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The constrained conformation additionally positions the pharmacophore residues (His, D-Phe, Arg, Trp) in an optimal spatial arrangement for simultaneous contact with the MC receptor binding pocket, which is why cyclic melanocortin analogs consistently demonstrate 10-100 fold greater potency than their linear counterparts in cAMP accumulation assays

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It is highest with paravertebral injections, followed by upper and lower extremity PNBs

If your legs are very muscular, make sure to relax your leg completely (sitting down helps) before injecting to avoid hitting muscle