SKDI DIAGNOSIS KETERANGAN TATALAKSANA

INFEKSI TROPIS
Ringan Doksisiklin 2 x 100 mg
Ampisilin 4x 500 mg
Amoksisilin 4 x 500 mg
Leptospirosis Berat Penicilin G 1.5 jt unit/6 jam IV
Ampisilin 1gr/6 jam IV
Ceftriaxon 1gr/hari IV
Profilaksis Doksisiklin 200 mg/minggu
Kloramfenikol 4x500 mg 10 hari
Ampisillin 2 gr/hr 10 hari (ACC bumil)
Demam Tifoid
Ciprofloxacin 2x500 mg 7 hari (X anak)
Carier/Rawat inap Ceftriaxon 1gr/hari IV
ARV (2 NRTI + 1 NNRTI) ~TEL/TNL
*NNRTI : Efavirenz, Nevirapine
*NRTI : Zinofudine, Lamifudine, Stavudine
HIV
tanpa komplikasi Profilaksis Dewasa : Kotrimoksazol 960 mg u/AIDS, CD <200
Anak : Kotrimoksazol 4-6 mg/kgBB
Profilaksis bayi ASI : Zidovudin + Nevirapin 6 minggu
dari Bumil HIV + Tanpa ASI : Zidovudin 6 minggu
Ascaris Lumbricoides
Ankylostoma 1. A : Albendazol 400 mg SD

2. M : Mebendazol 500 mg SD/2x100 3hr

3. P: Pirantel Pamoat 10 mg/kgbb u/anak & bumil
Enterobius Vermicularis P-M-A
Trichuris Trichura M-A
Strongyloides Albendazol 400 mg 3 Hr
Helminthiasis
Praziquantel 10mg/kgBB SD
Taeniasis Albendazol 400 mg 3 Hr
Mebendazol 3x100 mg 2-4 minggu
Taeniasis + Kesmen Albendazol 2 x 400 mg 8-30 Hr + steroid
4 (Neurosistercosis)
Scistosomiasis J Praziquantel 3x20 mg/kgBB/hr (60 mg)
Scistosomiasis M-H Praziquantel 2x20 mg/kgBB/hr (40 mg)
Akut DEC (DietilCarbamazin) 6 mg/kgbb (3x100 mg) 12 hari
ko infeksi loa loa tambah Ivermectin 150µg/kgbb SD
Filariasis
Kronik/Profilasis massal Albendazol 400 mg SD + DEC/Ivermektin
per tahun selama 5 thn
Falciparum Lini 1: ACT 3 Hr + Primakuin 1 Hr
Lini 2: KINA+Doksi/Tetra 7 Hr + Primakuin 1 Hr
Vivax/Ovale Lini 1: ACT 3 Hr + Primakuin 14 Hr
Lini 2: KINA+Doksi/Tetra 7 Hr + Primakuin 14 Hr
Malaria
Malareae Lini 1: ACT 3 Hr
Lini 2: KINA+Doksi/Tetra 7 Hr
ACT (Combine) Artesunat + Amodiakuin
Dihidroartemisin + Piperakuin
 Artesunat IV
Malaria Berat Hari 1: 2.4 mg/BB pada jam 0,12,24.
Lanjut 2.4 mg/24 jam sampai pasien sadar

tdk bisa infus/ Artemeter IM

di RS perifer/puskesmas Hari 1: 3.2 mg/BB dlm 2 dosis (1.6mg/BB/12 jam)
Lanjut 1.6 mg/BB/24 jam selama 4 hari
KINA HCL 10 mg/kgBB dalam 500cc D5% 8 jam
Max. 3 bulan Doksisiklin 100mg/hr
(2 hr sblm - 4 minggu setelah)
Malaria Profilaksis Klorokuin 500mg/minggu
Bumil/Anak
(1 minggu sblm - 4 minggu setelah)
Resisten Klorokuin Meflokuin 250 mg
Derajat 1 3-5 ml/kgBB/jam
Derajat 2 6-7 ml/kgBB/jam
DBD
Derajat 3 10-20ml/kgBB dalam 30 menit
Derajat 4 20-30 ml/kgBB bolus!
RHEUMA
Akut < 3hr Kolkisin 0.6-1.2 mg/jam (Maks 8 mg)
> 3hr Indometasin 150-200 mg/hr
4 Gout Arthritis
Kronik Allopurinol 3 x 100 mg
Probenesid
Grade 1 NSAID
3A OA Grade 2/3 Inj. Kortiko + As. Hyaluronat intraarticular
Grade 4 Total Knee Arthroplasty
Awal NSAID (Meloksikam, Na.Dic)
3A RA
Tepat DMARDS (Metotreksat/Klorokuin/Sulfasalazin)
Awal/Induksi Metilprednisolon 8 mg (High dose)
3A SLE
Tepat DMARDS (Metotreksat/Klorokuin)
Polimyalgia
1 rheumatoid Kortikosteroid

GINJAL
Sistitis Non (Wanita + tdk hamil only) Cotrimoxazole 2x960 / Ciprofloxacin 2x250 mg 3hr
Komplikata Amoksiklav 2x625 mg 7 Hr
Ciprofloxacin 2x500 7 hr
Sistitis Komplikata Anak Kotrimoksasol 10mg/kgBB
4
Bumil Nitrofurantoin 2x100, Amoksisilin 3 x 500 mg 3 hari
IV 10-14 Hr Fluorokuinolon: Ciprofloxacin/Levofloxacin
Pyenonefritis TMP-SMX : Cotrimoxazole
Bumil Cefadroxil 2 x 500 mg 7 hari

3A Sindrom Nefrotik
Continous Day Prednison 2 mg/kgBB (Maks. 60 mg )
(1 bln)->Alternating dose 1.5 mg/BB (Selang-seling 1 bln)
3A AKI Ur>200 Uremic Syndrome Rehidrasi, koreksi elektrolit + HD Cito!
ENDOKRIN
 DM Sekretegague Sulfonilurea : Glibenklamid/Glimepirid 1x2 mg/
Gliclazide/Glipizide/Gliquidone (Ginjal aman)
Non Sulfonilurea : Glinid
Biguanid Metformin 3x500 mg
Thiazolidinedion Pioglitazon
Alfa glukosidase inh. Acarbose
4 SGLT 2 Inh. Canagliflozin
Agonis GLP-1 Liraglutide
DPP4 Inhibitor Sitagliptin
Sesuai Indikasi Insulin 0.5 IU/KgBB 60% prandial-40% basal
KAD/HONK Insulin drips 0.1 IU/KgBB
Prandial (Analog) Novorapid (Aspart) / Apidra (Glulisin)
Basal (Analog) Lantus (Glagrin) / Levemir (Detemir)
Neuropati Diabetik Awal/simptomatik Pregabalin (Lyrica) 2x75 mg PO naik bertahap
Tepat Mecobalamin (Vit B12)
4 Hipoglikemia Ringan Larutan gula 15-20 gr dalam 15 menit (2-3 sdm)
3B Bolus D40% 1 flakon (25 cc) / D10% 150 cc
Berat Lanjut D10% 100cc/jam
u/ Hiperkolesteromia Statin (Malam hari)
4 Dislipidemia Ada TG >500 Gemfibrozil 2 x 600 mg/ Fenofibrat 300 mg
u/ HDL <40 only Asam Nikotinat (Niasin) 500-750 mg
Non farmako Defisit kalori 500-1000 kkal/hari
Aktivitas fisik (sesuai kondisi pasien)
4 Obesitas
Farmako Orlistat
Bedah Restrictive/Hybrid Bariatric Surgeries u/ IMT > 35
Mild Metimazol 3 x 5 mg/hr
Moderate Metimazol 3 x 10 mg/hr
Severe Metimazol 3 x 20 mg/hr
Bumil Trimester I PTU 3x100-200 mg (300-600 mg/hr)
3A Hipertiroid PTU 600-1000 mg / Metimazol 6x20 mg
Krisis Tiroid
+ loading cairan !
Lugol/iodide 6-8 tetes/jam
Propanolol IV / 60 mg oral
Radioterapi (Pre-Op) Radioaktif : I 131
Levotiroksin 1x25-50 mcg/hr
3A Hipotiroid Levotiroksin 1x200-500 mcg IV, lanjut 100 mcg/hr sampai
Koma Mixedem
stabil
2 Hipoparatiroid Ca Glukonas 1000 mg + Vit D
Addison Disease Hidrokortison 10-25 mg
1
Hipoadrenal Krisis Adrenal Awal : Infus Nacl
3B
Hidrokortison 100 mg bolus -> 100mg/4-6jm
GEH
Step Up Antasida/Ranitidin --> PPI
Epigastric Pain PPI (ROLE-P)
Robeplazole 10 mg
Omeprazole 20 mg
Dispepsia
 Lansoprazole 30 mg
Dispepsia
Esomeprazole 40 mg
Pantoprazole 40 mg
Post Prandial Fullness Prokinetik : Domperidone/Metoklopramid 3x10 mg
Bumil Antasida/Rani only
Up Faktor Defensif Sucralfat, Misoprostol
4
Untuk PPI Test PPI dosis ganda 1-2 mg
GERD
Step down PPI dosis tunggal 4 mg--> Antasida/Ranitidin
Ulkus Gaster/
Step down PPI --> Antasida/Ranitidin
Peptik/Duodenal

