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LAMPIRAN

PERATURAN DIREKTUR RS SARI ASIH KARAWACI


NOMOR 077/PER/DIR/RSSAK/II/2015
TENTANG
KEBIJAKAN OBAT HIGH ALERT DAN LOOK ALIKE SOUND ALIKE (LASA)
1.

DAFTAR OBAT ELEKTROLIT PEKAT (HIGH ALERT)

HIGH ALERT
CEK KEMBALI

No.
1

KELAS TERAPI
ELEKTROLIT
PEKAT

PELABELAN

: WARNA MERAH

PENYIAPAN

: TERPISAH DARI SEDIAAN LAIN

NAMA GENERIK

BENTUK
SEDIAAN

NAMA DAGANG

KEKUATAN

KALIUM KLORIDA

INJEKSI

KCL 7.46 (7.46% POTASSIUM


CHLORIDE INJEKTION)

7.46% 25 ML

40% MAGNESIUM
SULFATE

INJEKSI

Mg SO4 40

40% MAGNESIUM
SULFATE = Mg SO4. 7
H2O 10.0g 25 ML

20% MAGNESIUM
SULFATE

INJEKSI

Mg SO4 20

20% MAGNESIUM
SULFATE = Mg SO4. 7
H2O 10.0g 25 ML

NATRIUM KLORIDA 3%

INFUS

OTSU-SALINE 3 (3% SODIUM


CHLORIDE)

3% 500 ML

SODIUM BICARBONATE

INJEKSI

Meylon 84-BP

SODIUM
BICARBONATE 8,4%
(84mg/ml)
SODIUM 1 mM/ml
BICARBONATE 1
mM/ml
25 ML

OBAT

BUPIVACAIN HCl

INJEKSI

ANASTESI

BUVANEST

0,5% 20 ML

DECAIN SPINAL HEAVY

0,5% 4 ML

KETAMINE

INJEKSI

KETALAR

100 MG / 10 ML

PROPOFOL

INJEKSI

PROANES

10 MG / 20 ML

RECOFOL

10 ML / 20 ML

SEVOFLURANE

INHALASI

SEVODEX

250 ML

ISOFLURANE

INHALASI

ISOFLURANE

250 ML

MIDAZOLAM

INJEKSI

MILOZ

5 MG / ML

OBAT

EPINEPHRIN

INJEKSI

EPINEPHRINE

1 MG / ML

VASOKONTRIKSI

NOREPINEPHRIN

INJEKSI

RAIVAS

4 MG / 4 ML

LEVOSOL

8 MG / 8 ML

KETERANGAN
Elektrolit pekat tidak
boleh di simpan di
ruang perawatan
kecuali IGD, VK, Ok
dan ICU

OBAT

LIDOCAIN

INJEKSI

LIDOCAIN

20 % 20 MG / ML

ANTI ARITMA

AMIODARON

INJEKSI

CORDARON

150 MG / 3 ML

KENDARON

150 MG / 3 ML

OBAT

WAFARIN

TABLET

SIMARC

2 MG

ANTI TROMBOSIT

HEPARIN

TABLET

INVICLOT

25000 IU / 5 ML

CILOSTAZOL

TABLET

PLETAAL

50 MG

CLOPIDOGREL

TABLET

ANTIPLAT

50 MG

PENTOXIFYLLINE

TABLET

REOTAL

400 MG

FONDAPARINUX

INJEKSI

ARIXTRA

2,5 MG / 0,5 ML

STREPTOKINASE

INJEKSI

STREPTASE

1.500.000 IU

DEXTROSE

INJEKSI

D40%

40% 25 ML

DEXTROSE
HYPERTONIC, 40%

LARUTAN DYALISA

OBAT

GLIMEPIRID

TABLET

METRIX

ANTI DIABETES
ORAL

1 MG, 2 MG, 3 MG, 4


MG

ACARBOSE

TABLET

GLUCOBAY

50 MG, 100 MG

METFORMIN

TABLET

FORBETES

500 MG, 850 MG

INSULIN ASPART

INJEKSI

NOVORAPID FLEXPEN

300 IU / 3 ML

INSULIN DETEMIR

INJEKSI

LEVEMIR FLEXPEN

300 IU / 3 ML

INSULIN GLARGINE

INJEKSI

LANTUS

300 IU / 3 ML

INSULIN REGULAR

INJEKSI

ACTRAPID HM

100 IU / 10 GR

INJEKSI

ACTRAPID HM PENFIL

100 IU / 3 ML

10

INSULIN

OBAT

DIGOXIN

INJEKSI

FARGOXIN

200 MG / 5 ML

JANTUNG

DOPAMIN

INJEKSI

DOPAMIN

250 MG / 5 ML

DOBUTAMIN

INJEKSI

INODEX

250 MG / 5 ML

11

OBAT SEDATIV

CHLORALHYDRAT

PULVIS

CHLORALHYDRAT

12

OBAT RELAXASI
OTOT

ATRAKURIUM BESILAT

INJEKSI

TRACRIUM

50 MG / 5 ML

TRAMUS

25 MG / 2,5 ML

13

HORMON

OXYTOCIN

INJEKSI

INDUXIN

10 IU / ML

14

OBAT

FENTANIL

INJEKSI

FENTANYL

0,05MG/ML 2 ML

NARKOTIKA

MORFIN

INJEKSI

MORFIN

10MG/ML 1 ML

PETHIDIN HCl

INJEKSI

PETHIDIN

50MG/ML 2 ML

2.

