75 years old male pateint 
knonw to have  
DM     sicne  2005 
hypertension 
open heart  syndrome  and miultiple  stent 
last one last  years 
2  discopathy operation  
gour 
diabetic 

presented with   rise in creatninein     2.3   for the last  one   years 
bph 
c/o  frequency 

medication   quest    2.5 mg 1x2 
conconr  5 mg ocne 
ecurease  50/1000 
liponil  40 mg once 
alloril  100 mg once 
cadex   once daily 


plan 
add  doudart 
add   rapafin
add   res  q  
add   alfacal 
rtc after one month 