RANCANGAN KEBUTUHAN OBAT TAHUN 2017

NO NAMA OBAT SATUAN KEBUTUHAN

1 Allopurinol tablet 100 mg tab 3,600
2 Albendazol 400 mg tab 1,000
3 Albendazol susp 200mg/5ml botol 100
4 Ambroxol tab tab 7,200
5 Ambroxol syr 15 mg/ml botol 500
6 Aminofilin injeksi 24 mg/ml-10ml tab 180
7 Aminofilin tablet 200 mg tab 1,000
8 Aminitriptilin HCL tablet salut 25 mg tab 1,000
9 Amlodipin 5 mg tab 3,600
10 Amlodipin 10 mg tab 3,600
11 Amoksilin kapsul 250 mg kapsul 5,400
12 Amoksilin kapsul 500 mg kaplet 120,000
13 Amoksilin sirup kering 125 mg/5ml botol 1,800
14 Antalgin (Metampiron) tablet 500 mg tablet 5,000
15 Antalgin Injeksi 250 mg/ml-2ml amp 300
16 Antasida DOEN Tab tablet 72,000
17 Antasida DOEN susp botol 500
18 Anti Bakteri Topikal ( Betason) tube 360
19 Anti Bakteri DOEN salep kombinasi tube 450
20 Anti Hemoroid supp 180
21 Antifungi DOEN kombinasi pot 100
22 Anti Migren tablet 1,800
23 Aqua Pro Inj Steril 20 ml botol 360
24 Aqua Pro Inj Steril 25 ml botol 360
25 Asam Askorbat (VIT c) tablet 50 mg tablet 9,000
26 Asam Folat 1 mg tablet 10,000
27 Asam Mefenamat 500 mg tablet 27,000
28 Asam Traneksamat inj 250mg/5 ml amp 100
29 Asetosal tab 100 mg tablet 1,000
30 Asiklovir Krim 5% tube 540
31 Asiklovir tablet 200 mg tablet 3,600
32 Asiklovir tablet 400 mg tablet 5,400
33 Atropin Sulfat injeksi 0,25 mg/ml-1ml amp 100
34 Betametason krim 0,1% tube 900
35 Cefixime 100mg tab 1,800
36 Cefixime 100mg/5ml botol 200
37 Cetirizine kaps kapsul 9,000
38 Deksametason injeksi 5 mg.ml-1ml amp 500
39 Deksametason tablet 0,5 mg tablet 27,000
40 Diazepam injeksi 5 mg/ml-2 ml amp 500
41 Diazepam tablet 2 mg tablet 2,000
42 Difenhidramin HCI injeksi 10 mg/ml-1ml amp 300
43 Digoksin tablet 0,25 mg tab 1,800
44 Domperidone tab 10 mg tablet 3,600
45 Domperidone syrup botol 360
46 Efedrin HCI tablet 25 mg tablet 1,000
47 Epinefrina HCI/Bitartrat inj. amp 200
48 Eritromisin kapsul 500 mg kapsul 1,000
49 Eritromisin sirup 200 mg/5 ml botol 300
50 Etakridin (Rivanol) 300 ml botol 200
51 Etakridin (Rivanol) 100 ml botol 200
52 Etanol 70% 1000 ml botol 200
53 Etanol 70% 100 ml botol 200
54 Fenitoin Natrium kapsul 30 mg kapsul 1,800
55 Fenol Gliserol botol 180
56 Fitomenadion (Vit.K1) inj 10 mg/ml-1ml amp 200
57 Fitomenadion (Vit.K1) tablet 10 mg tablet 1,800
58 Furosemid tablet 40 mg tablet 3,600
59 Furosemid inj 10 mg/ml vial 100
60 Garam oralit untuk 200 ml air kantong 3,600
61 Gential violet larutan 1% botol 360
62 Gentamisin/Genoint SM 0,3% 3,5mg tube 360
63 Gentamisin TM 0.3 % botol 360
64 Glibenklamid tablet 5 mg tablet 9,000
65 Gliseril Guayacolat tablet 100 mg tablet 36,000
66 Glukosa larutan infus 10% steril botol 200
67 Glukosa larutan infus 5% steril botol 500
68 Griseofulvin tablet 125 mg,micronized tab 1,800
69 Haloperidoi tablet 0,5 mg tab 1,800
70 Haloperidoi tablet 1,5 mg tab 1,800
71 Hidroklorotiazid (HCI) tablet 25 mg tablet 5,400
72 Hidrokortison krim 2,5% tube 450
73 Ibuprofen tablet 400mg tab 36,000
74 Isosorbid Dinitrat tablet sublingual 5mg tab 1,000
75 Kalium Diklofenak 50mg tablet 9,000
76 Kalsium laktat (kalk) tablet 500mg tablet 10,800
77 Kaptopril tablet 12,5mg tablet 36,000
78 Kaptopril tablet 25mg tablet 36,000
79 Ketoprofen inj 100mg ampul 200
80 Ketoconazol tab 200mg tab 500
81 Ketoconazole 2% krim 10g tube 360
82 Kloramfenikol kapsul 250mg kapsul 5,400
83 Kloramfenikol suspensi 125mg botol 360
 84 Kloramfenikol Salep Mata 1% tube 450
85 Kloramfenikol tetes telinga 3% botol 360
86 Klorfeniramin maleat (CTM) tablet 4mg tablet 36,000
87 Klorpromazin tablet salut 100 mg tablet 2,000
88 Klorpromazin inj i.m 5mg/ml 2ml(HCL) amp 100
