The prostate is a gland located below the bladder of men. It surrounds the urethra you-REETH-rah which is a tube that drains urine from the bladder. BPH is an enlargement of the prostate gland. The symptoms of BPH, however, can be caused by an increase in the tightness of muscles in the prostate. If the muscles inside the prostate tighten, they can squeeze the urethra and slow the flow of urine. This can lead to symptoms such as: What is BPH? Food and Drug Administration. What Is Terazosin and How Does It Work? Methohexital: Concurrent use of methohexital and alpha-blockers increases the risk of developing hypotension and hypothermia. vivitrol prices costco
Guthrie R "Terazosin in the treatment of hypertension and symptomatic benign prostatic hyperplasia - a primary care trial. As shown, both the probability of a patient's remaining in sinus rhythm at six months and the change in QTc from baseline at steady state of dosing increased in an approximately linear fashion with increasing dose of Tikosyn. Note that in these studies, doses were modified by results of creatinine clearance measurement and in-hospital QTc prolongation. Wing LMH, Reid CM, Ryan P, et al, for Second Australian National Blood Pressure Study Group. A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med.
Fospropofol: General anesthetics can potentiate the hypotensive effects of antihypertensive agents. Additional adverse reactions have been reported, but these are, in general, not distinguishable from symptoms that might have occurred in the absence of exposure to terazosin. Carbetapentane; Pseudoephedrine: The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by alpha-blockers. Monitor blood pressure and heart rate. Geriatric patients may be more sensitive to the hypotensive and adverse effects dry mouth and drowsiness of terazosin. Monitor older adult patients closely. According to the Beers Criteria, terazosin is considered a potentially inappropriate medication PIM for use in geriatric patients and should be avoided as routine treatment of hypertension in this population due to the high risk of orthostatic hypotension and the availability of alternative agents with a superior benefit to risk profile. In addition, the Beers expert panel recommends avoiding terazosin in geriatric patients with syncope due to an increased risk of orthostatic hypotension or bradycardia, and also avoiding terazosin in elderly females with urinary incontinence, regardless of cause or type, because aggravation of incontinence may occur. The federal Omnibus Budget Reconciliation Act OBRA regulates medication use in residents of long-term care facilities LTCFs. According to the OBRA guidelines, antihypertensive regimens should be individualized to achieve the desired outcome while minimizing adverse effects. Antihypertensives may cause dizziness, postural hypotension, fatigue, and there is an increased risk for falls. Terazosin can cause significant hypotension and syncope during the first few doses; therefore, the dose should be administered at bedtime initially, and the drug slowly titrated as needed. There are many drug interactions that can potentiate the effects of antihypertensives. Some agents require a gradual taper to avoid adverse consequences caused by abrupt discontinuation.
Geriatric patients: approximately 14 hours. There is no known antidote to Tikosyn; treatment of overdose should therefore be symptomatic and supportive. The most prominent manifestation of overdosage is likely to be excessive prolongation of the QT interval. Older adults may be more sensitive to the side effects of this drug, especially dizziness, fainting, and low blood pressure when getting up from a sitting or lying position. These side effects can increase the risk of falling. Amobarbital: Concurrent use of amobarbital with antihypertensive agents may lead to hypotension. Monitor for decreases in blood pressure during times of coadministration.
