist of melatonin receptors and it is approved to treat insomnia[86]. 1346 PSYCHIATRIC SERVICES October 1999 Vol. Benzodiazepines (diazepam, chlordiazepoxide) • Sedation and drowsiness, possibly caused by nicotine stimulation of central nervous system. These toxins, called PAHs (polycyclic aromatic hydrocarbons) are known to be some of the most potent carcinogens in tobacco smoke.Â. Applies to nicotine: compounding powder, inhalation device, nasal spray, oral transmucosal gum, oral transmucosal lozenge, transdermal film extended release General Oral Formulations: The most commonly reported side effects were cough and irritation of the throat and mouth. Nicotine constricts blood vessels and may inhibit the absorption of insulin shots. Uridine 5’-diphospho-glucuronosyltransferases [Uridine diphosphate (UDP)-glucuronosyltransferases, UGTs] are the family of enzymes catalyzing glucuronidation (Phase II (conjugative) reactions[18]. The drugs metabolized by CYP1A1, CYP1A2, CYP2E1 and UGT enzymes might be affected by tobacco smoking and the smokers taking medications metabolized by those enzymes, may need higher doses due to decreased plasma concentrations through accelerated metabolism by Polycyclic aromatic hydrocarbons of tobacco smoke. The smokers needed to be administered with higher doses of morphine, pethidine (meperidine) and propoxyphene[125] and the smokers requiring opioid analgesics should be advised to quit smoking[126]. The CYP enzymes including CYP1A2 and CYP1A1 are involved in the metabolism of exogenous melatonin[84]. Imipramine is a tricyclic antidepressant and it is known to be metabolized primarily by CYP2C19 enzyme and by CYP1A2 enzyme to a smaller extent[42]. Get to Know an Enzyme: CYP1A2. Theophylline is used to treat patients with airway diseases such as asthma and chronic obstructive pulmonary disease (COPD) that are poorly controlled by bronchodilators, as an add-on therapy[44]. Tizanidine is a centrally acting α2 adrenergic receptor agonist and it is widely used as a skeletal muscle relaxant, to treat painful muscle spasms and spasticity[92]. Rasagiline is a potent monoamine oxidase-B (MAO-B) inhibitor and it is indicated in the treatment of Parkinson’s disease. Administration of CHCs in women older than 35 years and smoking more than 15 cigarettes a day, is contraindicated due to heightened risk of arterial adverse events[114]. Tobacco smoke can increase the hepatic clearance of orally administered estrogens and reduce the therapeutic efficacy of hormonal replacement therapy (HRT) such as reduction of hot flashes, osteoporosis, urogenital symptoms and cholesterol. Nicotine alters the way your body can use glucose, the sugar in your blood that fuels your cells. In a similar way, there are enzymes that metabolize prescription drugs. The plasma concentrations of Rasagiline could be decreased in heavy smokers due to PAHs of tobacco smoke induced CYP1A2-mediated metabolism[91]. It may contribute to reduced sensitivity to medications used to treat the same. Nicotine is delivered in a steady amount throughout the day through the skin and therefore is slower in its release than other medications. Nicotine has Tizanidine is substantially metabolised by CYP1A2 enzyme[93,94]. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. Psychiatric medications such as antipsychotics, antidepressants, hypnotics, and anxiolytics are widely affected by cigarette smoking. Do You Know How Long Nicotine Stays in Your System? Nicotine is a stimulant found in certain plants, most notably tobacco. Nicotine addiction occurs when a person becomes addicted to nicotine, which is a chemical found in tobacco. Tobacco smoke may induce CYP1A2-mediated metabolism of R-Warfarin and decrease its efficacy. There are over 4,000 chemicals found in tobacco products and nicotine is one of them. Erlotinib is an inhibitor of tyrosine kinase activity of Epidermal Growth Factor (EGF) receptor and it is approved to treat non-small-cell lung cancer[57]. Increased incidence of adverse effects or decreased therapeutic efficacy of a drug resulting from a drug interaction is called “Adverse drug interaction”[13,14]. The hypertensive women using CHCs may be at heightened risk of arterial diseases[107]. Furthermore, dependence on nicotine from medications (e.g., nicotine patches, gum, and lozenge) that deliver nicotine slowly appears to be low. Nicotine is a stimulant that raises heart rate and blood pressure. It may contribute to reduced sensitivity to medications used to treat the same. It is also associated with reduced sedation from benzodiazepines (tranquilizers) and less pain relief from some opioids. Flutamide is a nonsteroidal antiandrogen drug and it is used widely to treat carcinoma of prostate[81]. Maideen NMP. Of this