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Gall bladder/bile duct disease Acute pancreatitis and other pancreatic disorders have been reported, though the relationship to treatment is unclear Injection-site reactions Dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist Primary mechanism(s) of action Selectively binds and activates both GIP and GLP-1 receptors Example Tirzepatide (Mounjaro) Dosage Initial: 2.5 mg subcutaneous injection once weekly, titrated up to 5 mg weekly after 4 weeks If additional glycemic control is needed, dosage can be increased in 2.5 mg increments after at least 4 weeks on the current dosage

and (B) VMAT2-mediated exchange transport, in which amphetamine enters vesicles while monoamines are transported into the cytoplasm

(There are still black market peptide pushers that sell the now-banned peptides without a valid prescriptionbut this route is risky and not recommended)

Counterstaining by hematoxylin was done as a final step (Elsherbiny et al., 2019)