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RENCANA KEBUTUHAN OBAT PUSKESMAS

DINAS KESEHATAN KAB. LAMPUNG SELATAN


TAHUN 2020
PUSKESMAS : MERBAU MATARAM

PEMAKAIAN KEBUTUHAN
SISA STOK TOTAL HARGA KET
NO NAMA OBAT SATUAN RATA RATA SELAMA 18 HARGA (Rp)
(31 des 2018) (Rp)
PERBULAN BLN

1 2 3 4 5 6=((4)*18)-(5) 7 8=6*7 9

OBAT-OBATAN
1 Alopurinol tablet 100mg tablet 1,000 - 18,000 90 1,620,000
2 Alprazolam tablet 0,5mg tablet - 88 -
3 Alprazolam tablet 1mg tablet - 120 -
4 Ambroxol syrup 15 mg/ml botol - 3,500 -
5 Ambroxol tablet 30 mg tablet - 125 -
6 Aminofilin tablet 150 mg tablet 100 - 1,800 139 250,200
7 Amitriptilintabletsalut25mg(HCl) tablet - 167 -
8 Amlodipin tablet 5 mg tablet 1,200 10,000 11,600 73 846,800
9 Amlodipin tablet 10 mg tablet 4,790 (4,790) 94 (450,260)
10 Amoksisilin kapsul250mg kapsul 1,500 300 26,700 184 4,912,800
11 Amoksisilin kaplet 500mg tablet 3,500 1,500 61,500 232 14,268,000
12 Amoksisilin sirupkering125mg/5ml botol 70 250 1,010 3,400 3,434,000
Antasida DOEN tablet kunyah, komb :
13 Al OH 200 mg Mg OH 200 tablet 3,000 54,000 72 3,888,000
mg
Antasida DOEN SYR komb :
14 botol 30 9,100 (8,560) 2,025 (17,334,000)
Al OH 200 mg + Mg OH 200 mg / 5ml
Anti BakteriDOEN salep kombinasi:
15 Basitrasin 500IU/g + Polimiksin tube 60 (60) 3,035 (182,100)
10.000IU /g
Antifungi DOENKombinasi:Asam
16 pot 15 100 170 4,496 764,320
Benzoat6%+AsamSalisilat3%
Antihemoroid DOENkombinasi: Bismut
17 supp 15 10 260 3,167 823,420
subgalat 150 mg Heksaklorofen 2,5 mg
Antimigren: Ergotamin Tartrat1mg +
18 tablet 100 1,800 173 311,400
Kofein 50mg
19 Aqua proInjeksisteril,bebaspirogen vial 12 17 199 3,300 656,700
20 Asam Askorbat(VitaminC)tablet50mg tablet 2,800 17,000 33,400 105 3,507,000
21 Asam Folat tablet 0,4 mg tablet 2,000 4,000 32,000 70 2,240,000
22 Asam Mefenamat kapsul 500 mg tablet 2,400 - 43,200 223 9,633,600
23 Asiklovir krim 5% tube 25 - 450 3,300 1,485,000
24 Asiklovir tablet 200 mg tablet - - 237 -
25 Asiklovir tablet 400 mg tablet 200 3,600 349 1,256,400
26 Atapulgit 600mg tablet 1,000 18,000 136 2,448,000
Atropin Sulfat inj. i.m./i.v./s.k. 0,25
27 ampul - 1,595 -
mg/ml
PEMAKAIAN KEBUTUHAN
SISA STOK TOTAL HARGA KET
NO NAMA OBAT SATUAN RATA RATA SELAMA 18 HARGA (Rp)
(31 des 2018) (Rp)
PERBULAN BLN

1 2 3 4 5 6=((4)*18)-(5) 7 8=6*7 9

Besi (II) Sulfat200mg+AsamFolat0,25mg


28 tablet 300 30 5,370 367 1,970,790
tablet (tablet tambah darah kombinasi)