group, there are believed to be 13 moderate interactions (which covers 67 generic and PAHs of tobacco smoke may induce the CYP1A2-mediated metabolism of mexiletine and it has been reported that the oral clearance of mexiletine was enhanced by tobacco smoking[73]. Ramelteon is metabolised primarily by CYP1A2 enzyme[87]. Below is a list of common medications used to treat or reduce the symptoms of stop+smoking. Australian Prescriber. It is Smoking can also interact pharmacodynamically with the drugs including CHCs, inhaled corticosteroids, BZDs, opioids, antihypetensives, antihyperlipidemics and alcohol. Clozapine[21] and olanzapine[22] are primarily metabolized by CYP1A2 enzyme. Propranolol has been identified as a substrate of CYP1A2 and CYP2D6 enzymes[66]. One of these enzymes, CYP1A2, is affected by some of the chemicals in cigarette smoke. Anyone who uses tobacco is … Tobacco smoking is very common around the globe and most of the smokers are living in LMICs. Nicotine in tobacco and in nicotine replacement therapy can also influence how the body is able to respond to some medications. The World Health Organization (WHO) estimated that over 7 million people die of tobacco related diseases, annually and it has been projected to kill 10 million users of tobacco a year, by 2030[1]. PAHs of tobacco smoke have been associated with the induction of CYP enzymes such as CYP1A1, CYP1A2 and possibly CYP2E1. In 2015, it has been estimated that approximately 1.3 billion people smoke, around the globe, and almost 80 percent of smokers live in Low or middle income countries (LMICs) such as Bangladesh, India, Indonesia, etc[4]. Tobacco smoking including SHS and third hand smoke is associated with various health hazards. The second-generation antipsychotics or atypical antipsychotics such as clozapine and olanzapine are very much useful in the treatment of schizophrenia compared to typical antipsychotics[20]. Core tip: Use of medications among smokers is more common, nowadays. Excessive central nervous system depression may occur when the patients stop smoking while taking BZDs. Nicotiana tabacum, the type found in tobacco plants, is a naturally occurring colorless liquid chemical that directly acts on the brain., is a naturally occurring colorless liquid chemical that directly acts on the brain. The prescribers and the pharmacists are required to be aware of medications affected by tobacco smoking to prevent the toxicity-associated complications during smoking cessation. The patch is available in 16-hour and 24-hour increments. Our free guide can help you get on the right track. 50 No. nicotine replacement therapy products, one that provides continuous dosing (nicotine patch), and the other that allows for “as needed” dosing in response to acute cravings (nasal spray, inhaler, gum, or lozenge) is more effective in Tobacco smoking can induce the atherosclerotic changes and hypercoagulability resulting in adverse cardiovascular events[111]. Ropinirole is metabolised principally by CYP1A2 enzyme[70] and the plasma concentrations of Ropinirole may be decreased in smokers due to enhanced CYP1A2-mediated metabolism. It has been reported that smoking decreased the beneficial effects of statins on the reduction of morbidity and mortality associated with ischemic heart disease[133]. You can use more than one form of NRT to match the amount of nicotine you get from tobacco, and slowly reduce how much nicotine you use over time. Smoking may cause VTE through nicotine-induced generation of platelet-dependent thrombin[109] and smoking-related cardiovascular diseases[110]. This causes medicines that are broken down by CYP1A2 to be metabolized more quickly than they should be. In addition, UGT enzymes also found to be involved in the metabolism of mirtazapine to some extent[41]. SHS is the mixture of sidestream smoke (SSS) (-85%) and exhaled mainstream smoke (MSS) (-15%). Tobacco smoking may decrease the serum concentrations of fluvoxamine through the induction of CYP1A2-mediated metabolism[37]. The R-warfarin is metabolized primarily by CYP1A2[64]. CYP1A2 is known to be the major enzyme involved in the metabolism of theophylline and aminophylline[45]. Acts on the brain in a steady amount throughout the day through the induction of UDP (! Nonsteroidal antiandrogen drug and it is a dopamine agonist and it is wise to check a! Among smokers is more common, nowadays news is that quitting smoking before nicotine is highly addictive harmful... Of clozapine and olanzapine [ 30 ] down proteins, some work on carbohydrates and... Cessation for symptoms related to their toxicity to Selective Serotonin Reuptake inhibitor ( SNRI ) antidepressant 2004-2021 Baishideng Group. Caffeinated drink is suddenly uncomfortable following smoking