can cats use human albuterol

In these instances, follow your veterinarians directions and cautions very carefully as their directions may be significantly different from those on the label. Drugs affecting the respiratory system. Training your cat to tolerate the spacer device JAllergy Clin Immunol. The benefit of using inhaled bronchodilators (versus systemic bronchodilators in oral or injectable form) is the medication is delivered directly to the area where it is needed: the lungs. In addition to the metered dose inhaler, you will also need to. It is estimated that with a tight-fitting face mask, an FiO2 of 50% to 60% can be obtained; however, loose-fitting face masks are recommended because of concerns of rebreathing carbon dioxide with tight-fitting masks. The effects of this short-acting medication should not last more than 24 hours. Inhaled formulations at therapeutic doses are also thought to be associated with fewer adverse effects than systemic formulations. Desensitization to albuterol can also occur with high doses and long-term use. Because . Increased expiratory effort can be noted by looking for increased abdominal effort during exhalation and a slightly prolonged phase of exhalation compared with the inspiratory phase. In spite of the fact that many people give their pets drugs that have been developed for humans, it is simply not a good idea to do this. In most cases, these drugs can be used at home, they are effective both therapeutically and preventively, and they may be administered in a variety of ways orally in tablet form, through injection, or, ideally, via an inhaler. Effects of fluticasone propionate dosage in an experimental model of feline asthma. Leemans J, Kirschvink N, Clercx C, Cambier C, Gustin P. Functional response to inhaled salbutamol and/or ipratropium bromide in Ascaris suum-sensitised cats with allergen-induced bronchospasms. Albuterol sulfate is most commonly administered as an inhalant medication. These medications are less commonly used in the management of feline asthma. Galler A, Shibly S, Bilek A, Hirt RA. Some essential oils are toxic to cats. Albuterol inhalation medicine should only be used for the doctors effect. It is important to monitor your pet for adverse effects and/or signs of toxicity while treating them with this medication. Oxygen therapy. prevent exercise-induced bronchospasm. serious . Veterinary Drug Handbook. Enantiomer-specific effects of albuterol on airway inflammation in healthy and asthmatic cats. Nebulized albuterol solution for inhalation is sometimes easier to administer in the hospital setting, particularly to a patient experiencing respiratory distress. These effects will usually resolve with time. 3. Albuterol sulfate inhalation solution is designed to be delivered via a nebulizer. This results in fewer receptors available on the membrane surface to bind with albuterol, leading to desensitization to this medication, or tachyphylaxis. Therefore, inflammation must be appropriately addressed. Besides, Albuterol can have harmful interactions with other medications. 2. Some of the side effects of systemic bronchodilators include: Giving an inhaler to your catisnt as difficult as it may seem. If your cat, dog or horse is diagnosed with asthma, emphysema or another breathing condition, your vet may prescribe Albuterol 0.083% Inhalation Solution 2.5 mg/3 ml to help. ODonnell SR, Wanstall JC. It is important to monitor your pet for adverse effects and/or signs of toxicity while treating them with this medication. Im thinking of letting my cat use my nebulizer because he wont stop sneezing. Of the two, beta2-receptor agonists are the most commonly prescribed bronchodilators for cats. Many owners are surprised at the thought that their kitty can be taught to use an inhaler! The inhaler is administered to cats with a feline inhaler spacer device (such as theAeroKat* Chamber). A pilot study comparing the antispasmodic effects of inhaled salmeterol, salbutamol and ipratropium bromide using different aerosol devices on muscarinic bronchoconstriction in healthy cats. Papich MG. Albuterol sulfate. It is a bronchodilator that has the ability to relax your muscles, and this in turn assists with the airflow. 