29 Betahistin Mesilat tablet 6 mg tablet 900 1,100 15,100 110 1,661,000

30 Betametason krim0,1%(sebagaiValerat) tube 48 25 839 1,340 1,124,260

32 Bisakodil tab sal 5mg tablet - 300 -


33 Bromheksin tablet 8 mg tablet - 339 -
34 Bromheksin syrup botol - 5,400 -
35 Calamec Lotion botol - 8,800 -
36 Cetrizin sirup 5 mg/5ml botol 27 (27) 2,850 (76,950)
37 Cetrizin tab 10mg tablet 100 1,800 90 162,000
38 Deksametason injeksii.v.5mg/ml ampul 10 43 137 1,500 205,500
39 Deksametason tablet 0.5mg tablet 4,000 18,100 53,900 32 1,724,800
40 Diazepam injeksi 5 mg/ml ampul - 1,735 -
41 Diazepam tablet 2 mg tablet 30 540 86 46,440
42 Difenhidramin injeksii.m.10mg/ml (HCl) ampul - 1,095 -
43 Digoksin tablet 0,25 mg tablet 200 4,400 (800) 105 (84,000)
44 Dimenhidrinat tablet 50 mg tablet - 104 -
45 Doksisiklin kapsul 100 mg tablet - 270 -
46 Domperidon suspensi 5 mg/ml botol 50 900 2,700 2,430,000
47 Domperidon tablet 10 mg tablet 1,500 2,700 24,300 85 2,065,500
Epinefrin (Adrenalin)injeksi0,1% (sbg
48 ampul 10 270 (90) 1,408 (126,720)
HCl)
49 Eritromisin kaplet 500 mg tablet 500 9,000 750 6,750,000
50 Eritromisin sirup 200 mg / 5ml botol - 7,700 -
51 Etakridin larutan 0,1% botol - 3,125 -
52 Fenitoin kapsul100mg kapsul - 550 -
53 Fenobarbital injeksii.m./i.v.50mg/ml ampul - 1,857 -
54 Fenobarbital tablet 30mg tablet - 171 -
55 Fenol Gliseroltetestelinga10% botol 5 6 84 3,200 268,800
Fitomenadion
56 tablet 200 3,000 600 710 426,000
(Vit.K1)tabletsalutgula10mg
57 Fitomenadion (VitaminK1)injeksi 2mg/ml ampul 10 20 160 3,550 568,000

58 Furosemid tablet40mg tablet 1,000 700 17,300 77 1,332,100


59 Gameksan lotion 1% botol - 3,000 -
60 Garam Oralit serbuk bungkus 300 400 5,000 257 1,285,000
61 Gentamisin injeksi 40mg/ml ampul - 3,509 -
62 Gentamisin salep kulit 0,1% tube 25 450 4,400 1,980,000
63 Gentamisin Sulfat tetesmata0,3% botol 20 (20) 2,675 (53,500)
64 Gentian violet larutan 1 % botol 5 90 3,500 315,000
PEMAKAIAN KEBUTUHAN
SISA STOK TOTAL HARGA KET
NO NAMA OBAT SATUAN RATA RATA SELAMA 18 HARGA (Rp)
(31 des 2018) (Rp)
PERBULAN BLN

1 2 3 4 5 6=((4)*18)-(5) 7 8=6*7 9
65 Glibenklamida tablet 5 mg tablet 16,000 (16,000) 119 (1,904,000)
66 Gliseril guaiakolat tablet 100 mg tablet 4,000 72,000 180 12,960,000
68 Glukosa larutan infus 5% steril botol 5 15 75 6,900 517,500
69 Griseofulvin tablet 125 mg tablet 600 330 10,470 210 2,198,700
70 Haloperidol tablet 1,5 mg tablet 100 1,800 59 106,200
71 Haloperidol tablet 2 mg tablet - 56 -
72 Hidroklorotiazida tablet 25 mg tablet 500 4,800 4,200 155 651,000
73 Hidrokortison krim 2,5% 48 200 664 2,475 1,643,400
74 Hyoscine-N-Butilbromide tablet 10 mg tablet - 2,798 -
75 Ibuprofen suspensi 100 mg/5ml botol 25 40 410 4,465 1,830,650
76 Ibuprofen tablet 400 mg tablet 2,000 36,000 122 4,392,000
77 Ichtiol salp tube 15 270 150 40,500
78 Isoniazid tablet 100 mg tablet - 72 -
79 Isosorbid Dinitrat tablet sublingual 5 mg tablet 20 360 89 32,040
80 Kalsium Laktat (Kalk)tablet 500 mg tablet 2,000 7,000 29,000 59 1,711,000
81 Kaptopril tablet 12,5 mg tablet 2,500 (2,500) 62 (155,000)
82 Kaptopril tablet 25 mg tablet 100 3,000 (1,200) 75 (90,000)
83 Karbamazepin tablet 200 mg tablet - 230 -
84 Ketokonazol krim 2 % tube 25 60 390 2,518 982,020
85 Ketokonazol tablet 200 mg tablet 300 700 4,700 270 1,269,000
86 Klindamisin kapsul 150 mg kapsul - 715 -
87 Kloramfenikol kapsul 250 mg kapsul 800 10,000 4,400 310 1,364,000
88 Kloramfenikol salep mata 1 % tube 20 50 310 1,881 583,110
89 Kloramfenikol suspensi 125 mg / 5 ml botol 8 30 114 1,798 204,972
90 Kloramfenikol tetes mata 0,5 % botol 70 (70) 3,955 (276,850)
91 Kloramfenikol tetes telinga 3 % botol 10 180 6,800 1,224,000