Vardenafil: Concurrent use of phosphodiesterase PDE5 inhibitors and alpha-blockers may lead to symptomatic hypotension in some patients. Vardenafil, other PDE5 inhibitors, and alpha-blockers are systemic vasodilators which can lower blood pressure. If vasodilators are used in combination, an additive effect on blood pressure is anticipated. Patients should be stable on alpha-blocker therapy before starting PDE5 inhibitor therapy. If hemodynamic instability is evident on alpha-blocker therapy alone, there is an increased risk of symptomatic hypotension with concomitant PDE5 inhibitor therapy. For patients who are stable on alpha-blocker therapy, PDE5 inhibitors should be started at the lowest recommended dose. If a patients is currently receiving an optimized dose of a PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose. In general, patients should not be initiated on the orally disintegrating vardenafil tablets while on alpha-blocker therapy; however, if patients have previously used the film-coated tablets, this may be changed to the orally disintegrating tablets upon the advice of the healthcare provider. Stepwise increases in the alpha-blocker dose may be associated with further hypotension when taking a PDE5 inhibitor. Other variables, such as intravascular volume depletion and other antihypertensive drugs, may affect the safety of concomitant use of PDE5 inhibitors and alpha-blockers. Studies have been conducted to determine the effects of vardenafil on the potentiation of the blood-pressure-lowering effects of the alpha-blockers terazosin and tamsulosin. When vardenafil 10 or 20 mg was administered to healthy subjects taking terazosin 10 mg daily an alpha-1-blocker, there was significant augmentation of the hypotensive effects of terazosin on standing systolic blood pressure. What are the possible side effects of Tikosyn? Psaty BM, Heckbert SR, Koepsell TD et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. Carbetapentane; Phenylephrine; Pyrilamine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. NYHA Functional Class I or II. Approximately one-half had structural heart disease including ischemic heart disease, cardiomyopathies, and valvular disease and about one-half were hypertensive. A substantial proportion of patients were on concomitant therapy, including digoxin over 60% diuretics over 20% and ACE inhibitors over 30%. About 90% were on anticoagulants. Tikosyn is indicated for the conversion of atrial fibrillation and atrial flutter to normal sinus rhythm. If you use more than 1 dose daily and miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. The overall systemic clearance of dofetilide is decreased and plasma concentration increased with decreasing creatinine clearance. The dose of Tikosyn must be adjusted based on creatinine clearance see . Patients undergoing dialysis were not included in clinical studies, and appropriate dosing recommendations for these patients are unknown. There is no information about the effectiveness of hemodialysis in removing dofetilide from plasma.
Propofol: General anesthetics can potentiate the hypotensive effects of antihypertensive agents. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. There are many other ways to treat constipation, such as drinking more water or adding more fiber, fruits, and vegetables to your diet. These are often recommended in addition to taking laxatives. Cariprazine: Orthostatic vital signs should be monitored in patients who are at risk for hypotension, such as those receiving cariprazine in combination with antihypertensive agents. Atypical antipsychotics may cause orthostatic hypotension and syncope, most commonly during treatment initiation and dosage increases. Patients should be informed about measures to prevent orthostatic hypotension, such as sitting on the edge of the bed for several minutes prior to standing in the morning, or rising slowly from a seated position. Consider a cariprazine dose reduction if hypotension occurs. Tell your doctor if your condition does not improve or if it worsens. If you miss a dose of terazosin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Fluoxetine; Olanzapine: Olanzapine may induce orthostatic hypotension and thus enhance the effects of antihypertensive agents. Acetaminophen; Dichloralphenazone; Isometheptene: Sympathomimetics can antagonize the antihypertensive effects of adrenergic agonists when administered concomitantly. Patients should be monitored for loss of blood pressure control. In cases of overdose, cardiac monitoring should be initiated. Charcoal slurry may be given soon after overdosing but has been useful only when given within 15 minutes of Tikosyn administration. Treatment of Torsade de Pointes or overdose may include administration of isoproterenol infusion, with or without cardiac pacing. Administration of intravenous magnesium sulfate may be effective in the management of Torsade de Pointes. Close medical monitoring and supervision should continue until the QT interval returns to normal levels. prazosin
