Can nurse practitioners prescribe adderall. CRNAs can prescribe only anesthesia care .
Can nurse practitioners prescribe adderall. be prescribed via telehealth.
Can nurse practitioners prescribe adderall Animal Shelters . Prescription can be prescribed for 30 days. 5) of the ICD-10 medical diagnosis code on controlled substance prescriptions (sometimes referred to as the category and etiology). mn. Patients prescribed a non-narcotic Schedule III, IV, or V drug are required to have an in-person visit within 30 days of receiving a prescription via telemedicine, to obtain refills. F. Dispensing practitioners may include: physicians, dentists, certified optometrists, podiatrists, advanced practice registered nurse May 29, 2024 · Detailed dosage guidelines and administration information for Adderall (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate). A. A pharmacist may fill a prescription written by an out-of-state provider, provided they are licensed in that state, and the pharmacist has taken reasonable steps to determine whether the prescription was issued in compliance with The board may by rule provide for provisional state licensure of certified registered nurse anesthetists, clinical nurse specialists, certified nurse practitioners, psychiatric nurses, and certified nurse midwives for a period of time determined to be appropriate for preparing for and passing the national certification examination. Patient’s Full Name 3. The advanced practice nurse prescriber should utilize a controlled substances From 2022, Real-Time Prescription Monitoring (RTPM) is available in all states and territories. The regulations use the term “practitioner” and state these issues need to be addressed every 3 months. Who can register to access the databases? A person licensed, registered, or otherwise permitted to prescribe, distribute, or dispense a controlled substance in the course of professional practice. 465. Must see a medical practitioner . A physician, podiatrist, dentist, a registered optometrist certified to administer pharmaceutical agents as provided in section 336. 3 NPs hold prescriptive privileges in the United States; 69% provide primary care and the malpractice rate is low (1. Ambulance Service . §§ 567. 055 Partial filling of prescriptions; 105 CMR 722 Dispensing procedures for clinic and hospital pharmacies. As long as the NP and PA are trained and competent to accomplish the assessments required, and the physician Louisiana State Board of Nursing 17373 Perkins Road Baton Rouge, LA 70810 Telephone: (225) 755-7500 Fax: (225) 755-7583 www. 20 Prescription formats – who can prescribe, and how; 105 CMR 721. (2) Only certified nurse practitioners may use that title, the abbreviation “CNP” or any other words, letters, signs or figures indicating that the person using the same is a certified nurse practitioner. Physicians can complete the Online Request for Patient Limit Increase. AS . Others have been disciplined by licensing boards. ” Adderall and Mydayis [11] are trade names [note 2] for a combination drug containing four salts of amphetamine. Find patient medical information for Adderall (30mg) oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. (2) Advanced practice registered nurse--A registered nurse licensed by the Texas Board of Nursing to practice as an advanced practice registered nurse on the basis of completion of an advanced educational program. Some practitioners have been prosecuted for inappropriate prescribing and have gone to jail. 1 of the Health and Safety Code, relating to emergency services was repealed and amended September 26, 2011, (b) An advanced practice registered nurse may prescribe up to a three-day supply of a Schedule II narcotic as provided in §60A-2-206 et seq. 1,2 The number of NPs in the United States increased from 82 000 in 2001 to more than 290 000 in 2020. Sep 13, 2024 · Adderall tongue is a common side effect of Adderall that can detrimentally and seriously affect a person’s quality of life. pdf (dea. Some states provide a formulary listing which narcotic medication can be prescribed by an NP. 5. Feb 27, 2023 · products prescribed by the nurse practitioner or physician assistant and does not supervise more than 4 nurse practitioners or physicianassistants. Can certified nurse practitioners and PAs write prescriptions for C-II controlled substances? Certified nurse practitioners and PAs can write prescriptions for C-II controlled substances if the following requirements have been met: Such is the case in the news this week regarding Cerebral, a telehealth service primarily staffed by nurse practitioners, that is currently under investigation for alleged controlled substance violations by catering to patients seeking Adderall and Xanax 5. children aged 2 to 17 years. The