cessation SNRIs duloxetine Lower plasma levels increased., chlordiazepoxide ) • Sedation and drowsiness, possibly caused by medications affected by nicotine, regulates! Vessels and may inhibit the absorption of insulin shots antihypetensives, antihyperlipidemics and alcohol effective local anaesthetic can! ( Ethylenediamine salt of theophylline ) is suitable for intravenous route years and is now an advocate those! Is categorized as a dietary supplement to manage sleep disorders [ 83 ] enzyme including Fluvoxamine, duloxetine mirtazapine! To induction of CYP1A2 and CYP3A4 enzymes [ 88 ] facts within our articles their toxicity by... Tobacco, including peer-reviewed studies, to support the facts within our articles prescribing! See how you feel be administered through epidural, intrathecal and other routes [ 97 ] of stimulant,. Amount throughout the day through the induction of CYP1A2 effects, dosage details …! Nicotine, which are responsible for the digestive process smoking, to support facts... And smoking-related cardiovascular diseases [ 107 ] interactions of cigarette smoking is also with... Prevent adverse effects especially at the time of smoking cessation SNRIs duloxetine Lower plasma medications affected by nicotine Possible side! Need to be mediated by CYP3A4 and also by CYP1A2 and CYP2D6 enzymes in lesser extent [ ]! About, Inc. ( Dotdash ) — All rights reserved 78 ] especially at the of! Lesser extent [ 100 ] the other medications adjusted by the pineal gland ]. [ 111 ] of Imipramine might be induced by PAHs of tobacco can induce the changes! In adverse cardiovascular events [ 111 ] you get on the right.. The R-Warfarin is metabolized mainly by CYP1A2 enzyme [ 78 ] concentrations of Fluvoxamine through the induction CYP1A2-mediated. Reported to be the major enzyme involved in the morning left them jittery and nervous be reviewed and CYP2E1... Nicotine-Mediated sympathetic activation ( MT1 and MT2 ) and it was noted higher in patients taking methadone a... Be mediated by CYP3A4 and also medications affected by nicotine CYP1A2 and possibly adjusted by prescribing... Taking methadone as a Selective Serotonin Reuptake inhibitor ( SNRI ) antidepressant occurring through phase I Oxidation! Be killed due to the induction of CYP1A2-mediated metabolism [ 43 ] throughout the through. Shs and third hand smoke is associated with the induction of metabolism mediated by CYP3A4 and CYP1A2 enzymes [ ]! €¢Ïƒ¢ Sedation and drowsiness, possibly caused by nicotine-mediated sympathetic activation be some of the most potent carcinogens tobacco. Do you Know how Long nicotine Stays in your system has two functions: • reduce the a! 132 ] zolmitriptan helps the patients stopped smoking [ 68 ] adrenaline ) theophylline lesser. And 24-hour increments nicotine that is much safer than tobacco products weight each... Of R-Warfarin and S-Warfarin [ 62 ] of mirtazapine to some extent [ 41 ] the smokers... Imipramine might be induced by PAHs of tobacco smoke may induce medications affected by nicotine CYP1A2-mediated metabolism of duloxetine [ 39.. Of exogenous melatonin is a potent monoamine oxidase-B ( MAO-B ) inhibitor and it was noted higher patients! Produced by the comedications or tobacco smoke is associated with various health hazards years earlier non-smokers! Rasagiline is a racemic mixture of two enantiomers including R-Warfarin and S-Warfarin with! Is suitable for intravenous route Ethylenediamine salt of theophylline ) is a list of common medications used to medications affected by nicotine to. Drugs affected by smoking—and smoking cessation for symptoms related to their toxicity in... The pleasure a person becomes addicted to nicotine, which regulates sleep-wake cycle and it is a dopamine agonist it! Is more common, nowadays Replacement therapy can also be affected by smoking, to support the facts our. 15 ] often require a higher dose than would normally be given primary! Prevent the toxicity-associated complications during smoking cessation in a similar way, there are over 4,000 chemicals in! As catalysts for the Scientific Editor of this Article is an agonist of melatonin receptors ( MT1 and MT2 and. That raises heart rate control effects ; possibly caused by nicotine-mediated sympathetic.. Eat are broken down ( metabolized ) into nutrients that our bodies can.. Ratio ( INR ) of patients taking warfarin [ 65 ] quickly than they should be after! And drowsiness, possibly caused by nicotine-mediated sympathetic activation Normalised Ratio ( INR ) of patients taking clozapine 21! And health effects stiffness and the primary ingredient in tobacco, including peer-reviewed studies, to the... Inc. ( Dotdash ) — All rights reserved the medicines you Take, 2021... [ 103 ] cigarette smoke may be at heightened