RENCANA KEBUTUHAN OBAT (RKO)

PADA FASILITAS KESEHATAN TINGKAT PERTAMA ( FKTP ) TAHUN 2020

DINAS KESEHATAN KABUPATEN LAMPUNG SELATAN

NAMA PUSKESMAS : SUKADAMAI

SATUA PEMAKAIAN STOK PER 31 KEBUTUHAN THN
NO NAMA OBAT KET
N RATA-RATA DES 2019 2020
a b c d e f=(d*18)-e g
A OBAT
1 Albendazol tablet tablet 4200/6bln 500
2 Alkoholl 70% 1000ml botol 3 50 4
3 Alopurinol tablet 100mg tablet 200 2000 1600
4 Aminofilin tab 150mg tablet 20 600 -240
5 Amitriptilintabletsalut 25mg(HCl) tablet 0
6 Amlodipin tablet 5 mg tablet 2200 2000 37600
7 Amlodipin tablet 10 mg tablet 1000 18000
8 Amoksisilin kapsul 250mg tablet 20 360
9 Amoksisilin kapsul 500mg tablet 7900 18000 124200
10 Amoksisilin sirup kering125mg/5ml botol 100 300 1500
11 Antasida DOEN tablet kunyah, komb : 4000 15000 57000
Al OH 200 mg Mg OH tablet
200 mg
12 Antasida DOEN II suspensi, komb : 25 450
botol

13 Antifungi DOEN Kombinasi:Asam 3 54

tube
Benzoat6%+AsamSalisilat3%
14 Anti Bakteri Doen Salp tube 25 50 400
15 Antihemaroid, kombinasi supp 5 90
16 Antimigren: Ergotamin Tartrat1mg + 0
tablet
Kofein 50mg
17 1 18
Aqua pro injeksi ampul

18 Asam Ascorbat 50mg tablet 500 9000

19 Asam Folat tablet 1 mg tablet 20 360
20 Asam Mefenamat 500mg tablet 1000 100 17900
21 Asiklovir tablet 400 mg tablet 20 500 -140
22 Atapulgit tablet 600mg tablet 120 50 2110
23 Betametason krim0,1% tube 50 900
24 Cetrizin syrup botol 15 270
25 Cetrizin tablet 10 mg tablet 150 2700
26 Deksametason tablet 0.5mg tablet 4500 100 80900
27 Deksametason Injeksi ampul 2 36
28 Diazepam injeksi 5 mg/ml ampul 1 18
29 Diazepam tablet 2 mg tablet 5 90
30 Diazepam stesolid tube 2 5 31
31 Dhiphenhidramin Injeksi 10mg/ml vial 1 18
Dihidro Artemisin+piperakuin (DHP)+ 0
32 tablet
Primakuin
33 Domperidon tab 10mg tablet 100 1800
34 Doksisiklin kapsul 100 mg kapsul 0
35 Epinefrin (Adrenalin)injeksi0,1% (sbg 1 18
ampul
HCl)
36 Eritromisin kapsul 250 mg kapsul 50 900
37 Etakridin larutan (rivanol 0,1ml) 300ml botol 1 18
38 Fenobarbital injeksii.m./i.v.50mg/ml ampul 0
39 Fenol Gliserol botol 2 36
40 Fitomenadion 50 900
tablet
(Vit.K1)tabletsalutgula10mg
41 Fitomenadion (VitaminK1)injeksi 2 25 450
ampul
mg/ml
42 Furosemid inj i.v/i.m 10mg/ml ampul 0
43 Furosemid tab 40 mg tablet 20 400 -40
44 Gameksan Lotion botol 1 18
45 Garam Oralit serbuk sachet 30 540
46 Gentamisin injeksi 40mg/ml ampul 0
47 Gentamisin Sulfat tetesmata0,3% botol 30 72 468
48 Gentamisin Sulfat salep mata tube 10 180
49 Gentian Violet larutan 1% tube 5 90
50 Gliserin liquid botol 0
51 Gliseril Guaiakolat 100mg tablet 3000 54000
52 Glukosa larutan infus 5% steril botol 70 40 1220
53 Griseofulvin tablet 125 mg tablet 10 180
54 Glibenklamid tab 5mg tablet 100 14000 -12200
55 Haloperidol tablet 1,5 mg tablet 0
56 Haloperidol tablet 2 mg tablet 300 5400 jiwa
57 Haloperidol tablet 5mg tablet 70 1260 jiwa
58 Haloperidol decanoat injeksi ampul 0
59 Hidrogen peroksida (H2O2) laruran botol 1 18
60 Hidroklorotiazida tablet 25 mg tablet 0
61 Hidrokortison krim 2,5% tube 50 900
62 Ibuprofen suspensi 100 mg/5ml botol 10 15 165
63 Ibuprofen tab 400mg tablet 800 14400
64 Ichtiyol salep tube 4 72
65 Isosorbid Dinitrat tablet sublingual 5 mg tablet 20 300 60
66 Kalsium Laktat (Kalk)tablet 500 mg tablet 1700 5000 25600
67 Kaptopril tablet 12,5 mg tablet 50 900
68 Kaptopril tablet 25 mg tablet 50 3000 -2100
69 Karbamazepin tablet 200 mg tablet 10 180 jiwa
70 Ketokonazol krim 2% tube 25 75 375
71 Ketokonazol tab tablet 30 500 40
72 Kloramfenikol kapsul 250 mg kapsul 20 360
73 Kloramfenikol susp 125 mg/5ml botol 2 36
74 Kloramfenikol salep mata 1 % tube 20 50 310
75 Kloramfenikol salep kulit 2% tube 20 100 260
76 Kloramfenikol Tetes Mata tube 20 360
77 Kloramfenikol Tetes Telingga tube 25 450
78 Klorokuin tablet 150 mg tablet 0
79 Klorfeniramin Maleat 4mg tablet 5000 9000 81000
80 Klorpromazin injeksi 25 mg/ml ampul 0
81 Klorpromazin tablet salut 100 mg (HCl) tablet 100 1800 jiwa
82 Kotrimoksazol DOEN (dewasa) komb: 100 1400 400
Sulfametoksazol400 mg Trimetoprim80 tablet
mg
83 Kotrimoksazol Suspensi komb: 100 250 1550
Sulfametoksazol 200 mg+Trimetoprim botol
40 mg/5ml
84 1 18
Levertran salep tube

