INSTALASI FARMASI RUMAH·SAKIT AMC

DAFTAR PERESEPAN OBAT YANG TIDAK MASUK DALAM

FORi'\fULARIUM RUMAH SAKIT
BULAN JANUARI 2019
·,:
NO NAMAOBAT SEDIAAN JUMLAHR/ KET
1 Leucogen Injeksi 2
2 Sildenafil Tablet 2
�·
Jumlah 4
Jumlah RI 4
Total RI 21.048
% Ketidakpatuhan Resep Formulariurn .d.
21�48 x 100 % = 0,02%
% Kepatuhan Resep Formularium 21044
x 100 % = 99,08%
21048

Mengetahui, Bandung, 02 Februari 201S

Ka. lnstalasi Farmasi Koor. Dalmut Farmasi

()\(�
D�i Marlina Sari, S.Fann .. Apt Rina Marlina
, .
' ...

INSTALASI FARl\-fASI RUMAH SAKIT AMC

SESUAI
1'10 l'IAl IAD KA.l'I\J
FORMULARIU
l ACRAN 150 TAB v I

2 ACRAN INJEKSI ..;

3 AKILEN TE�S TELINGA ,J
4
5
AL 110 I NAN LACTOSE FREE 400GR
ALDISA SR KAPSUL "
'1
6 ALGANAX 0,25 MG TAB ',/
-v
7
8
AT.GANAYO,<; MGTAR
ALGANAX 1 MG TAB
,,
9 ALINAMIN FTAB -..J
10 ALLORIS SYRUP ,J
1 1
1 1 Afv1ADIAB 1 '1

"-1"
12 AMADIAB 2 TABLET
13 AMADIAB 3 TABLET .
J
14 AMADIAB 4 TABLET \/
i5 AMOXSAN 500 CAP
16 AMOXSAN FORTE SYR 60ML 'v
17 AMPICILLIN 1 GR INJ ../
18 ANADIUM TABLET '1
19 ANALSIK TAB \'
20 ANTIZA SYRUP 60 ML ,J
21 AQUA MARIS DAILY 30 ML v
22 ARIXTRA 2,5 INJEKSI BPJS ...;
23 ARKINE 2 MG TABLET STRIP v
24
25
ASPARKTAB
ASTHAROL TABLET "
\I
26 ASTHENOF 5 ML EYE DROP
27 AZTERCON 500 MG TABLET ,J

29 BAQUINORFORTETAB -v
• 30 BASAGLAR KWIKPEN 100 v
31 BEBELOVE 1 200 GR v
32 BECOMCTAB �
33 BENOSON NCR 5 GR ,J
34 BERRY VISION '1
35 BIOTHICOL FORTE SYR -.J
36 BIOTHICOL SYR 60ML ,J
37
38
39
BIOXONINJ
BORAG��OL S SUPP
BORAX GLYCERIN 8 ML
"
'./
vI
40 BRAXIDIN TAB \i
41 BROADCED I GR INJEKSI 'I/
42
43
BUFECT SYR 60ML
BUSCOPA.NTAB ,,vJ

44 CALOS CHEW ABLE TAB ' 60 TAB x

45 CATARLENT 5 CC • -.J
46 !CEFILA 100 MG KAPSlJL
47 CEFILA SIRUP
SESUAI
No NAMABARANG
FORMULARIU
48 CEFSPAN 100 MG SIRUP -.J
49 CEFXON 1 GR INJEKSI v
50 CBLEBREX 200 MG CAP v
51
52
CENFRES CENDO 5 ML
CEPHAFLOX l GR ,� ,
53
54 CERNEVIT VIAL \
55 CHANNA K.APSUL
 � r�J'I.A,">. .N.....A.. PLl�IS DR. Y SYRl�I·P
57 CIPLOS 500 \'

58 CINAM INJEKSI ,J
59 CLANEKSI 500 TAB v
60 CLIDIAZ TABLET \
61 COMBIVENT UDY NEBULES -.j
62 CONVER 2% MINIDOSE • v
63 CORTIDEX INJ '1
- I
64 CORTIDEX TAB 'I

65 COXIRON 60 MG TABLET v
66 COXIRON 90 MG TAB LET ,1
67 COXIRON 90 MG TABLET \
68 CURCUMA TAB \'

69 CURVIT 60 l\1L SIRUP ,.j

1� C\JR\!11 CL EMUL'Si\0"N \ 1'5 �

71 CYCLON 1 % TETES MATA v
72 DECUBALCREAM20GR x
73 DEHAF SACHET ,J
74 DEPRAM 10 MG TAB LET 'V
75 DESOLEX - N CREAM 10 MG �
76 DESOLEX CR 10 GR 'i
I