89 Klindamycin kap 150mg kapsul 1,000
90 Klindamycin kap 300mg kapsul 1,800
91 Kotrimoksazol Suspensi komb botol 500
92 Kotrimoksazol tablet komb 480 mg tab 3,600
93 Lansoprazol 30mg kapsul 2,000
94 Lidokain Komp. Injeksi, Kombinasi: amp 1,800
95 Loperamid 2 mg tab 3,600
96 Loratadin 10mg tablet 1,800
97 Metformin tablet 9,000
98 Magnesium Sulfat inj 40%(Otsu MGSO4 40%) vial 100
99 Magnesium Sulfat inj 20%(Otsu MGSO4 20%) vial 100
100 Metilergometrin Maleat tablet 0,125mg tab 1,800
101 Metilergometrin Maleat inj.0,200mg-1ml amp 100
102 Metilprednisolone 8mg tab 9,000
103 Metronidazol tablet 250 mg tablet 700
104 Metronidazol tablet 500mg tablet 1,800
105 Mikonazol krim/salep 2% (nitrat) tube 360
106 Molasma tab 2,5mg tab 1,000
107 Multivitamin Kombinasi Dewasa ( Ramaton) tab 1,000
108 Multivitamin Anak Plus DHA sirup (Bionick Mild) botol 300
109 Multivitamin Bayi Drop (Bionick Sirup Drop) botol 200
110 Natrium Bikarbonat tablet 500mg tablet 5,000
111 Natrium Diklofenak 50mg tablet 9,000
112 Natrium Klorida larutan infus 0,9% steril botol 1,800
113 Neuritropik Plus Vit E ( Neurovit E) tab 1,800
114 Nifedipine tablet 1,000
115 Nistatin Tablet salut 100.000 IU/g tab 1,000
116 Obat Batuk Pilek Kombinasi (Hustab) tablet 3,600
117 Obat Batuk Flu Anak Kombinasi Sirup (flutamol sirup) botol 750
118 Obat Anti Diare (Diapecta) tablet 1,000
119 Obat infeksi Kulit dan Peradangan (Chlorampecort) tube 200
120 Obat Herbal Vitamin Penambah Asi tablet 2,700
121 Obat Anti Neuralgia (Neurodial) tablet 2,000
122 Obat Neurotropik Injeksi (Mersibion) ampul 100
123 Ofloxacin 400mg tab sal sel tab 300
124 Obat Batuk Hitam (OBH) cairan botol 630
125 Oksitetrasklin HCI salep mata 1% tube 450
126 Oksitosin injeksi 10 IU/ml-1ml amp 500
127 Ondansetron 4mg inj amp 2,700
128 Ondansetron 4mg tab tablet 2,500
129 Omeprazole 20mg kapsul 2,000
130 Paracetamol Syrup 120 mg/5ml botol 3,600
131 Parasetamol drops botol 250
132 Paracetamol Tablet 500 mg tablet 126,000
133 Phenobarbital inj inta vena amp 200
134 Phenobarbital 30 mg tablet 2,000
135 Piracetam inj amp 100
137 Pirantel tablet 125 mg tablet 1,800
137 Pirantel Syr botol 100
138 Piridoksin HCI (Vit.B6) tablet 10 mg tablet 9,000
139 Piroxicam 20 mg kapsul 9,000
140 Povidon Iodida 10% 30 ml botol 200
141 Povidon Iodida 10% 300 ml botol 100
142 Prednisone tablet 5 mg tablet 9,000
143 Propiltiouracyl tablet 2,000
144 Ranitidine inj amp 2,700
145 Ranitidine tab tablet 10,800
146 Ringer Laktat Larutan infus steril plabot 6,000
147 Salbutamol 2mg tablet 3,600
148 Salbutamol Inhalasi/Aerosol 100 mcg/dosis botol 50
148 Salbutamol 2mg/ 5ml syr botol 360
149 Salep 2-4 , 30g pot 100
150 Salisil bedak 2% kotak 360
151 Sefadroxyl 500 mg kapsul 5,400
152 Sefadroxyl syr botol 360
153 Sefotaxim inj vial 900
154 Seftriaxone Serbuk Inj 1 g vial 900
155 Serum anti bisa ular Polivalen inj 5ml (ABU I) vial 100
156 Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S) ampul 540
157 Sianokobalamin (Vit. B12) Injeksi 500 mcg-ml amp 500
158 Simetidin tablet tablet 2,000
159 Simvastatin 20mg tablet 1,800
160 Siprofloksasin tablet 500 mg tablet 3,600
161 Spironolakton tablet 1,000
162 Thiamphenikol kap 500 mg kapsul 3,600
163 Thiamin HCI (Vit.B1) injeksi 100 mg/ml-1ml amp 200
164 Thiamin HCI/Mononitrat (Vit.B1) tablet 50 mg tablet 9,000
165 Tramadol inj 50mg/ml amp 100
166 Tramadol kapsul 50mg kapsul 900
167 Trihexyphenidil tab 1,800
168 Vaksin Rabies Vero kuur 100
169 Vitamin B komplek tablet tablet 27,000
170 Vitamin Peningkat Sistem Imun (Fituno) tablet 1,800
171 Zinkid 10mg/5ml syr botol 300
NO OBAT GIGI
1 Ethyl Clorida spray botol 100