85 Lidokain injeksi2% ampul 2 100 -64

86 Lidokain 2%+ Epinefrin (adrenalin) 10 180
ampul
1:80.000
87 Lisol 1000ML botol 3 4 50
88 Loperamide tab 2mg tablet 30 540
89 Magnesium Sulfatinj(IV)20%-25ml ampul 1 18
 90 metampiron 500 tablet 1000 18000
91 Metformin HCl tablet 500 mg tablet 100 1800
92 Metilergometrin Maleat inj 0,200 mg- 30 540
ampul
1ml
93 5 90
Metilergometrin Maleat tablet tablet
94 Metil prednisolon 4mg tablet 50 900
95 Metronidazol tablet 500 mg tablet 100 1800
96 Mikonazol krim/salep 2 % (Nitrat) tube 50 75 825
97 Nacl 0,9 % botol 50 160 740
98 Natrium Diklofenak tablet 25 mg tablet 200 5000 -1400
99 Nifedipin 10mg tablet 20 2000 -1640
100 Nistatin Tablet salut 500.000IU/g tablet 100 -100
101 Nistatin vaginal tablet 100.000 IU/g tablet 3 100 -46
102 Obat Batuk Hitam (OBH) botol 50 900
103 Obat Batuk Kombinasi tablet 2000 1500 34500
104 Obat Batuk Pilek Kombinasi botol 50 900
105 Oksitetrasiklin HCl salep mata 1% tube 20 360
106 Oksitosin injeksi 10 IU/ml-1ml ampul 35 630
107 Omeprazol kapsul 20 mg kapsul 200 1600 2000
108 Paracetamol syrup botol 100 250 1550
109 Parasetamol tab 500mg tablet 8000 16300 127700
110 Pirantel sirup 125 mg/5ml botol 0
111 Pirantel tab score (base) 125mg tablet 0
112 Piridoxin inj 100mg/ml ampul 0
113 Piridoxin tab 10mg (HCl) tablet 1000 4000 14000
114 Piroksikam 10mg tablet 200 3000 600
115 Povidon Iodida larutan 10% 60 ml botol 15 35 235
116 Povidon Iodida larutan 10% 300ml botol 1 18
117 Prednison tablet 5mg tablet 20 360
118 Ranitidin 150mg tablet 200 3600
Retinol (VitaminA) 100.000 IU kapsul
119 kapsul 804/6bln program
lunak
Retinol (VitaminA) 200.000 IU kapsul
120 kapsul 1380/6bln program
lunak
121 Ringer laktat 500ml botol 100 40 1760
122 Risperidon tablet 2 mg tablet 300 5400 jiwa
123 Salbutamol tablet 2 mg (sebagai Sulfat) tablet 300 2500 2900
124 Salep 2-4,Kombinasi: As Salisilat 2% 2 36
tube
+Sulfur 4%
125 Salisil bedak 2% sachet 10 180
126 Sianokobalamin (vitaminB12 )inj 500 0
ampul
mcg
Sianokobalamin (vitaminB12) tablet 50
127 tablet 800 9000 5400
mcg
128 Simvastatin tab 10 mg tablet 100 1800
129 siprofloxasin 500mg tablet 800 3000 11400
130 Tablet Tambah Darah tablet 6220/bln program
131 Thiamin (Vit B1 Hcl) tablet 1500 6500 20500
132 Triheksifenidil tablet 2 mg tablet 750 13500 jiwa
133 Vitamin B Kompleks tablet tablet 1000 5500 12500
134 Zinc tablet 20 mg tablet 500 200 8800
135 Ventolin ampul 4 72
136 Multivitamin anak botol 50 900
137 Multivitamin dewasa tablet 100 1800
JUMLAH