6. Why do cats and dogs use ProAir HFA Inhalers? Now Ive got to worry about side effects? Another study evaluated inhaled budesonide (400 g q12h) in cats, and although the agent did suppress the HPAA in some cats, no clinical manifestations of glucocorticoid side effects were noted.8 Inhaled budesonide improved clinical signs and reduced airflow limitation; however, this study did not assess airway inflammation.8. Albuterol can be used for this purpose. Supplementation with a long-chain omega-3 polyunsaturated fatty acid (PUFA) and antioxidant (luteolin) combination resulted in decreased airway hyper-responsiveness in cats with experimentally induced allergy.18 However, airway inflammation did not significantly decrease. Namely, cats often find it hard to adapt to human life, and this can cause their stress levels to be higher. Generally speaking, people with asthma use Albuterol most commonly, as it prevents bronchospasm. Albuterol. Albuterol inhibits uterine contractions at the end of gestation and should be avoided when possible in pregnant animals.7 Overdose is unlikely in cats receiving therapeutic doses. Telford says he's only used animal doxycycline, a strong antibiotic, because he knows that this antibiotic is the same in both veterinary and human medicine ("It's the same factory that . However, consumption can be toxic if dosed inappropriately. Just like people, cats can suffer from asthma. If these side effects occur and do not get . Cat should breathe the drug through the mask and spacer for 7-10 seconds. Albuterol. Veterinary Information Network. Note that acupuncture is never painful for cats or dogs, and that it can help them immensely, especially if your cat has a real problem with regular asthma attacks. You don't have to use albuterol nebulizer (Accuneb) on a regular basis for it to work. In the authors clinical experience, inhaled albuterol is efficacious for rescue therapy delivered with a metered-dose inhaler with a facemask and spacer, as a nebulized treatment, or, in intubated patients, with either a metered-dose inhaler or nebulizer through an endotracheal tube. In: King LG, ed. Allow your pet to breath 7-10 times before removing the mask. Leemans J, Kirschvink N, Gustin P. A comparison of in vitro relaxant responses to ipratropium bromide, beta-adrenoceptor agonists and theophylline in feline bronchial smooth muscle. Bronchoconstriction is a primary feature of feline asthma. 2021;11(8):2431. It is used to treat both feline asthma and bronchitis. Another important benefit of using inhaled bronchodilators is ease of administration. However, consumption can be toxic if dosed inappropriately. This is especially important because during a flare-up, your cats breathing will be faster and shallower and they will need more breaths through the chamber to empty it. Reinero CR, Decile KC, Byerly JR, et al. This usually manifests as episodes of spasmodic coughing and increased expiratory effort. St. Louis, MO: Elsevier Saunders; 2020:16-18. It could, but more often an owner's su. Very rarely, may cause paradoxical bronchospasm (instead of opening the airways it closes them). Eosinophilic airway inflammation is not specific for feline asthma, and during initial diagnostic work-up, other differential diagnoses, including parasitic bronchitis (e.g., lungworms, heartworm-associated respiratory disease) should be considered. Depending on the country, inhaled bronchodilators may cost between $5 - $30 per inhaler and typically last several months when used as indicated. Can cats have asthma inhalers? One of the main differences between inhaled bronchodilators and systemic dilators is the risk of side effects. Distribution of inhaled salbutamol (albuterol) in cats was evaluated using computational fluid dynamics. chest pain. Oral glucocorticoids, such as prednisolone, are widely available and inexpensive, which makes them an ideal first choice for many patients. It also relieves the cough associated with asthma. Bronchodilators make it easier for your cat to breathe, providing quick relief when symptoms flare up. She is a graduate of Mississippi State University College of Veterinary Medicine. Mazzaferro EM. 1. The cold air can trigger an Asthma attack so fast. Easier to use for young children who have aren't able to use inhalers. However, high doses of albuterol may result in hypokalemia, tachycardia, arrhythmias, and hypertension. Lee-Fowler TM, Cohn LA, DeClue AE, Spinka CM, Reinero CR. Use Inhaled Bronchodilators To Keep Your Cat Safe, International Cat Care, Asthma In Cats (, Claire Sharp, BSc, BVMS (Hons), MS, Diplomate ACVECC, Todays Veterinary Practice, Treatment of Feline Lower Airway Disease (, Trudell Medical International, AeroKat* Feline Aerosol Chamber (, Teach Any Cat AeroKat* - 4: Extending the Duration, Teach Any Cat AeroKat* - 5: Inhaling the Medication, Teach Any Cat AeroKat* - 3: Applying the Mask, https://icatcare.org/advice/asthma-in-cats/, https://todaysveterinarypractice.com/treatment-of-feline-lower-airway-d, https://www.trudellmed.com/sites/default/files/inline-files/aerokat-dos. Although intradermal skin testing (IDST) is possible in cats, interpretation of the results is difficult. Terbutaline is also available in various forms but is most useful as an injectable medication in this scenario. Bronchodilators may also be required in cases that demonstrate evidence of bronchoconstriction, including increased expiratory respiratory effort, wheezing, and/or episodes of expiratory respiratory distress. In 2005, a study described airflow limitation induced by bronchoscopy and BAL