{"id":4813,"date":"2024-11-01T06:15:53","date_gmt":"2024-11-01T06:15:53","guid":{"rendered":"https:\/\/healthmedicinet.com\/review\/?p=4813"},"modified":"2024-11-01T06:15:53","modified_gmt":"2024-11-01T06:15:53","slug":"hmn-how-to-stop-asthmatic-cough-steps-and-symptoms-in-2024","status":"publish","type":"post","link":"https:\/\/healthmedicinet.com\/review\/hmn-how-to-stop-asthmatic-cough-steps-and-symptoms-in-2024\/","title":{"rendered":"HMN: How to stop asthmatic cough: Steps and symptoms in 2025"},"content":{"rendered":"<p>\n<br \/>Do you know:  How to stop asthmatic cough: Steps and symptoms in 2025<\/p>\n<p>\n                                    Treatment for this kind of asthma usually includes prescription medicines, such as inhalers, but lifestyle changes can also help                                <\/p>\n<div id=\"main-content\">\n<div id=\"post-intro\">\n<div id=\"takeaways\">\n<h2>Key takeaways<\/h2>\n<ul>\n<li>\n<p>An asthmatic cough is often chronic and dry. It typically requires treatment with prescription asthma medications rather than OTC cough medicine.<\/p>\n<\/li>\n<li>\n<p>Lifestyle changes and minimizing common allergens can significantly aid in managing asthmatic cough symptoms.<\/p>\n<\/li>\n<li>\n<p>A combination of fast-acting bronchodilators and daily corticosteroid inhalers is commonly prescribed to treat and manage asthmatic coughs.<\/p>\n<\/li>\n<li>\n<p>Untreated asthmatic cough can lead to lung damage and other health issues, emphasizing the importance of a managed treatment plan.<\/p>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<section class=\"table-of-contents\">\n<div class=\"anchorLinks\">\n<div class=\"mobile-only\">\n<div class=\"dropdownLists\">\n<div class=\"dropdownBtn\"><span class=\"listsIcon\"><br \/>\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.singlecare.com\/blog\/wp-content\/themes\/singlecare\/images\/union.svg\" width=\"14\" height=\"20\"\/><\/span><br \/>\n\t\t\t\t\t\t\t<label><\/label><br \/>\n\t\t\t\t\t\t\t<span class=\"downArrow\"><br \/>\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.singlecare.com\/blog\/wp-content\/themes\/singlecare\/images\/dropDownArrow.svg\" width=\"24\" height=\"24\"\/><br \/>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n<p><span style=\"font-weight: 400;\">Do you have asthma? If so, you may cough while working up a sweat on the treadmill. Maybe being outdoors among allergens like ragweed and pollen gives you an asthmatic cough. Or maybe your cough is triggered by indoor allergens like pet dander, dust, or mold, chemical irritants such as perfumes and cleaning products, cold air or air pollution. No matter what the cause, it is often uncomfortable and inconvenient.\u00a0<\/span><\/p>\n<p><span data-sheets-root=\"1\" data-sheets-value=\"{\" class=\"compass-ads-new\" data-compass-id=\"628254\"><\/p>\n<aside class=\"top-section no-isi\">\n<figure class=\"col-1\">\n<div class=\"banner-heading\">\n<p><h3>\n\t\t\t\t\t\t\tNeed more Asthma medication?\t\t\t\t\t\t<\/h3>\n<\/p><\/div>\n<\/figure>\n<figure class=\"col-2\">\n<div class=\"inner-col-left\">\n<div class=\"description\">\n<p>!<\/p>\n<p>.<\/p>\n<\/p><\/div>\n<p>\t\t\t\t\t\t\t\t\t\t\t<a data-gtmdata=\"patientCompassCta1\" class=\"cta-link cta-link-mobile\" href=\"https:\/\/symliphy.com\/treatments\/asthma\/?campaign=singlecare\" target=\"_blank\" rel=\"nofollow noopener\"><\/a> <\/p><\/div>\n<\/figure>\n<figure class=\"col-3 no-supplimental-links-alt-layout no-client-approval-code\">\n<\/figure>\n<\/aside>\n<p>&#8220;}&#8221; data-sheets-userformat=&#8221;{&#8220;2&#8243;:6849,&#8221;3&#8221;:{&#8220;1&#8243;:0},&#8221;9&#8243;:1,&#8221;10&#8243;:2,&#8221;12&#8243;:0,&#8221;14&#8221;:{&#8220;1&#8243;:2,&#8221;2&#8243;:0},&#8221;15&#8243;:&#8221;Arial&#8221;}&#8221; data-sheets-formula=&#8221;=CONCATENATE(R[0]C[-2],R[0]C[-3],R[0]C[-1])&#8221;&gt;<\/p>\n<section class=\"compass-ads-new\" data-compass-id=\"628254\">\n<aside class=\"top-section no-isi\">\n<figure class=\"col-1\">\n<div class=\"banner-heading\">\n<p><h3>\n\t\t\t\t\t\t\tNeed more Asthma medication?