LAMPIRAN 1
(Informed Consent)
Farmasi RSUP Dr. Mohammad Hoesin Palembang Tahun 2015”, maka saya
mengisi kuesioner daftar obat umum yang telah disediakan berdasarkan kritis
tidaknya persediaan obat tersebut dengan memberikan tanda check list (√) pada
pokok kesehatan dan item obat ini tidak bisa diganti. Kekosongan dan
Adalah obat yang bekerja kausal yaitu obat yang bekerja pada sumber
pengobatan penyakit terbanyak dan item obat ini dapat diganti dengan
item yang ada di rumah sakit waktu itu walaupun tidak sama dengan yang
Adalah obat penunjang agar tindakan atau pengobatan menjadi lebih baik
untuk kenyamanan atau untuk mengatasi keluhan dan item obat ini dapat
Peneliti,
( Siska Sartika )
NIM. 10101001020
FORM CHECK LIST NILAI KRITIS OBAT
Nama Dokter :
LAMPIRAN 2
NO NAMA OBAT SATUAN JUMLAH KOMULATIF % KOMULATIF KEL W1
36 METHYL ERGOMETRINE TAB 18.502 3.241.010 94,47890425 C 1
37 VICCILLIN 1 GR INJEKSI AMP 16.311 3.257.321 94,95438732 C 1
38 IBUPROFEN 200 MG TABLET TAB 14.444 3.271.765 95,37544536 C 1
39 THEOPHILLIN 150MG CAP CAP 14.120 3.285.885 95,78705844 C 1
40 CEFOTAXIM I GR INJEKSI VIAL 10.306 3.296.191 96,08748935 C 1
41 VELCHROME INJ AMP 8.926 3.305.117 96,34769179 C 1
42 PIRACETAM 800 TABLET TAB 8.115 3.313.232 96,58425271 C 1
43 SPIRIVA 18 MCG REFILL (A) CAP 7.303 3.320.535 96,79714296 C 1
44 SYNTOCINON 1 ML INJEKSI AMP 6.979 3.327.514 97,00058827 C 1
45 SALOFALK 250 CAPSUL CAP 5.275 3.332.789 97,15436015 C 1
46 FLUCONAZOLE INF FLS 5.193 3.337.982 97,30574165 C 1
47 LAXADIN 60 ML SYRUP BTL 5.031 3.343.013 97,45240068 C 1
48 ALINAMIN F INJEKSI AMP 4.950 3.347.963 97,59669847 C 1
49 AMBROXOL SYRUP 15 MG BTL 4.788 3.352.751 97,73627378 C 1
50 PARASETAMOL SYRUP BTL 4.707 3.357.458 97,87348786 C 1
51 CENDO LYTEERS EYE DROP 15 ML BTL 4.544 3.362.002 98,00595032 C 1
52 MUCOGARD SYR FLS 4.544 3.366.546 98,13841277 C 1
53 VITKA INFANT AMP 4.463 3.371.009 98,26851399 C 1
54 DANOCRINE 200 MG CAPSUL CAP 3.327 3.374.336 98,36549959 C 1
55 ENYSTIN DROP FLS 3.246 3.377.582 98,46012396 C 1
56 OTSU SALIN 3% ASKIN BTL 3.246 3.380.828 98,55474833 C 1
57 STREPTOMYCIN 1G INJEKSI VIAL 3.246 3.384.074 98,6493727 C 1
58 KALITAKE 5G SACHET SACH 3.002 3.387.076 98,73688421 C 1
59 PHENOBARBITAL 30 MG BTL 3.002 3.390.078 98,82439571 C 1
60 IVELIP 20% 100 CC BTL 2.921 3.392.999 98,90954598 C 1
61 UNALIUM 5MG TABLET TAB 2.597 3.395.596 98,98525131 C 1
62 CROME INJ AMP 2.434 3.398.030 99,05620501 C 1
63 H2O2 3% TETES TELINGA 15 ML BTL 2.434 3.400.464 99,12715871 C 1
64 CLINIMIC INFUS BTL 2.191 3.402.655 99,1910287 C 1
65 NOCID KAPLET 2.029 3.404.684 99,25017622 C 1
66 PROFIBRAT 300 KAP CAPSULE 1.866 3.406.550 99,30457211 C 1
67 NUTRIVISION CAPSULE 1.785 3.408.335 99,35660677 C 1
68 BETAMESON CREAM TUBE 1.623 3.409.958 99,40391895 C 1
69 CEPEZET 100MG TAB TAB 1.623 3.411.581 99,45123114 C 1
70 INVICLOT INJEKSI VIAL 1.623 3.413.204 99,49854332 C 1
LAMPIRAN 2
NO NAMA OBAT SATUAN JUMLAH KOMULATIF % KOMULATIF KEL W1
71 CEFIROME INJ VIAL 1.298 3.414.502 99,53638141 C 1
72 CARBOL GLYCERIN TETES TELINGA BTL 1.217 3.415.719 99,57185826 C 1