92 Klorfeniramina Maleat (CTM )tablet 4 mg tablet 4,500 4,200 76,800 22 1,689,600

93 Klorpromazin injeksii.m.25mg/ml(HCl) ampul - 1,243 -


94 Klorpromazin tablet salut 25 mg (HCl) tablet 100 120 1,680 434 729,120
95 Klorpromazin tablet salut 100 mg (HCl) tablet - 147 -
96 Kodein tablet 10 mg tablet - 571 -
Kotrimoksazol DOEN (dewasa) komb:
97 Sulfametoksazol400 mg Trimetoprim80 tablet 600 1,800 9,000 299 2,691,000
mg
Kotrimoksazol Suspensi komb:
98 Sulfametoksazol 200 mg+Trimetoprim 40 botol 30 100 440 2,052 902,880
mg/5ml
99 Kuinin (Kina) tablet 200 mg tablet - 559 -
100 Kuinin tablet 222mg(H2SO4.7H2O) tablet - 697 -
101 Lansoprazol 30 mg - 303 -
PEMAKAIAN KEBUTUHAN
SISA STOK TOTAL HARGA KET
NO NAMA OBAT SATUAN RATA RATA SELAMA 18 HARGA (Rp)
(31 des 2018) (Rp)
PERBULAN BLN

1 2 3 4 5 6=((4)*18)-(5) 7 8=6*7 9
102 Levertran salep 6 108 2,800 302,400
103 Lidokain injeksi2% ampul 25 200 250 1,144 286,000
Lidokain inj2%(HCl)+Epinefrin1:80.000-
104 ampul 15 270 1,145 309,150
2ml
105 Lidokain Spray 10% Botol 12 (12) 860 (10,320)
106 Loperamid tablet 2 mg tablet 300 5,400 1,145 6,183,000
107 Magnesium Sulfatinj(IV)20%-25ml vial - 3,328 -
108 Magnesium Sulfatinj(IV)40%-25ml vial - 3,796 -
109 Metformin HCl tablet 500 mg tablet 300 2,000 3,400 150 510,000
Metilergometrin Maleat tab salut 0,125
110 tablet 100 1,800 210 378,000
mg
111 Metilergometrin Maleat inj 0,200 mg- 1ml ampul 10 180 2,959 532,620

112 Metilprednisolon tablet 4 mg tablet 200 3,600 134 482,400


113 Metoklopramide tablet 10mg tablet - 80 -
114 Metronidazol tablet 500 mg tablet 300 5,400 124 669,600
115 Mikonazol krim/salep 2 % (Nitrat) tube 24 48 384 3,414 1,310,976
116 N- asetil sistein kaps 200mg kapsul - 456 -
117 Natrium Bikarbonat tablet 500 mg tablet 50 900 656 590,400
118 Natrium Diklofenak tablet 25 mg tablet 2,100 4,700 33,100 -
119 Natrium Klorida larutan infus 0,9% tablet 15 10 260 445 115,700
120 Nifedipin tablet 10 mg tablet 100 1,900 (100) 6,410 (641,000)
121 Nistatin Tablet salut 500.000IU/g tablet 80 1,150 290 850 246,500
122 Nistatin vaginal tablet 100.000 IU/g tablet 50 900 560 504,000
123 Obat Batuk Hitam(O.B.H.) cairan botol 30 100 440 3,550 1,562,000
Obat Anti tuberkulosis FDC Kategori
124 paket - 288,199 -
Anak
125 Obat Anti tuberkulosis FDC Kategori 1 paket - 389,344 -
126 Obat Anti tuberkulosis FDC Kategori 2 paket - 1,297,894 -
127 Obat Anti tuberkulosis FDC sisipan paket - 173,030 -
128 Oksitosin injeksi 10 IU/ml-1ml ampul 10 12 168 1,199 201,432
129 Omeprazol kapsul 20 mg kapsul 90 1,180 440 130 57,200
130 Papaverin tablet 40 mg tablet 200 3,600 2,200 7,920,000
131 Parasetamol drops botol - 11,600 -
132 Parasetamol syrup 120 mg/ 5ml botol 50 250 650 1,107 719,550
133 Parasetamol tablet 500 mg tablet 4,000 900 71,100 53 3,768,300

