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Endocrine Prescribing Case Ralston Johns is a 28-year-old male patient who presents for follow up on his endocrine issues. He tells you that he is doing well. He is tolerating the new dose of Mounjaro without issues, but thinks he probably needs additional medication of some sort. He says he is tolerating the 5 mg per week well, and it has caused additional weight loss, but his BS are still “not where he would like them to be”. His co-pay for this strength of the med is higher than for the lower strength, it is $450 per month now—and he says he can still afford this to be healthy. His BS are in 150-160 range after meals and if he eats any carbs; no low BS readings You started him on Mounjaro 3 months ago, and he has lost 14 pounds so far. No low BS; a little constipation, but it is manageable with UltraMag [1] tab at HS PMH: Obesity, Type II DM, DLP Labs 1 week ago [fasting] —A1C 7.3%; FBS 130 mg/dL; TC 210 trigs 150 mg/dL, HDL 40 mg/dL; LDL 130 mg/dL; no proteinuria; CMP normal; TSH normal NKDA; Meds—Mounjaro 5 mg SC each week on Tuesdays; UltraMag [1] at bedtime; Crestor 5 mg daily On exam today: 5′ 10″ tall 250 pounds 98.6 80 pulse 130/82 [right arm seated] Ralston is a well developed Caucasian male in no acute distress. He is well groomed and appears his stated age. Cardiac and lung exams are unremarkable. No JVD, no bruits or murmurs. There is retinopathy on eye exam; skin is warm and dry; no lesions; peripheral pulses are all palpable symmetrically 2+/2+ There is no dec

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