\t\t\t\t\t\t<\/h3>\n<\/p><\/div>\n<\/figure>\n<figure class=\"col-2\">\n<div class=\"inner-col-left\">\n<div class=\"description\">\n<p>!<\/p>\n<p>.<\/p>\n<\/p><\/div>\n<p>\t\t\t\t\t\t\t\t\t\t\t<a data-gtmdata=\"patientCompassCta1\" class=\"cta-link cta-link-mobile\" href=\"https:\/\/symliphy.com\/treatments\/asthma\/?campaign=singlecare\" target=\"_blank\" rel=\"nofollow noopener\"><\/a> <\/p><\/div>\n<\/figure>\n<figure class=\"col-3 no-supplimental-links-alt-layout no-client-approval-code\">\n<\/figure>\n<\/aside>\n<\/section>\n<p><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Asthmatic cough treatment often includes two prescriptions.\u00a0 These asthma medicines include fast-acting bronchodilator inhalers, which open constricted airways to relieve your coughing attack, and\/or daily corticosteroid inhalers, which keep inflammation in the airways at bay. Certain lifestyle changes can help too. Here\u2019s how to stop an asthmatic cough in its tracks, according to experts.<\/span><span style=\"font-weight: 400;\"><br \/><\/span><span style=\"font-weight: 400;\"><br \/><\/span><b> <\/b><b>How common is asthma?<\/b><\/p>\n<h2 id=\"what-is-an-asthmatic-cough\"><span style=\"font-weight: 400;\">What is an asthmatic cough?\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">As opposed to a viral infection (like a cold or the flu), asthma is a long-term lung condition, says <\/span><a href=\"https:\/\/www.caseintegrativehealth.com\/drkelley\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Casey Kelley, MD<\/span><\/a><span style=\"font-weight: 400;\">, a board-certified family medicine physician, founder and medical director at <\/span><a href=\"https:\/\/www.caseintegrativehealth.com\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Case Integrative Health<\/span><\/a><span style=\"font-weight: 400;\">. <\/span><span style=\"font-weight: 400;\">It causes your airways to narrow, making breathing more difficult and can trigger coughing or wheezing.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While most might associate asthma with gasping for air, there is a type called cough-variant asthma that produces a chronic cough, Dr. Kelley explains. \u201cThis is generally what we refer to as a non-productive cough in that it is dry and doesn\u2019t produce mucus or phlegm,\u201d she says, adding it\u2019s usually triggered by airway swelling from exercise or exertion; it may also be accompanied by wheezing.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to Dr. Kelley, an asthmatic cough is usually chronic, lasting longer than six weeks. Typically, asthmatic coughs don\u2019t respond to traditional OTC cough medicine, and instead requires treatment with prescription asthma medication, she says.<\/span><\/p>\n<h3 id=\"can-an-asthmatic-cough-cause-damage-to-the-lungs\"><span style=\"font-weight: 400;\">Can an asthmatic cough cause damage to the lungs?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In short, yes. When not treated and managed appropriately, an asthmatic cough (and asthma in general) can damage your lungs, Dr. Kelley says. \u201cLong-term inflammation is never good, and the chronic inflammation of the bronchial passages can cause damage, and permanently narrow the airways,\u201d she says. What\u2019s more, inflammation can cause your bronchial muscles to become enlarged, which can reduce overall lung function.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Additionally, because an asthmatic cough can make movement difficult, it may increase your likelihood of health conditions like <\/span><span style=\"font-weight: 400;\">obesity<\/span><span style=\"font-weight: 400;\"> and <\/span><span style=\"font-weight: 400;\">high-blood pressure<\/span><span style=\"font-weight: 400;\">, explains Dr. Kelley. That\u2019s why it\u2019s so important to form a treatment plan with your medical team and\u00a0 take any prescribed medications as directed.\u00a0\u00a0<\/span><\/p>\n<h3 id=\"what-does-an-asthmatic-cough-sound-like\"><span style=\"font-weight: 400;\">What does an asthmatic cough sound like?