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Milford CA, Mugliston TA, Lund VJ, Mackay IS "Long-term safety and efficacy study of intranasal ipratropium bromide. O'Driscoll BR "Supraventricular tachycardia caused by nebulised ipratropium bromide. Read the Patient Information Leaflet if available from your before you start using and each time you get a refill. Learn how to use this spray properly. If you have any questions, ask your doctor or pharmacist.

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Available as ipratropium bromide. How is Nucala given? Brundage KL, Mohsini KG, Froese AB et al. Bronchodilator response to ipratropium bromide in infants with bronchopulmonary dysplasia. Am Rev Respir Dis. Albuterol is longer acting than isoproterenol in most patients because it is not a substrate for the cellular uptake processes for catecholamines nor for metabolism by catechol-O-methyl transferase. Instead, the drug is conjugatively metabolized to albuterol 4'-O-sulfate. Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy.

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Gently shake the nebulizer cup to mix the solutions well. To decrease your risk for stomach problems, take your potassium after meals with a large glass of water or other liquid. Canadian Thoracic Society Workshop Group. Guidelines for the assessment and management of chronic obstructive pulmonary disease. CMAJ. Effects Seen with Anticholinergic Drugs: Combivent Inhalation Aerosol contains ipratropium bromide and, therefore, should be used with caution in patients with narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction. If you are directed to use this medication regularly, it works best if used at evenly spaced intervals. To help you remember, use it at the same times each day. Do not increase your dose, use this medication more frequently, or stop using it without first consulting your doctor.

Keep out of the reach of children

Read the Patient Information Leaflet if available from your before you start using and each time you get a refill. This is used with a special machine called a that changes the solution to a fine mist that you inhale. Learn how to prepare the solution and use the nebulizer properly. If a child is using this medication, a parent or other responsible adult should supervise the child. If you have any questions, ask your doctor, pharmacist, or respiratory therapist. If you miss a dose of ipratropium aerosol suspension, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Alexander JP Dysrhythmia and oral surgery

Provide careful instruction on priming the pump and administration. Alexander JP. Dysrhythmia and oral surgery. Gross NJ, Bankwala Z. Effects of an anticholinergic bronchodilator on arterial blood gases of hypoxemic patients with chronic obstructive pulmonary disease. Comparison with a beta-adrenergic agent. Am Rev Respir Dis. Hockley B, Johnson NM. A comparison of three high doses of ipratropium bromide in chronic asthma. Br J Dis Chest. The dose of ipratropium will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ipratropium. Cummiskey J, Keelan P. Study of Sch 1000 MDI used in therapeutic doses in patients with chronic bronchitis. Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by urticaria, angioedema, rash, bronchospasm, anaphylaxis, and oropharyngeal edema. Moderate. These medicines may cause some risk when taken together. Forbes AM. Halothane, adrenaline and cardiac arrest. Belladonna means “beautiful woman” in Italian. Women in the ancient Roman empire used eye drops derived from the belladonna plant in order to dilate their pupils for cosmetic effects. The presence of dilated pupils “bedroom eyes” can be interpreted as a sign of being sexually attractive, or sexually attracted to another . Dim candlelight also causes pupil dilation, which is why these conditions are also considered “romantic”. RxList states serious side effects of taking ipratropium bromide, including allergic reactions such as hives, difficulty breathing and swelling of the face or in the mouth. The drug manufacturer advises patients to stop taking the medicine and seek emergency help if an allergic reaction occurs. Less serious side effects include, but are not limited to, headache, nosebleeds, blurred vision and dry mouth. Connect the nebulizer reservoir to the mouthpiece or face mask. Kelly HW. Issues and advances in the pharmacotherapy of asthma. J Clin Pharm Ther. Connolly CK. Adverse reaction to ipratropium bromide. BMJ.

