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(1990) Am J Physiol 259:G524-G529

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Crossing strategies are: (1) bypassing intranasal route, (2) lipid modifications (Dihexa), (3) active transporters (insulin, transferrin), (4) vehicles like nanoparticles or exosomes

hypertonic solutions (too concentrated) cause cells to shrink

That is not a great combination

Vomiting, diarrhea, and constipation are also reported, usually in the first few weeks of treatment or after dose increases