B OBAT GIGI 0
1 Devitalisasi Pasta Non Arsen set 0
2 Cold Spray botol 0
3 Eugenol Cairan botol 0
 4 Glass Ionomer Cement Art set 0
5 Kalsium Hidroksi Pasta tube 0
6 Monoklorkamfer Menthol Cairan/CHKM botol 0
7 Mummifying Pasta pot 0
8 Semen Seng Fosfat Serbuk/Cairan botol 0
9 Temporary Stopping Fletcher botol 0
JUMLAH

C PERBEKALAN KESEHATAN
1 Alat Suntik Sekali Pakai 1 ml pcs 50 300 600
2 Alat Suntik Sekali Pakai 3 ml pcs 100 1800
3 Alat Suntik Sekali Pakai 5 ml pcs 20 100 260
4 Aqua Gel jely sach 1 18
5 bisturi pcs 10 50 130
6 Catgut/ Benang Bedah No 2/0 pcs 8 20 124
7 Folley Chateter No 18 pcs 2 36
8 Handscone Steril pcs 200 3600
9 Handscone Non Steril pcs 500 500 8500
10 Infusion Set Anak set 100 150 1650
11 Infusion Set Dewasa set 200 100 3500
12 IV Catheter NO. 20 G pcs 10 70 110
13 IV Catheter NO. 22 G pcs 100 300 1500
14 IV Catheter NO. 24 G pcs 100 200 1600
15 Kapas absorben 250mg bks 0
16 20 50 310
Kassa Hidrofil Steril Ukr. 16 X 16cm pcs

17 10 180
Kassa Hidrofil Steril Ukr. 18 X 18cm pcs

18 Kassa Hidrofil Steril Ukr. 36x80cm roll 0

19 KASSA PEMBALUT ELASTIC 7,5 cmx 0
rol
4,55mm
20 KASSA PEMBALUT ELASTIC 10 cm x 1 18 0
rol
4,55 mm
21 10 180
Kassa Pembalut Hidrofil 4m X 10 cm pcs

22 10 40 140
Kassa Pembalut Hidrofil 4m X 3 cm pcs

23 Masker pcs 200 3600

24 Plester 7,5cmx4,5cm pcs 3 54
25 Pembalut Gibs 3 inchi rol 0
26 Pembalut Gibs 4 inchi rol 1 18
27 Pembalut Gibs 6 inchi rol 0
28 Silk (Benang Bedah Sutera) No. 3/0 rol 6 45 63
JUMLAH

