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EL

Dr. Lee

Endocrinology

Dose Review: Maya Patel

Injection Pen

Week 3 escalation · Dose held Week 2 due to nausea

Held at 2.5 mg — Week 3 escalation pending review

Propose: 5 mg pen·+2.5 mg from 2.5 mg current

Pen Dose Schedule

Maya is using a fixed-dose prefilled pen — no unit math required.

First Dose Health Pacing
Standard Protocol
Wk 1

2.5 mg

completed

Wk 1

2.5 mg

on schedule

Wk 2

2.5 mg

hold — mild nausea

Wk 2

5 mg

jumps — may cause nausea

Wk 3

5 mg

pending approval

Wk 3

5 mg

on schedule

Wk 4

5 mg

planned if tolerated

Wk 4

10 mg

on schedule

Why hold at 2.5 mg? Standard protocols jump from 2.5 mg directly to 5.0 mg. First Dose Health holds the dose when mild nausea is detected, giving the body time to adjust before escalating — keeping patients on track longer.

Patient Response

Week 2 Symptom Summary

Nausea

1/3

Mild

Reflux

0/3

None

Dizziness

0/3

None

Constipation

0/3

None

Held Week 2 — reassess for Week 3

Nausea 1/3 resolved by Day 14. Weight loss on track at −1.6 lbs. Safe to escalate to 5.0 mg pen.

Safety Rules

Nausea resolved to ≤ 1/3

Was 1/3, resolved by Wk2 end

No new onset of severe symptoms

No severe symptoms

Weight change within expected range

−1.6 lbs (expected: −1 to −4 lbs)

Patient completed check-in on time

Submitted Day 14

Fixed-dose pen — no unit calculation required

5.0 mg pen (single-dose prefilled)

Pen patient note

Maya uses a prefilled single-dose 5.0 mg pen. Unlike vial patients, no unit calculation is required — the dose is fixed. Approval here authorizes use of the next pen tier (5.0 mg). No syringe or concentration data applies.

Audit Trail

Complete clinical activity log

System·10:32 AM

Intake form received from Alex Rivera

System·10:32 AM

Risk assessment generated: 3 flags identified

System·10:33 AM

Micro-titration plan drafted: 2.5 mg start, 0.5 mg weekly steps

Dr. Kim·10:45 AM

Reviewed plan, approved Week 1 dose (2.5 mg / 25 units)

Alex Rivera·Day 7

Completed injection and symptom check-in

System·Day 7

Symptom analysis: Nausea mild (1/3), all others 0. Safe to escalate.

System·Day 7

Proposed Week 2 dose: 3.0 mg / 30 units -- awaiting clinician review