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Neurotransmitters influence trans-membrane ion flow either to increase (excitatory) or to decrease (inhibitory) the probability that the cell with which it comes in contact will produce an action potential

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Less common but clinically significant adverse effects include acute pancreatitis, gallbladder disease, hypoglycemia (particularly when combined with insulin or sulfonylureas), acute kidney injury (especially with severe gastrointestinal losses), and changes in heart rate