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. There was a tendency for patients to gain weight during Terazosin therapy. Before initiating Tikosyn therapy, previous antiarrhythmic therapy should be withdrawn under careful monitoring for a minimum of three 3 plasma half-lives. Duloxetine: Orthostatic hypotension and syncope have been reported during duloxetine administration. The concurrent administration of antihypertensive agents and duloxetine may increase the risk of hypotension. Monitor blood pressure if the combination is necessary. Both studies randomized patients to placebo or to doses of Tikosyn 125 mcg, 250 mcg, 500 mcg, or in one study a comparator drug, given twice a day these doses were lowered based on calculated creatinine clearance and, in one of the studies, for QT interval or QTc. Exclude possibility of prostate cancer before initiation of therapy for BPH. Even though you take terazosin hydrochloride and it may help you, terazosin hydrochloride may not prevent the need for surgery in the future. Testicular weights and morphology were unaffected by treatment. Terazosin may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to terazosin before you drive, use machines, or do anything else that could be dangerous if you are dizzy, drowsy, or are not alert. After you have taken several doses of terazosin, these effects should lessen. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Tikosyn than on placebo were: angina pectoris, anxiety, arthralgia, asthenia, atrial fibrillation, complications application, injection, incision, insertion, or device hypertension, pain, palpitation, peripheral edema, supraventricular tachycardia, sweating, urinary tract infection, ventricular tachycardia. Holtzman JL, Kaihlanen PM, Rider A et al. Concomitant administration of the terazosin and atenolol for the treatment of essential hypertension. Arch Intern Med. If a child is using this medication, a parent or other responsible adult should supervise and help the child use this medication properly. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs. danocrine price in mercury danocrine
Amyl Nitrite: Concomitant use of nitrates with other antihypertensive agents can cause additive hypotensive effects. Dosage adjustments may be necessary. Serum potassium should be maintained within the normal range before Tikosyn treatment is initiated and should be maintained within the normal range while the patient remains on Tikosyn therapy. Remember that your doctor has prescribed this because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication not have serious side effects. Tikosyn can be taken with or without food. If terazosin hydrochloride is helping you, you should notice an effect on your particular symptoms in 2 to 4 weeks of starting to take the medication. Tikosyn for up to three years. The clearest drug-effect associations were for sternebral and vertebral anomalies in both species; cleft palate, adactyly, levocardia, dilation of cerebral ventricles, hydroureter, hydronephroses, and unossified metacarpal in the rat; and increased incidence of unossified calcaneum in the mouse. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Roberts RG. Novel idea in BPH guideline: the patient as decision maker. Am Fam Physician. Ex-Lax, Feen-a-Mint, or speed up how fast a stool moves through the intestines by irritating the lining of the intestines. Regular use of stimulant laxatives is not recommended. Stimulant laxatives change the tone and feeling in the large intestine and you can become dependent on using laxatives all the time to have a bowel movement. Tikosyn. Of these, 4 cases occurred within the first 3 days of dosing and 3 cases occurred between Day 4 and the conclusion of the study. Female rats were unaffected. AUC 0-24 increased 11% after the first verapamil dose and after 3 weeks of verapamil treatment it increased by 24% with associated increases in C max 25% and C min 32% means. buy brand xalatan online canada
The absence of mutagenicity in a battery of tests, of tumorigenicity of any cell type in the mouse carcinogenicity assay, of increased total tumor incidence in either species, and of proliferative adrenal lesions in female rats, suggests a male rat species-specific event. Numerous other diverse pharmaceutical and chemical compounds have also been associated with benign adrenal medullary tumors in male rats without supporting evidence for carcinogenicity in man. Most reports were in patients treated with an alpha-1 blocker at the time IFIS occurred, but in some instances the alpha-1 blocker had been stopped prior to surgery. The manufacturer recommends that patients be questioned to determine whether or not they have taken alpha-1 blockers prior to being considered for cataract surgery. If it is determined that the patient has taken an alpha-1 blocker, the patient's ophthalmologist should be prepared for possible modifications to their surgical technique that may be necessary should IFIS be observed during the procedure. Peripheral alpha 1-adrenergic receptor blocking agents aka alpha 1-blockers cause vasodilation and can produce marked hypotension, especially orthostatic hypotension with syncope or other postural symptoms such as dizziness, lightheadedness, and palpitations. Orthostatic effects are most common during initiation of therapy and often occur within 90 minutes after the first dose. However, they can also occur following a dosage increase or resumption of therapy after an interruption of more than a few days. Agents with alpha 1a specificity, such as tamsulosin, act primarily on the prostate but are not devoid of hypotensive effects. Therapy with peripheral alpha-1 blockers should be administered cautiously in patients with or predisposed to hypotensive or syncopal episodes. Iloprost: The effects of iloprost on blood pressure may be additive to those of antihypertensive agents. Lower doses of the antihypertensive may be needed with combined treatment. In healthy volunteers, amlodipine, phenytoin, glyburide, ranitidine, omeprazole, hormone replacement therapy a combination of conjugated estrogens and medroxyprogesterone antacid aluminum and magnesium hydroxides and theophylline did not affect the pharmacokinetics of Tikosyn. In addition, studies in healthy volunteers have shown that Tikosyn does not affect the pharmacokinetics or pharmacodynamics of warfarin, or the pharmacokinetics of propranolol 40 mg twice daily phenytoin, theophylline, or oral contraceptives. Associated Press American Diabetes Association. Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site. Inform your doctor if your condition worsens.
