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Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures

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Elevated cAMP acts mainly through the following molecular pathways: inhibition of the ERK pathway, activation of the PKA-AMPK-mTOR pathway, and activation of the p38 signaling pathway [13, 17, 56,57,58]: first, it inhibits the extracellular signal-regulated kinase (ERK) pathway, decreasing its activation of cyclin D1, thereby hindering cyclin D1-mediated DNA replication initiation and transition into the S phase of the cell cycle [17]

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If markers stayed stable and skin exams are clean, you have objective evidence the protocol was tolerated safely