73 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL 1.136 3.416.855 99,60497387 C 1
74 HARNAL 0,2 MG CAPSULE CAP 1.136 3.417.991 99,63808949 C 1
75 CYCLOVID 200 MG INJEKSI VIAL 1.055 3.419.046 99,66884386 C 1
76 FARGOXIN INJ AMP 974 3.420.020 99,697237 C 1
77 DEPAKENE 250 MG SYRUP BTL 893 3.420.913 99,72326891 C 1
78 KENDARON INJEKSI AMP 893 3.421.806 99,74930081 C 1
79 LOVENOX P F S 40 MG INJEKSI AMP 811 3.422.617 99,77294233 C 1
80 BECOM Z. TABLET TAB 730 3.423.347 99,79422261 C 1
81 LEVEMIR FLEXPEN VIAL 730 3.424.077 99,81550289 C 1
82 RIVANOL KOMPRES BTL 730 3.424.807 99,83678317 C 1
83 CATAPRES INJEKSI AMP 649 3.425.456 99,85570221 C 1
84 DUMIN 125 MG SUPPOS SUPP 649 3.426.105 99,87462125 C 1
85 DEXORUBICIN 10MG INJEKSI VIAL 568 3.426.673 99,89117906 C 1
86 GAMARAAS INJEKSI VIAL 568 3.427.241 99,90773687 C 1
87 DEXTROMETHORPAN SYRUP 60 ML BTL 487 3.427.728 99,92193344 C 1
88 MIKASIN 250 MG INJ VIAL 487 3.428.215 99,93613001 C 1
89 AMOXISILLIN DRY SYRUP BTL 487 3.428.702 99,95032658 C 1
90 KSR 600MG TAB ASKIN TAB 406 3.429.108 99,96216191 C 1
91 MEBO OINT TUBE 325 3.429.433 99,97163601 C 1
92 OXALIPLATIN MEDAC 100MG INJ VIAL 325 3.429.758 99,98111011 C 1
93 NEUROBION 5000 INJEKSI AMP 162 3.429.920 99,98583258 C 1
94 AVASTIN 100MG/4ML INJ VIAL 81 3.430.001 99,98819382 C 1
95 BREXEL 20 MG/VIAL VIAL 81 3.430.082 99,99055505 C 1
96 CALNIC PLUS SYR BTL 81 3.430.163 99,99291629 C 1
97 CENDO TROPIN 0,5% EYE DROP 5 ML BTL 81 3.430.244 99,99527753 C 1
98 ELOXATIN 100 INJ VIAL 81 3.430.325 99,99763876 C 1
99 XYLOCAIN 2% PDF INJEKSI 20 ML AMP 81 3.430.406 100 C 1
LAMPIRAN 3
NO NAMA OBAT SATUAN TOTAL KOMULATIF % KOMULATIF KEL W2
1 FERRIPROX FCT 500 MG TAB TAB 10.941.533.881,00 10.941.533.881,00 48,39191455 A 3
2 OXALIPLATIN MEDAC 100MG INJ VIAL 1.392.157.548,00 12.333.691.429,00 54,54911059 A 3
3 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 1.389.059.357,00 13.722.750.786,00 60,69260404 A 3
4 GAMARAAS INJEKSI VIAL 1.249.663.456,00 14.972.414.242,00 66,21958114 A 3
5 ECOSOL RL B BRAUN BOTOL 1.019.118.400,00 15.991.532.642,00 70,72690992 A 3
6 CLINIMIC INFUS BTL 613.471.151,00 16.605.003.793,00 73,44015322 B 2
7 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL 586.205.766,00 17.191.209.559,00 76,03280793 B 2
8 FLUCONAZOLE INF FLS 545.307.689,00 17.736.517.248,00 78,44457975 B 2
9 ELOXATIN 100 INJ VIAL 460.103.363,00 18.196.620.611,00 80,47951223 B 2
10 IVELIP 20% 100 CC BTL 406.059.476,00 18.602.680.087,00 82,27542089 B 2
11 AVASTIN 100MG/4ML INJ VIAL 363.475.459,00 18.966.155.546,00 83,88299013 B 2
12 CITICHOLIN 250 MG INJEKSI AMP 345.256.045,00 19.311.411.591,00 85,40997905 B 2
13 CEFIROME INJ VIAL 168.785.713,00 19.480.197.304,00 86,15647985 B 2
14 VICCILLIN 1 GR INJEKSI AMP 156.581.208,00 19.636.778.512,00 86,84900291 B 2
15 LAXADIN 60 ML SYRUP BTL 133.324.484,00 19.770.102.996,00 87,43866676 B 2
16 FUROSEMIDA INJEKSI AMP 124.707.892,00 19.894.810.888,00 87,99022139 B 2
17 LEVEMIR FLEXPEN VIAL 114.133.240,00 20.008.944.128,00 88,49500674 B 2
18 DEPAKENE 250 MG SYRUP BTL 109.791.860,00 20.118.735.988,00 88,98059115 B 2
19 CO AMOXYCLAVE 625MG TABLET TAB 105.721.528,00 20.224.457.516,00 89,44817341 B 2