Triple Therapy 1st Line: O-K-A

(Ome 2x20 +Klaritromisin 2x500+Amox 2x1000)

Quadripel 2nd Line: Ter Bom

Gastritis (H.Pylori) (Tetra 4x250 +Bismuth 2x2 + Ome+ Metro)
3rd Line: M-OKA
(Metro 3x500 +OKA)
Ulkus Gaster/
3A Step down PPI --> Antasida/Ranitidin
Peptik/Duodenal
Tipe Diare Loperamid (Agonis opioid)
(+infeksi/berdarah) Atapulgit 600 mg (New Diatabs)
3A IBS Bisacodyl (Dulcolax), Proetilen Glikol (PEG),
Tipe Konstipasi
Sodium biphosphate enema
Tipe Nyeri Perut Papaverin, Hyosine Butylbromide
Giardiasis Metronidazol 3x250 mg 5 hari

Tertrasilklin 3x500 mg 2 hari/

Diare Kolera Doksi 300 mg SD/ Azitro 1 gr SD
Anak: Azitro 15 mg/kgbb hari 1, 2-5 hari berikutnya
7.5/kgbb
ETEC/EPEC Ciprofloksasin 2x500 5 hr / Cotrimoxazole
4 EHEC/EIEC/Shigellosis Ciprofloksasin 2x500 5 hr / Cotrimoxazole
Amoebiasis Metronidazol 4x500 mg 5 hari
Disentri
Balantidiasis Tetrasiklin 4x500 mg
Metronidazol 3x500 mg 5 hari
C. Botulinum Human Botulism Ig 50mg/kg SD
C. Perfringens Penicilin G 2-4 jt unit/6 jam IV
3B Inf. Clostridium
C. Dificille/ Stop Antibiotik
colitis pseudomembran Metronidazol 4 x 250-500mg 7-14 hr
HEPATOBILIER
2 Kolelitiasis Ursodiaxy Colic Acid (Urdafalk) 250 mg
Hepatoprotektor Curcuma
4 Hep A Simptomatik
3A Hepatitis Hep B ARV : Lamivudin
Hep c ARV : Ribavirin+Interferon
Piogenik Penicillin
3A Abses Hepar Aspirasi abses jika > 5cm
Amobeik Metronidazol 3x750 mg
 Hematemesis/melena Somatostatin
Profilaksis Ensefalopati Lactulosa (u/turunkan kadar amonia)
2 Serosis hepatis
Profilaksis
ruptur varises esofagus Propanolol
HOM
Def. FE Fe Elemental 3 x 60 mg
Ferro glukonat 4 x 1 tab (12% elemntal)
4 Ferro sulfat 3 x 1 tab (20% elemntal)
Anemia Mikrositik Ferro Susinat 3 x 1 tab (22% elemntal)
3A Ferro fumarat 2 x 1 tab (33% elemntal)
Thalasemia PRC : Hb target-Hb skrng x 3 x BB
Deferoxamin (u/kelasi besi)
3A Anemia Normositik Hemolitik Steroid
Def. B12 Vit B12 (Cyanocobalamin) IM
3A Anemia
Megaloblastik Def. Asam Folat B9 (As. Folat) 1 mg/hari
Flebotomi (Target Ht < 45%)
Polisitemia Vera/
2 Aspirin 40-80 mg/hr
Kriptogenik
Hidroksiurea 2x500 mg
Von Willebrand Desmopressin 0.3 mcg/kgIV
1
Disease konsentrat vWF, kriopresipitat
SKDI DIAGNOSIS KETERANGAN
RESPIRASI

4 Pertusis

4 Bronchiolitis
Profilaksis
4 Pnemonia

Dosis FDC
5-9 kg
10-14 kg
4 TB
15-19 kg
20-32 kg
Profilaksis
(kontak + <5 thn/HIV)
Step 1. Intermitten
Step 2. Persisten ringan
4 Asma (6-11 thn)
Step 3. Persisten sedang
Step 4. Persisten berat
NEURO
Pre hospital
Hospital
Kejang Demam
4
ICU
Rumatan
Profilaksis Kejang Demam
Intermitten (tiap demam)
KARDIO
Simptomatik, rujuk !
2 Penyakit Jantung Bawaan
PDA
DIGESTIF
Tanpa Dehidrasi

Dehidrasi Ringan-Sedang

4 Diare
Dehidrasi Berat

Syok Hipovolemi
GINJAL
Sindrom Nefritik
3A
Sindrom Nefrotik

ENDOKRIN
 Sadar
Tidak sadar
4
Hipoglikemia <2 thn
/3B
2-12 thn
>12 thn
GIZI
Atasi Hipoglikemia

4 Gizi Buruk Atasi Hipotermia

Atasi Dehidrasi

Alergi susu sapi

4 Masalah Susu Formula Profilaksis alergi
Intoleransi laktosa
INFEKSI

4 Campak

3A Kawasaki Disease

2 Scarlet Fever
NICU
HDN Prematur
TTN SC elektif
MAS Mekonium
Pneumonia kongenital
 TATALAKSANA
RESPIRASI
Eritromisin 40-50mg/kgBB dalam 4 dosis (4 dd 12.5mg)
or Azitromisin 10 mg/kgBB 5 hari
Alternatif : TMP 8-SMX 40 mg/kgBB dalam 2 dosis 14 hari
Simptomatik : Oksigen, paracetamol, dsb
Kotrimoksasol 4 mg/BB/kali 2x1 or Amoxicillin 25mg/BB
Ampi 50 mg/bb/6 jam + Genta 7.5 mg/bb/24 jam
2 RHZ + 4 RH (Tanpa Etambutol)

1 FDC
2 FDC
3 FDC
4 FDC
INH 10 mg/kgBB 6 bulan
INH 10 mg/kgBB 9 bulan (Mantoux +)
ICS low dose
ICS low dose
ICS low dose + LABA / ICS Medium dose
ICS Medium dose + LABA
NEURO
Diazepam rectal 5 mg (<12 kg)/10 mg (>12 kg) bisa ulang 2 kali
Diazepam IV 0.2-0.5 mg/BB or Midazolam 0.2/BB IM/Buccal
Fenitoin + Nacl / Fenobarbital 20 mg/BB
Fenobarbital / Fenitoin + Nacl 20 mg/BB
Midazolam, Fenobarbital
Asam valproat 15-40 mg, Fenobarbital 3-4 mg/BB
Diazepam oral 0.3 mg/bb or Diazepam rectal 0.5 mg/bb
KARDIO
Oksigen, infus, morfin
Indometasin 0.1-0.2 mg/kg
DIGESTIF
<1 thn : 50-100 ml oralit/bab
>1thn : 100 ml oralit/bab
Oralit 75 ml/kgBB/ 3 jam
< 6 bln : Zink 10 mg
> 6 bln : Zink 20 mg
< 1 thn : 30 ml/kgBB (u/ 1 jam) + 70 ml/kgBB (u/ 5 jam)
> 1 thn : 30 ml/kgBB (u/ 30 menit) +70 ml/kgBB (u/ 2.5 jam)
tdk bisa infus : Rujuk + NGT 20 cc/BB/jam selama 6 jam
Guyur RL 20 cc/kgBB secepatnya
GINJAL
Eritromisin 30mg/kgBB dalam 3 dosis (3 dd 10mg)
Continous Day Prednison 2 mg/kgBB (Maks. 60 mg )
(1 bln)->Alternating dose 1.5 mg/BB (Selang-seling 1 bln)
ENDOKRIN
 Larutan Gula oral (D10% 50 cc)
Bolus Dextrose 2 cc/kgBB (selain gizi buruk)
D10%
D25%
D50%
GIZI
Sadar : Dextrose Oral (D10% 50cc)
Tdk sadar : NGT + Bolus D10% 5cc/BB
Lampu 40w jarak 50 cm, Perawatan Metode Kanguru
ReSoMal 5 cc/BB/30 menit selama 2 jam
Rehidration Solution for Malnutrition
Susu terhidrolisat sempurna ekstensif, susu asam amino
Susu terhidrolisat parsial
Susu bebas laktosa
INFEKSI
Simptomatik + Vit A
<6 bulan : 50.000 IU Vit A
<1 thn : 100.000 IU Vit A
>1 thn : 200.000 IU Vit A
Aspirin 30 mg/kg/hari bagi 4 dosis
IVIG
Penicillin, eritromisin
NICU
Injeksi surfaktan
laringoskopi direct, suction intratracheal
Meropenem
Ampi 50 mg/bb/6 jam + Genta 7.5 mg/bb/24 jam
SKDI DIAGNOSIS KETERANGAN FARMAKO
SVT (HR >150) Stabil Manuver vagal (10 min) 1 a. carotis (Cek KI dulu!)
Adenosin 6 mg IV -> 12 mg IV
or CCB (Verapamil 80-120mg/Diltiazem 10 mg)
or BB (Bisoprolol 5-10 mg PO/bolus IV 2 mnt)
tidak stabil Kardioversi 50-100J (narrow regular)
Sinus bradikardi (HR <60) Reguler Atropin 1 mg IV bolus -> dopa/epi IV
PEA (Tanpa nadi) RJP + epinefrin
AV Blok I-IIa Observasi (Stabil)/Atropin 1 mg IV (tdk stabil)
AV Blok IIb-III Pacemaker
Sinus Takikardi (HR >100) Stabil Amiodarone 300 mg/IV 10-20 menit -> 150 mg
tidak stabil Kardioversi 50-100J (narrow regular)
Atrial Fibrilasi Stabil BB -> CCB -> Digoxin ~ABCD
~Pulsus defisit AF + CHF langsung Digoxin 0.125-0.5 mg
tidak stabil Kardioversi 120-200J (narrow Irregular)
Profilaksis Emboli Ada gang. katub/mitral stenosis : Warfarin (AVK)
(u/ cegah stroke iskemik, Tanpa : Rivaroxaban, dabigartan, apixaban (AKB/Anti
CHAD2 score) koagulan oral baru)