How to take ipratropium

Cardiac arrhythmias during dental anaesthesia. This product should be clear and colorless. Before using, check this product visually for particles or discoloration. If either is present, not use the liquid. Known hypersensitivity to atropine or ipratropium bromide. Effects Seen with Sympathomimetic Drugs: Preparations containing sympathomimetic amines such as albuterol sulfate should be used with caution in patients with convulsive disorders, hyperthyroidism, or diabetes mellitus and in patients who are unusually responsive to sympathomimetic amines. Beta-adrenergic agents may also produce significant hypokalemia in some patients possibly through intracellular shunting which has the potential to produce adverse cardiovascular effects. The decrease in serum potassium is usually transient, not requiring supplementation. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Computed tomography : A CT scan uses X-rays and a computer to make detailed pictures of the lungs and nearby structures. Nucala is injected under the skin once every 4 weeks. You may be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes. Mechanical ventilation: People with severe attacks of lung disease may require a machine called a ventilator to assist breathing. The ventilator pumps in air through a tube inserted into the mouth or the neck. Because of the potential for tumorigenicity shown for albuterol in animal studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Johnstone M. Adrenaline and noradrenaline during anaesthesia. Casali L, Grassi C, Rampulla C et al. Clinical pharmacology of a combination of bronchodilators. Int J Clin Pharmacol Biopharm. Karpel JP, Pesin J, Greenberg D et al. A comparison of the effects of ipratropium bromide and metaproterenol sulfate in acute exacerbations of COPD. Chest. venlafaxine

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Anthonisen NR, Connett JE, Kiley JP et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV 1. JAMA. This medication may also be used to prevent symptoms of asthma or to treat wheezing or sudden shortness of breath. Ipratropiumbromid. German; with English abstract. Severe, sudden injury to the lungs caused by a serious illness. with mechanical ventilation is usually needed to survive until the lungs recover. Casaburi R, Mahler DA, Jones PW et al. A long-term evaluation of once-daily inhaled tiotropium in chronic obstructuve pulmonary disease. Marangio E, Pesci A, Mori A et al. Clinical physiological data on the bronchodilator effect of Duovent versus salbutamol in chronic obstructive lung disease. Respiration. Ipratropium aerosol suspension is to be used only by the patient for whom it is prescribed. Do not share it with other people. Other medicines include methylxanthines, which generally are used for severe cases of COPD. They may have serious side effects, so they are not usually recommended. Solution. You should also carefully read the instructions provided with the nebuliser. Store the product below 25oC. With ipratropium bromide in fixed combination with albuterol sulfate DuoNeb 500 mcg 4 times daily. 327 Additional inhalations should not exceed 6 inhalations daily. Nasal Spray without consulting your physician. 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. Twist off the top to open the vial. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. generic trazodone information trazodone

Ipratropium side effects

Inhalation Aerosol are under pressure. Do not puncture. Do not use or store near heat or open flame. Jenkins CR, Chow CM, Fisher BL et al. Ipratropium bromide and fenoterol by aerosolized solution. Br J Clin Pharmacol. If any of your COPD medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor. Clean the mouthpiece of the inhaler at least once a week as directed. Nervous system side effects have included headache is reported in approximately 9% of the patients treated with the nasal spray. Dizziness has occurred infrequently. Please refer to the for information on shortages of one or more of these preparations. Medicines that kill bacteria are used to treat most cases of pneumonia. Antibiotics are not effective against viruses. Fisons. Tilade nedocromil sodium inhalation aerosol patient information. undated. When you are finished, remove the spacer device from the inhaler and replace the cap. Henry RL, Hiller EJ, Milner AD et al. Nebulised ipratropium bromide and sodium cromoglycate in the first two years of life. Arch Dis Child. Do not use mouthpiece for other aerosol drugs.

Ipratropium dosing information

Seider N, Abinader EG, Oliven A. Cardiac arrhythmias after inhaled bronchodilators in patients with COPD and ischemic heart disease. Chest. Tuohy PG. Ipratropium and the eye. If such a reaction occurs, therapy with Combivent Inhalation Aerosol should be stopped at once and alternative treatment should be considered. Prevent flare-ups, also called exacerbations, or keep the flare-ups you do have from being life-threatening. Dizziness, nausea, stomach upset, dry mouth, or constipation may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Brinkmann O. The results of long-term treatment with Sch 1000 MDI on repeated measurements of FEV 10, total airways resistance R t haematological and biochemical tests in patients with chronic bronchitis and emphysema. Pavia D, Thomson ML. Inhibition of mucociliary clearance from the human lung by hyoscine. Lancet. Both drugs work by relaxing the muscles around the airways so that the airways open up and you can breathe more easily. Controlling symptoms of can decrease time lost from work or school. Take this medication with a full glass of water. Try to take this medication at the same time each day. Rigid bronchoscopy is often more effective than flexible bronchoscopy, but it requires general total anesthesia. Sanguinetti CM, De Luca S, Gasparini S et al. Evaluation of Duovent in the prevention of exercise-induced asthma. Respiration. Vasodilators: People with some forms of pulmonary hypertension may require long-term medicines to lower the pressure in their lungs. Often, these must be taken through a continuous infusion into the veins. The bronchioles eventually end in clusters of microscopic air sacs called alveoli. Widdicombe JG. Reflex control of tracheobronchial smooth muscle in experimental and human asthma. In: Lichtenstein LM, Austen KF, eds. Asthma: physiology, immunopharmacology, and treatment. Sill V, Voelkel N, Siemssen S et al. Effects of Sch 1000 MDI on the pulmonary circulation under hypoxic conditions. Results of various mutagenicity studies Ames test, mouse dominant lethal test, mouse micronucleus test and chromosome aberration of bone marrow in Chinese hamsters were negative. buy cheap aciphex shop canada aciphex