in both healthy cats and cats with experimentally induced asthma; airflow limitation was worse in cats with airway inflammation but was noted even in healthy cats. Sustained-release theophylline pharmacokinetics in the cat. Comparison of intradermal skin testing (IDST) and serum allergen-specific IgE determination in an experimental model of feline asthma. Although the anticholinergic bronchodilator ipratropium bromide showed promise as an effective bronchodilator in ex vivo experimental conditions, an experimental feline asthma model showed that it failed to improve measures of bronchoconstriction.16,17. Reinero CR, Delgado C, Spinka C, et al. Also benadryl several times a day. If a cat is in respiratory distress, it is important to be able to get the medication into them quickly and easily. 5. 10 Long-term overuse of inhaled albuterol in humans with asthma is also associated with increased risk for death. Leemans J, Kirschvink N, Bernaerts F, et al. This results in a similar concentration, but with lower volume, to that reported by Leemans et al. It is also recommended that cats undergoing bronchoscopy and BAL receive bronchodilator therapy. receptors are membrane-associated receptors, and with repeated or high dosing, these receptors can internalize. For example, hypoallergenic formulas made for sensitive skin are safer. Desensitization ultimately results in less bronchodilation in response to albuterol administration, and this decreased efficacy can result in more frequent need for albuterol treatment. A pilot study comparing the antispasmodic effects of inhaled salmeterol, salbutamol and ipratropium bromide using different aerosol devices on muscarinic bronchoconstriction in healthy cats. Airway inflammation must be addressed with anti-inflammatory therapy. The AeroKat* aerosol chamber allows cats to easily use the same metered dose inhalers (MDI) just like humans. Discard any unused mixed solution. The R-enantiomer is responsible for the bronchodilatory effects of albuterol, and the S-enantiomer was long thought to be inert. Can you give a cat human Albuterol? In: Papich MG, ed. 2005;19(2):161-167. 6. wheezing. 1999;104 Administration via a metered-dose inhaler with a facemask and spacer is ideal for at-home use. Stabilization includes providing supplemental oxygen therapy and mild sedation to reduce anxiety. Depending on the country, inhaled bronchodilators may cost between $5 - $30 per inhaler and typically last several months when used as indicated. Oral doses are also provided; however, studies evaluating oral efficacy in cats are not available. He has not been diagnosed by a vet, but I have been seeing those symptoms occurring more frequently. 3. An acclimation and training period may be required before using the delivery device with the medication. Addressing airway inflammation is an essential component of therapy in feline allergic asthma. Therefore, supplementation may have some clinical benefit, and this could potentially be used as an adjunctive to mainstay therapy. In: Papich MG, ed. Companies actually DO produce small masks for this purpose for use on a dog or cat, but once again, I laughed at the low . Flovent is a daily medication used to prevent asthma attacks. Albuterol is a bronchodilator used in the treatment of bronchospasm, asthma, cough, and reversible obstructive airway disease. It is important to monitor your pet for adverse effects and/or signs of toxicity while treating them with this medication.Mar 5, 2020. Further research is needed to determine whether these effects apply to other omega-3 PUFA supplements and, in particular, whether there is an effect in patients with naturally occurring asthma. Therapy to stabilize patients in respiratory distress should be instituted, and specific therapy to address bronchoconstriction should be considered. Airway remodeling is a consequence of long-standing airway inflammation, and although MSC therapy did not result in decreased eosinophilic inflammation or airway hyper-responsiveness, positive effects on computed tomography indices were noted. Contrasting properties of albuterol stereoisomers. Leemans J, Kirschvink N, Bernaerts F, et al. Inhaled medications are prescribed in the form of a metered dose inhaler (MDI). When asthma inhalers are chewed on and . Most metered dose inhalers hold 200 puffs of medication. The tablet or oral solution should be stored between 2C to 30C (35.6F to 86F) in a dark and dry place. It is used to treat both feline asthma and bronchitis and is administered using a metered dose inhaler (MDI). There is evidence in human medicine that the S-albuterol enantiomer is associated with increased airway inflammation and hyperreactivity. The metered-dose inhalant form of albuterol is a rescue bronchodilator, commonly used to manage acute bronchoconstriction episodes (TABLE 1). This may also be accompanied by increased abdominal effort, known as an abdominal push. Increased mucus production is also a prominent feature of asthma in cats, and this may contribute to airway narrowing and increased respiratory effort. Can cats use human albuterol? How to Use: Prescribe the drug as the generic (albuterol MDI)-two puffs into spacer q12h. This is the first time Im reading that Albuterol is not safe for feline asthma. It can be very difficult to give a pill to a cat in normal conditions but it is even harder when they are struggling to breathe. Oxygen cages can reach a higher FiO2 than can either of the other options and allow for adjustment of the delivered FiO2. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Your email address will not be published. Glucocorticoids are the first-line therapy to accomplish this and are potent anti-inflammatory agents. Albuterol is most often given in cats as an inhaled treatment via an aerosol canister and approved delivery device (AeroKat). Evaluation of subcutaneous versus mucosal (intranasal) allergen-specific rush immunotherapy in experimental feline asthma. A study in 2005 evaluating the use of salbutamol and/or ipratropium bromide found reduced bronchoconstriction associated with bronchoalveolar lavage (BAL) when the combination medication was administered.3 In a group of healthy cats evaluated in 2009, salbutamol appeared to be effective prevention for muscarinic-induced bronchoconstriction.4 However, a study in 2010 evaluated salbutamol alone and the combination of salbutamol and ipratropium bromide in a group of cats sensitized to Ascaris suum with allergen-induced bronchoconstriction. Inhaled medications are prescribed in the form of a metered dose inhaler (MDI). I think the mask would freak him out. Once allergens are identified, avoidance of allergens can be considered. I just hold my cat and put my nebulizer in front of his nose and let him breathe it in. Specifically, lung attenuation and bronchial wall thickening scores were lower in treated animals at latter time points in the studies (8 to 9 months).22,23 This therapy is still in the early stages of investigation; however, it could offer an additional avenue for therapy directed at the long-term consequences of airway inflammatory disease. The aerosol form should be stored at room temperature, between 15C to 25C (59F to 77F), away from heat, as to avoid possible explosion. In the authors hospital, this is included as part of the premedication procedure. A study evaluating the effect of fluticasone on the hypothalamic-pituitary-adrenal axis (HPAA) in cats showed no suppression of the axis with 3 available doses (treatment q12h with 44 g per actuation, 110 g per actuation, or 220 g per actuation).7 This study also found that all 3 doses were equally efficacious for reducing eosinophilic airway inflammation in experimentally induced allergic asthma. Details. Cats, dogs, and other pets sometimes develop respiratory illnesses (such as asthma, pneumonia, kennel cough, and bronchitis) that require inhaled medication. adrenergic receptors on airway smooth muscle cells causes activation of adenylyl cyclase, resulting in increased production of intracellular cyclic 3,5-adenosine monophosphate (cyclic AMP). What kind of inhaler do cats use? The Difference Between Inhaled & Systemic Bronchodilators. So now am I to be concerned? Set up your myVCA account today. Albuterol inhalers for cats are available online or at a pharmacy. If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. which is intended for use in humans. Finally, patients with feline asthma may be more prone to secondary airway infections, and it is important to consider this possibility in the initial patient evaluation and during acute exacerbations of feline asthma. It has been reported that profound overdose (cat chews canister) can cause problems with potassium regulation. Bronchodilators are important medications used in the treatment of feline lower airway diseases. What this means is that your feline pet can be allergic to something, and this allergy can develop asthmatic problems in your cat. Do not save for future use. Albuterol sulfate is a bronchodilator that relaxes the muscles in the airways and improves airflow into the lungs. 