20 CYCLOVID 200 MG INJEKSI VIAL 104.436.160,00 20.328.893.676,00 89,91007078 B 2
21 MUCOGARD SYR FLS 101.212.424,00 20.430.106.100,00 90,3577103 B 2
22 CEFOTAXIM I GR INJEKSI VIAL 99.372.385,00 20.529.478.485,00 90,79721175 B 2
23 LOVENOX P F S 40 MG INJEKSI AMP 98.463.742,00 20.627.942.227,00 91,23269447 C 1
24 BREXEL 20 MG/VIAL VIAL 95.900.958,00 20.723.843.185,00 91,65684259 C 1
25 CEFIXIM 100MG CAP CAPSULE 95.338.013,00 20.819.181.198,00 92,07850092 C 1
26 SPIRIVA 18 MCG REFILL (A) CAP 93.614.090,00 20.912.795.288,00 92,49253474 C 1
27 BISOPROLOL TABLET TAB 92.314.326,00 21.005.109.614,00 92,90082 C 1
28 VELCHROME INJ AMP 89.261.675,00 21.094.371.289,00 93,29560408 C 1
29 DEXORUBICIN 10MG INJEKSI VIAL 87.486.030,00 21.181.857.319,00 93,68253488 C 1
30 KETOPROFEN 100 MG TAB TAB 83.487.288,00 21.265.344.607,00 94,05178016 C 1
31 ENYSTIN DROP FLS 81.146.977,00 21.346.491.584,00 94,41067477 C 1
32 CENDO LYTEERS EYE DROP 15 ML BTL 78.387.980,00 21.424.879.564,00 94,75736697 C 1
33 SYNTOCINON 1 ML INJEKSI AMP 76.423.087,00 21.501.302.651,00 95,09536889 C 1
34 ALINAMIN F INJEKSI AMP 55.680.183,00 21.556.982.834,00 95,34162967 C 1
35 MELOXICAM 15 MG TABLET TAB 53.350.080,00 21.610.332.914,00 95,57758493 C 1
LAMPIRAN 3
NO NAMA OBAT SATUAN TOTAL KOMULATIF % KOMULATIF KEL W2
36 ASAM TRANEKSAMAT 500 MG TAB 51.013.047,00 21.661.345.961,00 95,80320403 C 1
37 MIKASIN 250 MG INJ VIAL 42.358.722,00 21.703.704.683,00 95,99054702 C 1
38 GLUCOBAY 50MG TABLET TAB 40.166.293,00 21.743.870.976,00 96,16819339 C 1
39 KALITAKE 5G SACHET SACH 38.872.567,00 21.782.743.543,00 96,34011791 C 1
40 OMEPRAZOLE CAPSULE SANBE/AMS CAP 38.300.140,00 21.821.043.683,00 96,50951072 C 1
41 CROME INJ AMP 36.272.699,00 21.857.316.382,00 96,66993661 C 1
42 CURCUMA TABLET (BLISTER) TAB 36.043.864,00 21.893.360.246,00 96,82935042 C 1
43 OTSU SALIN 3% ASKIN BTL 34.231.041,00 21.927.591.287,00 96,98074652 C 1
44 VITKA INFANT AMP 33.473.128,00 21.961.064.415,00 97,12879055 C 1
45 CIPROFLOXACINE 500 MG TAB 32.718.461,00 21.993.782.876,00 97,27349686 C 1
46 ACYCLOVIR 200 MG TAB 30.999.478,00 22.024.782.354,00 97,4106005 C 1
47 RANITIDIN 150 MG TABLET TAB 30.828.621,00 22.055.610.975,00 97,54694847 C 1
48 SALOFALK 250 CAPSUL CAP 30.697.901,00 22.086.308.876,00 97,6827183 C 1
49 METRONIDAZOLE 500MG TAB 30.594.368,00 22.116.903.244,00 97,81803023 C 1
50 SIMARC 2 TABLET TAB 29.894.546,00 22.146.797.790,00 97,950247 C 1
51 FARGOXIN INJ AMP 29.212.911,00 22.176.010.701,00 98,07944906 C 1
52 DANOCRINE 200 MG CAPSUL CAP 29.082.133,00 22.205.092.834,00 98,20807272 C 1
53 ALPRAZOLAM 0,5 TABLET TAB 26.825.464,00 22.231.918.298,00 98,32671564 C 1
54 CATAPRES INJEKSI AMP 23.019.774,00 22.254.938.072,00 98,42852686 C 1
55 SOTATIC 10 MG TABLET TAB 22.096.322,00 22.277.034.394,00 98,52625387 C 1
56 ETHAMBUTOL 500 MG TABLET TAB 21.474.460,00 22.298.508.854,00 98,62123052 C 1
57 MEBO OINT TUBE 19.637.568,00 22.318.146.422,00 98,70808301 C 1
58 KENDARON INJEKSI AMP 19.161.509,00 22.337.307.931,00 98,79283001 C 1
59 INVICLOT INJEKSI VIAL 17.852.335,00 22.355.160.266,00 98,87178682 C 1