134 Piridoksin (Vitamin B6) tablet 10 mg(HCl) tablet 800 1,800 12,600 123 1,549,800

135 Piridoksin (Vitamin B6) injeksi 100mg/ml ampul - 1,445 -

136 Piroksikam tablet 10 mg tablet 1,000 6,800 11,200 323 3,617,600


137 Povidon Iodida larutan 10% 30 ml botol 20 360 2,550 918,000
PEMAKAIAN KEBUTUHAN
SISA STOK TOTAL HARGA KET
NO NAMA OBAT SATUAN RATA RATA SELAMA 18 HARGA (Rp)
(31 des 2018) (Rp)
PERBULAN BLN

1 2 3 4 5 6=((4)*18)-(5) 7 8=6*7 9
138 Povidon Iodida larutan 10% 300 ml botol 5 96 (6) 18,000 (108,000)
139 Prednison tablet 5 mg tablet 2,500 2,800 42,200 86 3,629,200
140 Primakuin tablet 15 mg tablet - 223 -
141 Propanolol tablet 10 mg (HCl) tablet - 54 -
142 Propiltiourasil tablet 100 mg tablet - 700 -
143 Ranitidin tablet 150 mg tablet 700 12,600 99 1,247,400
Retinol (VitaminA) 100.000 IU kapsul
144 kapsul - 319 -
lunak
Retinol (VitaminA) 200.000 IU kapsul
145 kapsul - 319 -
lunak
146 Ringer laktat larutan infus botol 6 10 98 7,150 700,700
147 Risperidon tablet 2 mg kapsul - 228 -
148 Salbutamol tablet 2 mg (sebagai Sulfat) tablet 500 2,000 7,000 63 441,000
Salep 2-4,Kombinasi: As Salisilat 2%
149 pot 20 46 314 2,400 753,600
+Sulfur 4%
150 Salisil bedak 2% kotak 10 80 100 4,534 453,400
Sianokobalamin (vitaminB12 )inj 500
151 ampul 5 90 1,035 93,150
mcg
Sianokobalamin (vitaminB12) tablet 50
152 tablet 1,000 3,000 15,000 46 690,000
mcg
153 Simvastatin tablet 10 mg tablet 300 5,400 110 594,000
Siprofloksasin tablet 500 mg (sebagai
154 tablet 300 5,800 (400) 265 (106,000)
HCl)
155 Tetrasiklin kapsul 500 mg kapsul - 303 -
156 Tiamin (VitaminB1) tablet 100 mg tablet 1,000 6,500 11,500 85 977,500
157 Triheksifenidil tablet 2 mg tablet - 85 -
158 Vitamin B Kompleks tablet tablet 3,000 3,100 50,900 117 5,955,300
159 Zinc tablet 20 mg tablet 1,000 1,500 16,500 524 8,646,000
J U M LAH ###

OBAT GIGI
1 DEVITALISASI PASTA NON ARSEN set - 256,790.00 -
2 ETIL KLORIDA SEMPROT botol 2 36 177,000 6,372,000
3 EUGNOL CAIRAN botol - - 18,824.00 -
4 GLASS IONOMER CEMENT ART set - - 761,390.00 -
5 KALSIUM HIDROKSI PASTA tube - - 333,830.00 -
6 MONOKLORKAMFER MENTOL CAIRAN/ botol - 77,030.00 -
7 MUMMIFYING PASTA pot - 309,312.00 -
8 SEMEN SENG FOSFAT SERBUK/CAIRAN botol - 197,732.00 -
9 TEMPORARY STOPPING FLETCHER botol - 184,250.00 -
J U M LAH 6,372,000

PERBEKALAN KESEHATAN
PEMAKAIAN KEBUTUHAN
SISA STOK TOTAL HARGA KET
NO NAMA OBAT SATUAN RATA RATA SELAMA 18 HARGA (Rp)
(31 des 2018) (Rp)
PERBULAN BLN

