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Measuring a second messenger (e.g., cAMP or Ca 2+ ) supports pathway engagement, but proving that the pathway is causally responsible for the cellular response requires additional evidence such as receptor antagonists, pathway inhibitors, receptor knockdown or knockout, or orthogonal rescue experiments

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The main reason is tolerability

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Tirzepatide (Mounjaro, Zepbound) is a related but distinct medication that acts as a dual GIP/GLP-1 receptor agonist