NO ALAT KESEHATAN
1 Alat Suntik sekali pakai 1 ml set 5,000
2 Alat Suntik Sekali Pakai 2,5 ml set 10,000
3 Alat Suntik Sekali Pakai 5 ml set 7,200
4 Catgut/Benang No. 2/0-3/0 set 648
5 Folley Cateter NO. 18 Pcs 50
6 Folley Cateter NO. 16 Pcs 100
7 Infusion set anak set 360
8 Infusion set dewasa set 900
9 IV Catheter No.18 set 300
10 IV Catheter No.20 buah 1,800
11 IV Catheter No.22 buah 3,600
12 IV Catheter No.24 buah 1800
13 Wing Neddle No.21 pcs 100
14 Wing Neddle No.23 pcs 100
15 Wing Neddle No.25 pcs 100
16 Handscoon 7 set 1,800
17 Handscoon 7,5 set 1,000
18 Handscoon M set 3,600
19 Handscoon L set 3,600
20 Plester 5 yard x 2 inch rol 216
21 Plester 5 cm x 4,5 m rol 200
22 Plester 4,5 m x 12,5 mm rol 200
23 Silk (Benang Bedah Sutera) No. 3/0 set 648
24 Kasa Gulung 15X4 gulung 1,800
25 Kasa Kompres 16x16 steril kotak 3,600
26 Kasa Steril 40 X 40 cm gulung 500
 27 Kapas pembalut absorben250 mg gulung 90
28 Kasa Hidrofil 4x 10 cm gulung 1,800
29 Masker pcs 3,600
30 Urine bag Pcs 100

