LAMPIRAN

KEPUTUSAN PENANGGUNGJAWAB KLINIK SAMBA PRATAMA

NOMOR :
TENTANG
KEBIJAKAN OBAT HIGH ALERT DAN LOOK ALIKE SOUND ALIKE (LASA)

1. DAFTAR OBAT ELEKTROLIT PEKAT (HIGH ALERT) HIGH ALERT

PELABELAN : WARNA MERAH
CEK KEMBALI
PENYIAPAN : TERPISAH DARI SEDIAAN LAIN

KELAS BENTUK KETERANGA

No. NAMA GENERIK SEDIAA NAMA DAGANG KEKUATAN
TERAPI N
N
1 ELEKTROLIT KALIUM KLORIDA INJEKSI KCL 7.46 (7.46% 7.46% 25 ML Elektrolit
PEKAT POTASSIUM pekat tidak
CHLORIDE boleh di
INJEKTION) simpan di
ruang
40% MAGNESIUM INJEKSI Mg SO4 40 40% perawatan
SULFATE MAGNESIUM kecuali IGD,
SULFATE = Mg VK, Ok dan
SO4. 7 H2O ICU
10.0g 25 ML
20% MAGNESIUM INJEKSI Mg SO4 20 20%
SULFATE MAGNESIUM
SULFATE = Mg
SO4. 7 H2O
10.0g 25 ML
NATRIUM INFUS OTSU-SALINE 3 3% 500 ML
KLORIDA 3% (3% SODIUM
CHLORIDE)
SODIUM INJEKSI Meylon 84-BP SODIUM
BICARBONATE BICARBONATE
8,4% (84mg/ml)
SODIUM 1 mM/
ml
BICARBONATE
1 mM/ml
25 ML
2 OBAT BUPIVACAIN HCl INJEKSI BUVANEST 0,5% 20 ML
ANASTESI DECAIN SPINAL 0,5% 4 ML
HEAVY

KETAMINE INJEKSI KETALAR 100 MG / 10

ML
PROPOFOL INJEKSI PROANES 10 MG / 20 ML

RECOFOL 10 ML / 20 ML

SEVOFLURANE INHALAS SEVODEX 250 ML

I
ISOFLURANE INHALAS ISOFLURANE 250 ML
I
MIDAZOLAM INJEKSI MILOZ 5 MG / ML

3 OBAT EPINEPHRIN INJEKSI EPINEPHRINE 1 MG / ML Ada

VASOKONTRI NOREPINEPHRIN INJEKSI RAIVAS 4 MG / 4 ML
KSI
LEVOSOL 8 MG / 8 ML

4 OBAT LIDOCAIN INJEKSI LIDOCAIN 20 % 20 MG / Ada

ML
ANTI ARITMA AMIODARON INJEKSI CORDARON 150 MG / 3 ML

KENDARON 150 MG / 3 ML

5 OBAT WAFARIN TABLET SIMARC 2 MG

ANTI HEPARIN TABLET INVICLOT 25000 IU / 5
TROMBOSIT ML

1
 KELAS BENTUK KETERANGA
No. NAMA GENERIK SEDIAA NAMA DAGANG KEKUATAN
TERAPI N
TROMBOSIT N
CILOSTAZOL TABLET PLETAAL 50 MG

CLOPIDOGREL TABLET ANTIPLAT 50 MG Ada

PENTOXIFYLLINE TABLET REOTAL 400 MG

FONDAPARINUX INJEKSI ARIXTRA 2,5 MG / 0,5

ML
STREPTOKINASE INJEKSI STREPTASE 1.500.000 IU

6 DEXTROSE DEXTROSE INJEKSI D40% 40% 25 ML

HYPERTONIC
, 40%

7 LARUTAN
DYALISA

8 OBAT GLIMEPIRID TABLET METRIX 1 MG, 2 MG, 3 Ada

MG, 4 MG
ANTI
DIABETES ACARBOSE TABLET GLUCOBAY 50 MG, 100 MG
ORAL
METFORMIN TABLET FORBETES 500 MG, 850 Ada
MG
9 INSULIN INSULIN ASPART INJEKSI NOVORAPID 300 IU / 3 ML
FLEXPEN