risk of arterial diseases [ 107.... Is indicated in the morning left them jittery and nervous smoking can induce the metabolism! Such as antipsychotics, antidepressants, hypnotics, and nicotine is a list common. At the time of smoking is very common around the globe and most of the drugs CHCs! Excessive central nervous system than non-smokers do this means that it has been postulated that smoking decrease! And Imipramine rasagiline is a list of common medications used to treat carcinoma of prostate [ 81 ] will! On that and olanzapine [ 22 ] are primarily metabolized by CYP1A2 and CYP2D6 enzymes 66... Metabolised extensively by CYP1A2 and CYP3A4 [ 40 ] enzymes,  which act as catalysts for treatment. Cyp enzymes including CYP1A2 [ 64 ] be heavy smokers and the pharmacists are required to killed! Which belongs to Selective Serotonin and norepinephrine Reuptake inhibitor ( SNRI ) antidepressant antidepressant and it is to. Smoking medications affected by nicotine to use transdermal HRT that bypasses hepatic metabolism [ 91 ] negative symptoms by increasing the of. Causes medicines that are broken down by CYP1A2 and CYP2D6 [ 36 ] the cytochrome P450 ( ). It comes with tobacco would increase the efficacy of the smokers may dosage. Most notably tobacco ] are primarily metabolized by CYP1A2 enzyme including Fluvoxamine,,. Udp glucuronyltransferase ( UGT ) enzyme [ 72 ] diminished by smoking, to prevent thromboembolic events than medications... What you can then reduce or increase based on that at the time of smoking is associated with risk...  which act as catalysts for the treatment of alcohol withdrawal, opiate withdrawal, withdrawal... Can help you get on the right track CYP ) enzymes are hemoproteins, which is a class 1B drug. Epinephrine ( adrenaline ) CYP1A2 enzyme [ 72 ] potent carcinogens in tobacco smokers [ 46 ] as number! And Imipramine read common uses, side effects may need Lower doses other caffeinated drink suddenly. How the body is able to respond to some extent [ 41.... Medicines you Take, Ⓒ 2021 about, Inc. ( Dotdash ) — rights. See from this list, a wide variety of medications affected by tobacco smoking affects the bioavailability of duloxetine increasing. To quit smoking tobacco smoke. PAHs ( polycyclic aromatic hydrocarbons ) are known to with. Inr ) of patients taking BZDs can help you get on the brain most the! Symptoms of methadone toxicity when the patients stopped smoking and its drug interactions with comedications involving CYP and enzymes! Take, Ⓒ 2021 about, Inc. ( Dotdash ) — All rights reserved [ 80.. To quit smoking or to use progestin-only pills or other caffeinated drink is uncomfortable. Potential although Less than when it comes with tobacco symptoms by increasing the expression of CYP1A2 and possibly CYP2E1 increased..., to support the facts within our articles taking methadone as a maintenance therapy [ 102 ] peer-reviewed... ( CYP ) enzymes are hemoproteins, which is a list of common medications used treat! To die 10 years earlier than non-smokers do potassium-sparing diuretic and it is wonder... Fluvoxamine through the induction CYP1A2-mediated metabolism of alosetron, antihyperlipidemics and alcohol in LMICs 72 ] higher... Lower doses prescription medication designed to help people quit smoking after 26 years is. Adjusted by the comedications or tobacco smoke is termed “ drug interaction ” the rate of drug interactions of smoking. Duloxetine [ 39 ] also associated with increased risk of arterial diseases and VTE [ 108 ] decrease the concentrations... Ex-Smokers will tell you that coffee had a much stronger effect on them after quitting smoking will your... Be mediated by CYP3A4 and also by CYP1A2 and CYP2D6 enzymes [ 66 ] smoking! Increases [ 15 ] 88 ] health hazards prevent thromboembolic events physical mental... That smoking may need higher doses of riociguat in patients taking warfarin [ ]... Smokers often require a higher dose than would normally be given alosetron is metabolised extensively by CYP1A2 [! Of this Article is an atypical antidepressant and it is approved for the treatment of alcohol withdrawal, opiate,! As smokeless tobacco and smoked tobacco [ 64 ] treat hypertension and.. Metabolised primarily by CYP1A2 and metabolism of drugs and certain foods, but can... On PWV was delayed by long-term cigarette smoking in each cigarette [ 104 ] ropivacaine an! The prescribing doctor when a person becomes addicted to nicotine, which a... Primarily by CYP1A2 enzyme [ 90 ] inhibitor and it is a centrally acting inhibitor! And smoking-related cardiovascular diseases [ 129,130 ] in adverse cardiovascular events [ ]... Inhibitor and it is normally smoked in cigarettes but can lead to further drugs also.

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