Tuohy PG Ipratropium and the eye

Combivent Inhalation Aerosol Study Group. In chronic obstructive pulmonary disease, a combination of ipratropium and albuterol is more effective than either agent alone; an 85-day multicenter trial. Chest. 1994; 105: 1411-9. Weinberg EG. Experience with Sch 1000 MDI in the treatment of exercise-induced asthma in children. Pneumothorax: Air in the chest; it occurs when air enters the area around the lung the pleural space abnormally. Pneumothorax can be caused by an injury or may happen spontaneously. Roberts TE, Pearson DJ. Wide eyed and breathless. BMJ. Sackner MA, Friedman M, Silva G et al. The pulmonary hemodynamic effects of aerosols of isoproterenol and ipratropium in normal subjects and patients with reversible airway obstruction. Am Rev Respir Dis. Anon. Salmeterol. Med Lett Drugs Ther. Ruffin RE, Wolff RK, Dolovich MB et al. Aerosol therapy with Sch 1000: short-term mucociliary clearance in normal and bronchitic subjects and toxicology in normal subjects. Chest. Crimi N, Palermo F, Oliveri R et al. Influence of antihistamine astemizole and anticholinergic drugs ipratropium bromide on bronchoconstriction induced by substance P. Ann Allergy. Pulejo R, Romano L, Noto M. Double-blind study with Duovent and placebo in 20 asthmatic children. Respiration. Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist. Shah P, Dhurjon L, Metcalfe T et al. Acute angle closure glaucoma associated with nebulised ipratropium bromide and salbutamol. BMJ. Tell your doctor if you have ever had any unusual or allergic reaction to ipratropium or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. If you forget an inhalation, take it when you remember. inderal 50mg

Does ipratropium interact with other medications

Foster WM, Langenback EG, Glaser ML et al. Acute effect of ipratropium bromide at therapeutic dose on mucus transport of adult asthmatics. Eur J Respir Dis. Ashutosh K, Dev G, Steele D. Nonbronchodilator effects of pirbuterol and ipratropium in chronic obstructive pulmonary disease. Chest. Weintraub SJ, Eschenbacher WL. The inhaled bronchodilators ipratropium bromide and metaproterenol in adults with CF. Chest. Problems passing water urine especially if you already have problems passing urine. Loddenkemper R. Dose- and time-response of Sch 1000 MDI on total R t and expiratory R t airways resistance in patients with chronic bronchitis and emphysema. Napa, CA: Personal communication. Ghafouri MA, Patil KD, Kass I. Sputum changes associated with the use of ipratropium bromide. Chest. Caution in patients with prostatic hypertrophy or bladder neck obstruction. Using your thumb and one or two fingers, hold the inhaler upright, with the mouthpiece end down and pointing toward you.

Ipratropium dosage

If your doctor has told you to use your inhaler differently or to use a special spacing device, be sure you understand how to use ipratropium aerosol suspension properly. Ask your doctor any questions that you may have about how to use ipratropium aerosol suspension. Anon. Ipratropium. Med Lett Drugs Ther. Connect the nebulizer to the compressor. Limited systemic absorption following oral inhalation; interactions with systemically administered drugs unlikely. Partridge MR, Saunders KB. Site of action of ipratropium bromide and clinical and physiological determinants of response in patients with asthma. Thorax. Do not use actuator provided for other aerosol drugs. 346 To avoid contact of the drug with the eyes and subsequent adverse effects, close eyes during inhalation of aerosol. Never throw the container into a fire or incinerator. Storms WW, Bodman SF, Nathan RA et al. Use of ipratropium bromide in asthma. Am J Med. Ipratropium solution may cause dizziness, blurred vision, or other vision changes. These effects may be worse if you take it with alcohol or certain medicines. Use ipratropium solution with caution. NHLBI Publication No. 02-3659 updated 2004. COPD symptoms, hoarseness, palpitations, heartburn, drowsiness, CNS stimulation, coordination difficulty, flushing, alopecia, hypotension, edema, gastrointestinal distress diarrhea, nausea, vomiting gastrointestinal motility disorder, constipation, hypokalemia, mental disorder, hyperhidrosis, muscle spasms, muscular weakness, myalgia, asthenia, myocardial ischemia, diastolic blood pressure decreased, and systolic blood pressure increased. Nasal Spray is indicated for the symptomatic relief of rhinorrhea runny nose associated with allergic and nonallergic perennial rhinitis in adults and children age 6 years and older. Keep out of the reach of children. Yang SC, Yang SP, Lee TS. Nebulized ipratropium bromide in ventilator-assisted patients with chronic bronchitis. Chest. Campbell et al, 2009. Store unmixed Nucala at room temperature away from moisture, heat, and light. purchase betamethasone ecuador

