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Selected nicotinic agonists were used to activate and desensitize high-sensitivity (HS; (α4)2(β2)3) or low-sensitivity (LS; (α4)3(β2)2) isoforms of human α4β2-nicotinic acetylcholine receptors (nAChR). Function was assessed using 86Rb+ efflux in a stably-transfected SH-EP1-hα4β2 human epithelial cell line, and two-electrode voltage-clamp electrophysiology in Xenopus oocytes expressing concatenated pentameric HS or LS α4β2-nAChR constructs (HSP and LSP). Unlike previously-studied agonists, desensitization bythe highly-selective agonists A-85380 and sazetidine-A (Saz-A) preferentially reduced α4β2-nAChR HS-phase vs. LS-phase responses. The concatenated-nAChR experiments confirmed that ≈20% of LS-isoform ACh-induced function occurs in an HS-like phase, which is abolished by Saz-A preincubation. Six mutant LSP were generated, each targeting a conserved agonist-binding residue within the LS-isoform-only α4(+)/(-)α4 interface agonist binding site. Every mutation reduced the percentage of LS-phase function, demonstrating that this site underpins LS-phase function. Oocyte-surface expression of the HSP and each of the LSP constructs was statistically indistinguishable, as measured using β2-subunit-specific [125I]mAb295 labeling. However, maximum function is approximately 5x greater on a "per receptor" basis for unmodified-LSP vs. HSP α4β2-nAChR. Thus, recruitment of the α4(+)/(-)α4 site at higher agonist concentrations appears to augment otherwise-similar function mediated by the pair of α4(+)/(-)β2 sites shared by both isoforms. These studies elucidate the receptor-level differences underlying the differential pharmacology of the two α4β2-nAChR isoforms, and demonstrate that HS vs. LS α4β2-nAChR activity can be selectively manipulated using pharmacological approaches. Since α4β2 nAChR are the predominant neuronal subtype these discoveries likely have significant functional implications, and may provide important insights for drug discovery and development.