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

PELABELAN : WARNA MERAH

PENYIAPAN : TERPISAH DARI SEDIAAN LAIN

BENTUK
No. KELAS TERAPI NAMA GENERIK NAMA DAGANG KEKUATAN KETERANGAN
SEDIAAN

1 ELEKTROLIT KALIUM KLORIDA INJEKSI KCL 7.46 (7.46% POTASSIUM 7.46% 25 ML Elektrolit pekat tidak
PEKAT CHLORIDE INJEKTION) boleh di simpan di
ruang perawatan
40% MAGNESIUM INJEKSI Mg SO4 40 40% MAGNESIUM kecuali IGD, VK, Ok
SULFATE SULFATE = Mg SO4. 7 dan ICU
H2O 10.0g 25 ML
20% MAGNESIUM INJEKSI Mg SO4 20 20% MAGNESIUM
SULFATE SULFATE = Mg SO4. 7
H2O 10.0g 25 ML
NATRIUM KLORIDA 3% INFUS OTSU-SALINE 3 (3% SODIUM 3% 500 ML
CHLORIDE)
SODIUM BICARBONATE INJEKSI Meylon 84-BP SODIUM
BICARBONATE 8,4%
(84mg/ml)
SODIUM 1 mM/ml
BICARBONATE 1
mM/ml
25 ML
2 OBAT BUPIVACAIN HCl INJEKSI BUVANEST 0,5% 20 ML
ANASTESI 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
3 OBAT EPINEPHRIN INJEKSI EPINEPHRINE 1 MG / ML
VASOKONTRIKSI NOREPINEPHRIN INJEKSI RAIVAS 4 MG / 4 ML
LEVOSOL 8 MG / 8 ML

1
4 OBAT LIDOCAIN INJEKSI LIDOCAIN 20 % 20 MG / ML
ANTI ARITMA AMIODARON INJEKSI CORDARON 150 MG / 3 ML
KENDARON 150 MG / 3 ML
5 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
6 DEXTROSE DEXTROSE INJEKSI D40% 40% 25 ML
HYPERTONIC, 40%
7 LARUTAN DYALISA
8 OBAT GLIMEPIRID TABLET METRIX 1 MG, 2 MG, 3 MG, 4
MG
ANTI DIABETES
ORAL ACARBOSE TABLET GLUCOBAY 50 MG, 100 MG
METFORMIN TABLET FORBETES 500 MG, 850 MG
9 INSULIN 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 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 ATRAKURIUM BESILAT INJEKSI TRACRIUM 50 MG / 5 ML
OTOT
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
2. DAFTAR OBAT LOOK ALIKE SOUND ALIKE (LASA)
a. Look alike (RUPA MIRIP)

LlaASA
LASA

PELABELAN : WARNA KUNING

3
ABBOTIC SYRUP 125MG/5ML ABBOTIC SYRUP 250 MG/5ML
AMOXAN 250 MG CAPSUL AMOXAN 500 MG CAPSUL
AMOXAN SYRUP AMOXAN FORTE SYRUP
BIOTHICOL SYRUP BIOTHICOL FORTE SYRUP
BUFECT SYRUP BUFECT FORTE SYRUP
CEFAT SYRUP CEFAT FORTE SYRUP
CLANEKSI SYRUP CLANEKSI FORTE SYRUP
CLARITIN SYRUP CELESTAMIN SYRUP
EPEXOL SYRUP EPISAN SYRUP
RHINOFED SYRUP RHINOS JUNIOR SYRUP
ALLORIS TABLET EPEXOL TABLET
AMLODIPIN 5 MG TABLET AMLODIPIN 10 MG TABLET
CELEBREX 100 MG TABLET CELEBREX 200 MG TABLET
DIAZEPAM 2 MG TABLET PHENOBARBITAL 30 MG TABLET
ERYSANBE 500 CAPLET GRATIZIN 10 MG TABLET
FEROFORT TABLET REOTAL CAPLET
FLUIMUCIL CAPSUL CEFSPAN 100 MG CAPSUL
FORBETES 500 MG TABLET FORBETES 850 MG TABLET
GLIMEPIRID 1 MG TABLET SIMVASTATIN 10 MG TABLET
LYNORAL TABLET THYRAX TABLET
MEFINAL 250 CAPSUL MEFINAL 500 CAPSUL
NEUROTAM 1200 MG TABLET NEVOX XR TABLET
NOLIPO TABLET PURICEMIA TABLET
PANTOZOL 20 MG TABLET PANTOZOL 40 MG TABLET
PROLIC 150 MG CAPSUL PROLIC 300 MG CAPSUL
PREMASTON TABLET POSPARGIN TABLET
PROLACTA DHA MOTHER CAPSUL PROLACTA DHA BABY CAPSUL
RIMACTACID PEDIATRIC TABLET RIMCUR PEDIATRIC TABLET
SANPRIMA TABLET SANPRIMA FORTE TABLET
STROCAIN TABLET STUGERON TABLET
TRAJENTA TABLET TOPAMAX TABLET
TRAMADOL CAPSUL SPIRAMYCIN 500 CAPLET
AMINOPHYLIN INJEKSI CALCIUM GLUCONAS INJEKSI
AMOXAN INJEKSI 1 GR COLSANCETIN 1 GR INJEKSI
BECLOV INJEKSI ACRAN INJEKSI
CEFTRIAXON 1 GR INJEKSI CEFOTAXIM 1 GR INJEKSI
EPINEPHRIN INJEKSI EPHEDRINN INJEKSI
KETALAR INJEKSI DYNASTAT INJEKSI
KETOROLAC INJEKSI CITICOLIN INJEKSI
LASIX INJEKSI NOVALGIN INJEKSI
RATIVOL INJEKSI TROVENSIS 4 MG INJEKSI
TAXEGRAM 1 GR INJEKSI TAXEGRAM 0.5 MG INJEKSI
CINOLON CREAM CINOLON N CREAM
DAKTARIN CREAM DAKTARIN DIAPER CREAM
DESOLEX CREAM SAGALON CREAM
ELOCON CREAM GARAMYCIN CREAM
FORDERM CREAM TERMISIL CREAM
KENACORT A CREAM MYCO Z OINT
NOROID DERMA RUSH NOROID CREAM
AKILEN EAR DROP CROM OPTHAL EYE DROP
ILIADIN DROP 0,025% ILIADIN DROP 0,05%

4
5
 b. Sound alike (UCAPAN MIRIP)

LlaASA
LASA

PELABELAN : WARNA KUNING

BENZATIN BENZIL PENISILIN PROCAIN PENICYLLIN
CEFAT CEFSPAN
CLIMADAN CERADAN
DOBUTAMIN DOPAMIN
DOPACEF TERPACEF
FLAGYSTATIN FLADYSTIN
FLAVIN PLAVIX
FUTROLIT TROLIT
HEPTASAN HISTAPAN
KALXETIN COLSANCETIN
LACTAFIT LACTACID
MEROSAN MEFUROSAN
OTOPAIN OTTOPAN
PRIDESIA FORDESIA
PULMICORT FLAMICORT
QUBI TEN Q TEN
RECOFOL RATIVOL
RYVEL RANIVEL
STREPTOMYCIN SPIRAMICYN
TRADOSIK TORASIC
TRIOFUSIN TUTOFUSIN