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Phosphodiesterase hydrolyzes cyclic AMP (cAMP) to 5-AMP, and by inhibiting phosphodiesterase, ATZ blocked the hydrolysis of cAMP to 5-AMP, resulting in increased cAMP levels ( in vitro studies, we conclude that ATZ exposure would lead to elevated cAMP levels due to its inhibition of phosphodiesterase

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The truth is that exceeding the recommended dose does not make the pain any better, but rather just increases risk for liver damage