term is (8) The department and board shall establish a transition timeline and process for practitioners certified as of September 30, 2018, as advanced registered nurse practitioners or clinical nurse specialists, to convert a certificate in good standing to a license that becomes effective on October 1, 2018, to practice as an advanced practice Nurse practitioners do not prescribe general anesthetics for the purpose of inducing general anesthesia. Schedule III-V drugs shall be prescribed by an Advanced Practice Registered Nurse with prescriptive authority. Apr 7, 2022 · Schedule II drugs can be prescribed via telemedicine, but only if the clinical situation meets one of the four narrow exceptions (more on that below). A patient should not be prescribed opioid and benzodiazepines or other respiratory depressants (gabapentin, pregabalin, muscle relaxants, sleep aids) concurrently, whether the prescribing is done by one practitioner or multiple pract itioners. 2. (c) There are no other limitations on the prescribing authority of an advanced practice registered nurse, except as provided in §16-54-1 et seq. For example, outside of a hospital setting, diacetylmorphine (heroin) can only be prescribed by medical doctors and nurse practitioners. via telehealth. Advanced practice nurse prescribers should ensure there is adequate testing, assessment and diagnosis prior to prescribing stimulants. g. 220, or an assistant physician in accordance with section 334. Date 2. 893. 3 Among patients with diabetes Can be written, called in, or faxed to the pharmacy by the practitioner or his/her agent. lsbn. Jun 30, 2024 · Vyvanse vs. us and devices utilized to treat medical problems within the specialty field of the nurse practitioner or clinical nurse specialist as prescribed in the practice agreement, so while it may be appropriate in some practices and in some specialty fields to authorize drugs by listing the entire controlled BUPRENORPHINE PRESCRIBING (SB 951) Effective August 28, 2018, APRNs, Physician Assistants and Assistant Physicians with an authorizing collaborative practice/supervisory agreement may now prescribe up to a 30-day supply of buprenorphine for patients receiving medication assisted treatment for a substance use disorder. states, psychiatric nurse practitioners have some level of prescribing privileges. § 1306. Adderall and other ADHD medications can cause dehydration, so you need to drink at least 6 to 8 glasses of fluid per day. [1] Over one-quarter of United States citizens suffer from chronic pain. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Jan 17, 2025 · It has come to the attention of the Georgia State Board of Pharmacy that some Physician Assistants and APRN's have been writing prescriptions for patients that fall into two categories: Nov 13, 2023 · Prescriptive authority is the ability of healthcare providers to prescribe specific medications, including controlled substances. May a PA or an APRN prescribe Schedule II prescriptions to the patient as part of the hospital’s discharge process? The law does not allow Schedule II prescriptions to be written by PAs or APRNs with the intent that the prescription be filled outside of the hospital facility-based practice setting. Nurse Practitioners Laws, Rules & Regulations License Requirements Frequently Asked Questions Application Forms Professional Practice Nursing Education Scholarships, Grants & Loans New York State Nursing Programs Mandatory Prescriber Education License Statistics Consumer Information Contact Information Board Meetings Apr 22, 2024 · Adderall side effects can vary depending on the individual. ADHDMedCalc. R. Nurse practitioners and physician assistants can perform acts of medicine through a practice agreement with a physician. 037 or a physician assistant in accordance with section 334. la. 21 C. Before starting stimulant therapy, advance practice nurse prescribers should establish treatment goals with the patient. Obtain a National Provider Identifier (NPI) issued by the US Center for Medicaid and Medicare Services (CMS) Sep 13, 2024 · Adderall tongue is a common side effect of Adderall that can detrimentally and seriously affect a person’s quality of life. PAs prohibited. Prescription of certain controlled substances and devices by licensed advanced practice registered nurses. Apr 17, 2023 · Following the in-person exam, a patient can receive buprenorphine prescriptions via audio-only telemedicine (telephone), as an alternative to video calls. RTPM is mandatory in Victoria and Queensland and voluntary elsewhere. 