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Phase III is mediated by ABC (ATP-binding cassette) transporter proteins: P-glycoprotein (MDR1/ABCB1), MRPs (multidrug resistance-associated proteins), and BCRP
This stimulates a negative feedback loop that directly inhibits the exocytotic release of norepinephrine into the synaptic cleft, decreasing local vascular tone
Metoclopramide is the only FDA-approved drug for gastroparesis, and it carries a black box warning for tardive dyskinesia risk with long-term use
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