Atrial Flutter Stabil BB selektif : Bisoprolol 5-10mg PO/atenolol 25-50mg

PO/Metoprolol 2x50-100mg PO
CCB : Verapamil 2x40/Diltiazem 3x30
tidak stabil Kardioversi 50-100J (narrow regular)
VT Stabil Amiodaron 300 mg/Prokainamid 20-50mg
tdk stabil + nadi kardioversi 100J (Wide regular)
Torsade stabil MgSO4 20% 1-2g/IV
tanpa nadi/Irreguler Defibrilasi 200J (Bifasik)/360J (Mono)
Defibrilasi 200J (Bifasik)/360J (Mono) tiap sblm RJP
VF/VT tanpa nadi Epi (baru mulai di RJP kedua) -> [RJP+Amiodaron
Shockable 300] -> [RJP+Epi] -> [RJP + Ami 150] -> [RJP+Epi] ->
Cardiac Arrest [RJP+o] -> [RJP+o] -> dst
3B
Asitol/PEA RJP + epinefrin 1mg (segera)-> [RJP+o]
Non Shockable -> [RJP+Epi]-> [RJP+o]-> [RJP+Epi]-> [RJP+o] dst
Premature Complex PVC/VES, PAC BB, CCB non DHP (Verapamil)
Hipokalemia KCL IV 20 mEq/jam
(Gel. U, K <3.5)
Hiperkalemia Ca Glukonas 10% 20 ml IV 10 menit /
Gang. Elektrolit Insulin 10 IU dlm 50 ml D40 (Jika EKG msh normal)
(T Tall, K >5.5)
Hipokalsemia
(Long QT interval) Ca Glukonas 10% 20 ml IV 10 menit

Tatalaksana awal Oksigen (sO2 <90%)

Aspirin 160 -320 mg
Nitrat sublingual 5 mg maks 3 kali, (Cek KI dulu!)
Clopidogrel 300 mg
Morfin (injeksi 2-4 mg/oral 5-10 mg) (?)
< 12 jam : Primary PCI
Definitif STEMI Jika jarak rujuk u/PCI >2 jam + Fibrinolitik dulu

ACS
 Fibrinolitik: Streptokinase 1.5 jt 30-60min
ACS
or Altaplase 15 mg IV bolus (KI: Riw. Stroke < 6 bln)
>12 jam : Antikoagulan
Definitif Antikoagulan LMWH 5 hari
NSTEMI/UAP - Fondaparinux (Arixtra) 2.5 mg SC) KI: CKD
- Enoxaparin (Lovenox) 1 mg/kg 2x1 Ada babi
NSTEMI + HF bisa primary PCI
Angina Prinzmetal CCB (u/kontroller)
Profilaksis Aspirin 80 mg
Oksigen / Intubasi
Nitrat sublingual / Nitrogliserin
Edema Paru
Furosemid IV 0.5-1 mg/kgbb
Morfin IV 2-4 mg
Sesak/udem Furosemid IV 0.5-1 mg/kgbb
A : ace-i/ARB
B : Beta bloker
3A CHF S : Spironolakton
D : stop semua ganti Digoksin
AF + CHF Digoxin 0.125-0.5 mg PO
Intoksikasi digoksin Charcoal,kolestiramin,anti aritmia
HCT (Tiazid 12.5-50 mg)
ACE/ARB (Captopril 2x25/Candesartan 8 mg)
Primer/Esensial BB (Bisoprolol/ Propanolol)
CCB (Amlodipin 5-10 mg/Verapamil/Diltiazem)
4 Hipertensi
Urgency Captopril sublingual
Emergency Nicardipin IV 0.5 mcg (Perpidin)
or Diltiazem IV 5-15 mcg (Herbesser)
Penyakit Jantung Rematik Penisilin -> eritromisin jika alergi
Profilaksis Penisilin 1x/bulan selama 5 tahun
selama 10 tahun (jika ada tanda karditis)
PAD ->TO/ALI/CLI Awal Cilostazol 2x100 mg PO
3A
Definitif Revaskularisasi (Stent)
CVI (Insufisiensi vena kronis) Awal Stocking compresion/Inj. skelroterapi
Definitif Striping vena
DVT Heparin 5.000 U IV
>100 Nitrogliserin 10-20 mcg/menit IV
>70-100, Hangat Dobutamin 2-20 mcg/kg/min IV
>70-100, Dingin Dopamin 5-15 mcg/kg/min IV
3B Syok Kardiogenik <70 Norepinefrin 0.5-30 mcg/kg/min IV
<90, Hangat Dobutamin 2-20 mcg/kg/min IV
<90, N<50 kali Dopamin 5-15 mcg/kg/min IV
<90, N>50 kali Norepinefrin 0.5-30 mcg/kg/min IV
SKDI DIAGNOSIS KETERANGAN
Terkontrol*
Intermitten
Persisten ringan
Persisten sedang
Persisten berat

Serangan
Awal
4 Asma

Ringan
Sedang
Berat
Controller

Reliefer

CURB 65 : 0-1
.+ komorbid/riwayat antibiotik
3 bln
CURB 65 : >2
CURB 65 : >2 + Sepsis
Pneumonia
4
komunitas LEVEL

Curiga MRSA
Kat 1
Kat 2
Anak
Dosis KDT
<37 kg
37-55
55-70
TB Paru tanpa >70
4
komplikasi Drug Induced Hepatitis
Ikterus
Non ikterus
x RHZ
x RZ
 xH
Neuritis Perifer
TB Milier (Ekstra paru)
Bronkhitis akut,
4 Simptomatik
Bronkiolitis akut
Grup A. GOLD I: FEV1 >80
Grup B. GOLD II: FEV1 50-80
3B PPOK
Grup C. GOLD III: FEV1 30-50
Grup D. GOLD IV: FEV <30
Probable & Confirmed
3B Flu Burung
Profilaksis/suspek
3B Abses Paru
Pneumonitis
2 hipertensif
 TATALAKSANA

step 1: ICS 200-400 mcg + LABA or SABA jika dibutuhkan

step 2: ICS 200-400 mcg + LABA jika dibutuhkan
step 3: ICS 200-400 mcg + LABA dialy
step 3: ICS 400-800 mcg + LABA dialy
step 5: ICS >800 mcg+LAMA+kortiko oral
+Teofilin+Antileukotrin
*Naik step kalau terkontrol sebagian/tdk terkontrol

Oksigen 2-4 lpm, nebul SABA (Ventolyn 2.5 mg)

(Jika tdk ada nebu: SC Terbutalin (SABA) 0.3-0.5mg/
Aminofilin/Epinefrin 1:1000 0.3 )
Respon baik-> Obat pulang SABA + kortiko oral 3-5 hr
SABA + SAMA = Combivent --> rawat inap jika 3x gagal
ICU : Kortiko sistemik oral/IV, dll
ICS (Kortikosteroid inhalasi) : Budesonide, Pulmicort
B2 Agonis long acting (LABA): Folmoterol
Symbicort = Budesonide + Folmoterol
B2 Agonis short acting inhalasi : Salbutamol, ventolyn
Kortikosteroid oral/IV
Anti kolinergik : Combivent
Level 1/2

Level 1+2 /Level 3 (Oral)

Level 1+2 /Level 3 (IV)
non pseudomonas : Level 3 or Level 4
pseudomonas : Level 5
1. Beta laktam + beta laktamase (Skip?)
2. Makrolid
3. Fluorokuinolone
4. Cephalosporin Gen 3
5. Karbapenem
Linezolid / Vankomisin
2 RHZE + 4 (RH)3
2 RHZES + 1 RHZE + 5 (RHE)3
2 RHZ + 4 RH

2 tab 4 FDC - Streptomisin 500 mg

3 tab 4 FDC - Streptomisin 750 mg
4 tab 4 FDC - Streptomisin 1000 mg
5 tab 4 FDC - Streptomisin 1000 mg