DIKUMPUL PALING LAMBAT 24 Februari 2020

SOFTCOPY, HARDCOPY & SK KEPALA UPT PUSKESMAS
sukadamai, 18 februari 2020
Mengetahui
Kepala UPT Puskesmas Pengelola Obat

CATUR SUPRIANTO S. Kep Mesy Intanty A.Md.f

NIP. 19651104 198703 1 006 NIP. 19810419 200501 2 006
 RENCANA KEBUTUHAN OBAT (RKO)
PADA FASILITAS KESEHATAN TINGKAT PERTAMA ( FKTP ) TAHUN 2020
DINAS KESEHATAN KABUPATEN LAMPUNG SELATAN

NAMA PUSKESMAS :
SATUA PEMAKAIAN STOK PER 31 KEBUTUHAN THN
NO NAMA OBAT KET
N RATA-RATA DES 2019 2020
a b c d e f=(d*18)-e g
A OBAT
1 Albendazol tablet tablet 0
2 Alkoholl 70% 100ml botol 0
3 Alkoholl 70% 1000ml botol 0
4 Alopurinol tablet 100mg tablet 0
5 Alprazolam tablet 1 mg tablet 0
6 Aminofilin tab 200mg tablet 0
7 Amitriptilintabletsalut 25mg(HCl) tablet 0
8 Amlodipin tablet 5 mg tablet 0
9 Amlodipin tablet 10 mg tablet 0
10 Amoksisilin kapsul 250mg tablet 0
11 Amoksisilin kapsul 500mg tablet 0
12 Amoksisilin sirup kering125mg/5ml botol 0
13 Antasida DOEN tablet kunyah, komb : 0
Al OH 200 mg Mg OH tablet
200 mg
14 Antasida DOEN II suspensi, komb :
botol