INSULIN DETEMIR INJEKSI LEVEMIR 300 IU / 3 ML

FLEXPEN
INSULIN INJEKSI LANTUS 300 IU / 3 ML
GLARGINE
INSULIN REGULAR INJEKSI ACTRAPID HM 100 IU / 10 GR

INJEKSI ACTRAPID HM 100 IU / 3 ML

PENFIL

10 OBAT DIGOXIN INJEKSI FARGOXIN 200 MG / 5 ML

JANTUNG DOPAMIN INJEKSI DOPAMIN 250 MG / 5 ML

DOBUTAMIN INJEKSI INODEX 250 MG / 5 ML

11 OBAT CHLORALHYDRAT PULVIS CHLORALHYDRAT

SEDATIV
12 OBAT ATRAKURIUM INJEKSI TRACRIUM 50 MG / 5 ML
RELAXASI BESILAT
OTOT TRAMUS 25 MG / 2,5 ML

13 HORMON OXYTOCIN INJEKSI INDUXIN 10 IU / ML

14 OBAT FENTANIL INJEKSI FENTANYL 0,05MG/ML 2

ML
NARKOTIKA MORFIN INJEKSI MORFIN 10MG/ML 1 ML

PETHIDIN HCl INJEKSI PETHIDIN 50MG/ML 2 ML

2
2. DAFTAR OBAT LOOK ALIKE SOUND ALIKE (LASA)
a. Look alike (RUPA MIRIP)