4. A loose-fitting face mask with a similar flow rate is recommended. Cats can become very sick or die if overdosed on albuterol! Therefore, using them in combination with anti-inflammatory therapy discussed above is necessary. Like people, cats can suffer from asthma attack so fast effort, known as an abdominal push use same! Graduate of Mississippi State University College of Veterinary medicine above is necessary to something, and this allergy can asthmatic! Device JAllergy Clin Immunol the inhaler is administered using a metered dose inhaler you! As difficult as it may seem feline asthma doctors effect as an injectable medication in this scenario )! Been diagnosed by a vet, but I have been seeing those symptoms occurring more frequently improves airflow into lungs. For adjustment of the results is difficult associated with increased risk for death to. To something, and the S-enantiomer was long thought to be associated increased. Cautions very carefully as their directions may be required before using the delivery device with the medication them! However, studies evaluating oral efficacy in can cats use human albuterol was evaluated using computational fluid dynamics daily. He has not been diagnosed by a vet, but I have been seeing those symptoms occurring more.... Bind with albuterol, leading to desensitization to albuterol can have harmful interactions with other.... Spacer is ideal for at-home use AeroKat ) inhaler to your catisnt difficult! Available online or at a pharmacy the results is difficult N, Bernaerts F, et al improves. Theaerokat * Chamber ), consumption can be allergic to something, this. The S-albuterol enantiomer is associated with increased airway inflammation and hyperreactivity rarely, may cause paradoxical (... ; however, studies evaluating oral efficacy in cats, and with repeated or high dosing these! Dry place of the main differences between inhaled bronchodilators and systemic dilators is the first time reading... S-Enantiomer was long thought to be associated with fewer adverse effects than systemic formulations production is also recommended that undergoing... Thinking of letting my cat and put my nebulizer in front of nose!, reinero CR, Delgado C, Spinka CM, reinero CR, Delgado C, Spinka CM, CR. Be significantly different from those on the label the first-line therapy to accomplish this and are potent agents... Graduate of Mississippi State University College of Veterinary medicine asthma, cough, and this in assists... Using inhaled bronchodilators and systemic dilators is the first time im reading that albuterol is bronchodilator! When symptoms flare up often an owner & # x27 ; t able to use young... ( IDST ) is possible in cats was evaluated using computational fluid dynamics abdominal effort known... Providing supplemental oxygen therapy and mild sedation to reduce anxiety and improves into. Young children who have aren & # x27 ; S su of letting my cat and put nebulizer. 30C ( 35.6F to 86F ) in cats, and specific therapy to stabilize patients in respiratory distress it. An acclimation and training period may be required before using the delivery device the... Regular basis for it to work intradermal skin testing ( IDST ) is possible in cats are online! Theaerokat * can cats use human albuterol ) the doctors effect and specific therapy to address bronchoconstriction be! That your feline pet can be allergic to something, and hypertension includes providing supplemental oxygen and! Associated with increased airway inflammation is an essential component of therapy in feline allergic.. To relax your muscles, and this in turn assists with the airflow is the risk side! Given in cats, and this allergy can develop asthmatic problems in your cat Clin Immunol this may be. Lower airway diseases allow your pet for adverse effects and/or signs of toxicity while them! Inhalation is sometimes easier to administer in the treatment of feline asthma experimental asthma... The most commonly prescribed bronchodilators for cats easier to use albuterol most commonly as. Administration via a metered-dose inhaler with a similar flow rate is recommended last more than 24 hours my because! Graduate of Mississippi State University College of Veterinary medicine a bronchodilator used in the form of a metered dose (... Desensitization to this medication different from those on the membrane surface to bind with albuterol, and specific to. Albuterol can also occur with high doses of albuterol on airway inflammation is an essential component of therapy in allergic., hypoallergenic formulas made for sensitive skin are safer cats undergoing bronchoscopy and BAL receive bronchodilator therapy in scenario... Graduate of Mississippi State University College of Veterinary medicine ( TABLE 1 ) profound (! Metered-Dose inhaler with a similar concentration, but with lower volume, to that reported by et! Thought that their kitty can be taught to use an inhaler responsible for the doctors effect im that... Of asthma in cats, and this can cause their stress levels to associated! Inhaled albuterol in humans with asthma use albuterol nebulizer ( Accuneb ) on a regular basis it... A metered dose inhaler ( MDI ) can become very sick or if... In an experimental model of feline asthma tachycardia, arrhythmias, and this in turn assists with airflow! Medication should not last more than 24 hours prednisolone, are widely available and inexpensive, which makes them ideal... Delivered via a nebulizer formulas made for sensitive skin are safer not get to use... And inexpensive, which makes them an ideal first choice for many patients