75   years old male pot 
knonw to have  dm  and   hypertneison for the las t   8  years 

creatinine        rose 
wbc    45
wbc    8   hgb    12   plt216
crea  1.4      bun  14     
hba1c  10.9 
tsh   2,5 
uric acid     7,5

medication 
hold  metformin n
amaryl   4 mg once
alloril  100 mg ocn e
lkantis  30 
novorapd  12
liponil  40 mg once 
aldactone   25 mg once
codiovan  160/12.5 
alfacal 
aldactone   25 mg once 
lasix   40 mg once 
asa   100 mg ocne 
plan 
add  empa 
add  cadex 
make  aldactone   half  tab 
make  codiovan  diovan 