LASA

PELABELAN : WARNA KUNING

3
ABBOTIC SYRUP 125MG/5ML
AMOXAN 250 MG CAPSUL
AMOXAN SYRUP
BIOTHICOL SYRUP
BUFECT SYRUP
CEFAT SYRUP
CLANEKSI SYRUP
CLARITIN SYRUP
EPEXOL SYRUP
RHINOFED SYRUP
ALLORIS TABLET
AMLODIPIN 5 MG TABLET
CELEBREX 100 MG TABLET
DIAZEPAM 2 MG TABLET
ERYSANBE 500 CAPLET
FEROFORT TABLET
FLUIMUCIL CAPSUL
FORBETES 500 MG TABLET
GLIMEPIRID 1 MG TABLET
LYNORAL TABLET
MEFINAL 250 CAPSUL
NEUROTAM 1200 MG TABLET
NOLIPO TABLET
PANTOZOL 20 MG TABLET
PROLIC 150 MG CAPSUL
PREMASTON TABLET
PROLACTA DHA MOTHER CAPSUL
RIMACTACID PEDIATRIC TABLET
SANPRIMA TABLET
STROCAIN TABLET
TRAJENTA TABLET
TRAMADOL CAPSUL
AMINOPHYLIN INJEKSI
AMOXAN INJEKSI 1 GR
BECLOV INJEKSI
CEFTRIAXON 1 GR INJEKSI
EPINEPHRIN INJEKSI
KETALAR INJEKSI
KETOROLAC INJEKSI
LASIX INJEKSI
RATIVOL INJEKSI
TAXEGRAM 1 GR INJEKSI
CINOLON CREAM
DAKTARIN CREAM
DESOLEX CREAM
ELOCON CREAM
FORDERM CREAM
KENACORT A CREAM
NOROID DERMA RUSH
AKILEN EAR DROP
ILIADIN DROP 0,025%
SAGESTAM EYE DROP
CENDO CENFRES MD
CENDO EFRISEL 10% EYE DROP
CENDO FENICOL 0,5% EYE DROP
CENDO FLOXA MD
CENDO LFX MD
CENDO MYCETIN EYE OINT
CENDO POLYDEX EYE DROP
CENDO POLYDEX MD
CENDO PROTAGENTA MD
CENDO TIMOL 0.5 % EYE DROP
CENDO TONOR 0,25% MD
CENDO XITROL MD
LEVOCIN INFUS
INFUSAN KAEN 3B
DUMIN SUP 125 MG
STESOLID RECTAL 5 MG
ABBOTIC SYRUP 250 MG/5ML
AMOXAN 500 MG CAPSUL
AMOXAN FORTE SYRUP
BIOTHICOL FORTE SYRUP
BUFECT FORTE SYRUP
CEFAT FORTE SYRUP
CLANEKSI FORTE SYRUP
CELESTAMIN SYRUP
EPISAN SYRUP
RHINOS JUNIOR SYRUP
EPEXOL TABLET
AMLODIPIN 10 MG TABLET ADA
CELEBREX 200 MG TABLET
PHENOBARBITAL 30 MG TABLET
GRATIZIN 10 MG TABLET
REOTAL CAPLET
CEFSPAN 100 MG CAPSUL
FORBETES 850 MG TABLET
SIMVASTATIN 10 MG TABLET. ADA
THYRAX TABLET
MEFINAL 500 CAPSUL
NEVOX XR TABLET
PURICEMIA TABLET
PANTOZOL 40 MG TABLET
PROLIC 300 MG CAPSUL
POSPARGIN TABLET
PROLACTA DHA BABY CAPSUL
RIMCUR PEDIATRIC TABLET
SANPRIMA FORTE TABLET
STUGERON TABLET
TOPAMAX TABLET
SPIRAMYCIN 500 CAPLET
CALCIUM GLUCONAS INJEKSI
COLSANCETIN 1 GR INJEKSI
ACRAN INJEKSI
CEFOTAXIM 1 GR INJEKSI
EPHEDRINN INJEKSI
DYNASTAT INJEKSI
CITICOLIN INJEKSI
NOVALGIN INJEKSI
TROVENSIS 4 MG INJEKSI
TAXEGRAM 0.5 MG INJEKSI
CINOLON N CREAM
DAKTARIN DIAPER CREAM
SAGALON CREAM
GARAMYCIN CREAM
TERMISIL CREAM
MYCO Z OINT
NOROID CREAM
CROM OPTHAL EYE DROP
ILIADIN DROP 0,05%
HYALOPH EYE DROP
CENDO EYEFRES MD
CENDO TROPINE 1 % EYE DROP
CENDO POLYGRAN EYE DROP
CENDO NATACEN MD
CENDO GIFLOX MD
CENDO GENTAMYCIN EYE OINT
CENDO XYTROL EYE DROP
CENDO POLYNEL MD
CENDO GLAUPLUS MD
CENDO PROTAGENTA 5 ML EYE DROP
CENDO TONOR 0,5% MD
CENDO TOBROSON MD
TRICHODAZOLE INFUS
INFUSAN D10, 1/5 NS (N5)
DUMIN SUP 250 MG
STESOLID RECTAL 10 MG
4
 b. Sound alike (UCAPAN MIRIP)

LASA

PELABELAN : WARNA KUNING

BENZATIN BENZIL PENISILIN PROCAIN PENICYLLIN

CEFAT CEFSPAN
CLIMADAN CERADAN
DOBUTAMIN DOPAMIN
DOPACEF TERPACEF
FLAGYSTATIN FLADYSTIN
FLAVIN PLAVIX
FUTROLIT TROLIT
HEPTASAN HISTAPAN
KALXETIN COLSANCETIN
LACTAFIT LACTACID
MEROSAN MEFUROSAN
OTOPAIN OTTOPAN
PRIDESIA FORDESIA
PULMICORT FLAMICORT
QUBI TEN Q TEN
RECOFOL RATIVOL
RYVEL RANIVEL
STREPTOMYCIN SPIRAMICYN
TRADOSIK TORASIC
TRIOFUSIN TUTOFUSIN