60 PROFIBRAT 300 KAP CAPSULE 17.124.040,00 22.372.284.306,00 98,94752255 C 1
61 ISONIAZIDE 300 MG (INH) TABLET TAB 17.108.008,00 22.389.392.314,00 99,02318738 C 1
62 PHENITOIN 100MG CAP CAP 16.022.470,00 22.405.414.784,00 99,09405112 C 1
63 CAPTOPRIL 25 MG TABLET TAB 15.588.893,00 22.421.003.677,00 99,16299725 C 1
64 AMBROXOL SYRUP 15 MG BTL 15.081.165,00 22.436.084.842,00 99,22969781 C 1
65 STREPTOMYCIN 1G INJEKSI VIAL 14.931.043,00 22.451.015.885,00 99,29573441 C 1
66 RIFAMPICIN 300MG CAPSULE CAP 13.500.976,00 22.464.516.861,00 99,35544616 C 1
67 CHLORAMPHENICOL 250MG CAPSUL CAP 12.818.202,00 22.477.335.063,00 99,41213815 C 1
68 NOCID KAPLET 12.269.423,00 22.489.604.486,00 99,46640301 C 1
69 HARNAL 0,2 MG CAPSULE CAP 11.551.559,00 22.501.156.045,00 99,51749293 C 1
70 PREDNISON 5MG TABLET TAB 10.617.210,00 22.511.773.255,00 99,56445043 C 1
LAMPIRAN 3
NO NAMA OBAT SATUAN TOTAL KOMULATIF % KOMULATIF KEL W2
71 PARASETAMOL SYRUP BTL 10.330.821,00 22.522.104.076,00 99,6101413 C 1
72 UNALIUM 5MG TABLET TAB 9.607.802,00 22.531.711.878,00 99,65263443 C 1
73 NUTRIVISION CAPSULE 8.926.167,00 22.540.638.045,00 99,69211283 C 1
74 PIRACETAM 800 TABLET TAB 8.114.697,00 22.548.752.742,00 99,72800229 C 1
75 TRAMADOL TABLET TAB 7.587.242,00 22.556.339.984,00 99,76155893 C 1
76 CARBOL GLYCERIN TETES TELINGA BTL 7.303.227,00 22.563.643.211,00 99,79385945 C 1
77 DUMIN 125 MG SUPPOS SUPP 6.232.087,00 22.569.875.298,00 99,82142255 C 1
78 XYLOCAIN 2% PDF INJEKSI 20 ML AMP 3.921.379,00 22.573.796.677,00 99,83876592 C 1
79 CALNIC PLUS SYR BTL 3.651.614,00 22.577.448.291,00 99,85491617 C 1
80 BETAMESON CREAM TUBE 3.319.560,00 22.580.767.851,00 99,86959783 C 1
81 DIAZEPAM 2 MG TAB 3.217.315,00 22.583.985.166,00 99,88382728 C 1
82 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 2.750.882,00 22.586.736.048,00 99,89599381 C 1
83 AMINOPHYLLIN 200 MG TAB 2.541.645,00 22.589.277.693,00 99,90723493 C 1
84 THEOPHILLIN 150MG CAP CAP 2.292.877,00 22.591.570.570,00 99,9173758 C 1
85 RIVANOL KOMPRES BTL 2.190.968,00 22.593.761.538,00 99,92706595 C 1
86 VITAMIN C 50 MG TAB 2.047.338,00 22.595.808.876,00 99,93612086 C 1
87 METHYL ERGOMETRINE TAB 1.849.226,00 22.597.658.102,00 99,94429957 C 1
88 AMOXISILLIN DRY SYRUP BTL 1.719.666,00 22.599.377.768,00 99,95190526 C 1
89 H2O2 3% TETES TELINGA 15 ML BTL 1.663.091,00 22.601.040.859,00 99,95926073 C 1
90 DIMENHYDRINAT 50 MG TAB TAB 1.620.701,00 22.602.661.560,00 99,96642872 C 1
91 GLIBENCLAMIDE TABLET TAB 1.501.073,00 22.604.162.633,00 99,97306763 C 1
92 DEXTROMETHORPAN SYRUP 60 ML BTL 1.195.294,00 22.605.357.927,00 99,97835414 C 1
93 BECOM Z. TABLET TAB 1.026.103,00 22.606.384.030,00 99,98289236 C 1
94 IBUPROFEN 200 MG TABLET TAB 965.881,00 22.607.349.911,00 99,98716423 C 1
95 CENDO TROPIN 0,5% EYE DROP 5 ML BTL 912.903,00 22.608.262.814,00 99,9912018 C 1
96 NEUROBION 5000 INJEKSI AMP 886.125,00 22.609.148.939,00 99,99512093 C 1
97 KSR 600MG TAB ASKIN TAB 682.373,00 22.609.831.312,00 99,99813891 C 1
98 CEPEZET 100MG TAB TAB 331.956,00 22.610.163.268,00 99,99960707 C 1
99 PHENOBARBITAL 30 MG BTL 88.842,00 22.610.252.110,00 100 C 1