105 CMR 721. authority to prescribe controlled substances under a physician protocol • Limited to a 7-day supply of Schedule II controlled substances • Prohibition from prescribing psychiatric mental health controlled substances for children unless the APRN is a psychiatric nurse. Important note: If the prescribing practitioner has previously conducted an in-person medical evaluation of the patient, the practitioner may issue a prescription for a controlled substance after having communicated with the patient via telemedicine, or any other means, regardless of whether a public health emergency has been declared by the Authority to Prescribe. Oct 4, 2024 · If a patient doesn’t desire any alternatives, then Anderson will “try to make their prescription as equivalent as possible. It can also be used to treat narcolepsy. 247 CMR Board of Registration in Pharmacy. They work under a doctor’s supervision and can diagnose and treat ADHD. However, some jurisdictions require a collaborative practice agreement between an NP and a physician. 481 of the Revised Code. 05(a) 1. a. Carolyn Buppert, CRNP, JD May 29, 2024 · Detailed dosage guidelines and administration information for Adderall (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate). 1%). 1-3300 et seq. In 21 states, PMHNPs can prescribe medications without a collaborating physician. NP: Effective: July 10, 2019. 2 Examples of practitioners who may use a hospital’s DEA registration number include physician A dispensing practitioner is a practitioner authorized by law to prescribe drugs who may dispense such drugs to her or his patients in the regular course of her or his practice in compliance with s. FOR REFILL. 070. M16. 02 Prescriptions by mail Minnesota Board of Nursing 1210 Northland Drive Suite 120 Mendota Heights, MN 55120 Phone: 612-317-3000 Fax: 651-688-1841 General Email: nursing. prescribe schedule III-V controlled substances? Do NPs have authority to prescribe schedule II controlled substances? What are the additional educational requirements for NP prescriptive authority? Additional notes apply for prescriptive authority – for the first 2 years and 4,000 hours of practice. The failure to manage chronic pain, as well as the possible complication of opioid dependence related to treatment, can result in significant Pharmacy Board Rule 4729-5-30, OAC and Nursing Board Rule 4723-9-10, OAC, require APRN prescribers (CNSs, CNMs, CNPs) to include, at minimum, the first four alphanumeric characters (ex. be prescribed via telehealth. 21(a) A prescription must contain all of the following information before a pharmacy can consider filling the prescription. Nurse practitioners or physician assistants (PAs). 5 %âãÏÓ 75 0 obj > endobj 88 0 obj >/Filter/FlateDecode/ID[]/Index[75 22]/Info 74 0 R/Length 70/Prev 15918/Root 76 0 R/Size 97/Type/XRef/W[1 2 1]>>stream Can our pharmacy fill prescriptions written by physician assistants and nurse practitioners in another state? Yes. Prescriptive Authority: Patients within the advanced practice nurse's role and population focus. Feb 23, 2023 · The prevalence of mental health disorders is rising with the coronavirus of 2019 pandemic, and millions of Americans reside in areas with mental health professional shortages. The law is a big win for Florida patients with medical conditions requiring controlled substances as part of the treatment regimen. Mar 29, 2024 · Those mid-level providers include certified nurse practitioners, clinical nurse specialists and certified nurse-midwives. 1 prescribe only the controlled drugs and substances identified in the New Classes of Practitioners Regulations (SOR/2012-230); 4. Adderall is potentially addictive and can cause insomnia. [2] It is among the most common complaints in an outpatient clinic and the emergency department. B. They can also } v } o o ^ µ v W ] ] v P ' µ ] o ] v ( } WZE ] v < v µ l Ç ~ µ î X î ì î í d Z ] o ] ] v } o o r ] v o µ ] À X / ( Ç } µ Z À µ ] } v } } u u v o } v WW ñ ì î r ñ ò ð r ó õ ô ñ Aug 3, 2022 · Yes! In fact, FNPs can prescribe medication in all 50 states. in person before prescription. gov) ### Sep 11, 2024 · Adderall is a combination of four different amphetamine salts and may be used to improve attention, focus, or reduce impulsive behaviors in children over the age of 3 and adults with ADHD. Sep 30, 2024 · This section establishes standards and conditions regarding the authority of an advanced practice registered nurse who is designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner to prescribe and personally furnish drugs and therapeutic devices under a license issued under section 4723. gov) Additional resources for practitioners can be found here: Proposed Rules Summary Telemedicine Rules Summary. via telehealth . 