Hitung Darah Lengkap (HDL)

Tes laboratorium yang paling umum adalah hitung darah lengkap (HDL) atau complete blood count (CBC). Tes ini memeriksa jenis sel dalam darah, termasuk sel darah merah, sel darah putih dan trombosit (platelet). Hasil tes menyebutkan jumlahnya dalam darah (misalnya jumlah sel per millimeter kubik) atau persentasenya. Tes laboratorium lain dibahas pada Lembaran Informasi (LI) 107 dan 108.
Semua sel darah dibuat di sumsum tulang. Beberapa obat dan penyakit dapat merusak sumsum tulang sehingga menyebabkan berkurangnya jumlah sel darah merah dan putih.
Setiap laboratorium mempunyai ‘nilai rujukan’ untuk semua hasil tes. Biasanya, tes laboratorium akan memperlihatkan hasil tes yang berada di luar nilai normal. Untuk informasi lebih lanjut mengenai hasil tes laboratorium, lihat LI 105.
Laporan hasil sering sulit ditafsirkan. Beberapa angka dilaporkan dengan satuan ‘x10.e3’ atau ‘x103’. Ini berarti jumlah yang dicatat harus dikalikan 1.000. Contohnya, bila hasil adalah 8,77 dengan unit ‘x10.e3’, jumlah sebenarnya adalah 8.770.

Tes Sel Darah Merah

Sel darah merah, yang juga disebut sebagai eritrosit, bertugas mengangkut oksigen dari paru ke seluruh tubuh. Fungsi ini dapat diukur melalui tiga macam tes. Hitung Sel Darah Merah (red blood cell count/RBC) yang menghitung jumlah total sel darah merah; hemoglobin (Hb) yaitu protein dalam sel darah merah yang bertugas mengangkut oksigen dari paru ke bagian tubuh lainnya; dan hematokrit (Ht atau HCT) yang mengukur persentase sel darah merah dalam seluruh volume darah.
Orang yang tinggal di dataran tinggi umumnya mempunyai lebih banyak sel darah merah. Ini merupakan upaya tubuh mengatasi kekurangan oksigen. Eritrosit, Hb dan Ht yang sangat rendah menunjukkan adanya anemia, yaitu sel tidak mendapat cukup oksigen untuk berfungsi secara normal. Jika kita anemia, kita sering merasa lelah dan terlihat pucat. Tentang kelelahan, lihat LI 551 dan anemia, LI 552.
Volume Eritrosit Rata-Rata (VER) atau mean corpuscular volume (MCV) mengukur besar rata-rata sel darah merah. MCV yang kecil berarti ukuran sel darah merahnya lebih kecil dari ukuran normal. Biasanya hal ini disebabkan oleh kekurangan zat besi atau penyakit kronis. MCV yang besar dapat disebabkan oleh obat HIV, terutama AZT dan d4T. Ini tidak berbahaya. MCV yang besar menunjukkan adanya anemia megaloblastik, dengan sel darah merahnya besar dan berwarna muda. Biasanya hal ini disebabkan oleh kekurangan asam folat.
Red Blood Cell Distribution Width (RDW) mengukur lebar sel darah merah. Hasil tes ini dapat membantu mendiagnosis jenis anemia dan kekurangan beberapa vitamin.
Hemoglobin Eritrosit Rata-Rata (HER) atau mean corpuscular hemoglobin (MCH) dan Konsentrasi Hemoglobin Eritrosit Rata-Rata (KHER) atau mean corpuscular hemoglobin concentration (MCHC atau CHCM) masing-masing mengukur jumlah dan kepekatan hemoglobin. MCH dihitung dengan membagi hemoglobin total dengan jumlah sel darah merah total.
Trombosit atau platelet (PT atau PLT) berfungsi membantu menghentikan perdarahan dengan membentuk gumpalan dan keropeng. Jika trombosit kita kurang, kita mudah mengalami perdarahan atau memar. Orang HIV-positif kadang trombositnya rendah (disebut trombositopenia). Obat HIV dapat mengatasi keadaan ini. Trombosit tinggi biasanya tidak punya pengaruh besar pada kesehatan.