This helps to relieve symptoms of such as difficulty in beginning the flow of urine, weak stream, and the need to urinate frequently or urgently including during the middle of the night. It is not known if Tikosyn is safe and effective in children under 18 years of age. The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply. Sevoflurane: General anesthetics can potentiate the hypotensive effects of antihypertensive agents. Additional adverse events have been reported, but these are, in general, not distinguishable from symptoms that might have occurred in the absence of exposure to Terazosin. The safety profile of patients treated in the long-term open-label study was similar to that observed in the controlled studies. The presence of other medical problems may affect the use of terazosin. Tetracaine: Local anesthetics may cause additive hypotension in combination with antihypertensive agents. Use extreme caution with the concomitant use of tetracaine and antihypertensive agents. Risperidone: Risperidone may induce orthostatic hypotension and thus enhance the hypotensive effects of antihypertensive agents. Lower initial doses or slower dose titration of risperidone may be necessary in patients receiving antihypertensive agents concomitantly. It is unknown if this drug passes into milk. Consult your doctor before -feeding. Bromocriptine: Bromocriptine has only minimal affinity for adrenergic receptors; however, hypotension can occur during bromocriptine administration. Orthostatic hypotension occurs in 6% of acromegaly patients receiving the drug. Hypotension occurred frequently approximately 30% in postpartum studies, which in rare cases approached a decline in supine pressure of almost 60 mmHg. It is unknown if bromocriptine is the exact cause of this effect. However, the drug should be used cautiously with other medications known to lower blood pressure such as antihypertensive agents. Monitoring of blood pressure should be considered, especially during the initial weeks of concomitant therapy. Tikosyn and placebo for 551 and 207 patient years, respectively. Carbetapentane; Chlorpheniramine; Phenylephrine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. Hill SJ, Lawrence SL, Lepor H. New use for alpha blockers: benign prostatic hyperplasia. Am Fam Physician. store hydroxychloroquine vaistai
After adjustment for creatinine clearance, no additional dose adjustment is required for patients with mild or moderate hepatic impairment. Patients with severe hepatic impairment have not been studied. Tikosyn should be used with particular caution in these patients. If Terazosin capsules are helping you, you should notice an effect on your particular symptoms in 2 to 4 weeks of starting to take the medication. Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well. Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. Guaifenesin; Phenylephrine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. Blood pressure is the tension of the blood within the blood vessels. If blood is pumped too forcefully, or if the blood vessels are too narrow, the pressure of the blood against the walls of the vessels rises. What is Hypertension High Blood Pressure? It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding. ovem.info trandate
Tikosyn than placebo in patients with supraventricular arrhythmias: angioedema, bradycardia, cerebral ischemia, cerebrovascular accident, edema, facial paralysis, flaccid paralysis, heart arrest, increased cough, liver damage, migraine, myocardial infarct, paralysis, paresthesia, sudden death, and syncope. Ibuprofen; Pseudoephedrine: The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by alpha-blockers. Monitor blood pressure and heart rate. Desmopressin is used to control the amount of urine your kidneys make. Normally, the amount of urine you make is controlled by a certain substance in the body called vasopressin. In people who have "water diabetes" diabetes insipidus or certain kinds of head injury or brain surgery, the body does not make enough vasopressin. Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. This medication helps to control increased thirst and too much urination due to these conditions, and helps prevent dehydration. Olanzapine: Olanzapine may induce orthostatic hypotension and thus enhance the effects of antihypertensive agents. Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet. Use and dose must be determined by your doctor. Rarely, probably less than once in every several thousand patients Terazosin and other α 1-antagonists have been associated with priapism painful penile erection, sustained for hours and unrelieved by sexual intercourse or masturbation. Two or three dozen cases have been reported. Your doctor will do tests before you start and while you take Tikosyn. lexapro
This list is not complete and other drugs may interact with terazosin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Terazosin capsules, like other alpha-adrenergic blocking agents, can cause marked lowering of blood pressure, especially postural hypotension, and syncope in association with the first dose or first few days of therapy. A similar effect can be anticipated if therapy is interrupted for several days and then restarted. Syncope has also been reported with other alpha-adrenergic blocking agents in association with rapid dosage increases or the introduction of another antihypertensive drug. Syncope is believed to be due to an excessive postural hypotensive effect, although occasionally the syncopal episode has been preceded by a bout of severe supraventricular tachycardia with heart rates of 120 to 160 beats per minute. Additionally, the possibility of the contribution of hemodilution to the symptoms of postural hypotension should be considered. Take terazosin by mouth with or without food. Carefully monitor BP during initial titration or subsequent upward dosage adjustment. Importance of informing clinician if bothersome dizziness, lightheadedness, or palpitations occur. This medicine may be harmful if swallowed. It has also been used to help treat bladder problems in women. After applying this medication, wait at least 15 minutes before putting in your contact lens. Dopamine: In general, alpha-blockers should not be used during dopamine infusion. The undesired peripheral vasoconstriction observed with high-dose dopamine is opposed by alpha-adrenergic blockers. Read the patient instruction sheet that comes with this product before you start using desmopressin and each time you get a refill. If you have any questions, consult your doctor or pharmacist. FDA pregnancy category C. It is not known whether terazosin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Dofetilide had no genotoxic effects, with or without metabolic activation, based on the bacterial mutation assay and tests of cytogenetic aberrations in vivo in mouse bone marrow and in vitro in human lymphocytes. Rats and mice treated with dofetilide in the diet for two years showed no evidence of an increased incidence of tumors compared to controls. Patients to be discharged on Tikosyn therapy from an inpatient setting as described above must have an adequate supply of Tikosyn, at the patient's individualized dose, to allow uninterrupted dosing until the patient can fill a Tikosyn prescription. The MIC values of terconazole against most Lactobacillus spp. Concomitant use of trimethoprim alone or in combination with sulfamethoxazole is contraindicated. Trimethoprim 160 mg in combination with 800 mg sulfamethoxazole co-administered BID with Tikosyn 500 mcg BID for 4 days has been shown to increase dofetilide AUC by 103% and C max by 93%. Tranylcypromine: The use of hypotensive agents and tranylcypromine is contraindicated by the manufacturer of tranylcypromine because the effects of hypotensive agents may be markedly potentiated.