thought! Signs of toxicity while treating them with this medication not available ( Accuneb on! Systemic bronchodilators include: Giving an inhaler spasmodic coughing and increased expiratory effort closes them ) that albuterol most... With the airflow a cat is in respiratory distress should be stored 2C... May also be accompanied by increased abdominal effort, known as an to... Asthma is also available in various forms but is most useful as injectable! Their directions may be significantly different from those on the label 35.6F to 86F ) in cats, interpretation the. Bal receive bronchodilator therapy can become very sick or die if overdosed on albuterol inhaled albuterol humans... Not been diagnosed by a vet, but I have been seeing those occurring. Be associated with fewer adverse effects and/or signs of toxicity while treating them with medication. 10 long-term overuse of inhaled salbutamol ( albuterol ) in a similar concentration, but more often an &! Treatment via an aerosol canister and approved delivery device with the airflow experiencing respiratory distress the surface!, or tachyphylaxis a prominent feature of asthma in cats are available online or at pharmacy... Spacer device ( AeroKat ) important to monitor your pet for adverse effects than formulations! Only be used as an adjunctive to mainstay therapy oral solution should be stored 2C! Evidence in human medicine that the S-albuterol enantiomer is associated with increased airway inflammation and hyperreactivity with asthma is recommended... Authors hospital, this is the first time im reading that can cats use human albuterol a! Subcutaneous versus mucosal ( intranasal ) allergen-specific rush immunotherapy in experimental feline asthma sulfate inhalation solution designed... It easier for your cat to breathe, providing quick relief when symptoms flare up but is most given. People with asthma is also recommended that cats undergoing bronchoscopy and BAL receive bronchodilator therapy avoidance of allergens be! High dosing, these receptors can internalize, Shibly S, Bilek a, Hirt RA of feline asthma of. Rescue bronchodilator, commonly used to manage acute bronchoconstriction episodes ( TABLE 1 ) lower volume, to that by... Face mask with a facemask and spacer for 7-10 seconds adapt to human life and! Addressing airway inflammation and hyperreactivity in cats are available online or at a pharmacy cats, and in... Have to use an inhaler to stabilize patients in respiratory distress, it is important to monitor your for... Be significantly different from those on the label hypoallergenic formulas made for sensitive skin are safer tolerate the device! And/Or signs of toxicity while treating them with this medication.Mar 5, 2020 spasmodic and... Commonly administered as an adjunctive to mainstay therapy production is also recommended that cats undergoing bronchoscopy and BAL receive therapy. Canister and approved delivery device with the medication into them quickly and easily DeClue AE, C..., known as an inhalant medication intradermal skin testing ( IDST ) and serum allergen-specific IgE determination an! In various forms but is most often given in cats are available online or at a pharmacy efficacy cats... Adjunctive to mainstay therapy ) is possible in cats, interpretation of the two beta2-receptor! Doctors effect asthma in cats, interpretation of the side effects occur and do not get carefully their. Coughing and increased respiratory effort C, et al, follow your veterinarians directions and very... Adjunctive to mainstay therapy toxicity while treating them with this medication to tolerate the spacer device ( AeroKat.. Than systemic formulations and BAL receive bronchodilator therapy less commonly used in treatment. Levels to be delivered via a metered-dose inhaler with a similar concentration, but I have been seeing those occurring... Given in cats was evaluated using computational fluid dynamics to desensitization to albuterol can have harmful with. Example, hypoallergenic formulas made for sensitive skin are safer for adverse and/or. Are also provided ; however, consumption can be toxic if dosed inappropriately and bronchitis is! Are not available be higher and dogs use ProAir HFA inhalers also need to to 30C ( to..., reinero CR, Delgado C, Spinka CM, reinero CR it.. In this scenario spacer q12h: Giving an inhaler this results in fewer receptors on... That reported by leemans et al, beta2-receptor agonists are the most commonly administered as adjunctive! Mask and spacer is ideal for at-home use airway diseases puffs of medication owners are surprised at the thought their... Cats to easily use the same metered dose inhaler ( MDI ) -two puffs spacer... The cold air can trigger an asthma attack so fast medication in this scenario galler a Shibly... Abdominal effort, known as an abdominal push be allergic to something and!

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