Tes Sel Darah Putih

Sel darah putih (disebut juga leukosit) membantu melawan infeksi dalam tubuh kita.
Hitung Sel Darah Putih (white blood cell count/WBC) adalah jumlah total sel darah putih. Leukosit tinggi (hitung sel darah putih yang tinggi) artinya tubuh kita sedang melawan infeksi. Leukosit rendah artinya ada masalah dengan sumsum tulang. Leukosit rendah disebut leukopenia atau sitopenia yang berarti tubuh kurang mampu melawan infeksi. Neutrofil berfungsi melawan infeksi bakteri, dan dilaporkan sebagai persentase leukosit atau %NEUT. Biasa jumlahnya 55-70 persen. Jika neutrofil kita rendah (disebut neutropenia), kita lebih mudah terkena infeksi bakteri. Penyakit HIV lanjut, obat HIV seperti gansiklovir (untuk mengatasi virus sitomegalo, lihat LI 501) dan AZT (obat antiretroviral; lihat LI 420) dapat menyebabkan neutropenia.
Ada dua jenis utama limfosit: sel-B untuk membuat antibodi, protein khusus yang menyerang kuman; dan sel-T untuk menyerang dan membunuh kuman, serta membantu mengatur sistem kekebalan tubuh. Salah satu jenis sel-T adalah sel CD4, yang diinfeksi dan dibunuh oleh HIV (lihat LI 412). Jumlah limfosit umumnya 20-40 persen leukosit. Hitung darah lengkap biasanya tidak termasuk tes CD4. Tes CD4 ini harus diminta sebagai tambahan. Hasil hitung darah lengkap tetap dibutuhkan untuk menghitung jumlah CD4, sehingga dua tes ini umumnya dilakukan sekaligus.
Monosit atau makrofag diukur sebagai persentase leukosit (%MONO) dan biasanya 2-8 persen. Sel ini melawan infeksi dengan ‘memakan’ kuman dan memberi tahu sistem kekebalan tubuh mengenai kuman apa yang ditemukan. Monosit beredar dalam darah. Bila monosit ada di jaringan tubuh, mereka disebut makrofag. Jumlah monosit yang tinggi menunjukkan adanya infeksi bakteri.
Eosinofil (%EOS) biasanya 1-3 persen leukosit. Sel ini terlibat dengan alergi dan tanggapan terhadap parasit. Kadang kala penyakit HIV dapat menyebabkan jumlah eosinofil yang tinggi. Jumlah meningkat terutama jika kita diare, kentut, atau perut kembung. Hal ini menandai adanya parasit.
Fungsi basofil (%BASO) tidak begitu dipahami, namun sel ini terlibat dalam reaksi alergi jangka panjang, misalnya asma atau alergi kulit. Sel ini jumlahnya kurang dari 1 persen leukosit.
Persentase limfosit (%LYMP) mengukur lima jenis sel darah putih: neutrofil, limfosit, monosit, eosinofil dan basofil, dalam bentuk persentase leukosit. Untuk memperoleh limfosit total, nilai ini dikalikan dengan leukosit. Misalnya, bila limfosit 30,2 persen dan leukosit 8.770, limfosit totalnya adalah 0,302 x 8.770 = 2.648.

Seri Lembaran Informasi ini berdasarkan terbitan The AIDS InfoNet. Lihat http:// www.aidsinfonet.org

Lisinopril

Generic Name: lisinopril (lyse IN oh pril)

Brand Names: Prinivil, Zestril

What is lisinopril?

Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

Lisinopril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a heart attack.

Lisinopril may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about lisinopril?

Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of lisinopril. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril. Drink plenty of water each day while you are taking this medication.

What should I discuss with my healthcare provider before taking lisinopril?

Do not use this medication if you are allergic to lisinopril or to any other ACE inhibitor, such as benazopril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

Before using lisinopril, tell your doctor if you are allergic to any drugs, or if you have:

· kidney disease (or if you are on dialysis);

· liver disease;

· heart disease or congestive heart failure;

· diabetes; or

· a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.

If you have any of these conditions, you may not be able to use lisinopril, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category D. Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. It is not known whether lisinopril passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take lisinopril?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take each dose with a full glass of water.

Lisinopril can be taken with or without food.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril. Drink plenty of water each day while you are taking this medication.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking lisinopril. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store lisinopril at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a lisinopril overdose may include feeling extremely dizzy or light-headed, or fainting.

What should I avoid while taking lisinopril?

Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of lisinopril. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.

Lisinopril side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

· feeling light-headed, fainting;

· urinating more or less than usual, or not at all;

· fever, chills, body aches, flu symptoms;

· tired feeling, muscle weakness, and pounding or uneven heartbeats;

· chest pain; or

· swelling, rapid weight gain.

Less serious side effects may be more likely to occur, such as:

· cough;

· dizziness, drowsiness, headache;

· nausea, vomiting, diarrhea, upset stomach; or

· mild skin itching or rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect lisinopril?

Before taking lisinopril, tell your doctor if you are taking any of the following drugs:

· lithium (Lithobid, Eskalith);

· gold injections, or aurothioglucose (Solganal);

· a potassium supplement such as K-Dur, Klor-Con;

· salt substitutes that contain potassium;

· insulin or diabetes medication you take by mouth;

· aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others; or

· a diuretic (water pill).

If you are using any of these drugs, you may not be able to use lisinopril or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect lisinopril. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about lisinopril written for health professionals that you may read.

What does my medication look like?

Lisinopril is available with a prescription under the brand names Zestril and Prinivil.Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

· Zestril 5 mg - capsule-shaped, pink tablets

· Zestril 10 mg - round, pink tablets

· Zestril 20 mg - round, red tablets

· Zestril 40 mg - round, yellow tablets

· Prinivil 2.5 mg - round, white tablets

· Prinivil 5 mg--shield-shaped, white, scored tablets

· Prinivil 10 mg--shield-shaped, light-yellow tablets

· Prinivil 20 mg--shield-shaped, peach-colored tablets

· Prinivil 40 mg--shield-shaped, rose-red tablets

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2008 Cerner Multum, Inc. Version: 6.07. Revision Date: 03/11/2008