Stop obat

18-24 ES
2 HES + 10 HE
6-9 RZE
Vit B6 (Piridoksin) 50-100 mg/hr
2 RHZE + 4 RH + kortikosteroid bila perlu
Antitusif/Ekspektoran, Antipiretik
Antibiotik, bronkodilator bila perlu
Vaksin influenza + SAMA/BA
LABA/MA
LAMA + ICS
LAMA + ICS + Oksigen
Oseltamivir 2 x 75 mg 5 hari
Zanamivir 2x2 puff 5 hari/ 2x4 puff 3 hr
Oseltamivir 1 x 75 mg 7 hari
Klindamisin 600 mg IV/8jam atau oral / Metronidazol
Prednison
SKDI DIAGNOSIS KLASIFIKASI FARMAKO
Abortif Non spesifik Ibuprofen, dsb.
Abortif Clasic (aura) Sumatriptan 2 x 50-100 mg
Abortif Common Ergotamin 2 x 1 mg
Migran
Profilaksis Propanolol 40-240 mg
Amitriptilin
4 Asam valproat 500-1000 mg
Tension Type Headache Abortif PCT 1000 mg
NSAID : Ibuprofen 1-2 x 400 mg,
Asam mefenamat 3 x 500 mg
Mucle relaxant
Profilaksis Amitriptilin 30-75 mg
Cluster Abortif O2 100% sungkup 10-12 lpm 15-20 menit
Triptan / Ergotamin
Profilaksis CCB : Verapamil, diltiazem
Litium / Kortikosteroid / Amitriptilin
3A
Neuralgia Trigeminal Carbamazepin 2 x 100 mg, max 600-1200
Gabapentin, Amitriptilin
Neuralgia Post Herpetik Gabapentin 300 mg, ditingkatkan 600 mg
Asam valproat / Amitriptilin / Carbamazepin
Kejang Parsial Carbamazepin 2 x 100 mg,
maintenance 800-1200 mg
Fenitoin
Petit Mal Etosuksimid 1-2 x 250 mg
maintenance 20-30 mg/kg
3A
Asam valproate
Grand Mal / Mioklonik / Asam valproate 15 mg/kg/hari 2-3 kali,
Atonik max 60 mg/kg
Fenitoin 300-400 mg
Kejang ibu hamil Lamotrigin/Gabapentin/fenitoin
Status Epileptikus Stage II Diazepam 0.15-0.2 mg/kg, max 10 mg
3B Stage III Fenitoin 20 mg/kg, max 1500 mg
Stage IV Midazolam
Rabies Tatalaksana awal Cuci air mengalir + sabun 10-15 menit
(Hewan tdk ditangkap) Resiko Minimal VAR 0,5 ml 4 dosis : hari 0 (2x), 7 (1x), 21 (1x)
3A
Resiko Tinggi VAR + SAR heterolog 40 IU/kgBB,
homolog 20 IU/kgBB
Tetanus Kejang Diazepam IV 0,1-0,3 mg/kg/kali tiap 2-4 jam
Antibiotik Penisilin Prokain 50.000 IU/kg/kali tiap 12 jam
3B Metronidazole loading 15mg/kg/jam
lanjut 7,5mg/kg/6 jam 7-10 hari
ATS (skin test!) 50.000-100.000 IU dibagi 3 dosis 0-7-21
HTIG 3000-6000 IU IM
Meningitis Bakteri Ceftriaxone + Vankomisin + Deksametasone
Bayi < 3 bulan Ampisilin + Cefotaxime
3B
TB OAT Kat 1 selama 9-12 bulan + Kortikosteroid
Criptococcus (jamur) Amfoteresin B + Flukonazol ~ tinta india
2 Cerebral toxoplasmosis Multiple ring enhacment Primetamin + sulfadiazin/klindamisin
2 Abses cerebri Soliter Ring enhacment Metro 500mg/8 jam IV + ceftriaxone IV
Guillain Barre Syndrome Plasmafaresis (200-250 ml plasma/kg 7-14 hari)
3A
IVIG / Kortikosteroid
Acetilcolin Esterase Inhibitor 'stigmin'
neostigmine, pyridostigmin
3A Myasthenia Gravis + Timektomi (bila perlu)
Krisis Myastenik Ventilator + KS dosis tinggi + plasmafaresis/IVIG
Krisis Kolinergik Ventilator + atropin
Prednisone 60 mg/hari selama 5 hari
4 Bell's Palsy tapp off 5 mg/hari (selama 2 minggu)
+ Eye patch/artificial tear
Demensia Donepezil 5 mg
2 Acetilcolin Esterase Inhibitor
Galantamine
Sindrom Parkinson < 50 Amantadin
50 - 59 Bromokriptin
3A
>60 Levodopa
Ter sedikit side effect Pramipeksol u/muda
Stroke Iskemik < 3 jam rTPA: Altaplase 0.6-0.9 mg/kg
> 3 jam Aspirin 80 mg, Clopidogrel 75 mg
Stroke Hemoragik Intraserebral Anti fibrinolitik : Asam traneksamat
Subarachnoid CCB : Nimodipin 15 mg/kg/jam, naik 30 mg
3B Primary Survey (ABCD)
Awal Mannitol 20% loading 0,5-1 gr/kg/20 menit,
lanjut 0,25-0,5 gr/kg/4-6 jam or NaCL 3%
+ Posisi semi fowler!
TIA Antiplatelet (Aspirin)
akibat emboli: antikoagulan (warfarin)
<3 jam: Metilprednisolone IV bolus 30 mg/ 15
menit, 45 menit istirahat, LANJUT 23 jam berikutnya
Trauma Medula Spinalis Bulbocavernosus (+) 5.4 mg/kg/jam
3B

3-8 jam: LANJUT 47 jam berikutnya 5.4 mg/kg/jam

DD Syok spinal Bulbocavernosus (-) Vasopressor
Wrist splint 3-4 minggu
3A CTS Injeksi Cortico
Analgetik: Na Diklofena, Gabapentin
3A HNP NSAID
Periodik Paralisis KSR 3 x 1
Chorea Huntington Haloperidol
Syndenham Chorea Penisilin (demam rematik) + Haloperidol
Tremor Propanolol 60-80 mg
SKD
I DIAGNOSIS
Intoksikasi Obat Depresan
Intoksikasi Obat Stimulan
2 (Amfe/MDMA, kokain,
ketamin)
Intoksikasi Obat Halusinogen
KETERANGAN
Opioid Intoksikasi
Opioid Withdrawl
Alkohol Intoksikasi
Alkohol Withdrawl
Benzo Intoksikasi
Benzo Withdrawl
Intoksikasi
Withdrawl
(Ganja, LSD)

Kecanduan Rokok

Sianida
Jengkolat
Organofosfat

Psikosis AP 1/Tipikal

4
AP 2/Atipikal

Organik (Delirium)
Ekstrapiramidal Syndrome Umum
Akatisia only
Distonia Akut only
Distonia, Akatisia
4 Parkinsonism,
rabbit syndrome

Neuroleptic Malignant
Syndrome

Depresi ringan sedang SSRI

4
Trisiklik
Gangguan Afektif Bipolar Tipe 1/kini mania
Tipe 2/kini depresi
Mood Stabilizer
3A

Gangguan Cemas Benzodiazepine

3A
3A

Gangguan Tidur Short/Early/Sleep onset

insomnia
2
Middle/Maintenance

Late/Terminal
2 Narkolepsi, Hipersomnia
2 Gang. Somatoform
2 Gang. Kebiasaan & impuls Trikotilomania, dkk
Bulimia, binge eating, dll.
3A
Gang. Makan & body dismorfik Anoreksia Nervosa
Stimulan
2 ADHD
Non stimulan
2 ASD
1 Gang. Motorik: Tic/Tourette
Gang. Post partum Baby blues
3A Depresi
Psikotik
2 Fobia Spesifik
Akut
3B PTSD Stabil/kausal
 FARMAKO
Naloxone 0.4-0.8 mg, bisa 2 mg, maks 10
Metadone 20-30 mg, maks 50 / Klonidin
Thiamin (B1) / Etanol-metanol/Fomipezol
Benzodiazepin 5-20 mg 4-6 jam
Flumazenil 0.2 mg IV
Fenobarbital
Simtomatik
Bromokriptin

Simtomatik
Buspiron, Bupropion 2x150 mg/
Vareniklin Tartat 2x1 mg 12 minggu
Natrium Thiosulfat
Natrium Bikarbonat
Sulfa atropin 2 mg
Haloperidol HCL (Butyrohenon) 5-15 mg IM/4 -6
jam Maks 20 mg/hari!
Clorpromazin (Phenotiazin) 150-600 mg, atau 50-
100 mg IM, tiap 4-6 jam
Risperidon 2x2 mg
Clozapin 1-2 x 12,5 mg,max 600 mg/hari
Olanzapin 10-20 mg
Haloperidol tab 0.5-1.5 mg
Trihexyphenidyl 2x2 mg
Propanolol (Beta bloker)
Sulfas atropin (Benztropine), difenhidramin
Clonazepam, lorazepam
Difenhidramin, Amatadine
Awal : Stop Anti psikotik !!
Dantrolen/Bromokriptin/
levodopa/karbidopa/Benzodiazepin
Fluoxetine 1 x 20 mg
Setraline 1 x 25-50 mg
Amitriptilin 2 x 25-50 mg
Mood Stabilizer + Anti psikotik
Mood Stabilizer + anti depresan
Litium 250-500 mg
Lamotrigrin 1x25 mg
Asam valproat 3 x 250 mg
Carbamazepin 2-3 x 400-600 mg
Short : Alprazolam 3 x 0.25-0.5 mg
Long : Diazepam 2-3 x 2-5 mg / Estazolam
Chlordiazepoxide 2-3 x 5-10 mg,
Lorazepam 2-3 x 1 mg,
Clobazom 2-3 10 mg
Short benzodiazepine: Triamzolam, Midazolam
Intermediet benzodiazepine : Alprazolam
Long benzodiazepine :
Diazepam/Estazolam/Fenobarnital
Anti depresant: Amitriptilin/SSRI
Metilfenidat/Modafinil
SSRI/Amitriptilin
SSRI
SSRI
Stabilkan Kondisi umum, Amitriptilin
Metilfenidat 0.3-0.7 mg/kgbb/hr
Atomoksetine 10 mg
AP 2 (Risperidon/Aripriprazole) + SSRI
AP 1 (Haloperidol)
konseling
SSRI
AP 1
Benzodiazepin (Alprazolam, Diazepam 3x5 mg)
Desensitasi, Exposure therapy
SSRI
SKDI DIAGNOSIS KETERANGAN
MATA MERAH + VISUS NORMAL
Anterior (Seboroik)
4 Blefaritis Anterior (Ulseratif)
Posterior
4 Trikiasis, Distrikiasis
2 Entropion, Ectropion Rujuk
Virus

