LAPORAN PENGELOMPOKAN PERBEKALAN FARMASI BERDASARKAN FORMULARIUM NASIONAL

DI UNIT KERJA UPT PUSKESMAS PUJON

TAHUN 2022

NO NAMA OBAT BENTUK KEKUATAN KOMPOSISI FORNAS NON FORNAS

SEDIAAN SEDIAAN
1 Alopurinol 100 mg TABLET 100 mg alopurinol √
2 ambroxol TABLET 30 mg ambroxol √
3 Amilodipin 5 mg TABLET 5 mg amlodipin √
4 Amlodipin 10 mg TABLET 10 mg amlodipin √
5 Amoksilin 500 mg TABLET 500 mg amoksilin √
6 Antasida (MgOH 200mg+AlOH 200mg) TABLET 200 mg MgOH dan AlOH3 √
7 Asam Askorbat (Vitamin C) tab 250 mg TABLET 250 mg asam askorbat √
8 Asam mefenamat 500mg TABLET 500 mg asam mefenamat √
9 Asiklovir 400mg TABLET 400 mg asiklovir √
10 betahistin 6 mg TABLET 6 mg betahistin √
11 Cefadroxil 500mg TABLET 500 mg cefadroxil √
12 Cetirizin 10mg TABLET 10 mg cetirizin √
13 Dimenhidrinat tablet 50mg TABLET 50 mg dimenhidrinat tablet √
14 Domperidon tablet 10 mg TABLET 10 mg domperidon tablet √
15 Zinc tablet dispersible 20 mg TABLET 20 mg zinc √
16 Glibenklamid 5 mg TABLET 5 mg glibenklamid √
17 Ibuprofen 400 mg TABLET 400 mg ibuprofen √
18 Isosorbid Dinitrat sublingual 5 mg TABLET 5 mg isosorbid dinitrat √
19 Kalsium Laktat (Kalk) 500 mg TABLET 500 mg kalsium laktat √
20 Kaptopril 25 mg TABLET 25 mg kaptopril √
21 Kaptopril 12,5 mg TABLET 12,5 mg kaptopril √
22 Ketokonazol 200mg tablet TABLET 200 mg ketokonazol √
23 Klindamycin 150mg TABLET 150 mg klindamycin √
24 Klopidogrel TABLET 30 mg klopidogrel √
25 Klorfeniramin Maleat (CTM) 4 mg TABLET 4 mg klorfeniramin maleat √
26 Kotrimoksazol dewasa kombinasi : Sulfametoksazol400mg+Trimetoprim80mg TABLET 480 mg sulfametoxazole dan trimetoprim √
27 Metformin 500mg tablet TABLET 500 mg metformin √
28 Metil Prednisolon 4 mg TABLET 4 mg metil prednisolon √
29 Metilergometrin Maleat 0,125 mg TABLET 0,125 mg metilergometrin maleat √
30 Metoklopramid 10mg TABLET 10 mg metoklopramid √
31 Metronidazol 500mg TABLET 500 mg metronidazol √
32 Natrium Diklofenac 50 mg TABLET 50 mg natrium diklofenac √
33 Nistatin tablet vaginal 100.000 IU/g TABLET 100.000 IU nistatin √
34 Omeprazole 20mg TABLET 20 mg omeprazole √
35 PARASETAMOL TABLET 500 mg TABLET 500 mg parasetamol √
36 Ranitidin tablet 150 mg TABLET 150 mg ranitidin √
37 Salbutamol tablet 2 mg TABLET 2 mg salbutamol √
38 Salbutamol tablet 4 mg TABLET 4 mg salbutamol √
39 Simvastatin 10 mg TABLET 10 mg simvastatin √
40 Siprofloksazin tablet 500 mg TABLET 500 mg siprofloksazin √
41 Tiamin HCL (VitB1) 50 mg TABLET 50 mg tiamin hcl √
42 Noza TABLET Paracetamol, triprolidin, pseudoefedrin √
43 Pularex TABLET 500 mg Attapulgite √
44 meloxicam 15 mg TABLET 15 mg meloxicam √
45 Albendazol 400mg TABLET 400 mg albendazol √
46 Tablet Tambah Darah ( Ferro Fumarat 60 mg + Asan Folat 0,4 mg ) TABLET 60 mg tablet tambah √
47 Amitriptilin HCL 25 mg TABLET 25 mg amitriptilin hcl √
48 Haloperidol 1,5 mg TABLET 1,5 mg haloperidol √
49 Haloperidol 5 mg TABLET 5 mg haloperidol √
50 Klorpromazin HCL tablet salut 100 mg TABLET 100 mg klorpromazin hcl √
51 Risperidone 2mg TABLET 2 mg risperidone √
52 Triheksifenidil Hidroklorida tab 2 mg TABLET 2 mg triheksifenidil hidroklorida √
53 Azithromycin TABLET 30 mg azithromycin √
54 Efavirenz (EFV) 600 mg TABLET 600 mg efavirenz √
55 Lamivudine 150 mg TABLET 150 mg lamivudine √
56 Nevirapine (NVP) 200mg TABLET 200 mg nevirapine √
57 Tenofovir 300 TABLET 300 mg tenofovir √
58 Tenofovir 300 + Lamivudin 300 + Efaviren 600 (Triple FDC) Dewasa (3051201) TABLET TLE √
59 Zidovudine(ZDV)300mg+Lamivudine(3TC)150mg TABLET 300 mg zidovudine dan lamivudin √
60 Diazepam 2 mg TABLET 2 mg diazepam √
61 Diazepam 5 mg TABLET 5 mg diazepam √
62 Kodein tablet 10mg TABLET 10 mg kodein tablet √
63 Isoniazid (INH) 100 mg TABLET 100 mg isoniazid √
64 Obat Tuberkulosis kategori I ( FDC ) TABLET HRZE √
65 Deksametason injeksi 5 mg/ml INJEKSI 5 mg/ml deksametason √
66 Difenhidramin HCL Inj 10mg/ml INJEKSI 10 mg/ml difenhidramin hcl √
67 Epinefrin injeksi INJEKSI 1 mg epinefrin √
68 Fitomenadion (Vit K1)inj 10mg/ml INJEKSI 10 mg/ml fitomenadion / Vitamin K √
69 Furosemid injeksi INJEKSI 10 mg furosemid √
70 Lidokain komp injeksi,Kombinasi:Lidokain HCl2%+Epinefrin1:8000002ml INJEKSI 2% lidokain dan epinefrin √
71 Magnesium sulfat injeksi (IV) 40 % 0 25 ml INJEKSI 40% magnesium sulfat √
72 Magnesium sulfat injeksi (IV) 20 % 0 25 ml INJEKSI 20% magnesium sulfat √
73 Metilergometrin Maleat inj. 0,200mg/ml INJEKSI 0,2 mg/ml metilergometrin maleat √
74 Metoklopramid inj. 5mg / ml INJEKSI 5 mg/ml metoklopramid √
75 Oksitosin injeksi 10 IU/ml 0 1 ml INJEKSI 10 IU oksitosin √
 BENTUK KEKUATAN
NO NAMA OBAT SEDIAAN SEDIAAN KOMPOSISI FORNAS NON FORNAS