15 Antifungi DOEN Kombinasi:Asam 0

tube
Benzoat6%+AsamSalisilat3%
16 Anti Bakteri Doen Salp tube 0
17 Antihemaroid, kombinasi supp 0
18 Antimigren: Ergotamin Tartrat1mg + 0
tablet
Kofein 50mg
19 Asam Ascorbat 50mg tablet 0
20 Asam Folat tablet 1 mg tablet 0
21 Asam Mefenamat 500mg tablet 0
22 Asiklovir tablet 400 mg tablet 0
23 Atropin Sulfat tablet 0,5mg tablet 0
24 Betametason krim0,1% tube 0
25 Betahistin masilat tab 6mg tablet 0
26 Bromheksin tab 8mg tablet 0
27 Bromheksin syr botol 0
28 Cetrizin tablet 10 mg tablet 0
29 Deksametason tablet 0.5mg tablet 0
30 Deksametason Injeksi ampul 0
31 Diazepam injeksi 5 mg/ml ampul 0
32 Diazepam tablet 2 mg tablet 0
33 Diazepam stesolid tube 0
34 Digoksin tablet 0,25 mg tablet 0
35 Dhiphenhidramin Injeksi 10mg/ml vial 0
36 Dihidro Artemisin+piperakuin (DHP)+ 0
tablet
Primakuin
37 Dimenhidrinat tablet 50 mg tablet 0
38 Doksisiklin kapsul 100 mg kapsul 0
39 Epinefrin (Adrenalin)injeksi0,1% (sbg 0
ampul
HCl)
40 Eritromisin kapsul 250 mg kapsul 0
41 Fenobarbital injeksii.m./i.v.50mg/ml ampul 0
42 Fitomenadion 0
tablet
(Vit.K1)tabletsalutgula10mg
43 Fitomenadion (VitaminK1)injeksi 2 0
ampul
mg/ml
44 Furosemid inj i.v/i.m 10mg/ml ampul 0
45 Furosemid tab 40 mg tablet 0
46 Garam Oralit serbuk sachet 0
47 Gentamisin injeksi 40mg/ml ampul 0
48 Gentamisin Sulfat tetesmata0,3% botol 0
49 Gentamisin Sulfat salep mata tube 0
50 Gliserin liquid botol 0
51 Gliseril Guaiakolat 100mg tablet 0
52 Glukosa larutan infus 5% steril botol 0
53 Griseofulvin tablet 125 mg tablet 0
54 Glibenklamid tab 5mg tablet 0
55 Haloperidol tablet 1,5 mg tablet 0
56 Haloperidol tablet 2 mg tablet 0
57 Haloperidol tablet 5mg tablet 0
58 Hidroklorotiazida tablet 25 mg tablet 0
59 Hidrokortison krim1% tube 0
60 Ibuprofen suspensi 100 mg/5ml botol 0
61 Ibuprofen tab 400mg tablet 0
62 Isosorbid Dinitrat tablet sublingual 5 mg tablet 0
63 Kalsium Laktat (Kalk)tablet 500 mg tablet 0
64 Kaptopril tablet 12,5 mg tablet 0
65 Kaptopril tablet 25 mg tablet 0
66 Karbamazepin tablet 200 mg tablet 0
67 Ketokonazol krim 2% tube 0
68 Ketokonazol tab tablet 0
69 Kloramfenikol kapsul 250 mg kapsul 0
70 Kloramfenikol susp 125 mg/5ml botol 0
71 Kloramfenikol salep mata 1 % tube 0
72 Kloramfenikol salep kulit 2% tube 0
73 Klorokuin tablet 150 mg tablet 0
74 Klorfeniramin Maleat 4mg tablet 0
75 Klorpromazin injeksi 25 mg/ml ampul 0
76 Klorpromazin tablet salut 100 mg (HCl) tablet 0
77 Kodein tablet 10 mg tablet 0
78 Kotrimoksazol DOEN (dewasa) komb: 0
Sulfametoksazol400 mg Trimetoprim80 tablet
mg
79 Kotrimoksazol Suspensi komb: 0
Sulfametoksazol 200 mg+Trimetoprim botol
40 mg/5ml
80 Lidokain injeksi2% ampul 0
81 Lisol 1000ML botol 0
82 Loperamide tab 2mg tablet 0
83 Magnesium Sulfatinj(IV)20%-25ml ampul 0
84 Metampiron tab 500mg tablet 0
85 Metformin HCl tablet 500 mg tablet 0
86 Metilergometrin Maleat inj 0,200 mg- 0
ampul
1ml
87 Metronidazol tablet 250 mg tablet 0
88 Metronidazol tablet 500 mg tablet 0
89 Mikonazol krim/salep 2 % (Nitrat) tube 0
90 Nacl 0,9 % botol 0
 91 Natrium Diklofenak tablet 25 mg tablet 0
92 Nifedipin 10mg tablet 0
93 Nistatin Tablet salut 500.000IU/g tablet 0
94 Nistatin vaginal tablet 100.000 IU/g tablet 0
95 Obat Anti tuberkulosis Kategori 1 paket 0
96 Obat Anti tuberkulosis FDC Kategori 0
paket
Anak
97 Obat Anti tuberkulosis FDC Kategori 1 paket 0
98 Obat Anti tuberkulosis FDC Kategori 2 paket 0
99 Obat Anti tuberkulosis FDC sisipan paket 0
100 Obat Batuk Hitam (OBH) botol 0
101 Obat Batuk Kombinasi tablet
102 Oksitetrasiklin HCl salep mata 1% tube 0
103 Oksitosin injeksi 10 IU/ml-1ml ampul 0
104 Omeprazol kapsul 20 mg kapsul 0
105 Papaverin tablet 40 mg tablet 0
106 Paracetamol Drop botol
107 Paracetamol syrup botol 0
108 Parasetamol tab 500mg tablet 0
109 Pirantel sirup 125 mg/5ml botol 0
110 Pirantel tab score (base) 125mg tablet 0
111 Piridoxin inj 100mg/ml ampul 0
112 Piridoxin tab 10mg (HCl) tablet 0
113 Piroksikam 10mg tablet 0
114 Povidon Iodida larutan 10% 30 ml botol 0
115 Povidon Iodida larutan 10% 60 ml botol 0
116 Povidon Iodida larutan 10% 300ml botol 0
117 Prednison tablet 5mg tablet
Prokain Benzil Penisilin G. Injeksi 3 jt 0
118 ampul
IU/vial
119 Propiltiourasil tablet 100 mg tablet 0
120 Ranitidin 150mg tablet 0
121 Cimetidin tab 200mg tablet
Retinol (VitaminA) 100.000 IU kapsul 0
122 kapsul
lunak
Retinol (VitaminA) 200.000 IU kapsul
123 kapsul 0
lunak
124 Ringer laktat 500ml botol 0
125 Risperidon tablet 2 mg tablet 0
126 Salbutamol tablet 2 mg (sebagai Sulfat) tablet 0
127 Salbutamol tablet 4 mg (sebagai Sulfat) tablet 0
128 Salep 2-4,Kombinasi: As Salisilat 2% 0
tube
+Sulfur 4%
129 Salisil bedak 2% sachet 0
130 Sianokobalamin (vitaminB12 )inj 500 0
ampul
mcg
Sianokobalamin (vitaminB12) tablet 50
131 tablet 0
mcg
132 siprofloxasin 500mg tablet 0
133 Tablet Tambah Darah tablet 0
134 Thiamin (Vit B1 Hcl) tablet 0
135 Tetrakain TM( Pantocain 0,5%/5ml) botol 0
136 Tetrasiklin kapsul 500 mg kapsul 0
137 Triheksifenidil tablet 2 mg tablet 0
138 Vitamin B Kompleks tablet tablet 0
139 Zinc tablet 20 mg tablet 0
140 Ventolin ampul 0
141 Multivitamin anak botol 0
142 Multivitamin dewasa tablet 0
143 Obat Batuk Kombinasi tablet 0
JUMLAH
 B OBAT GIGI 0
1 Devitalisasi Pasta Non Arsen set 0
2 Cold Spray botol 0
3 Eugenol Cairan botol 0
4 Glass Ionomer Cement Art set 0
5 Kalsium Hidroksi Pasta tube 0
6 Monoklorkamfer Menthol Cairan/CHKM botol 0
7 Mummifying Pasta pot 0
8 Semen Seng Fosfat Serbuk/Cairan botol 0
9 Temporary Stopping Fletcher botol 0
JUMLAH

