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Bacteriostatic water used for reconstitution should be discarded after 28 days to prevent pH shifts from bacterial growth

Pappu, J

A., & Ramirez, S

2014;9(8):e103490.

Most states accept that a video consultation can establish a valid patient-provider relationship, but: Best practices: Document a comprehensive history: Current weight, weight history, diet/exercise attempts, medical comorbidities (diabetes, hypertension, sleep apnea), psychiatric history, current medications Conduct a visual exam: Assess habitus, ask patient to self-report current weight and vital signs (or coordinate with a local pharmacy/lab) Review or order labs: TSH (rule out hypothyroidism), fasting glucose/A1c, lipid panel, liver/kidney function Obtain informed consent: Document discussion of risks, benefits, alternatives, and expected outcomes Create a treatment plan: Include dietary/exercise counseling (can be delegated to a health coach or dietitian, but must be documented) Asynchronous-only prescribing is risky