Carbinoxamine; Hydrocodone; Pseudoephedrine: The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by alpha-blockers. Monitor blood pressure and heart rate. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using terazosin while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use terazosin, check with your doctor. Discuss any possible risks to your baby. AFl after drug-induced or electrical cardioversion. In a short term study Study 1 patients were randomized to either 2, 5 or 10 mg of Terazosin capsules or placebo. Terazosin than in patients receiving placebo. Similar adverse reaction rates were observed in placebo-controlled monotherapy trials. Terazosin hydrochloride is a white, crystalline substance, freely soluble in water and isotonic saline and has a molecular weight of 459. Do not rinse the dropper. Replace the dropper cap after each use. Ethinyl Estradiol: Estrogen-containing oral contraceptive may induce fluid retention and may increase blood pressure in some patients taking antihypertensive agents. Such patients should be monitored to confirm that the desired antihypertensive effect is being obtained. Aripiprazole: Aripiprazole may enhance the hypotensive effects of antihypertensive agents. Store at room temperature away from light and moisture. not store in the bathroom. Capsules should be stored between 68-77 degrees F 20-25 degrees C because they may soften or melt if stored at higher than recommended temperatures. Keep all away from children and pets. Jungers P, Ganeval D, Pertuiset N et al. Influence of renal insufficiency on the pharmacokinetics and pharmacodynamics of terazosin. Am J Med. Guaifenesin; Pseudoephedrine: The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by alpha-blockers. Monitor blood pressure and heart rate. purchase etodolac from canada
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What is a laxative? Patients should also be told that drowsiness or somnolence can occur with Terazosin capsules, requiring caution in people who must drive or operate heavy machinery. Genitourinary complaints have rarely included impotence and priapism. cefixime mail order usa
Therapy should be initiated with the lowest dosage possible and titrated gradually based on patient response and tolerance in accordance with the individual product package labeling. During initiation or reinstitution of therapy and following an increase in dosage, patients should be advised not to rise abruptly from a sitting or recumbent position and to avoid situations where injury could result if syncope occur. Concomitant use of alcohol, extensive periods of standing, prolonged or intense exercise, and exposure to heat can also precipitate orthostatic hypotension and should be minimized. If dizziness, lightheadedness or palpitations occur, the patient should sit or lie down, and seek medical attention if symptoms are recurrent or bothersome. sominex
Terazosin helps relieve the symptoms of BPH. It does NOT change the size of the prostate, which may continue to grow. However, a larger prostate does not necessarily cause more or worse symptoms. Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs. Lancet. Do not share Terazosin capsules with anyone else; it was prescribed only for you.
Hernandez RH, Angeligreaves M, Carvajal AR, Pajuelo JG, Padilla MCA, Armashernandez MJ "Terazosin: ex vivo and in vitro platelet aggregation effects in patients with arterial hypertension. Dizziness, lightheadedness, or fainting especially when getting up from a lying or sitting position may be more likely to occur in the elderly, who are more sensitive to the effects of terazosin. These medications have specific and limited indications based on the cause and categorization of incontinence. Patients should be assessed periodically for medication effects on urinary incontinence as well as lower urinary tract symptoms and treatment tolerability.