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The donor responsible for the decyanation seems to be glutathione, which PA patients need for lowering their increasing levels of homocysteine

Across multiple drug classes, common patterns emerge: Corticosteroids accelerate protein breakdown and deplete calcium, vitamin D, magnesium, zinc, and vitamin Cnutrients required for bone strength, collagen synthesis, and immune repair Acetaminophen consumes glutathione, increasing oxidative stress and impairing cellular recovery NSAIDs interfere with iron, folate, and vitamin C absorption while disrupting prostaglandin-driven tissue healing Opioids suppress endocrine and immune signaling necessary for regeneration Individually, these effects may appear modest

however, when they were administered at a 60-min interval, this abrogation did not occur

They just hand you the standard dose and hope for the best