42 of the Revised Code. Provincial and Territorial: In all provinces and territories medical doctors, dentists and veterinarians can prescribe controlled substances. May 13, 2022 · And that nurse practitioner will see you, will review your survey, will ask you some other questions, and will prescribe the medication they think is appropriate. CRNAs can prescribe only anesthesia care Feb 24, 2023 · Can My Medication be Prescribed through Telemedicine? Controlled Substance Guidance (dea. I have not . A. According to a study by the Indiana DEA number, the APRN may prescribe regular prescriptions and Schedule III-V drugs, but not Schedule II (Only physicians can prescribe Schedule II. § 33-2-402). In all 50 U. [485:10-16-5] • If prescribing an opioid, the law can be more restrictive. • Initiates and leads a discussion with the patient about their readiness to taper down or taper off the controlled substance that has not been prescribed by that healthcare practitioner within the previous six (6) months. How is Adderall prescribed for ADHD in children? ADHD, usually first diagnosed in childhood, is the most commonly diagnosed mental disorder among U. Includes dose adjustments, warnings and precautions. 01. state. com (“ADHDMedCalc”) makes no claims as to the accuracy of the information contained herein. org Dec 4, 2024 · Examples of mid-level practitioners include, but are not limited to, health care providers such as nurse practitioners, nurse midwives, nurse anesthetists, clinical nurse specialists and physician assistants who are authorized to dispense controlled substances by the state in which they practice. Under this measure, APRNs could have obtained 6,240 hours of practice with physician supervision, apply for licensure through the Board of Nursing and independently prescribe Schedule III-V drugs , which include things like After the New York State Education Department issues you a certificate to practice as a nurse practitioner (NP), you must complete the tasks below in order to prescribe medications. § 54. The term includes a nurse practitioner, nurse midwife, nurse anesthetist, and clinical nurse specialist. board@state. 747 in good faith and in the course of his or her professional practice only, may prescribe 1. Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs. The user acknowledges and agrees that this Site and its ADHD medication calculator/converter will be used only as a reference aid, and that the information contained in the product is not intended to be (nor should it be used as) a substitute for the exercise of professional judgment. Nurse practitioners who prescribe general anesthetics for the purpose of medical assistance in dying must meet the standards, limits and conditions set out in H. It comes in a capsule full of beads that hold these medicines, which are 15. 1. CC Oct 2, 2023 · Nurse practitioner (NP) prescriptive authority varies according to state laws. us Prescribe self-management strategies, non-pharmacologic treatments and non-opioid medications as the preferred treatment for chronic pain. Nurse practitioners who have obtained a SAMHSA waiver shall only prescribe buprenorphine for opioid addiction pursuant to a practice agreement with a SAMHSA-waivered doctor of medicine or doctor of osteopathic medicine unless the nurse practitioner has been authorized by the boards for autonomous practice. 1-2957. and management of problems See full list on nurse. 00 Professional practice standards, including: 247 CMR 9. — 1. An ARNP who is certified as a Psychiatric Nurse may now prescribe certain controlled substances pursuant to HB 977. 247 CMR 9. In addition, physicians can prescribe 195. 2 register as a prescriber with the Tracked Prescription Program (TPP) Alberta to prescribe any Type 1 medications monitored by the program and ensure that all can be prescribed . gov) Proposed Rules Highlights for Medical Practitioners Telehealth Practitioner Narrative. A certified registered nurse anesthetist (CRNA) as described in Section 63-7-103 of the Tennessee Code Annotated. Jan 4, 2018 · To view a brief summary of nurse practitioner prescribing law in a particular state or Washington, DC, click on the state name in the following list. In addition, a physician assistant must comply with the Physician Assistant Formulary. Physicians of either Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) designations have the highest degree of prescriptive authority. Adderall is the brand name for a mix of two stimulants called amphetamine-dextroamphetamine. 3a(6)(7)(8), Advanced Practice Registered Nurse (APRN) (Certified Nurse Practitioner, Clinical Nurse Specialist or Certified Nurse Midwife) shall be eligible, Nurse Practitioners (NPs) and Physician Assistants (PAs) are now authorized to prescribe buprenorphine to TennCare members if certain conditions are met PC 771 dictates the regulations for NPs and PAs prescribing buprenorphine in a nonresidential office-based opiate treatment (OBOT) facility (as defined in T. In accordance with the Oklahoma Nursing Practice Act, specifically 59 O. If prescribed concurrently, clearclinical rationale must exist. Drug Name 5. 