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">An asthmatic cough is usually dry, meaning that it doesn\u2019t produce any mucus or phlegm says Dr. Kelley. It may also be accompanied by shortness of breath and\/or high-pitched whistling or wheezing sound in the chest, but an asthma cough can occur as a standalone symptom.\u00a0<\/span><\/p>\n<h2 id=\"symptoms-associated-with-asthma-cough\"><span style=\"font-weight: 400;\">Symptoms associated with asthma cough<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In addition to causing the airways in the lungs to become inflamed and swollen, <\/span><a href=\"https:\/\/acaai.org\/asthma\/symptoms\/asthma-cough\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">asthma<\/span><\/a><span style=\"font-weight: 400;\"> causes breathing tubes to constrict and tighten, making the lungs more reactive to allergens or irritants. Coughing is the body\u2019s way of clearing irritants from the lung. Along with a dry cough, you may experience:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Wheezing<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chest tightness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Shortness of breath<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">A<\/span><span style=\"font-weight: 400;\">n asthmatic cough can seem like many other types of cough, says <\/span><a href=\"https:\/\/www.lenhorovitz.com\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Len Horovitz,<\/span><\/a> <span style=\"font-weight: 400;\">MD, an\u00a0 internist and pulmonary specialist at <\/span><a href=\"https:\/\/www.northwell.edu\/news\/a-symphony-of-medicine-and-music\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Northwell Health\u2019s Lenox Hill Hospital<\/span><\/a><span style=\"font-weight: 400;\"> in New York. That\u2019s why it\u2019s important to differentiate it from other coughs with other causes such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Allergic coughs<\/b><span style=\"font-weight: 400;\"> are dry and may be accompanied by itching and sneezing; they usually resolve with allergy medications or removal of the allergen.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Sinus-related coughs<\/b><span style=\"font-weight: 400;\"> with post nasal drip are usually wet, triggered by nasal secretions that drain down the back of the throat.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4865789\/\" target=\"_blank\" rel=\"noopener\"><b>Gastrointestinal reflux disease (GERD) or acid reflux-related coughs<\/b><\/a><span style=\"font-weight: 400;\"> are marked by coughing after meals or at night time and often occur with regurgitation and heartburn.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9136724\/\" target=\"_blank\" rel=\"noopener\"><b>Chronic coughs with neurologic origins<\/b><\/a><span style=\"font-weight: 400;\"> are dry, often caused by a tickling or choking sensation; they can last for months or years.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Coughs related to respiratory infections<\/b><span style=\"font-weight: 400;\"> are usually wet (productive) and accompanied by other symptoms such as fever, fatigue, and general cold\/flu symptoms; they usually resolve after the infection has cleared<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-stop-an-asthmatic-cough\"><span style=\"font-weight: 400;\">How to stop an asthmatic cough<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are many different treatments for an asthmatic cough, says Dr. Kelley. The best treatment will depend on the patient, and the severity of asthma symptoms.\u00a0<\/span><\/p>\n<h3 id=\"1-take-medication\"><span style=\"font-weight: 400;\">1. Take medication<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There are several types of prescription medication used to treat an asthmatic cough, including inhaled corticosteroids, bronchodilators, and leukotriene receptor antagonists.