1 2 3 4 5 6=((4)*18)-(5) 7 8=6*7 9
1 Alkohol botol 20 360 3,300 1,188,000
2 ALAT SUNTIK SEKALI PAKAI 1 ML pcs 20 400 (40) 800 (32,000)
3 ALAT SUNTIK SEKALI PAKAI 3 ML pcs 50 200 700 800 560,000
4 ALAT SUNTIK SEKALI PAKAI 5 ML pcs 20 200 160 1,050 168,000
5 Bisturi pcs 5 90 3,000 270,000
6 CATGUT/ BENANG BEDAH NO 2/0 kotak 5 16 74 59,000 4,366,000
7 CATGUT/ BENANG BEDAH NO 3/0 kotak 10 180 59,000 10,620,000
8 FOLLEY CHATETER NO 18 pcs 2 36 18,450 664,200
9 Gel chateter tube 3 54 82,500 4,455,000
10 H2O2 botol 1 18 18,700 336,600
11 HANDSCONE Uk. 7,5 psg 50 900 8,800 7,920,000
12 HANDSCONE Uk. M psg 50 400 500 8,800 4,400,000
13 HANDSCONE Uk. L psg 50 1,400 (500) 8,800 (4,400,000)
14 INFUSION SET ANAK set 2 82 (46) 5,660 (260,360)
15 INFUSION SET DEWASA set 5 90 - 6,550 -
16 IV CATHETER NO. 20 G pcs 5 90 10,500 945,000
17 IV CATHETER NO. 22 G pcs 5 10 80 10,500 840,000
18 IV CATHETER NO. 24 G pcs 5 6 84 10,500 882,000
KAPAS PEMBALUT / ABSORBEN 250
19 bungkus 5 3 87 14,500 1,261,500
GRAM
20 KASSA HIDROFIL STERIL UK. 16 X 16 kotak 50 240 660 8,800 5,808,000

21 KASSA HIDROFIL UK. 36 x 80cm rol 1 18 250,250 4,504,500


22 KASSA PEMBALUT HIDROFIL 4m X 10 c rol 5 20 70 33,000 2,310,000
23 Lisol 1 L botol 1 20 (2) 25,000 (50,000)
24 MASKER pcs 150 1,500 1,200 800 960,000
25 PLESTER 2,5cm x 4,5m rol 2 36 14,375 517,500
26 PLESTER 7,5cm x 4,5m rol 2 25 11 41,000
27 PLESTER pharmafix 5cm x 500cm pcs 2 36 31,000 1,116,000
28 SILK (BENANG BEDAH SUTERA) No. 3/0 pcs 52 (52) 53,000 (2,756,000)
29 URINE BAG set 2 36 10,500 378,000
J U M LAH 46,971,940

VAKSIN & SERUM -


1 ABU vial - 479,996 -
2 ATS vial - 130,999 -
3 VAR ampul - 250,888 -

OBAT - OBATAN LAIN


1 Multivitamin anak botol 15 270 18,000 4,860,000
PEMAKAIAN KEBUTUHAN
SISA STOK TOTAL HARGA KET
NO NAMA OBAT SATUAN RATA RATA SELAMA 18 HARGA (Rp)
(31 des 2018) (Rp)
PERBULAN BLN

1 2 3 4 5 6=((4)*18)-(5) 7 8=6*7 9
2 Multivitamin dewasa tablet - 1,550 -
3 Ventolin nebulilizer ampul 3 54 12,000 648,000
4 Obat batuk pilek kombinasi tablet 20 360 434 156,240
J U M LAH 5,664,240
T O T A L (a+b+c+d) 208,708,880

Mengetahui
KA. UPT PUSKESMAS PENGELOLA FARMASI PUSKESMAS

JAMALUDDIN,SKM.MM SUSILAWATI.AMD.Fis
NIP . 19690725 199103 1 006 NIP.19790305 201407 2 004

WAJIB DIBACA
!!!
KETERANGAN PENGISIAN :
Kolom 3 satuan : satuan terkecil dari sediaan
kolom 4 sisa stok : Sisa stok bulan AGUSTUS tahun 2018
Kolom 5 rata rata pemakaian perbulan : RATA RATA PEMAKAIAN PER BULAN TAHUN 2018 smp bln AGUSTUS
PEMAKAIAN KEBUTUHAN
SISA STOK TOTAL HARGA KET
NO NAMA OBAT SATUAN RATA RATA SELAMA 18 HARGA (Rp)
(31 des 2018) (Rp)
PERBULAN BLN

1 2 3 4 5 6=((4)*18)-(5) 7 8=6*7 9
kolom 6 kebutuhan selama 18 bulan : ESTIMASI SISA STOK DES 2018
BILA ADA OBAT-OBATAN DAN ALKES HABIS PAKAI YANG DILUAR FORMAT HARAP DIISIKAN DI BARIS LAIN LAIN
DILARANG MERUBAH FORMAT !!!

USULAN DISERAHKAN KE SEKSI KEFARMAKMIN SEBELUM TGL 30 SEPTEMBER 2018 :


1. SOFT COPY (Email (seksiobatlampungselatan@yahoo.co.id) / diserahkan langsung menggunakan FLASH DISK (USB) ) +
SK PEMBUAT RKO 2019
2. HARD COPY (Print out di tandatangani Ka UPT & Pengelola farmasi) diserahkan langsung+ SK KAPUSK PEMBUAT RKO
2019
6