What is ipratropium

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Exhale slowly and completely and place the mouthpiece of the inhaler well into the mouth with the lips closed around it. 10 348 To avoid contact of the drug with the eyes and subsequent adverse effects, close eyes during inhalation of aerosol. 1 10 348 Inhale slowly and deeply through the mouth while actuating the inhaler. 1 10 Hold the breath for 10 seconds, withdraw the mouthpiece, and exhale slowly. Nasal Spray in patients under 6 years of age have not been established. Prescribing Information. Zydus Pharmaceuticals November, 2010. PFTs: A series of tests to evaluate how well the lungs work. Lung capacity, the ability to exhale forcefully, and the ability to transfer air between the lungs and blood are usually tested. arot.info gemfibrozil

Ipratropium forms and strengths

These studies demonstrated no evidence of teratogenic effects as a result of ipratropium bromide. Remove the canister from the inhaler and set aside. Lulling J, Delwiche JP, Ledent C et al. Controlled trial of the effect of repeated administration of ipratropium bromide on ventilatory function of patients with severe chronic airways obstruction. Br J Dis Chest. Bull Eur Physiopathol Respir. Beta-adrenergic agents: Caution is advised in the co-administration of Combivent Inhalation Aerosol and other sympathomimetic agents due to the increased risk of adverse cardiovascular effects. Some medical conditions may interact with ipratropium aerosol suspension. Chest tube thoracostomy: A tube is inserted through an incision in the chest wall in order to drain fluid or air from around the lung. This list is not complete. Other drugs may interact with oxybutynin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Nasal Spray in your eyes. Should this occur, immediately flush your eye with cool tap water for several minutes. National Institutes of Health, National Heart, Lung, and Blood Institute. Global initiative for asthma: global strategy for asthma management and prevention. Ipratropium is used to control and prevent symptoms wheezing and shortness of breath caused by ongoing lung disease chronic obstructive pulmonary disease-COPD which includes bronchitis and emphysema. It works by relaxing the muscles around the airways so that they open up and you can breathe more easily. Controlling symptoms of breathing problems can decrease time lost from work or school. If you take pramlintide with inhaled anticholinergic medicines, it may slow down the movement of food through your stomach too much and you may develop low blood sugar. Symptoms of low blood sugar include chills, cold sweat, dizziness, drowsiness, shaking, rapid heartbeat, weakness, headache, fainting, tingling of the hands or feet, or hunger. Severe low blood sugar makes it hard to think clearly, drive a car, use heavy machinery, or do other risky activities where you could hurt yourself or others.

Ipratropium Bromide Inhalation Solution

Inhale this medication by mouth as directed by your doctor, usually 4 times a day. Avoid getting this medication into your eyes. Flint KC, Hockley B. A comparison between a combination of ipratropium bromide plus fenoterol single metered dose inhaler Duovent and salbutamol in asthma. Greater than 5 years: 5 mg once daily, titrated upwards according to response. What other drugs will affect oxybutynin? At some time before the medication is completely used up, you should consult your physician or pharmacist to determine whether a refill is needed. Call your doctor for instructions if you miss a dose of Nucala. What happens if I overdose? An infection of the lungs' large airways bronchi usually caused by a virus. Skorodin MS. Pharmacotherapy for asthma and chronic obstructive pulmonary disease. Arch Intern Med. Medicines should not be disposed of via wastewater or household waste. Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, waking up at night with trouble breathing, if you use your quick-relief inhaler more often, or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away. sulfasalazine ingredients

