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However, as discussed elsewhere in this review, competition for L-arginine and L-ornithine substrates by synthetic enzymes is often rate-limiting in the synthesis of nitrergic co-transmitters (Figure 1), and the absolute level of available Put in the brain is generally fairly low (Malik et al., 2020

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If the patient does not have interest in MOUD, you should treat the patient symptomatically using clonidine for restlessness, naproxen for pain, and ondansetron for nausea control