77 DESTAVELL 5 MG TABLET -v

v"
78 DHAVITSYR
' 79 DTAFORMTN XR TABLET
80 DICYNONE INJ 250MG/2ML v
81 DOPAMET 250 MG TAB \
82 DULCOLAX 5 TAB \

83 DUMIN l 25/4t\1LRECTAL ...;

84 EDORISAN DROP ...;
85 ELKANACL �
86 ELOX CREAM 5GR v
,i
87 EMIBIONCAP '
88 ENSURE FOS VANILA 400 GR 'I/
89 EPEXOL SYR 120ML '1
90 EPEXOL TAB -.: _,
9i EPISAN SIRUP i 00 ML v
92 ERYSANBE SYR v
93
94
ESOFERR INJEKSI
ESOMAX INJEKSI
. -y
v
95 ETERFIX INFUS -v
96 EUPHYLLIN RETARD MITE TAB v
 SESUAI
No NAMABARANG
FORMULARIU
97 EUPHYLLIN RETARD TAB ,.J
98 EZELIN INSULIN GLARGINE -.J
99
100
F AK.TU OINT 20 GR
FARGOXIN INJEKSI \ " 1
101 FG TROCHES TAB \
I
102 FLAMAR EMULGEL 20GR \

103 FLAMERGI TETES MATA ..J

104
105
FLIXOTIDE NEBULES
FLOXA 0,6 ML MINIDOSE "'lj
106 FLOXA TETES MATA 5 ML \
•: 107 FLUIMUCIL 200 SACHET '1
108 POLAVIT 400 MCG TAB '1
109 FOR..\.fiJNO TAB \
110 FUNGATIN DROP ,.J
111 FUZIDE SYRUP 60 ML : ,.j
112 GELOFUSIN 500 CC '1
113 GiOVAN FEMTh-,INE HYGIENE \
114 GLAUSETA TABLET 'i
115 GLITA VEN SIRUP ,J.
116 GLUCOVEL l TABLET \
ll7 GLUTROP TAB LET ...J

II8 GLYBOTIC 250 MG INJ ,J

119 HEPAB ALANCE CAPS \
120 HERBESER CD 200 KAPSUL v
121 HEXADOLGARGLE60ML 'i

,,v"
122 HI BONE TAB
123 HISTRIN DROP
124 HISTRIN FT 5 MG TAB
125 HUMALOG KWIKPEN 3 ML -.J
126 HYSTOLAN TAB \

'
127
128
129
IMBOOSTFORCEEXTRASTRENGTHTABLET
IMBOOSTFORCESYRUP
IMUNOSSYR
"v
...;

130 INFLESCO TABLET \

131 INOXIN 400 MG TABLET x
132 TNVlCLOT INJEKSI ,J
133
134
IPROX SIRUP
ISPRINOL SYR ,..;,
135 KALNEX 500 MG v
136
137
138
I(ALQUEST POWDER
KEREN 25 MG INJEKSI
KETO G TABLET
"
v
..J
139 L-BIOSACH v
,1
140 L- CISIN TABLET '
141
142
LACTACYD SOL PINK 60 ML
LACTO B SACHET "
...;
..;
143
..
144
LAFALOS CREAM
. . ,...
.'
..... ,. .- - . . .............. ,. -�� .,

145 LANAKELOID CR 10 GR

No
195
I NYSTIN DROP
NAMABARANG

196 OPICEF 125 SYR \,

197 OPICEF 500 CAPS v

198 OPICORT TABLET v
199 OPILAX 60.ML SYR '-)
200 OPINACEA TABLET v
201 OPINEURON CAPL '-)
 202 OPIPROL 2,5 MG TABLET
203 OREZ!NC SIRUP '1
204 ORNISP AR ORAL POWDER '1
•'
"
205 OSTARJNSYR
206 OTEDE TABLET x
207 OTlLON TETES TELINGA \j
208 OTOPAIN EAR DROP v
209 OTIOP AN DROP .· -:
210
2i l
OTIOPAN SYRUP
OVACARETABLET "\/
212
213
OXOFERIN SOL 30 ML
OXORIL SYR 60 ML
"..j
'v

214
215
OXYLA INJEKSI
P PRED MlNIDOSE '5 PCS
'\
216
217
P ANTOCAIN 2% TETES MATA
PANVELL 40 MG TABLET "..;
218 PANVELL lNJEKSI ..J
219
220
221
PARIET TAB 20 MG
PEHACAIN INJ
PEHADOXIN FORTE TAB
"x
..j

222 PENTABIO VAKSIN 0,5 ML \I

223 PIBAKSIN OINT I OGR

..j
"
225
224 PIRALENINJ
PIRALEN 10 MG TAB
I 226
227
PIROTOP CREAM 10 GR
PLASMINEX 500 TAB "..j
228 POLIDEMISINTETES MATA
"
""
229 POLYSILANE SYR 1 OOML
230 IC 500 MG TAB
PONSA..M.
231 PRAGESOL 1 GR INJEKSI 'J
...,,
232 PRE NAN /LACTOGEN PREMATURE 400 GR
233
234
PREABORTAB
PRENAMIA KAPS "
\
235 PRO TB 2 KID TABLET ..J
236 PRO TB 3 TABLET ..j
237 PROBIOKID SACHET '1
238 PRO['jcURON TAB \/