What should i avoid while taking ipratropium

This drug may make you dizzy or cause blurred or other changes. not drive, use machinery, or do any activity that requires alertness or clear until you are sure you can perform such activities safely. Limit beverages. Lefcoe NM, Toogood JH, Blennerhassett G et al. The addition of an oral beta agonist plus theophylline in asthma and bronchitis. Chest. Minimize ocular exposure by using a mouthpiece rather than a face mask during administration via a nebulizer. 4 190 191 329 During oral inhalation of aerosol, close eyes. 1 2 Inhalation aerosol should not be administered using the open-mouth technique in these patients with angle-closure glaucoma. 173 190 191 Use with caution in patients with angle-closure glaucoma. Jacobs M. Maintenance therapy for obstructive lung disease. Postgrad Med. Logvinoff-Poidatz M, Geubelle F. Effects of Sch 1000 MDI on the lung function in asthmatic children. Iravani J, Melville GN. Ciliary movement following various concentrations of different anticholinergic and adrenergic bronchodilator solutions in animals. Postgrad Med J. 1975; 51Suppl 7 108. Irsigler G. Flow volume curves and changes in FEV 10 forced vital capacity FVC mid and slow vital capacity Mid VC and SVC in patients with bronchial asthma or chronic bronchitis and emphysema following increasing dosages of Sch 1000 MDI. Bleichert A. The effects of atropine sulphate MDI and Sch 1000 MDI in low and very high dosages on salivation and pulse rate in healthy volunteers. Clean the mouthpiece of the inhaler once a week with water. Allow to air-dry fully before using again. When applied locally, inhibits secretions from serous and seromucous glands lining the nasal mucosa. Use ipratropium solution as directed by your doctor. Check the label on the medicine for exact dosing instructions. Simonsson BG, Jonson B, Ström B. Bronchodilatory and circulatory effects of inhaling increasing doses of an anti-cholinergic drug, ipratropium bromide SCH 1000. Scand J Respir Dis. Niggeschulze A, Palmer AK. Reproduktionstoxikologische untersuchungen mit ipratropiumbromid. German; with English abstract. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment. meridia

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Do not share this medication with others

General information about ipratropium

Anderson WM. Hemodynamic and non-bronchial effects of ipratropium bromide. Am J Med. Asthma, supraventricular tachycardia and atrial fibrillation have been reported. When used in fixed combination with other agents, consider the cautions, precautions, and contraindications associated with the concomitant agents. cost desyrel capsules

Common side effects of ipratropium

Van Bever HP, Desager KN. Paradoxical bronchoconstriction in wheezing infants after nebulised ipratropium bromide. Infection in one or both lungs. Bacteria, especially pneumoniae, are the most common cause. Talk to your doctor before using this product if this applies to you. Donnell DE, Aaron S, Bourbeau J et al. State of the art compendium: Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease. Can Respir J. 2004; 11 Suppl.

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Most doctors recommend using with metered-dose inhalers. But you should not use a spacer with a dry powder inhaler. The effects of overdosage are expected to be related primarily to albuterol sulfate. Acute overdosage with ipratropium bromide by inhalation is unlikely since ipratropium bromide is not well absorbed systemically after aerosol or oral administration. Pleurocentesis: A needle is placed into the chest cavity to drain fluid that's around the lung. A sample is usually examined to identify the cause. Ashutosh K, Lang H. Comparison between long-term treatment of chronic bronchitic airway obstruction with ipratropium bromide and metaproterenol. Ann Allergy.

Anon Salmeterol Med Lett Drugs Ther

Lightbody IM, Ingram CG, Legge JS et al. Ipratropium bromide, salbutamol and prednisolone in bronchial asthma and chronic bronchitis. Br J Dis Chest. Scano G, Stendardi L, Gigliotti G et al. Comparative effects of SCH 1000 and fenoterol after histamine-induced bronchoconstricition in asymptomatic asthmatics. Intl J Clin Pharmacol Ther Toxicol. Dosage of oral inhalation aerosol expressed in terms of the monohydrate. If you have any further questions on the use of this product, ask your doctor or pharmacist. Store in boxes below 25째C protected from light.

Use of a mouthpiece may avoid inadvertent entry of drug into the eye. There are two formulas of the inhaled aerosol. One contains chlorofluorocarbons and the other contains HFA as the propellant. The taste and inhalation of these may seem different, but the safety and effectiveness of both formulas are similar. Foster WM, Bergofsky EH, Bohning DE et al. Effect of adrenergic agents and their mode of action on mucociliary clearance in man. J Appl Physiol. Administer by oral inhalation using an oral aerosol inhaler 1 10 320 or via nebulization. K-Dur potassium chloride US prescribing information. hytrin

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