LAMPIRAN 4
N
O NAMA OBAT SATUAN User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8 User 9 User 10 User 11 User 12
1 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL 3 3 2 1 3 1 1 3 3 3 3 1
2 DUMIN 125 MG SUPPOS SUPP 3 3 1 1 2 1 1 3 1 2 1 1
3 DEPAKENE 250 MG SYRUP BTL 2 2 1 1 3 1 1 3 1 2 1 1
4 DIAZEPAM 2 MG TAB 1 3 2 1 3 1 1 1 1 2 1 1
5 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 2 3 1 1 1 1 1 2 1 2 1 2
6 PHENOBARBITAL 30 MG BTL 2 2 2 1 3 1 1 1 1 2 1 1
7 ASAM TRANEKSAMAT 500 MG TAB 1 2 1 1 1 1 1 1 2 2 2 2
8 FARGOXIN INJ AMP 3 3 1 1 1 1 1 1 1 2 1 1
9 CEPEZET 100MG TAB TAB 2 1 2 1 2 1 1 1 1 2 1 1
10 FUROSEMIDA INJEKSI AMP 2 3 1 1 1 1 1 1 1 2 1 1
11 METRONIDAZOLE 500MG TAB 2 1 1 1 1 1 1 1 1 2 1 3
12 PARASETAMOL SYRUP BTL 2 1 1 1 1 1 1 2 1 1 1 3
13 PHENITOIN 100MG CAP CAP 2 1 1 1 3 1 1 1 1 2 1 1
14 PIRACETAM 800 TABLET TAB 2 1 1 1 3 1 1 1 1 2 1 1
15 RIFAMPICIN 300MG CAPSULE CAP 2 1 1 1 1 1 1 2 1 2 1 2
16 RIVANOL KOMPRES BTL 2 2 1 1 1 1 1 1 1 1 2 2
17 XYLOCAIN 2% PDF INJEKSI 20 ML AMP 1 3 1 1 1 1 1 1 1 1 1 3
18 BISOPROLOL TABLET TAB 2 2 1 1 1 1 1 1 1 2 1 1
19 CITICHOLIN 250 MG INJEKSI AMP 2 1 1 1 2 1 1 1 1 2 1 1
20 DIMENHYDRINAT 50 MG TAB TAB 1 2 1 1 2 1 1 1 1 2 1 1
21 DEXORUBICIN 10MG INJEKSI VIAL 2 1 1 1 1 1 1 3 1 1 1 1
22 ETHAMBUTOL 500 MG TABLET TAB 2 1 1 1 1 1 1 2 1 2 1 1
23 H2O2 3% TETES TELINGA 15 ML BTL 2 1 1 1 1 1 3 1 1 1 1 1
24 IBUPROFEN 200 MG TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 3
25 ISONIAZIDE 300 MG (INH) TABLET TAB 2 1 1 1 1 1 1 2 1 2 1 1
26 OTSU SALIN 3% ASKIN BTL 2 2 1 1 1 1 1 1 1 2 1 1
27 ACYCLOVIR 200 MG TAB 1 1 1 1 1 1 1 1 2 2 1 2
28 AMBROXOL SYRUP 15 MG BTL 2 1 1 1 1 1 1 2 1 1 1 2
29 BETAMESON CREAM TUBE 1 1 1 1 1 3 1 1 1 1 1 1
30 CAPTOPRIL 25 MG TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
LAMPIRAN 4
NO NAMA OBAT SATUAN User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8 User 9 User 10 User 11 User 12
31 CARBOL GLYCERIN TETES TELINGA BTL 1 1 1 1 1 1 3 1 1 1 1 1
32 CATAPRES INJEKSI AMP 2 1 1 1 1 1 1 1 1 2 1 1
33 CENDO LYTEERS EYE DROP 15 ML BTL 1 1 1 3 1 1 1 1 1 1 1 1
34 CENDO TROPIN 0,5% EYE DROP 5 ML BTL 1 1 1 3 1 1 1 1 1 1 1 1
35 ELOXATIN 100 INJ VIAL 2 1 1 1 1 1 1 1 1 2 1 1
36 FERRIPROX FCT 500 MG TAB TAB 2 1 1 1 1 1 1 1 1 2 1 1
37 FLUCONAZOLE INF FLS 2 1 1 1 1 1 1 1 1 1 1 2
38 GAMARAAS INJEKSI VIAL 2 1 1 1 1 1 1 1 1 2 1 1
39 GLIBENCLAMIDE TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
40 GLUCOBAY 50MG TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
41 HARNAL 0,2 MG CAPSULE CAP 2 1 1 1 1 1 1 1 1 2 1 1
42 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 2 1 1 1 1 1 1 1 1 2 1 1
43 KSR 600MG TAB ASKIN TAB 2 1 1 1 1 1 1 1 1 2 1 1
44 METHYL ERGOMETRINE TAB 2 1 1 1 1 1 1 1 1 2 1 1
45 NEUROBION 5000 INJEKSI AMP 2 1 1 1 2 1 1 1 1 1 1 1
46 OMEPRAZOLE CAPSULE SANBE/AMS CAP 2 1 1 1 1 1 1 1 1 2 1 1
47 OXALIPLATIN MEDAC 100MG INJ VIAL 2 1 1 1 1 1 1 1 1 2 1 1
48 PREDNISON 5MG TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
49 PROFIBRAT 300 KAP CAPSULE 2 1 1 1 1 1 1 1 1 2 1 1
50 RANITIDIN 150 MG TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