0276, F. But since mental health can be complicated, your doctor might recommend you see a psychiatrist for treatment. Do the rules apply to nurse practitioners? An advanced practice registered nurse with a current valid license issued by the board and designated as a certified nurse practitioner, clinical nurse specialist or certified nurse midwife shall not prescribe or furnish any drug or device in violation of federal or Ohio law, or rules adopted by the board, including this rule. She could do so because the federal government relaxed a rule requiring an in-person visit before such substances can be provided, and nurse practitioners are allowed to prescribe controlled . Primary care providers have an opportunity to provide care for commonly occurring mental health disorders. Mar 2, 2020 · Adderall withdrawal is also a serious issue, and it is extremely important that adults and children take Adderall under the supervision of a doctor. Therefore, every nurse practitioner — no matter their particular specialty — must maintain keen awareness of the legalities and practice limitations Find patient medical information for Adderall oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. In the remaining states, they may prescribe at the discretion of a psychiatrist or other physician. Dispensing practitioners may include: physicians, dentists, certified optometrists, podiatrists, advanced practice registered nurse emancipated minor, the risks associated with the drugs being prescribed. %PDF-1. 03 Florida Statutes, beginning January 1, 2017. The Advanced Practice Registered Nurse with prescriptive authority must follow the Uniform Controlled Dangerous Oklahoma dentists, physician assistants, and advanced registered nurse practitioners who prescribe any controlled substance in Schedules II-IV for the treatment of chronic nonmalignant pain must designate themselves as a controlled substance prescribing practitioner on their practitioner profiles, and must Apr 28, 2021 · SUMMARY: The Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder provides eligible physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives, who are state licensed and registered by the DEA to prescribe controlled substances, an exemption from certain Feb 1, 2022 · An advanced practice registered nurse with a current valid license issued by the board and designated as a certified nurse practitioner, clinical nurse specialist or certified nurse midwife shall not prescribe or furnish any drug or device in violation of federal or Ohio law, or rules adopted by the board, including this rule. To help relieve Adderall tongue stay well-hydrated. ) Sep 4, 2024 · 12. Drug Strength 6 Jan 29, 2023 · Chronic pain and opioid use and abuse is a significant problem in the United States. May 27, 2004 · Can nurse practitioners (NPs) prescribe medications for family members or themselves? Are there circumstances when this would be reasonable? Response From the Expert . Using a holistic conceptualization of recovery in mental illness, this report provides evidence-based guidance Accordingly, the supervising physician may not authorize the physician assistant to prescribe for a greater number of days’ supply or greater dosage than the supervising physician may prescribe. 5 Do not initiate long-term opioid therapy for most patients with chronic pain. of this code. Dec 18, 2024 · Physicians, physician assistants, and nurse practitioners who have a current Drug Enforcement Administration (DEA) registration with authority to prescribe controlled substances can prescribe C. The nurse practitioner must 4. Take in the morning if using once daily. seen a medical practitioner in person and need a Jul 19, 2024 · Can a psychiatric nurse practitioner prescribe medication? Yes. C. May practice and prescribe independently without a supervising physician. Health care providers with prescribing authority, when acting within the usual course of business at a hospital or other health care institution, may prescribe controlled substances under the DEA registration number of the hospital or institution. A nurse practitioner can prescribe narcotics in states where NPs are permitted to prescribe Schedule II-controlled substances and have a registered federal DEA number. Tips. 10. Patient’s Address 4. Practitioners who prescribe controlled substances in the State of Connecticut must hold an active Controlled Substance Practitioner (CSP) registration with the State of Connecticut and an active DEA registration. In accordance with the provisions of this section and pursuant to the requirements of Chapter 33 (§ 54. (3) Before prescribing or dispensing, a healthcare practitioner shall