Bakteri
Chlamidia (Trakoma)
4 Konjungtivitis Infeksi

GO

4 Konjungtivitis Alergi

Konjungtivitis Sicca
4
(Dry Eye Syndrome)
4 Episkleritis
3A Skleritis
Awal
3A Pterygium
Definitif
2 Pinguekula Rujuk
MATA MERAH + VISUS TURUN
Bakteri

Virus
3A Keratitis
Jamur

Acanthamoeba

Dosis
3A Xeroftalmia

Xn - X1A
X1A + Campak/ > X1A
Anterior (Iridosiklitis)
3A Uveitis
Posterior (Koroiditis)

3B Glaukoma Awal
3B Glaukoma Awal

2 Endoftalmitis Rujuk
2 Panoftalmitis Rujuk
MATA TENANG + VISUS TURUN MENDADAK
2 Ablasio Retina Rujuk
2 CRVO, BRVO Rujuk
2 Neuritis Optik Rujuk
MATA TENANG + VISUS TURUN PERLAHAN
Miopia
4 Kelainan Refraksi Hipermetropia
Astigmatism
40 thn
4 Presbiopia 50 thn
60 thn
2 Katarak Rujuk
AMD (Age-related Macular
2 Rujuk
Degeneration)
ADNEKSA
3A Dakrioadenitis (virus),
Dakriosistitis (bakteri)

4 Hordeolum H. Eksterna
H. Interna
3A Kalazion
2 Epikantus Rujuk
2 Xantelasma Rujuk
TRAUMA
4 Perdarahan Subkonjungtiva
4 Benda Asing Konjungtiva
Trauma tajam/penetrasi
2 Benda Asing Kornea Rujuk
Awal
3A
Hifema

Bedah

3B Trauma Asam/Basa
 TATALAKSANA
TA MERAH + VISUS NORMAL
Cuci sampo bayi, kompres hangat + Ab topikal
Cuci sampo bayi, kompres hangat + Ab topikal + Ab oral
Eyelid massage arah vertikal + Ab topikal + Ab oral
Epilasi
Rekonstruksi Palpebra
Adenovirus : Artificial Tear
Varicella Zoster virus : Asyclovir Salep 3% 5x1 (10 hr)
Ab topikal (Kloramfenikol 4 dd 1 selama 7 hr)
Ab topikal (Eritromisin 0.5%/Tertrasiklin 1%)
Ab oral (Doksisiklin 2x100 mg 21 hr, Eritromisin 50
mg/kgBB/hr)
Irigasi Nacl 4x/hr + Ab topikal (Kloramfenikol)
+ Ceftriaxon IM. Bisa tambah Azitromisin 1 gr IM
Neonatus : Irigiasi + Cefotaxim 100mg/kgBB IM SD
Hindari Alergen
Mast cell stabilizer (Sodium Cromoglikat 2%)
+ Antihistamin topikal + Steroid topikal
Artificial Tear (Karboksimetilselulosa, sodium hialuronat)

Kortikosteroid topikal + kompres dingin

Kortikosteroid sistemik + NSAID
Artificial Tear (Karboksimetilselulosa, sodium hialuronat)
Ekstirpasi + conjungtival graft
Eksisi
ATA MERAH + VISUS TURUN
Ab topikal (Polygran) + oral
GO : Ceftriaxone 1gr IV/12 jam 3 hari (rawat inap)
Antiviral topikal (Asyclovir ED 3%) + oral
Candida Albican : ampoterecin B 1.5% ~ Alam
Aspergillus : Natamycin 5%
Amoebisida (Poly Hexa Methylen Biguanide) 0.02%
Vit A 30.000 unit/hr selama 1 minggu
<6 bulan : 50.000 IU Vit A
<1 thn : 100.000 IU Vit A
>1 thn : 200.000 IU Vit A
1 kali pemberian
Hari 1, 2 dan 15 / Hari 0,1 dan 14
Steroid topikal
Sulfas atropine: Siklopentolat 1% (u/midriasis + sikloplegik)
Steroid topikal + sistemik
Stop produksi cairan :
Acetazolamid HCL 500mg PO, lanjutkan 4x250 mg/hr
Timolol Maleat 0.5% 2x1 tetes/hr
 Keluarkan cairan :
Pilocarpin 2% (u/miosis)
Latanoprost (diuretik)
Anti mual-muntah + Analgetik + KCL
In. Ab Intravitreal (Vancomysin), Eviserasi
Enuklease
NANG + VISUS TURUN MENDADAK
Retinospeksi pneumatik, scleral buckling
Fotokoagulasi, atasi sebab dasar, O2
Steroid
NANG + VISUS TURUN PERLAHAN
Lensa sferis terkecil
Lensa sferis terbesar
Lensa silinder
Lensa +1.00 D
Lensa +2.00 D
Lensa +3.00 D
Ekstraksi Katarak (ECCE, ICCE, Fakoemulsifikasi)
Fotokoagulasi, Anti VEGF

ADNEKSA
Kompres hangat + Ab sistemik + Insisi bila abses

Kompres hangat + Ab topikal + Insisi

Insisi horizontal
Insisi vertikal
Kompres hangat + Inj. steroid + Insisi kuretase
Koreksi bedah
Diet rendah lemak + Eksisi
TRAUMA
Tidak perlu (Sembuh spontan 1-3 minggu)

Anestesi topical + ekstraksi dgn lidi kapas + Ab topikal

Ab sistemik

Bedrest, posisi semifowler

sikloplegik topikal + turunkan TIO
Asam traneksamat
Parasintesis, trabeculectomy
Irigasi secepatnya 15-30 menit 2L Nacl 0.9% per mata
Sikloplegia, antinbiotik
EDTA u/trauma basa
SKDI DIAGNOSIS KLASIFIKASI
TELINGA (Kronik >2 bln)
Perikondritis/kondritis Aspirasi : Pus + riw. Infeksi
Hematom auricula Aspirasi : Darah + riw. Trauma
(Othematom)
3A
3B Aspirasi : Cairan kuning +
Pseudokista auricula
idopatik, tdk nyeri
Fistula preauricular

Otitis Eksterna Sirkumskripta

Difusa
4
Maligna (+ parese N.VII)
Otomikosis
Aspergillus
Candida
Serumen Obturans Jika keras
Miringitis Bullosa u/cegah infeksi sekunder!
3A

3A Herpes Zoster Otika

1. Oklusi
Otitis Media Supuratif Akut
2. Hiperemis
4 3. Supuratif
4. Perforasi

5. Resolusi
Benigna/tenang/Aman/
Otitis Media Supuratif Kronik tubotimpani/mukosa
3A Maligna/ganas/atikoantral
Otitis Media Awal
Serosa/Efusi
Definitif
3A Trauma Akustik, NIHL

4 BPPV dirumah
by dokter
Motion sickness
4

3A Meniere Disease

3A Otosklerosis
Hidung (Kronik > 3 bln)
 Rhinitis Alergi Definitif
Intermitten
(<4X/mg or < 4 bulan)

Persisten sedang berat

3A
Rhinitis Vasomotor

Rhinitis Medikamentosa

Rhinitis Atropi/ozaena/sikka

Rhinosinusitis
Kronis
Epistaksis Anterior
4

Posterior
Polip Nasal
2
Definitif
Tenggorokan (Kronik > 2 mg)
Akut
4 kronik
Tonsilitis
3A

Hidung
Tonsil/faring/laring
3B Difteri Nasofaring
Ada
Bullneck/penyulit/terlambat
berobat (>3 hr)
Tonsilitis Fungal
Faringitis Bakteri
Virus
Jamur
4 Kronik
3A
Laringitis

Epiglossitis (Pseudocroup)
Obstruksi jalan napas

Sindroma Croup
3B batuk menggongong
(Laringo-trakeo-bronkhitis)
4 Pertusis batuk melengking
 FARMAKO
(Kronik >2 bln)
Salep gentamisin + Ciprofloksasin 2 x 500
Kompres dingin + bebat tekan 5 hari
Definitif : Aspirasi
Insisi Drainase
Bersihkan antiseptik
Komplikasi abses : Insisi Drainase
Ab topikal (Basitracin, neomisin, Polymixin B)
Definitif : Insisi drainasi jika furunkel blm pecah
Berat : Ampisilin 4 x 250mg
Tampon antibiotik (Ofloxacin) / burowi
Berat : Ampisilin 4 x 250mg
Ciprofloxacin
As. Asetat 2% (Ear/aural toilet) + Antijamur
Miconazole
Nystatin
Carbol gliserin 10% / H2O2 3% 3 hari
Antibiotik (Amoksisilin)
Antinyeri + dekongestan
Asiklovir 5x800 / Valak 3x1000 7-10 hr
Dekongestan
(Tetes efedrin 0.5-1%/ oksimetazolin)
Analgetik + Antibiotik oral
Miringotomi (Rujuk) + Antibiotik oral
H2O2 3% 3-5 hr (Ear Toilet)
+ Ab topikal (Ofloxacin)
Observasi
Miringoplasty
Mastoidektomi, timpanoplasty
Dekongestan + anti histamin (jika riw.alergi)