51 STREPTOMYCIN 1G INJEKSI VIAL 2 1 1 1 1 1 1 1 1 2 1 1
52 THEOPHILLIN 150MG CAP CAP 2 2 1 1 1 1 1 1 1 1 1 1
53 VITKA INFANT AMP 1 1 1 1 1 1 1 3 1 1 1 1
54 ALPRAZOLAM 0,5 TABLET TAB 1 2 1 1 1 1 1 1 1 2 1 1
55 AMOXISILLIN DRY SYRUP BTL 2 1 1 1 1 1 1 2 1 1 1 1
56 AVASTIN 100MG/4ML INJ VIAL 1 1 1 1 1 1 1 1 1 2 1 1
57 BECOM Z. TABLET TAB 1 1 1 1 1 1 1 1 1 1 1 2
58 BREXEL 20 MG/VIAL VIAL 1 1 1 1 1 1 1 1 1 2 1 1
59 CEFOTAXIM I GR INJEKSI VIAL 1 1 1 1 1 1 1 1 1 1 1 2
60 CHLORAMPHENICOL 250MG CAPSUL CAP 2 1 1 1 1 1 1 1 1 1 1 1
LAMPIRAN 4
NO NAMA OBAT SATUAN User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8 User 9 User 10 User 11 User 12
61 CIPROFLOXACINE 500 MG TAB 2 1 1 1 1 1 1 1 1 1 1 1
62 CLINIMIC INFUS BTL 1 1 1 1 1 1 1 1 1 2 1 1
63 CROME INJ AMP 1 1 1 1 1 1 1 1 1 2 1 1
64 CYCLOVID 200 MG INJEKSI VIAL 2 1 1 1 1 1 1 1 1 1 1 1
65 DANOCRINE 200 MG CAPSUL CAP 2 1 1 1 1 1 1 1 1 1 1 1
66 ENYSTIN DROP FLS 2 1 1 1 1 1 1 1 1 1 1 1
67 INVICLOT INJEKSI VIAL 2 1 1 1 1 1 1 1 1 1 1 1
68 IVELIP 20% 100 CC BTL 2 1 1 1 1 1 1 1 1 1 1 1
69 KALITAKE 5G SACHET SACH 2 1 1 1 1 1 1 1 1 1 1 1
70 KENDARON INJEKSI AMP 2 1 1 1 1 1 1 1 1 1 1 1
71 KETOPROFEN 100 MG TAB TAB 2 1 1 1 1 1 1 1 1 1 1 1
72 LAXADIN 60 ML SYRUP BTL 2 1 1 1 1 1 1 1 1 1 1 1
73 LEVEMIR FLEXPEN VIAL 2 1 1 1 1 1 1 1 1 1 1 1
74 LOVENOX P F S 40 MG INJEKSI AMP 2 1 1 1 1 1 1 1 1 1 1 1
75 MEBO OINT TUBE 2 1 1 1 1 1 1 1 1 1 1 1
76 MELOXICAM 15 MG TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 1
77 MIKASIN 250 MG INJ VIAL 2 1 1 1 1 1 1 1 1 1 1 1
78 MUCOGARD SYR FLS 2 1 1 1 1 1 1 1 1 1 1 1
79 NOCID KAPLET 2 1 1 1 1 1 1 1 1 1 1 1
80 NUTRIVISION CAPSULE 2 1 1 1 1 1 1 1 1 1 1 1
81 SALOFALK 250 CAPSUL CAP 2 1 1 1 1 1 1 1 1 1 1 1
82 SIMARC 2 TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 1
83 SOTATIC 10 MG TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 1
84 SPIRIVA 18 MCG REFILL (A) CAP 2 1 1 1 1 1 1 1 1 1 1 1
85 SYNTOCINON 1 ML INJEKSI AMP 2 1 1 1 1 1 1 1 1 1 1 1
LAMPIRAN 4
NO NAMA OBAT SATUAN User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8 User 9 User 10 User 11 User 12
86 TRAMADOL TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 1
87 VITAMIN C 50 MG TAB 1 1 1 1 1 1 1 1 1 1 1 2
88 CALNIC PLUS SYR BTL 1 1 1 1 1 1 1 1 1 1 1 1
89 CEFIXIM 100MG CAP CAPSULE 1 1 1 1 1 1 1 1 1 1 1 1
90 CEFIROME INJ VIAL 1 1 1 1 1 1 1 1 1 1 1 1
91 CO AMOXYCLAVE 625MG TABLET TAB 1 1 1 1 1 1 1 1 1 1 1 1
92 CURCUMA TABLET (BLISTER) TAB 1 1 1 1 1 1 1 1 1 1 1 1
93 DEXTROMETHORPAN SYRUP 60 ML BTL 1 1 1 1 1 1 1 1 1 1 1 1
94 ECOSOL RL B BRAUN BOTOL 1 1 1 1 1 1 1 1 1 1 1 1
95 UNALIUM 5MG TABLET TAB 1 1 1 1 1 1 1 1 1 1 1 1
96 VELCHROME INJ AMP 1 1 1 1 1 1 1 1 1 1 1 1
97 VICCILLIN 1 GR INJEKSI AMP 1 1 1 1 1 1 1 1 1 1 1 1
98 ALINAMIN F INJEKSI AMP 1 1 1 1 1 1 1 1 1 1 1 1
99 AMINOPHYLLIN 200 MG TAB 1 1 1 1 1 1 1 1 1 1 1 1
LAMPIRAN 4
4 DIAZEPAM 2 MG
18 84 5,995717345 A 3
6 PHENOBARBITAL 30 MG
18 120 8,565310493 A 3
8 FARGOXIN INJ
17 154 10,99214847 A 3
10 FUROSEMIDA INJEKSI
16 186 13,27623126 A 3
11 METRONIDAZOLE 500MG
16 202 14,41827266 A 3
12 PARASETAMOL SYRUP
16 218 15,56031406 A 3
16 RIVANOL KOMPRES