<\/span><\/p>\n<h4 id=\"inhaled-corticosteroids\"><span style=\"font-weight: 400;\">Inhaled corticosteroids<\/span><\/h4>\n<p><span style=\"font-weight: 400;\">Inhaled corticosteroids<\/span><span style=\"font-weight: 400;\"> like <\/span><span style=\"font-weight: 400;\">Flovent<\/span><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">Pulmicort<\/span><span style=\"font-weight: 400;\">, and <\/span><span style=\"font-weight: 400;\">Advair<\/span><span style=\"font-weight: 400;\">, are a common first-line treatment, says Dr. Kelley. These medications come as a steroid or a steroid combined with a long-acting beta-agonist. Used daily on a long-term basis to prevent symptoms, these medications work by decreasing airway inflammation.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Flovent coupons<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Pulmicort coupons<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Advair coupons<\/span><\/p>\n<h4 id=\"bronchodilators\"><span style=\"font-weight: 400;\">Bronchodilators<\/span><\/h4>\n<p><span style=\"font-weight: 400;\">Bronchodilators<\/span><span style=\"font-weight: 400;\">, or rescue inhalers like <\/span><span style=\"font-weight: 400;\">Ventolin<\/span><span style=\"font-weight: 400;\"> and <\/span><span style=\"font-weight: 400;\">Proventil<\/span><span style=\"font-weight: 400;\"> that contain albuterol are used for quick relief during asthma flare-ups. Rescue inhalers are used as needed to treat coughing or shortness of breath, says Dr. Kelley. These should be used less frequently and should not replace a daily controller inhaler, she says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ventolin coupons<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Proventil coupons<\/span><\/p>\n<h4 id=\"leukotriene-receptor-antagonists\"><span style=\"font-weight: 400;\">Leukotriene receptor antagonists<\/span><\/h4>\n<p><span style=\"font-weight: 400;\">Singulair<\/span><span style=\"font-weight: 400;\"> is a <\/span><span style=\"font-weight: 400;\">leukotriene receptor antagonist<\/span><span style=\"font-weight: 400;\">, a type of long-term oral medication taken daily that treats allergies to help prevent asthma attacks. Dr. Horovitz says he prescribes Singulair to his asthma patients, especially when they also have sinus disease.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Singulair coupons<\/span><\/p>\n<p><b> Asthma treatments &amp; medications<\/b><\/p>\n<h3 id=\"2-minimize-common-triggers\"><span style=\"font-weight: 400;\">2. Minimize common triggers<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Carpeting and drapes accumulate dust and should be avoided, says Dr. Horovitz. To <\/span><span style=\"font-weight: 400;\">minimize allergens inside the home<\/span><span style=\"font-weight: 400;\">, HEPA air filters are important. And while no one wants to get rid of their dog or cat, sometimes animals can be a precipitating factor. \u201cI would tell any asthmatic not to get a cat,\u201d he says.<\/span><span style=\"font-weight: 400;\"><br \/><\/span><span style=\"font-weight: 400;\"><br \/><\/span><b> <\/b><b>Asthma attack triggers and how to prevent them<\/b><\/p>\n<h3 id=\"3-practice-breathing-exercises\"><span style=\"font-weight: 400;\">3. Practice breathing exercises\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The American Lung Association <\/span><a href=\"https:\/\/www.lung.org\/lung-health-diseases\/wellness\/breathing-exercises\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">recommends<\/span><\/a><span style=\"font-weight: 400;\"> breathing exercises to strengthen the lungs and make them more efficient. They include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Pursed lip breathing: <\/b><span style=\"font-weight: 400;\">Take a deep breath in through your nose and out through your mouth (with pursed lips) for at least twice as long.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Diaphragmatic breathing:<\/b><span style=\"font-weight: 400;\"> Also called belly breathing, this is done by breathing in through your nose (paying attention to your stomach as it expands from the air) and slowly breathing out. For example, breathe in for two counts and out for four to six counts.