Grommet/Pipa telinga (watchfull waiting 3 bln)

Neuroprotektor (Vit. B complex)
Betahistine 3x6 mg
Brandt daroff
Manuver Epley
Scopalamine (Hyoscine butylbromide)
Antihistamine, dimenhidrinate
Diazepam, betahistine u/akut!
Diuretik (HCT), Diet rendah garam
Natrium fluoride, stapedektomi
Kronik > 3 bln)
 Hindari Alergen

Anti Histamin, Nasal dekongestgan

Topikal : Phenilefrin 0.5%
Sistemik : Pseudoefedrin tab 2 x 60 mg
Kortikosteroid Topikal
Fluticason/mometason spray 1x2 spray
Nasal Dekongestan sistemik, KS topikal,
Antihistamin (jika rinore/bersin)
Stop obat (Phenilefrin/Efedrin/Napazoline)
Kortikosteroid Topikal
Cuci hidung + Antibiotik (Amininoglikosida/cipro)
+ Vit A
Antibiotik spektrum luas + simptomatik
FESS (Fungsional endoscopy sinus surgery)
Awal : bebat tekan (Manuver Trotter)
Tampon anterior/borzalf (2 Hr)
Kaustik AgNO3 jika tampak sumber perdarahan
Tampon Belloq (3 Hr)
Kortikosteroid intranasal
Polipektomi
an (Kronik > 2 mg)
Antibiotik spektrum luas 3-5 hr
Antibiotik spektrum luas 7-10 hr
Amoksisilin 3x500 mg/
Cephalexin/Cefadroksil/Azitromisin
ADS (skin test !) + Penicillin/eritromisin
ADS 20.000 IU Intramuskular
ADS 40.000 IU IM/IV
ADS 60.000 IU Intravena

ADS 80-100.000 IU Intravena

Nystatin drop 100.000 U/ml (7-14 hr)

Antibiotik spektrum luas
Simptomatik (Analgetik/antipiretik)
Anti-Jamur
Agen Kaustik
Istirahat bicara 2-3 hr (Vokal rest)
Simptomatik, stop rokok/obati GERD
Antibiotik spektrum luas
Intubasi/trakeostomi
Ringan/sedang:
Dexamethason 0.6 mg/kgBB SD
Berat: Tambah Epinefrin/adrenalin
(Nebu 20 min 2 ml 1 : 1000 dalam 2-3 cc NaCl)
Eritromisin 4 x 500 mg (40-50mg/kgBB/hr)
SKDI DIAGNOSIS KETERANGAN
PIODERMA
Furunkel Krusta
Folikulitis
Furunkulosis Bersih
4
Karbunkel Mau Aja Bagi Kolor
Impetigo Krustosa 2-3x selama 7-10 hari
Ektima
Selulitis Luas
Erisipelas
3A
Flegmon Erisipelas
*by Streptococcus Karbunkel
3A Eritrasma

4 Paronikia
Pus
VIRUS
Asik Valak
7 hari

Topikal
4 Varicella, Herpes Zoster
Anak
6-12 thn
2-6 thn
<2 thn
3A Neuralgia post herpetik

Asik Valak
4 Herpes Simpleks
tanpa komplikasi Primer : 7 hari
Sekunder : 5 hari
3A Hand, Foot, & Mouth
Disease
Farmako
3A Moluskum Kontagiosum
Non-Farmako

3A Veruka Vulgaris
Hamil
Non-Farmako
JAMUR

Topikal

4 Tinea
4 Tinea
Sistemik (14 hari)
Capitis/Pedis : 4-8 minggu
Corporis/Cruris : 2-4 minggu

Kuku Tangan : 2 pulse (bulan)

2 Tinea Unguium
Kuku Kaki : 3-4 pulse (bulan)

Topikal
4 Pitryasis Versikolor
Sistemik (5-7 hari)

Topikal
4 Kandidosis kutis

Oral trush
3A Kandidiasis mukokutan

PARASIT

Scabies

Pedikulosis capitis, pubis

4
Topikal
Farmako
Cutaneus Larva Migran

Insect bite/Pruritus herba

DERMATITIS EKSIM
Dermatitis Atopi
3A
Dermatitis Kontak DKA, DKI
3A

3A Dermatitis Popok/
Napkin eczema
3A Neurodermatitis/LSK
3A Dermatitis Statis
4 Dermatitis Numular/
Discoid eczema
4 Dermatitis Venenata
4 Pitiriasis Alba

LESI ERITRO-SKUAMOUS
4 Pityriasis rosea
4 Dermatitis seborik ringan KOH +
Anak

3A Psoriasis vulgaris Sedang

Berat >10%
MORBUS HANSEN
PB 1 lesi
(Single skin lesion)

Morbus Hansen/Lepra PB 2-5 lesi

4
tanpa komplikasi Hari 1: RD, Hari 2-28 :D
MB
Hari 1: RDK, Hari 2-28: DK

Tipe 1 : Reversal
3A Reaksi Lepra
Tipe 2 : ENL
LAINNYA
Ringan
4 Acne vulgaris

Sedang

3A Acne vulgaris
Berat
Konglobata
Hamil

3A Rosasea

Kortikosteroid + AH oral
3B Reaksi Obat
Topikal
2 Dermatitis Herpetiformis
Pemphigus vulgaris
2
Pemphigoid bullosa

4 Urtikaria Akut

3A Urtikaria Kronis > 6 minggu

3B Angioedema

Kristalina
Miliaria Rubra
4
Kel. Ekrin Profunda
 Miliaria
4
Kel. Ekrin
Pustulosa

Hidradenitis supurativa
3A
Kel. Apokrin
Abses
3A Dermatitis Perioral Antibiotik topikal

Areata
3A Alopesia
Androgen

Lentigo/Melasma/
Frackles
3A Hiperpigmentasi

Post Inflamasi
Vitiligo
3A Hipopigmentasi

Farmako
3A Hiperhidrosis

Non Farmako

Pompholix
4 Dishidrosis Chronic Vesicobullous
Chronic hiperkeratotik
ID reaction
4 Clavus (Mata ikan)
DUH/SEKRET
SKS dan ADE
GO

Alternatif
ADE
NGO

MeMe
Trichomoniasis
4
MeMeKli
Bakterial Vaginosis

KoKoFIN

Candidiasis
Vulvovaginalis

Fluko dan Itra

ULKUS
Asik Asik Valak

HSV
 HSV
Pertama
Rekurren
Seas
Ulkus molle/Chancroid
4

Ba Pa Do Er
Ulkus Durum/Sifilis (St.I)

3 As Dos buCin
Granuloma
Inguinale/Donovanosis

BUBO & KUTIL

14 Do Er Tetra
2 LGV

Lilin TICA ber TOXIN

3A Kondiloma Akuminata

Non-Farmako (hamil 1st line)

 TATALAKSANA
PIODERMA
PK 1: 5000
Rivanol 1% / Asam Salisilat 0.1% / Povidon iodine 1%
Mupirocin 2%
Asam Fusidat 2%
Basitrasin 2%
Kloramfenikol 2%
Dewasa : Dikloksasilin/kloksasilin 4x250 mg
Anak : Amoxcilin 3 x 500 mg, Eritromisin 20-50 mg/kg)
Penisilin Prokain 600.000 Iu/12 jam (5 hari)
Insisi Drainase
Topikal : Tetrasiklin 3%
Sistemik : Eritromisin 4x250 14 hr / 4x500 7 hr
Atasi faktor predisposisi
Antiseptik + Ab oral (Fluklosasilin 4 x 500 mg)
Incisi Drainase
VIRUS
Asiklovir 5 x 800 mg
Valasiklovir 3 x 1000 mg
Famsiklovir 3 x 250-500 mg
Bedak salisil 2%
Asiklovir 4x20 mg/kgBB
4 x 800 mg
4 x 400 mg
4 x 200 mg
Kompres dingin
Gabapentin 3x100, Amitriptilin 75 mg, steroid
Asiklovir 5 x 200 mg