16 282 20,12847966 A 3
18 BISOPROLOL TABLET
15 313 22,34118487 A 3
20 DIMENHYDRINAT 50 MG TAB
15 343 24,48251249 A 3
22 15 373 26,62384011 A 3
ETHAMBUTOL 500 MG TABLET
27 ACYCLOVIR 200 MG
15 448 31,97715917 A 3
28 AMBROXOL SYRUP 15 MG
15 463 33,04782298 A 3
29 BETAMESON CREAM
14 477 34,04710921 A 3
30 CAPTOPRIL 25 MG TABLET
14 491 35,04639543 A 3
32 CATAPRES INJEKSI
14 519 37,04496788 A 3
37 FLUCONAZOLE INF
14 589 42,041399 A 3
38 GAMARAAS INJEKSI
14 603 43,04068522 A 3
39 GLIBENCLAMIDE TABLET
14 617 44,03997145 A 3
44 14 687 49,03640257 A 3
METHYL ERGOMETRINE
51 STREPTOMYCIN 1G INJEKSI
14 785 56,03140614 A 3
53 VITKA INFANT
14 813 58,02997859 A 3
57 BECOM Z. TABLET
13 867 61,88436831 A 3
58 BREXEL 20 MG/VIAL
13 880 62,81227695 A 3
59 CEFOTAXIM I GR INJEKSI
13 893 63,74018558 A 3
61 CIPROFLOXACINE 500 MG
13 919 65,59600286 A 3
62 CLINIMIC INFUS
13 932 66,52391149 A 3
63 CROME INJ
13 945 67,45182013 A 3
66 13 984 70,23554604 B 2
ENYSTIN DROP
67 INVICLOT INJEKSI
13 997 71,16345468 B 2
69 KALITAKE 5G SACHET
13 1023 73,01927195 B 2
70 KENDARON INJEKSI
13 1036 73,94718059 B 2
72 LAXADIN 60 ML SYRUP
13 1062 75,80299786 B 2
73 LEVEMIR FLEXPEN
13 1075 76,7309065 B 2
74 LOVENOX P F S 40 MG INJEKSI
13 1088 77,65881513 B 2
75 MEBO OINT
13 1101 78,58672377 B 2
76 MELOXICAM 15 MG TABLET
13 1114 79,51463241 B 2
78 MUCOGARD SYR
13 1140 81,37044968 B 2
79 NOCID
13 1153 82,29835832 B 2
80 NUTRIVISION
13 1166 83,22626695 B 2
82 SIMARC 2 TABLET
13 1192 85,08208423 B 2
83 SOTATIC 10 MG TABLET
13 1205 86,00999286 B 2
85 SYNTOCINON 1 ML INJEKSI
13 1231 87,86581014 B 2
86 TRAMADOL TABLET
13 1244 88,79371877 B 2
87 VITAMIN C 50 MG
13 1257 89,72162741 B 2
LAMPIRAN 4
88 12 1269 90,57815846 C 1
CALNIC PLUS SYR
90 CEFIROME INJ
12 1293 92,29122056 C 1
93 DEXTROMETHORPAN SYRUP 60 ML
12 1329 94,8608137 C 1
94 ECOSOL RL B BRAUN
12 1341 95,71734475 C 1
96 VELCHROME INJ
12 1365 97,43040685 C 1
97 VICCILLIN 1 GR INJEKSI
12 1377 98,2869379 C 1
98 ALINAMIN F INJEKSI
12 1389 99,14346895 C 1
99 AMINOPHYLLIN 200 MG
12 1401 100 C 1
LAMPIRAN 5
NO NAMA OBAT SATUAN W1 (Nilai Pemakaian) W2 (Nilai Invetasi) W3 (Nilai Kritis) NIK (W1+W2+2W3) KEL
1 FERRIPROX FCT 500 MG TAB TAB 3 3 3 12 A
2 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 3 3 3 12 A
3 CAPTOPRIL 25 MG TABLET TAB 3 1 3 10 A
4 CHLORAMPHENICOL 250MG CAPSUL CAP 3 1 3 10 A
5 CIPROFLOXACINE 500 MG TAB 3 1 3 10 A
6 FUROSEMIDA INJEKSI AMP 2 2 3 10 A
7 GAMARAAS INJEKSI VIAL 1 3 3 10 A
8 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 3 1 3 10 A
9 ISONIAZIDE 300 MG (INH) TABLET TAB 3 1 3 10 A
10 METRONIDAZOLE 500MG TAB 3 1 3 10 A
11 OMEPRAZOLE CAPSULE SANBE/AMS CAP 3 1 3 10 A
12 OXALIPLATIN MEDAC 100MG INJ VIAL 1 3 3 10 A
13 PREDNISON 5MG TABLET TAB 3 1 3 10 A
14 RANITIDIN 150 MG TABLET TAB 3 1 3 10 A
15 ACYCLOVIR 200 MG TAB 3 1 3 10 A
16 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL 1 2 3 9 B
17 ASAM TRANEKSAMAT 500 MG TAB 2 1 3 9 B
18 AVASTIN 100MG/4ML INJ VIAL 1 2 3 9 B
19 BISOPROLOL TABLET TAB 2 1 3 9 B
20 CEFOTAXIM I GR INJEKSI VIAL 1 2 3 9 B
21 CITICHOLIN 250 MG INJEKSI AMP 1 2 3 9 B
22 CLINIMIC INFUS BTL 1 2 3 9 B
