PATIENT PRESENTATION

Ast (aspartat amino transferase) normal: dewasa anak 0-35 IU/L

ALT (alanin amino transferase) normal: 10-35IU/L

ALK phos (alkalin phospatase) normal: dewasa 42-136 IU/L

A1c (Hba1c) normal: dewasa: non diabetes< 5%, diabetes dikontrol dgn baik 2,5-
6%, diabetes tdk terkontrol dgn baik >8%.

BUN (Blood Urea Nitrogen) Normal: dewasa 10-20 mg/dl

Ca (calsium) normal: dewasa 4,4-5,3 mg/dl level kritis diatas 6,29 mg/dl

Cl (Clorida) normal: dewasa 96-106 Meq/l

CO2 (carbondioksida) normal: dewsa 22-30 Meq/L

Gluc random (glukosa acak) > 200mg/dl

Scr (serum kreatinin) normal: dewsa wanita 0,5-1,1 mg/dl , pria 0,6-1,2 mg/dl

HDL Dewsa > 50 mg/dl

LDL dewsa < 100 mg/dl

T.col (total kolesterol) <200mg/dl

Phos (phospat) dewsa 2,5-4,5mg/dl

T. bili (total bilirubin) dewsa total <1,4 mg/dl

Trig (trigliserida) dewasa <150mg/dl

K (potasium/kalium) dewsa 3,5-5 Meq/L

Na (natrium/sodium) dewsa 136-145 Me/L

Interactions between your selected drugs
Moderate

lisinopril metformin

Applies to: lisinopril, metformin

MONITOR: Limited data suggest that ACE inhibitors may potentiate the hypoglycemic
effects of oral antidiabetic drugs, including metformin. The mechanism is unknown.
Symptomatic and sometimes severe hypoglycemia has occurred.

MANAGEMENT: Close monitoring for the development of hypoglycemia is recommended

if ACE inhibitors are coadministered with metformin, particularly in patients with advanced
age and/or renal impairment. Dosage adjustments may be required if an interaction is
suspected. Patients should be apprised of the signs and symptoms of hypoglycemia (e.g.,
headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, palpitations),
how to treat it, and to contact their physician if it occurs. Patients should be observed for loss
of glycemic control when ACE inhibitors are withdrawn.

Interactions between your selected drugs and food

Moderate

lisinopril food

Applies to: lisinopril

GENERALLY AVOID: Moderate-to-high dietary intake of potassium can cause

hyperkalemia in some patients who are using angiotensin converting enzyme (ACE)
inhibitors. In some cases, affected patients were using a potassium-rich salt substitute. ACE
inhibitors can promote hyperkalemia through inhibition of the renin-aldosterone-angiotensin
(RAA) system.

MANAGEMENT: It is recommended that patients who are taking ACE inhibitors be advised
to avoid moderately high or high potassium dietary intake. Particular attention should be paid
to the potassium content of salt substitutes.