Asiklovir 3 x 400 mg
Valasiklovir 2 x 500 mg
Simptomatik
Cegah makan/minum asam
Cantharidin 0.7-0.9%, Adapelen 0.1%, Podofilin 10-25%
Kuretase, Cryosurgery, Enukleasi
Asam salisilat keratolitik >2%
AgNO3 25%
TCA 50%
Cryotherapy, skapel, kauter
JAMUR
Antifungal + Hepatoprotektor (Vit.B com/curcuma)
Terbinafin 1%
Klotrimazole 1%
Ketokonazole 2%, Mikonazole 2%
 Griseofulvin 1-2 x 500 mg (10-25 mg/kgBB/hari)
Terbinafin 250 mg
Ketokonazole 200 mg
Itrakonazole 100 mg
Ketokonazole 2%
Terapi denyut : Terbinafin 2 x 250 mg 1 minggu, off 3
minggu (1 pulse/siklus)
Alt : Itrakonazole 2 x 200 mg
Shampo selenium sulfida 1.8% (2-4x/minggu)
Gol. Azole : Shampo Ketokonazole 2% (2x, 2-4 minggu)
Ketokonazole 200 mg
Itrakonazole 200 mg
Ketokonazole zalf 2%
Ketokonazole 200 mg
Nistatin drop 4 x 400.000 IU (100.000 IU/ml) 7 hari
Nystatin drop 4x2 ml (anak), 4x4 ml (dewasa)
PARASIT
Permethrin 5% (hamil) 8 jam
Sulfur Presipitatum 4-20% (anak <2 bulan) 3 hari
Gameksan 1% (x hamil)
Benzil benzoal 20-25% (3 hari)
Permethrin 1% (hamil) 2 jam u/capitis, 10 menit u/pubis
Gameksan 1% (x hamil, anak <6 tahun) 12 jam
Malathion 0.5% semalaman
Hidrokortison, etil klorida spray
Albendazole 400 mg (3 hari)
Thiabendazole 2 x 50 mg/kg (max 3 gr) (2-5 hari)
Ivermectin 1-2 x 6 mg
Kortikosteroid topikal + analgetik + anti histamin oral
Infeksi sekunder : AB topikal/oral
DERMATITIS EKSIM
Anti Histamin
Salep kortikosteroid
Salep kortikosteroid
Antibiotik (infeksi), anti histamin (bila gatal)
Hidrokortison 2/2.5%

Clobetazole 0.05% (Steroid dosis tinggi)

Betametazone cr + elevasi tungkai
Betametazone cr + AH

Kortikosteroid topikal
Hindari pajanan matahari + pelembab
+ steroid dosis rendah
SI ERITRO-SKUAMOUS
Anti Histamin oral (CTM)
 Shampo Selenium Sulfat 1.8%
Ketokonazol 2%
Hidrocortison topikal
Clobetazole 0.05%
PUVA
Metotrexate
MORBUS HANSEN
Rifampicin 600 mg
Ofloxacin 400 mg
Minosiklin 100 mg
Rifampicin 600 mg (2x1)
Dapson 100 mg
Rifampicin 600 mg (2x1)
Dapson 100 mg
Klofazimin 300 mg (hari 1) -> 50 mg (Hari 2-28)
Aspirin (Ringan), Prednison 40 mg
Aspirin (Ringan), Prednison 40 mg, Klofazimin 800 mg
LAINNYA
Komedo : Asam retinoid topikal
Papul : AB topikal (Klindamisin, Eritromisin)
Lini 2 : Azeleic Acid / Asam salisilat
Komedo : Asam retinoid topikal +/- Benzil peroksida 5%
Papul : AB oral 7-10 hari ~TiDaK
Tetrasiklin 2 x 500 mg
Doksisiklin 2 x 100 mg
Klindamisin 1 x 300 mg
Isotretinoin tab + steroid oral
Steroid intralesi
BPO (Benzil peroksida) 5% (Pengganti retinoid)
Eritromisin 2 x 500 mg
Hindari faktor risiko !! Makanan pedas, alkohol
Ab topikal, Ab sistemik, steroid (=acne)
Dexametason/Prednison oral
Asam salisilat 2% + menthol
Dapson
Prednison 60-150 mg/hr
Prednison 40-60 mg/hr
Anti Histamin 1 Gen 2: Cetirizine/loratadin 10 mg
Anti Histamin 1 Gen 1 : CTM 3 x 4 mg
Kortikosteroid
Anti Histamin 1 Gen 1 : CTM 3 x 4 mg
Kortikosteroid
Gang napas : Epi 1:1000 0.3 cc IM
Tidak perlu terapi / + Lotion Menthol
Lotion Clorheksidin or Betametason 0.1%, asam salisilat
Isotretinoin, lanolin
 Antibiotik
Kortiko intralesi
Klindamisin 3 x 300 mg 4 mg
Incisi Drainase
Stop pencetus!
+ Krim Eritromisin/Clindamisin/Metronidazole
Lotion Minoksidil 2x2-5%
Lotion Minoksidil 2x2-5%
+Finasterid 1 mg/hr or Dutasverid 0.5 mg/hr
Hidroquinon 2-5 %

or Tretinoin 0.1 %
Acylic Acid
Salep kortikosteroid
Calcineurin Inhibitor (Tacrolimus)
PUVA
Alumunium klorohidrat 20% Blok kel. Ekrin!
Antikolinergik topikal (Glikopirolat)
Injeksi Botox Invasif !
Iontophoresis, laser

Kortikosteroid topikal
Calcineurin Inhibitor (Tacrolimus)
Imunosupresnat (Siklosporin)
Kronik : Botulinum Toxin A
Asam salisilat 40% / Urea 40% / Cryoterapi
DUH/SEKRET
Sefiksime 400 mg SD
Kanamisin 2 gr SD
Seftriaksone 250 mg IM SD
Tiamfenikol 3.5 gr SD
Azitromisin 1 gr SD
Doksisiklin 2 x 100 mg 7 hari
Eritromisin 4 x 500 mg 7 hari
Metronidazole 2 gr SD
Metronidazole 2 x 500 mg 7 hari
Metronidazole 2 gr SD
Metronidazole 2 x 500 mg 7 hari
Klindamisin 2 x 300 mg 7 hari
Klotrimazole spp 200 mg 3 hari
Klotrimazole spp 500 mg SD
Flukonazole 150 mg SD
Itrakonazole 200 mg SD
Nistatin spp 100.000 IU 7 hari
KI : hamil, Pilihan : Virgin
ULKUS
Asyclovir 2x500
 Asyclovir 3x400
Valasyclovir 2x500
7 hr
5 hr
Siprofoloksasin 2 x 500 3 hr
Eritromisin 4 x 500 mg 7 hari
Azitromisin 1 gr SD
Seftriaksone 250 mg IM SD
Benzatin Benzopenisilin G 2.4 Jt IM SD
Penicillin Procain 600.000 IM 10 hari
Doksisiklin 2 x 100 mg 30 hari
Eritromisin 4 x 500 mg 30 hari
Azitromisin 1 gr 3 minggu
Doksisiklin 2x100 mg 3 minggu
Siprofoloksasin 2 x 500 3 minggu
BUBO & KUTIL
Doksisiklin 2 x 100 mg 14 hr
Eritromisin 2 x 500 mg 14 hr
Tertrasiklin 4 x 500 mg 14 hr
Tingtura Pedofilin 10-25%
TCA 80-90% hamil 2nd line
podofilotoxin 0.5% (Bisa terapi dirumah)
Cryotherapy, skapel, kauter
 PASAL KETERANGAN
Pasal 133 & 134 KUHP Dokter harus buat VER
Pasal 222 KUHP Keluarga tdk bisa tolak autopsi (u/mati tdk wajar)
Pasal 352 KUHP Luka Ringan
Pasal 351/353 KUHP Luka sedang
Pasal 90 KUHP Luka berat
Pasal 287 KUHP Perkosaan
Pasal 286 KUHP Perkosaan korban tdk sadar : Penjara 9 thn
Pasal 285 KUHP Perkosaan korban sadar : Penjara 12 thn
Pasal 76 No 23 Thn 2009 Maksimum abortus UK 40 hari/6 minggu
Pasal 3 KODEKI Kemandirian profesi
pasal 20 KODEKI Dokter harus jaga kesehatan :)
Pasal 267 KUHP Surat sakit palsu : Penjara 4 thn/ 8 thn kalau ranap
Pasal 338-340 KUHP Pembunuhan : Penjara 15/20 thn
Pasal 341-343 KUHP Pembunuhan anak/Infantisida
Pasal 346 KUHP Wanita Abortus Kriminalis (tanpa indikasi medis)
Pasal 347-348 KUHP Pihak lain (Dengan/tanpa persetujuan wanita)
Pasal 349 KUHP Tenaga medis bantu Abortus kriminalis
Pasal 359 KUHP Pembunuhan tdk sengaja : Penjara 1-5 thn
UU No.29 Thn 2004 Tentang Praktik Kedokteran : STR, SIP, dsb.
UU No.36 Thn 2009 Tentang Kesehatan
Pasal 75 Dilarang aborsi kecuali indikasi
Pasal 194 Hukuman pasal 75: Penjara 10 thn, denda 1 milyar
*KUHP: Kitab UU Hukum Pidana
 DIAGNOSIS SIGN/SYMPTOM
ORTOPEDI
Fr. Colles Dinner fork deformity
Fr. Smith Garden Spade deformity
Fr. Supracondylar humerus Gunstock deformity (Cubitus varus) -komplikasi-
N. Radius Drop Hand
N. Medianus Ape/benediction/obstetric hand, OK sign (-)
N. Ulnaris Claw hand
Peroneal nerve palsy Drop Foot
Erb's palsy Waiter tip deformity
Dislokasi Shoulder Ant. Half. Bulb appereance
Dislokasi Shoulder Post. Halfmoon overlap
Carpal Tunnel Syndrome Atrofi tenar, Flick Sign, Tinnel test, Luthy's sign
Guyon Tunnel Syndrome Atrofi hypotenar
Cubital Tunnel Syndrome Claw hand + Wertenberg sign, Frommet sign
HNP Cervical Spurling test/Lhermitte, Nafzinger (+)
HNP Lumbal Laseque, Bragard sicard
Spondilolisis Scotty dog
Osteomielitis subakut Abses Brodie
Ewing sarcoma Onion Skin
Osteosarcoma Sunburst, Coddman triangle
chondrisarcoma Pop corn app.
Osteochondroma Cauliflower/mushroom app.
Osteoid osteoma, osteoblastoma Central nidus
Giant cell tumor Soap bubble app.
Multiple mieloma Punchout lytic, bence protein, BNP: egg fried
Duchene Muscular Dystrophy Gower sign
Dev. Dislocation of Hip (DDH) Barlow test, Ortolani test, Trendelenburg test (+)
Rikets/Osteomalacia (Def. Vit D3) Bowed leg, craniotabes, roseary beads
Osteogenesis Imperfecta/Brittle Sklera biru, fraktur multiple
ACL Lachman test, pivot test
PCL Posterior sag
Meniscus tear Locking, Mc murray, Thessaly, Apley
Ankle Sprain Thomson test/Simmond/Calf squeeze (+)
Tenosynovitis Canavel sign
De Quarvain Tenosynovitis Finkelstein test (+)
UROLOGI
Trauma uretra anterior Butterfly hematom
Trauma uretra posterior Floating prostat
Ruptur buli intraperitoneal Molar teeth
Ruptur buli extraperitoneal Flame shape
Torsio Appendix testis Blue dot sign
Torsio testis Angel sign, Deming sign (+)
Orchidoepididimitis Phren sign (+)
BPH 3 inverted sign
DIGESTIF
Apendisitis Kocher's, Mc.Burney, Rovsing, Blumberg, Dunphy
Psoas, Obturator sign, Ten horn sign
Pankreatitis Cullen Sign, Gray turner, Fox sign, Colon cut off sign
Ca caput pankreas Courvoiser sign
Peritonitis Pneumoperitoneum, rigler sign, falciform lig.sign,
crescent sign, cupola sign, football (babygram)
Peritonitis TB Fenomena papan catur
Ileus Paralitik Air fluid level line up/segaris
Air fluid level step ledder, Metalic sound, darm
Ileus Obstruktif contour, darm steifung,
string of beads/pearls
Ca Colon Apple core appareance/filling defect
Trauma Limpa Kehr sign, Traub sign
Trauma Hepar Boa sign
ONKO
Phylloides tumor Leaf like pattern
Lipoma Signet ring cell, slippage sign
Kista ateroma Pungta (+)
Neurofibromatosis tipe 1/ Von Café-au-lait spot
Recklinhausen sindrom
BEDAH ANAK
Hirsprung Disease Mouse tail, saw tooth, 3 Zone
Achalasia Esofagus Mouse tail/Bird peak
Atresia Esofagus Gasless abdomen, USG: Polihidramnion
Atresia Renal USG: Oligohidramnion
HPS Olive shaped mass (Zaitun) , umbrella/mushroom
sign, string sign, single bubble, caterpiler sign
Atresia Duodenum Double bubble
Red currant jelly stool, sausage sign, dance sign,
Intususepsi/Invaginasi portio like sign, doughnut sign/target sign/sandwich
sign, coiled spring
Volvulus Pseudokidney/Coffee bean, screw sign
Divertikulum Meckel Hot spot
Divertikulum Zanker Pharygeal pouch C5-6
BEDAH SARAF
Contusio Salt & Paper sign
EDH Bikonveks
SDH Crescent sign, Bikonkaf
SAH Stellata
Fraktur Basis Cranii Anterior : Racoon Eye, Bloody rhinore
Media : Battle sign, Bloody otore
Hidrocephalus (Anak) Sunset phenomenon, cracked pot sign, cerebral cry
BTKV
Efusi pleura Eliis damoiceau line, meniscus sign
Hidropneumothorax Air Fluid Level
Open pneumothorax Sucking wound
Flail chest Paradoxal breathing
 BEDAH PLASTIK
Le Fort I Floating palate (horizontal)
Le Fort II Floating maxilla (pyramidal)
Le Fort III Floating face (transversal)
 DIAGNOSIS KETERANGAN
OBSTETRI
Endometritis Pervaginam
SC

