68   years old male pt 
knonw to have DM   X  23  
HTN 
DLD 
 HE WAS DOING WELL 
CREATININE  1,35 
2/225  HIS CREATIINE  3,3    A ND  RECENTLY HIS CREATININE   REACHED   4,5 
BP  160/70 
MEDICATION 
HE WAS ON 
EMPA  10 MG ONCE 
VALSAN       160/25 
LIPONIL 40 MG ONCE 
NOVORAPID 
LEVIMER 
ALLORIL 
CADEX  
MEPRAL 
SITAGLU 

PLAN 
DO RENAL   US   AND  RENAL DOPPLER 
DO LABS   SICNE HIS CREATININE INCREASED RAPIDLY    FROM 3-5 
STOP EMPA 
STOP VALSAN 
STOP ALLORIL 
STOP  SITAGLU   100 
ADD  MOCOCORD 
ADD   


REFERRRED FROM DR AMEEN  HARB 
