... anorexia, nausea and hyperemesis (severe vomiting). Tn. Basir is a routine outpatient clinic with a diagnosis of heart RSMS CHF, atrial fibrillation and decreased kidney function, and get a routine prescription
R / Digoxin 0.25 mg 1 x daily 1 tablet
Furosemide 80 mg 2 x daily 1 tablet
The results of laboratory tests showed:
Potassium 3.1 mmol / L (3.5-5,5)
Serum urea 40 mmol / L (3.0 to 6.5)
Serum creatinine 600  mol / L (50-120)
Digoxin serum levels of 3.5  g / L (1-2)
What problem is being experienced by Mr. Basir as she entered the emergency room?
When you see the problem is experienced, should be changed Tn.Basir therapy?
What are your recommendations as pharmacists in IFRS?