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The Secretary may: Direct agency priorities Encourage enforcement discretion Appoint or replace FDA leadership Order internal review of regulatory positions Support re-evaluation of prior safety determinations The Secretary may not: Bypass statutory requirements Ignore the Administrative Procedure Act Unilaterally legalize peptide compounding Regulatory change must follow defined legal pathways

LOW DOSES (1-2 ug/kg/min) it selectively activates D1 receptors The D1 mediated effect to increase renal blood flow may be of clinical significance (e.g

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Neumeyer, from Massachusetts General Hospital

The point is to recognise that the risk is elevated and to respond appropriately if symptoms appear