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This increased -lactam reactivity is explained by the R 2 substituent that may act as a leaving group (Perez-Inestrosa et al., 2005), which is in agreement with previous observations in cephalosporins with a good leaving group at this position (Llinas et al., 2004)

Other treatments being investigated include topical calcium channel blockers (diltiazem and nifedipine), which have a similar effect to GTN ointment

R., Bihamta, M