76 Omeprazol injeksi INJEKSI 40 mg omeprazol √

77 neurobion injeksi INJEKSI 5000 iu neurobion √
78 diazepam inj 10 mg/2ml INJEKSI 10 mg/2ml diazepam inj √
79 Antifungi (As. Benzoat6%+As. salisilat 3%) SALEP 3% As. Benzoat dan As. salisilat √
80 betametason krim 0,05% SALEP 0.05% betametason √
81 Gentamisin salep mata 0,3% SALEP 0.30% gentamisin salep √
82 Hidrokortison krim 2,5 % SALEP 2.50% hidrokortison √
83 Miconazol cream 2 % SALEP 2% miconazol √
84 Oksitetrasiklin HCL 1 % salep mata SALEP 1% oksitetrasiklin hcl √
85 Salep 24 Komb: As salisilat2%+Belerang endap4% SALEP 2% salep 24 komb √
86 Permetrin/Scabicid krim 5% SALEP 5% permetrin √
87 Garam oralit untuk 200 ml air SERBUK garam oralit √
88 Salisil Bedak 2 % SERBUK 2% salisil √
89 Amoksilin 125mg/5ml SIRUP 125 mg/5 ml amoksilin √
90 Cetirizin syr SIRUP 5 mg/5ml cetirizin √
91 decolgen syr SIRUP parasetamol, CTM, Phenylpropanolamine √
92 Domperidon sirup/suspensi 5mg/5ml SIRUP 5 mg/5ml domperidon √
93 Ibuprofen suspensi 100mg/5ml SIRUP 100 mg/5 ml ibuprofen √
94 Kloramfenikol suspensi 125mg/5ml SIRUP 125 mg/5 ml kloramfenikol √
95 Kotrimoksazol Suspensi komb: Sulfametoksazol 200mg+Trimetoprim40mg/5ml SIRUP 240 mg/5 ml kotrimoksazol √
96 Obat flu anak ( febrinex) SIRUP Parasetamol, dexklorfeniramin maleat, GG √
97 Parasetamol sirup 120mg/5ml SIRUP 120 mg/5 ml parasetamol √
98 Gentamisin tetes mata 0.3% TETES 0.30% gentamisin √
99 Parasetamol drop 100mg/ml btl @ 15ml TETES 100 mg parasetamol √
100 ketoprofen (SUPRAFENID) supp 100 mg SUPPOSITORIA 100 mg ketoprofen √
101 Stesolid rectal supp 5 mg SUPPOSITORIA 5 mg diazepam √
102 Anti Hemoroid (Bismut subgallat150mg+Heksaklorofen2,5mg) SUPPOSITORIA 150 mg Bismut subgallat √
103 ventolin nebule NEBUL 2,5 mg Salbutamol √

Mengetahui Malang, 28 April 2022

Atasan Langsung Pembuat Laporan

drg. Angga An Novita Gufron, S. Farm., Apt.

NIP. 197911092007012008 NIP. 199201132019031010