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To puke out is to agree (when drunk, usually) to gay sex, but then sobering up and deciding not to have the gay sex.

Comes from a combination of puke and get out.
Joe: Yo dude, you said last night you'd give me head? What's the deal? You'd better not puke out on me!
Andy: I was drunk, I'm puking out!
by JVJ March 28, 2011
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