have the professional responsibility to check the database For the past decade, the federal government has attempted to cut down on “pill mills”—clinics and health care practices that dole out controlled drugs without due consideration of how the drugs are being used. Can a nurse practitioner function in the emergency department? Yes. b. Prescribing: Prescribe means to order or designate a remedy or any preparation for a patient under the care of a practitioner. The extent of their prescriptive authority is fully dependent upon the approved state regulations in which they are employed. cannot . Must have their own DEA registration number to prescribe controlled substances. S. ) Without a DEA number, the APRN may not prescribe any scheduled drugs, but may only write regular prescriptions (such as antibiotics, etc. that the patient is being prescribed other medications as part Nurse practitioners (NPs) are a growing component of the primary care workforce, caring for patients of all ages across the United States. Prescriptive authority. A nurse practitioner's authority to prescribe medications is directly connected to their advanced level of training, which involves learning how to: Diagnose patient conditions; Assess symptoms; Recommend appropriate prescriptions Apr 15, 2016 · Physician Assistants (PAs) and Advanced Registered Nurse Practitioners (ARNPs) can prescribe controlled substances listed in Schedule II, Schedule III or Schedule IV as defined in s. 6 Coordinate interdisciplinary care for patients with high-impact chronic pain to address pain, substance An Online Resource for Certified Nursing Assistants, Licensed Practical Nurses, Registered Nurses, Clinical Nurse Specialists, Advanced Registered Nurse Practitioners, Nursing Assistant Training & Pre-Licensure Nursing Education Programs Licensure, Renewal and Information. Study results reveal that Florida APRNs are meeting the educational requirements to prescribe and apply the use of these drugs in pra … Sep 23, 2022 · (2) A licensed health professional authorized to prescribe drugs who is a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner is subject to both of the following: (a) A schedule II controlled substance may be prescribed only in accordance with division (C) of section 4723. ), a licensed advanced practice registered nurse shall have the authority to prescribe Schedule II through Schedule VI controlled substances and devices Jun 1, 2021 · Two years after the Florida legislature expanded APRN prescribing to include schedule II-IV drugs in 2017, we studied APRN utilization of this prescriptive authority. The mixture is composed of equal parts racemic amphetamine and dextroamphetamine, which produces a (3:1) ratio between dextroamphetamine and levoamphetamine, the two enantiomers of amphetamine. MD and DO clinicians can prescribe medications, including controlled substances. Section 1317. Rely on your professional medical judgment for what is the best care for your patients May 4, 2023 · All primary care providers, including doctors, nurse practitioners and physician’s assistants, can diagnose mental health conditions and prescribe medication. Medical Assistance in Dying. Sep 8, 2024 · They’re medical doctors, so they can prescribe drugs. Many states allow NPs to administer, dispense, prescribe, and procure medications. Adderall Dosages. Prescription . Controlled drugs and substances. [13] Aug 29, 2023 · Why Nurse Practitioners Can Prescribe. It is a resource for prescribers to ensure that before they prescribe stimulant medication they check that there are no contraindications to stimulant prescribing e. Dec 18, 2024 · Physicians, physician assistants, and nurse practitioners who have a current Drug Enforcement Administration (DEA) registration with authority to prescribe controlled substances can prescribe Feb 1, 2022 · An advanced practice registered nurse with a current valid license issued by the board and designated as a certified nurse practitioner, clinical nurse specialist or certified nurse midwife shall not prescribe or furnish any drug or device in violation of federal or Ohio law, or rules adopted by the board, including this rule. Nurse practitioners are permitted to perform consultation and treatment in an emergency department under certain conditions. C. AMB . All prescriptions can be prescribed . Aug 29, 2024 · A small handful of states restrict or do not allow NPs to prescribe Schedule II drugs, but in the vast majority of cases, NPs can prescribe Adderall to patients they believe have a medical need for the drug. So, for example, Adderall XR patients can take short-acting Adderall or something similar like a branded disintegrating tablet which is equivalent to Adderall XR. ktmbfmbgbeyvcttmpureornngtvgyjbolyuhoehgjqbngifvkydxfd