FORMULIR KESESUAIAN PERESEPAN DENGAN FORMULARIUM NASIONAL

PERIODE BULAN .................................. TAHUN 2017 S/D BULAN..........................................TAHUN 2017

KETERSIADAAN OBAT DI FORNAS

NO NAMA OBAT PERSENTASE
ADA TIDAK ADA
3 Acyclovir Tab 200 mg 100%
5 Acyclovir Krim 100%
7 Alat suntik skl pakai 1 ml 100%
8 Alat suntik skl pakai 5ml 100%
9 Alat suntik skl pakai 2,5 ml 100%
10 Alprazolam tab 0.5 mg 100%
11 Allopurinol tab 100 mg 100%
16 Aminophylin tab 100%
17 Amitriptilin tab 100%
18 Amlodipin tab 5 mg 100%
19 Amlodipin tab 10 mg 100%
20 Amoxicilin dry sir 100%
21 Amoxicilin kap 500 mg 100%
22 Antasida DOEN sirup 100%
23 Antasida DOEN tab 100%
24 Anti Bakteri salf 100%
25 Anti Fungi Doen [WF]slp 100%
26 Anti Haemorhoid Suppos 100%
29 As Ascorbic Tab 50mg ( Vit C ) 100%
30 Asam Folat Tab 1 mg 100%
32 Asam Mefenamat 500 mg 100%
34 Asam Traneksamat Tablet 100%
37 Atropin Sulfat Injeksi 100%
39 Betametason slp 100%
41 Carbamazepin 200 mg 100%
42 Cat Gut + Jarum bedah 100%
43 Cetirizin Tab 100%
44 Cetirizin Sirup 100%
45 Devitalisasi Pasta (obat gigi) 100%
46 Dexametason inj 100%
47 Dexametason tab 0,5 mg 100%
48 Diazepam tab 2 mg 100%
49 Diazepam inj 100%
51 Diazepam Rectal 5 mg 100%
53 Difenhidramin inj 100%
54 Digoxin tab 0,25mg 100%
55 Diltiazem Tab 100%
56 Dimenhidrinat Tab 100%
57 Domperidon Tab 100%
58 Domperidon Suspensi 100%
61 Epinefrin inj 100%
 62 Erytromisin Kap 250 mg 100%
63 Erytromisin Kap 500 mg 100%
64 Erytromisin Sirup 100%
65 Etakridin lrt 0,1 100%
66 Etambutol 500 mg 100%
67 Etanol 70 % 100%
68 Etilklorida semprot 100%
69 Eugenol cairan 100%
73 Fenobarbital tab 30 mg 100%
75 Fenol Glyserol Lrt TT 100%
76 Fitomenadion inj 100%
77 Fitomenadion tab 10 mg 100%
78 Furosemid tab 40 mg 100%
80 G Guayakolat tab 100 mg 100%
81 Garam Inggris (Mg So4) 100%
82 Garam Oralit 200ml 100%
83 Gentian Violet lrt 100%
86 Glibenklamid tab 5 mg 100%
87 Glimepiride Tab 1 mg 100%
88 Glimepiride Tab 2 mg 100%
89 Glukosa 5% infus 100%
90 Glukosa 10% infus 100%
91 Griseofulvin tab 125 mg 100%
92 Griseofulvin tab 500 mg 100%
93 H C T tab 25 mg 100%
94 Halloperidol tab 1,5 mg 100%
97 H2O2 Larutan 50 % 100%
98 Hidrokortison slp 2,5 % 100%
99 Ichtyol Salep 100%
100 INH Tab 100 mg 100%
101 I N H Tab 300 mg 100%
102 Ibuprofen 200 mg 100%
103 Ibuprofen 400 mg 100%
104 Ibuprofen Suspensi 100%
105 Infusion set anak 100%
106 Infusion set dws 100%
107 Isosorbid DNT tab 5 mg 100%
108 IV catheter no 18 100%
109 IV catheter no 20 100%
110 IV catheter no 22 100%
111 IV catheter no 24 100%
116 Kals lactas tab 500 mg 100%
117 Kapas Berlemak 100%
118 Kapas Pembalut 250 gram 100%
119 Kapas Pembalut 1000 gram 100%
120 Kaptopril tab 25 mg 100%
121 Kaptopril tab 12,5 mg 100%
122 Kasa 4x 3 cm 100%
123 Kassa 4 m x 15cm 100%
124 Kassa Pembalut 2 m x 80cm 100%
125 Kasa Steril 40/40 100%
126 Ketokonazol Tab 100%
127 Ketokonazol krim 100%
128 Kloramfenicol kap 250 mg 100%
129 Kloramfenicol SK 100%
130 Kloramfenicol SM 1% 100%
131 Kloramfenikol TM 0.5 % 100%
132 Kloramfenicol TT 3% 100%
133 Kloramfenicol Suspensi 100%
134 Klorfeniramin Mal Tab 4mg 100%
136 Klorpromazin tab 100 mg 100%
137 Kotri tab 480 mg 100%
138 Kotri suspensi 100%
139 Levetran Zalf 100%
140 Lidocain comp inj 100%
142 Lisol ~ kresol 50% 100%
143 Loratadin Tablet 100%
145 Megotrin inj 0,2mg-1ml 100%
146 Megotrin tab 0,125 mg 100%
147 Metformin Tab 100%
148 Metoklopramid Tab 100%
149 Metronidazol 250 mg 100%
150 Metronidazol 500 mg 100%
151 Mikonazol Krim 100%
152 Monoklorkamfer [ Chkm] 100%
153 Na Bicarbonas tab 500 mg 100%
154 Na Cl 0,9% infus 100%
155 Na Diklofenak Tab 25 mg 100%
156 Na Diklofenak Tab 50 mg 100%
157 Nifedipin 100%
158 Nistatin tab 100%
159 Norit tab 100%
160 O B H Sirup 100%
162 Oksitetra SK 3% 100%
163 Oksitetra SM 1% 100%
164 Oksitosin inj 100%
167 P T U tab 100 mg 100%
170 Parasetamol tab 500 mg 100%
171 Parasetamol Sirup 100%
175 Pirantel Pamoat tab 125 mg 100%
176 Piridoxin [B6] tab 10 mg 100%
177 Piroksikam 20 mg 100%
178 Plester 100%
179 Pov Yodida 60ml 100%
180 Pov Yodida 10% 300ml 100%
182 Prednison tab 5 mg 100%
184 Propranolol tab 10 mg 100%
185 Propranolol tab 40 mg 100%
186 Pyrazinamid tab 500 mg 100%
187 Ranitidin Tab 100%
191 Ringer Lactat infus 100%
192 Salbutamol Tab 2 mg 100%
193 Salbutamol Tab 4 mg 100%
194 Salep 2 - 4 Komb 100%
195 Salisil Bedak 2% 100%
197 Serum Anti Tetanus inj1500 IU 100%
199 Sianokobalamin Tab 100%
200 Silk (Benang bedah+JJ ) 100%
201 Simetidin tab 200 mg 100%
202 Simvastatin Tab 100%
203 Siprofloxasin kap 500 mg 100%
206 Sulfa setamid TM 5% 100%
207 Tablet + DARAH 100%
210 Tetra kap 500mg 100%
211 Tetrakain TM 0.5 % 100%
212 Tiamin (B1) tab 50mg 100%
213 Trihexi Fenidil tab 2mg 100%
216 Vitamin B komplex tab 100%
218 Zinc Tab 100%
219 Zinc Sirup 100%
220 Etanol 70% 100 ml 100%
221 Piroxicam 10 mg 100%