DAFTAR OBAT LOOK ALIKE SOUND ALIKE (LASA)

a. Look alike (RUPA MIRIP)

LlaASA
LASA
PELABELAN

: WARNA KUNING

ABBOTIC SYRUP 125MG/5ML


AMOXAN 250 MG CAPSUL
AMOXAN SYRUP
BIOTHICOL SYRUP
BUFECT SYRUP
CEFAT SYRUP
CLANEKSI SYRUP
CLARITIN SYRUP
EPEXOL SYRUP
RHINOFED SYRUP
ALLORIS TABLET
AMLODIPIN 5 MG TABLET
CELEBREX 100 MG TABLET
DIAZEPAM 2 MG TABLET
ERYSANBE 500 CAPLET
FEROFORT TABLET
FLUIMUCIL CAPSUL
FORBETES 500 MG TABLET
GLIMEPIRID 1 MG TABLET
LYNORAL TABLET
MEFINAL 250 CAPSUL
NEUROTAM 1200 MG TABLET
NOLIPO TABLET
PANTOZOL 20 MG TABLET
PROLIC 150 MG CAPSUL
PREMASTON TABLET
PROLACTA DHA MOTHER CAPSUL
RIMACTACID PEDIATRIC TABLET
SANPRIMA TABLET
STROCAIN TABLET
TRAJENTA TABLET
TRAMADOL CAPSUL
AMINOPHYLIN INJEKSI
AMOXAN INJEKSI 1 GR
BECLOV INJEKSI
CEFTRIAXON 1 GR INJEKSI
EPINEPHRIN INJEKSI
KETALAR INJEKSI
KETOROLAC INJEKSI
LASIX INJEKSI
RATIVOL INJEKSI
TAXEGRAM 1 GR INJEKSI
CINOLON CREAM
DAKTARIN CREAM
DESOLEX CREAM
ELOCON CREAM
FORDERM CREAM
KENACORT A CREAM
NOROID DERMA RUSH
AKILEN EAR DROP
ILIADIN DROP 0,025%

ABBOTIC SYRUP 250 MG/5ML


AMOXAN 500 MG CAPSUL
AMOXAN FORTE SYRUP
BIOTHICOL FORTE SYRUP
BUFECT FORTE SYRUP
CEFAT FORTE SYRUP
CLANEKSI FORTE SYRUP
CELESTAMIN SYRUP
EPISAN SYRUP
RHINOS JUNIOR SYRUP
EPEXOL TABLET
AMLODIPIN 10 MG TABLET
CELEBREX 200 MG TABLET
PHENOBARBITAL 30 MG TABLET
GRATIZIN 10 MG TABLET
REOTAL CAPLET
CEFSPAN 100 MG CAPSUL
FORBETES 850 MG TABLET
SIMVASTATIN 10 MG TABLET
THYRAX TABLET
MEFINAL 500 CAPSUL
NEVOX XR TABLET
PURICEMIA TABLET
PANTOZOL 40 MG TABLET
PROLIC 300 MG CAPSUL
POSPARGIN TABLET
PROLACTA DHA BABY CAPSUL
RIMCUR PEDIATRIC TABLET
SANPRIMA FORTE TABLET
STUGERON TABLET
TOPAMAX TABLET
SPIRAMYCIN 500 CAPLET
CALCIUM GLUCONAS INJEKSI
COLSANCETIN 1 GR INJEKSI
ACRAN INJEKSI
CEFOTAXIM 1 GR INJEKSI
EPHEDRINN INJEKSI
DYNASTAT INJEKSI
CITICOLIN INJEKSI
NOVALGIN INJEKSI
TROVENSIS 4 MG INJEKSI
TAXEGRAM 0.5 MG INJEKSI
CINOLON N CREAM
DAKTARIN DIAPER CREAM
SAGALON CREAM
GARAMYCIN CREAM
TERMISIL CREAM
MYCO Z OINT
NOROID CREAM
CROM OPTHAL EYE DROP
ILIADIN DROP 0,05%
4

b. Sound alike (UCAPAN MIRIP)

LlaASA
LASA
PELABELAN

: WARNA KUNING

BENZATIN BENZIL PENISILIN


CEFAT
CLIMADAN
DOBUTAMIN
DOPACEF
FLAGYSTATIN
FLAVIN
FUTROLIT
HEPTASAN
KALXETIN
LACTAFIT
MEROSAN
OTOPAIN
PRIDESIA
PULMICORT
QUBI TEN
RECOFOL
RYVEL
STREPTOMYCIN
TRADOSIK
TRIOFUSIN

PROCAIN PENICYLLIN
CEFSPAN
CERADAN
DOPAMIN
TERPACEF
FLADYSTIN
PLAVIX
TROLIT
HISTAPAN
COLSANCETIN
LACTACID
MEFUROSAN
OTTOPAN
FORDESIA
FLAMICORT
Q TEN
RATIVOL
RANIVEL
SPIRAMICYN
TORASIC
TUTOFUSIN