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\t\t<\/p>\n<div class=\"singlecare-dynamic-newsletter-wrapper sin-newsletter-wrapper\">\n\t\t\t<span class=\"heading\">Sign up for our newsletter<\/span><\/p><\/div>\n<p>\t<\/span><\/p>\n<h3 id=\"4-try-lifestyle-changes\"><span style=\"font-weight: 400;\">4. Try lifestyle changes\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A whole body approach can help to <\/span><a href=\"https:\/\/allergyasthmanetwork.org\/what-is-asthma\/lifestyle-changes-to-manage-asthma\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">manage symptoms<\/span><\/a><span style=\"font-weight: 400;\"> of asthma. You can try to:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Prioritize sleep and rest<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Maintain a healthy weight<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Exercise regularly<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Manage your allergies<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eat healthy whole foods including lean protein, fruits and vegetables, and minimally processed carbohydrates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stay up to date on your vaccinations, including COVID, pneumonia, and influenza<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Work with your healthcare provider to make an asthma action plan<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Take your medications as prescribed<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Dr. Horovitz says elderberry syrup may be worth a try, although it\u2019s not a miracle cure. He would not recommend using Vicks Vaporub for an asthmatic cough. That\u2019s because although it may seem soothing, products like menthol, eucalyptus, and other inhalants, can actually trigger an asthmatic cough, he says.<\/span><\/p>\n<p><strong><\/strong> <b>Home remedies for asthma\u2014and what to do if they don\u2019t work<\/b><\/p>\n<p><span style=\"font-weight: 400;\">There are a few ways to stop an asthmatic cough that occurs at night, Dr. Kelley says.\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Clean your bedroom regularly to avoid dust mites and other allergen exposure.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Invest in a humidifier (dry air is a common asthma trigger). Be sure to clean humidifier per owner\u2019s manual.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sleep with your head slightly elevated to alleviate pressure on your lungs and airways.\u00a0<\/span><\/li>\n<\/ul>\n<h2 id=\"the-bottom-line\"><span style=\"font-weight: 400;\">The bottom line<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If you have untreated asthma, see a provider to make a treatment plan. Usually, treating your underlying asthma with prescription medications (like bronchodilators and inhaled corticosteroids) will control an asthmatic cough, says Dr. Horovitz. And while an asthmatic cough alone doesn\u2019t warrant a trip to the emergency room, he says that if you\u2019re experiencing shortness of breath (difficulty breathing can be life-threatening), go to the ER for immediate medical attention.\u00a0<\/span><\/p>\n<p><svg style=\"display:none\">\n  <g id=\"facebook\">\n    <rect width=\"32\" height=\"32\" rx=\"4\" fill=\"var(--social-bg)\"\/>\n    <path fill=\"var(--social-ico)\" d=\"M19.51 9.32003H21.39V6.14003C20.4798 6.04538 19.5652 5.99865 18.65 6.00003C15.93 6.00003 14.07 7.66003 14.07 10.7V13.32H11V16.88H14.07V26H17.75V16.88H20.81L21.27 13.32H17.75V11.05C17.75 10 18.03 9.32003 19.51 9.32003Z\"\/>\n  <\/g>\n  <g id=\"twitter\">\n    <rect width=\"32\" height=\"32\" rx=\"4\" fill=\"var(--social-bg)\"\/>\n    <path fill=\"var(--social-ico)\" d=\"M26 9.9506C25.2483 10.2767 24.4534 10.4923 23.64 10.5906C24.4982 10.0779 25.1413 9.27138 25.45 8.3206C24.6436 8.80066 23.7608 9.1389 22.84 9.3206C22.2245 8.65317 21.405 8.2089 20.5098 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