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Management approach: Add H2 receptor antagonist (famotidine 20 mg twice daily) or antacids as needed

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No PT-141s MC1R binding affinity is 50-fold lower than its MC4R affinity, meaning the dose required to produce melanogenesis would far exceed the dose that causes intolerable MC4R-mediated side effects like nausea and blood pressure elevation

8 Inhibition of glycogen phosphorylase is a very important effect of insulin as the catalytic capacity of this enzyme is 50-fold higher than glycogen synthase in human skeletal muscle

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