23 CYCLOVID 200 MG INJEKSI VIAL 1 2 3 9 B
24 DEPAKENE 250 MG SYRUP BTL 1 2 3 9 B
25 DIAZEPAM 2 MG TAB 2 1 3 9 B
26 ELOXATIN 100 INJ VIAL 1 2 3 9 B
27 ETHAMBUTOL 500 MG TABLET TAB 2 1 3 9 B
28 FLUCONAZOLE INF FLS 1 2 3 9 B
29 GLIBENCLAMIDE TABLET TAB 2 1 3 9 B
30 GLUCOBAY 50MG TABLET TAB 2 1 3 9 B
31 PHENITOIN 100MG CAP CAP 2 1 3 9 B
32 RIFAMPICIN 300MG CAPSULE CAP 2 1 3 9 B
33 ALPRAZOLAM 0,5 TABLET TAB 2 1 3 9 B
34 BECOM Z. TABLET TAB 1 1 3 8 B
35 BETAMESON CREAM TUBE 1 1 3 8 B
LAMPIRAN 5
NO NAMA OBAT SATUAN W1 (Nilai Pemakaian) W2 (Nilai Invetasi) W3 (Nilai Kritis) NIK (W1+W2+2W3) KEL
36 BREXEL 20 MG/VIAL VIAL 1 1 3 8 B
37 CARBOL GLYCERIN TETES TELINGA BTL 1 1 3 8 B
38 CATAPRES INJEKSI AMP 1 1 3 8 B
39 CENDO LYTEERS EYE DROP 15 ML BTL 1 1 3 8 B
40 CENDO TROPIN 0,5% EYE DROP 5 ML BTL 1 1 3 8 B
41 CEPEZET 100MG TAB TAB 1 1 3 8 B
42 CROME INJ AMP 1 1 3 8 B
43 DANOCRINE 200 MG CAPSUL CAP 1 1 3 8 B
44 DIMENHYDRINAT 50 MG TAB TAB 1 1 3 8 B
45 DEXORUBICIN 10MG INJEKSI VIAL 1 1 3 8 B
46 DUMIN 125 MG SUPPOS SUPP 1 1 3 8 B
47 ECOSOL RL B BRAUN BOTOL 3 3 1 8 B
48 FARGOXIN INJ AMP 1 1 3 8 B
49 H2O2 3% TETES TELINGA 15 ML BTL 1 1 3 8 B
50 HARNAL 0,2 MG CAPSULE CAP 1 1 3 8 B
51 IBUPROFEN 200 MG TABLET TAB 1 1 3 8 B
52 KSR 600MG TAB ASKIN TAB 1 1 3 8 B
53 METHYL ERGOMETRINE TAB 1 1 3 8 B
54 NEUROBION 5000 INJEKSI AMP 1 1 3 8 B
55 OTSU SALIN 3% ASKIN BTL 1 1 3 8 B
56 PARASETAMOL SYRUP BTL 1 1 3 8 B
57 PHENOBARBITAL 30 MG BTL 1 1 3 8 B
58 PIRACETAM 800 TABLET TAB 1 1 3 8 B
59 PROFIBRAT 300 KAP CAPSULE 1 1 3 8 B
60 RIVANOL KOMPRES BTL 1 1 3 8 B
61 STREPTOMYCIN 1G INJEKSI VIAL 1 1 3 8 B
62 THEOPHILLIN 150MG CAP CAP 1 1 3 8 B
63 VITAMIN C 50 MG TAB 3 1 2 8 B
64 VITKA INFANT AMP 1 1 3 8 B
65 XYLOCAIN 2% PDF INJEKSI 20 ML AMP 1 1 3 8 B
66 AMBROXOL SYRUP 15 MG BTL 1 1 3 8 B
67 AMOXISILLIN DRY SYRUP BTL 1 1 3 8 B
68 IVELIP 20% 100 CC BTL 1 2 2 7 B
69 KETOPROFEN 100 MG TAB TAB 2 1 2 7 B
70 LAXADIN 60 ML SYRUP BTL 1 2 2 7 B
LAMPIRAN 5
NO NAMA OBAT SATUAN W1 (Nilai Pemakaian) W2 (Nilai Invetasi) W3 (Nilai Kritis) NIK (W1+W2+2W3) KEL
71 LEVEMIR FLEXPEN VIAL 1 2 2 7 B
72 MELOXICAM 15 MG TABLET TAB 2 1 2 7 B
73 MUCOGARD SYR FLS 1 2 2 7 B
74 SOTATIC 10 MG TABLET TAB 2 1 2 7 B
75 ENYSTIN DROP FLS 1 1 2 6 C
76 INVICLOT INJEKSI VIAL 1 1 2 6 C
77 KALITAKE 5G SACHET SACH 1 1 2 6 C
78 KENDARON INJEKSI AMP 1 1 2 6 C
79 LOVENOX P F S 40 MG INJEKSI AMP 1 1 2 6 C
80 MEBO OINT TUBE 1 1 2 6 C
81 MIKASIN 250 MG INJ VIAL 1 1 2 6 C
82 NOCID KAPLET 1 1 2 6 C
83 NUTRIVISION CAPSULE 1 1 2 6 C
84 SALOFALK 250 CAPSUL CAP 1 1 2 6 C
85 SIMARC 2 TABLET TAB 1 1 2 6 C
86 SPIRIVA 18 MCG REFILL (A) CAP 1 1 2 6 C
87 SYNTOCINON 1 ML INJEKSI AMP 1 1 2 6 C
88 TRAMADOL TABLET TAB 1 1 2 6 C
89 CEFIXIM 100MG CAP CAPSULE 2 1 1 5 C
90 CEFIROME INJ VIAL 1 2 1 5 C
91 CO AMOXYCLAVE 625MG TABLET TAB 1 2 1 5 C
92 CURCUMA TABLET (BLISTER) TAB 2 1 1 5 C
93 VICCILLIN 1 GR INJEKSI AMP 1 2 1 5 C
94 AMINOPHYLLIN 200 MG TAB 2 1 1 5 C
95 CALNIC PLUS SYR BTL 1 1 1 4 C
96 DEXTROMETHORPAN SYRUP 60 ML BTL 1 1 1 4 C
97 UNALIUM 5MG TABLET TAB 1 1 1 4 C
98 VELCHROME INJ AMP 1 1 1 4 C
99 ALINAMIN F INJEKSI AMP 1 1 1 4 C
LAMPIRAN 6