239 PROTHERINE INJEKSI ...;

240 PROVELYN 75 MG KAPSUL v
241 PSIDII SYRUP .· v
--
242 IPULMICORT � -
RESPULES 0,5 MG \
243 PUMPISEL lNJEKSI
SESUAI
No NAMABARANG
FORMULARIU
244 PUMPITOR CAP ...}
245 PUMPITOR INJEKSI v
246 QCEFCAP ...}
247 QUATRO 0,4 MCG KAPSUL y
248 RANIVEL OOEKSI ..J
249 RANIVEL SIRUP ,J
250 RATIVOL 30 INJEKSI 'V
251 REBAMID l 00 MG TABLET -../
252
253
REGIVELL INJEKSI 4 ML
SAGESTAMCR
,,
...}

•' 254 SAGESTAM INJ '1

255 SANADRYL DMP 60 ML �
256 SANADRYL EXP 60 :ML \
257 SANBE TEARS 8 ML '1
258 SANEXON 125 MG INJ .· v
259 SANFURO SIRUP
"
 260 SAN'MOLDROP ..J
261 SANMOL FORTE SIRUP ,.:
262 SANMOLFORTETABLET \I

263 SANMOL INFUS ',j

264 SANMOLTAB 'V

265 SANORil\TE 0.1 % HIJAU '1
266 SANPICILLIN I GR INJ "
268
267
269
SCOPAMIN PLUSG TAB
SANSULIN LOG
SENDICOL SYRUP 250 y",J
"270
271
272
SEROQUEL XR 400 MG TABLET
SETROVEL INJEKSI
SILOXAN 5 ML TETES MATA
'-!
..J
273 SIMTRAM TABLET 'V
274 SMECTA SACHET y
,. 275 SODERMIX CREAM 15 GR ...}
276 SPORETIK 100 MG CAP -'1
277 SPORETIK 200 MG KAPLET \

278 SPORETIK SYR \

279 SUPRABION TABLET ...}
280 SUPRAMOX DROP y
281 TAXEGRAM l GR INJ v
282
283
284
TB VIT 6 SYRUP 225 ML
TEQUINOL 500 CAP
TERFACEF INJ
"
\
'i
I
285 THROMBO ASPil.,ET TABLET 'I
286 THROMBO GELL l O GR \
287 TIMOL 0,5% TETES MATA 5 ML \
288 TOBRO 0,6 ML MINIDOSE -..:
289 TOBROSON MDS EYE DROP �
290 TOBROSON TETES MATA \'
- -� --- �
291 lTUl'ED.bX -�
IABLEI \
292 TONOTAN TABLET
 SESUAl
No NAMABARANG
FORMULARIU
293 TOPCORTCR 'i
294 TO.RAMIN 10 :MG TAB LET v
295 TRACEDOL KAPLET vI
296 TRACETAT SIRUP ,J
297 TRAMAL Sl.WP ,'
298 TREMENZA Sx K v
299 TREMENZA TAB v
300 TRICHODAZOL 500 TAB -...;
301
302
TRIFEDRIN CUM EXP SIRUP
1RILAC TABLET
,,
..J

303 TRIXIM SIRUP v

304 TROGYL SIRUP ,.j
305
306
TROMBUFIT SACHET
TROVENSIS 4 MG INJ ,\,
307 TROVENSIS 8 MG TAB l
\f
308 TUZALOSCAP \
309 ULTRAPROCT N CR '1
310
31 l
UMKALIN SIRUP
URDAHEX CAPSUL 'v
312 UROTRACTIN CAP \
313 UTROGESTANlOOOVULA \'
314 VALISANBE2 \
315 VALISANBE 5 'I
316 VALISANBE INJ \
317 VECTRINE SYRUP -../
318 VELLEPSY SIRUP v
319
320
VELUTINE NEBULES
VITADION INJEKSI
,,v
I

321 VITRO LENTA 5 ML \'

322 VOXIB 25 MG TABLET \
323 XITROL ED 5 ML v
#32 4 ..J
..,
ZAMELDROP . .
�
3._5 su urr
1£'7.,TIBITVI "A\J.VIu\X TTH 1:) ML

sumber SJMRS Laporan Penerimaan Barang Gudang

Jumlah obat yang diterima gudang farmasi 325
Jumiah item obat yang tidak sesuai formularium Rumah Sak.it 8

Presentase tingkat ketidakpatuhan = 8/325 x 100% 2.46%

Mengetahui, Bandung, 03 Februari 2019

Ka Instalasi Farmasi Koo. Dalmut Farmasi
\ .
I _,\,,,1·,,.�?17,l
• I �

( Devi Marlina Sari, S.Farm.,Apt ) ( Rina Marlina