Toxoplasmosis <18 mg
>18 mg

Mastalgia (Bendungan)

Farmako

Salpingitis
 TATALAKSANA
OBSTETRI
Ampicillin 2 gr/6 jam IV + Gentamisin 5 mg/bb/24 jam IV
Clindamycin 900 mg/8 jam IV + Gentamisin

Spiramisin
Pirimetamin + Sulfadiazine + Folinic Acid

kompres hangat 5 menit, kompres dingin setelah menyusui

pompa ASI 2-3 jam sekali
Bromokriptin 2.5 mg (Agonis dopamin) stop prolaktin

Clindamycin 900 mg IV/8jam + Genta 2 mg/kg IV

or Cefotetan 2 gr IV/12jam + Doksisiklin 100 mg/12jam
DIAGNOSIS NAMA LAIN
Sindrom Metabolik X Syndrome
Cauliflower ear Wrestel ear
PCOS Stein Levental Syndrome
Herpes Zoster Shingles
Herpes Zosrer Otika Ramsay hunt syndrome
Hemofilia B Cristmas Disease
Osteogenesis Imperfekta Britttle Bone Disease
Neurofibromatosis Tipe 1 Von recklinhausen's disease
Factitious Disoreder Munchausen syndrome
Clostrididum Dificille Infection Kolitis Pseudomembran
AV Blok II Mobitz 1 Wenckebach
SV Blok II Mobitz 2 Hay Block
Agenesis renal Potter syndrome
Keratosis seboroik Keratosis Aktinik
Keratosis seboroik Gastric Outlet Obstruction
Neuralgia Trigeminal Tic douloureux
Hernia medial + Ingunial ipsilateral Pentaloon/saddlebag hernia
Congenital Talipes Equinovarus (CTEV) Club Foot
Pes Planus Flat Foot
Tarsal Coalition Spastic Flat Foot
Arteritis Temporal Giant Cell Arteritis
Tiroditis De Quarvain (Sub Akut) Giant Cell Thyroiditis
Erupsi morbiliformis Exanthema drug eruption
Eritroderma Dermatitis Exfoliata Generalisata
Toxin Epidermolisis Necrosis (TEN) Lyell Syndrome
Distimia Depresi Neurosis
Dermatitis Numular Discoid Eczema
Granuloma Inguinale Donovanosis
LSK Neurodermatitis
SSSS Ritter's disease
Konjungtivitis+Ureteritis+Arteritis Reiter's disease
Vaskulitis IgA Henoch-Schonlein Purpura
Polisitemia Vera Polisitemia Kriptogenik
Voyeurisme Skopofilia
Flu singapura hand, foot, and mouth disease (HFMD)
Hidranitis Supuratif Acne Inversa
Angina Prinzmetal Angina Inversa
Dermatitis Atopi Neurodermatitis disemintata,
prurigo besnier
Ingorwn toenail Onychocryptosis/unguis incarnatus
Tinea Pedis (Tipe Interdigital) Athlete's foot
DM Tipe 1.5 Latent Autoimmune Diabetes in Adults (LADA)
Fenomena tetesan lilin Karsvlek sign
Dix Hallpike Manuver Nylen Barany Manuver
Nyeri Goyang Portio Candelier sign
Racoon's eye Brill Hematome/Hematom kacamata
 DIAGNOSIS KATA KUNCI
Keratokonus Munson sign
AMD Drusen
Dry Eye Foamy tears
Retinitis pigmentosa Bone spicule
Trachoma Herbert pits
Glaukoma kongenital Haab's striae, buftalmos
Presbikusis Cocktail party sign
Otosklerosis Paracusis willisi, Schwarte/Flaminggo sign
Timpanosklerosis Membran Timpani : Ada semilunar, tapal kuda
Nasal vestibular Furunkulosis Rudolph sign
Fibrosis kistik Clorida keringat (>60)
DMD Gower sign
Cerebral palsy kaki gunting
Laryngomalasia Omega shape
Ankylosing Spondilitis Bamboo spine, schober test (+)
GBS Disosiasi sitoalbumin
Myestenia Gravis EMG: Harvey masland test (+)
Parkinson T.R.A.P, Myerson test
Abses cerebri Ring enhancement
Toxoplasma cerebri Multiple Ring enhancement
Criptococcus meningitis Tinta india : Gambaran telur mata sapi
Tiroiditis Hashimoto Hürthle or Askanazy cells, anti TPO (+)
Limfaedema Stemmer sign (+)
vWF Disease Ristocetin test (+)
Multiple myeloma C.R.A.B, bence jones protein, M spike, Fried Egg
Limfoma Hodgkin Owl Eyes
Limfoma burkitt (Non Hodgkin) Starry sky
Coartatio aorta Three sign
TGA Egg in a string
TOF Boot shape
Ebstein anomalt Squared shape
LVE Shmoo sign
Regurgitasi aorta Apex : Austin Flint Murmur
Emboli pulmonal S1Q3T3, Palla sign, westermark's sign,
hamptons hump sign
Bronkhiektasis Tram track line
Pityriasis rosea Skuama Collaratte, herald patch
Rubeola/campak/morbili Koplik spot, 3 C
Rubella/campak jerman Forcheimer spot, pembesaran KGB
Roseola infantum/Exantema subitum Nagayama spot
Alopecia Areata Exclamation point hair (tanda seru)
Donovanosis/Granuloma inguinal Glosed safety pin (peniti), Beefy red
Gemelli Dikorion Diamnion Lambda sign
Gemelli Monokorion Diamnion T-sign