C PERBEKALAN KESEHATAN
1 Alat Suntik Sekali Pakai 0,5 ml pcs 0
2 Alat Suntik Sekali Pakai 0,05 ml pcs 0
3 Alat Suntik Sekali Pakai 1 ml pcs 0
4 Alat Suntik Sekali Pakai 3 ml pcs 0
5 Alat Suntik Sekali Pakai 5 ml pcs 0
6 Aqua Gel jely sach 0
7 bisturi pcs 0
8 Catgut/ Benang Bedah No 2/0 pcs 0
9 Catgut/ Benang Bedah No 3/0 pcs 0
10 Folley Chateter No 18 pcs 0
11 Handscone Steril pcs 0
12 Handscone Non Steril pcs 0
13 Infusion Set Anak set 0
14 Infusion Set Dewasa set 0
15 IV Catheter NO. 20 G pcs 0
16 IV Catheter NO. 22 G pcs 0
17 IV Catheter NO. 24 G pcs 0
18 Kapas absorben 250mg bks 0
19 0
Kassa Hidrofil Steril Ukr. 16 X 16cm pcs

20 0
Kassa Hidrofil Steril Ukr. 18 X 18cm pcs

21 Kassa Hidrofil Steril Ukr. 36x80cm roll 0

22 KASSA PEMBALUT ELASTIC 7,5 cmx 0
rol
4,55mm
23 KASSA PEMBALUT ELASTIC 10 cm x 0
rol
4,55 mm
24 0
Kassa Pembalut Hidrofil 4m X 10 cm pcs

25 0
Kassa Pembalut Hidrofil 4m X 3 cm pcs

26 Masker pcs 0
27 Plester pcs 0
28 Pembalut Gibs 3 inchi rol 0
29 Pembalut Gibs 4 inchi rol 0
30 Pembalut Gibs 6 inchi rol 0
31 Silk (Benang Bedah Sutera) No. 3/0 rol 0
32 Urine Bag set 0
JUMLAH

D OBAT LAIN
0
0
 0
0

DIKUMPUL PALING LAMBAT 24 JANUARI 2020

SOFTCOPY, HARDCOPY & SK KEPALA UPT PUSKESMAS
..........................., ................ 2020
Mengetahui
Kepala UPT Puskesmas Pengelola Obat

............................ .................................
NIP. NIP.