III OBAT BRANDED

NO NAMA OBAT SATUAN STOCK AWAL
1 Bricasma turb 0,5 mg box 50
2 Curcuma syr botol 1800
3 Kombinasi Metampiron dan vit B ( Goralgin ) tablet 3600
4 Multivitamin ibu hamil dan menyusui (Ironyl) tablet 3600
5 Multivitamin anak komb. Probiotik+DHA (Dhavit) Botol 900
6 Multivitamin anak komb.mengandung lysin botol 300
7 Obat Antibiotik Kombinasi (miraclav) Tablet 500
8 Obat Batuk Flu kombinasi anak ( Protexinal syr ) botol 750
9 Obat Flu Sirup (febrinex susp) Botol 500
10 Obat Batuk Flu kombinasi dewasa (Protexinal tab) tablet 5000
11 Obat Flu Tablet Dewasa ( Flutab ) tablet 5000
12 Obat Batuk Pilek Tablet (noza) Tablet 5000
13 Obat Diare Tablet (nodiar) Tablet 5000
14 Obat Gangguan Cerna/Multienzim (progastrik) Tablet 5000
15 Obat Infeksi Kulit dan Peradangan (Chloramfecort) Tube 10gr 100
16 Pulmicort turb 200 box 10
17 Symbicort turb 160 dos box 10
18 Ulsafate / Sukralfat Susp 500mg/5ml botol 100
19 Zincpro drops 15 ml botol 200
III OBAT PROGRAM
NO NAMA OBAT SATUAN STOCK AWAL
1 ACT (Arthesunate+Amodiaquin) tab Tablet 100
2 Gentamicyn Injeksi Ampul 50
3 Mineral Mix Sacc 200
4 Obat Anti Tuberculosis kat. 1 Paket 60
5 Obat Anti Tuberculosis kat. 2 Paket 36
6 Obat Anti Tuberculosis anak Paket 25
7 Phytomenadion inj 2mg/ml amp 100
8 Retinol 100.000 IU kapsul lunak 3000
9 Retinol 200.000 IU kapsul lunak 5000
10 Tablet Tambah Darah tablet 45000
11 Zink Tablet 3600

Pemohon
Petugas Farmasi

Maratus Sholikah
NIP: 198309202010012015
V
……………………2016
Pengelola

Nama
NIP
 DINAS KESEHATAN KABUPATEN TULANG BAWANG BARAT
PUSKESMAS KIBANG BUDI JAYA
KECAMATAN LAMBU KIBANG
SURAT BUKTI BARANG KELUAR
NO.01/PKBJ/GF/SBBK/VIII/2017
NO NAMA OBAT SATUAN KEBUTUHAN
1 Allopurinol tablet 100 mg tab 3,600
2 Albendazol 400 mg tab 1,000
3 Aminofililn injeksi24mg/ml-10ml botol 100
4 Aminofilin tablet 200mg tab 7,200
5 Aminitriptilin HCL tablet salut 25 mg botol 500
6 Amlodipin 5mg tab 180
7 Amoksillin kapsule 250mg tab 1,000
8 Amoksillin 500 mg tab 1,000
9 Amoksillin sirup kering 125mg/5ml tab 3,600
10 Antalgin(Metampiron 500mg) tab 3,600
11 Antasida doen tab kapsul 5,400
12 Anti bakteri doen salep kombinasi kaplet 120,000
13 Anti Hemoroid botol 1,800
14 Anti fungi doen kombinasi tablet 5,000
15 Anti Migren amp 300
16 Asam askorbat (vit c) 50mg tablet 72,000
17 Asetosal tablet 100mg botol 500
18 Asiklovir tablet 200mg tube 360
19 Asiklovir tablet 400 mg tube 450
20 Atropin Sulfat injeksi 0,25 mg/ml-1ml supp 180
21 Deksametason injeksi 5mg.ml-1ml pot 100
22 Deksametason tablet 0,5 mg tablet 1,800
23 Diazepam injeksi 5mg/ml-2ml botol 360
24 Diazepam tablet 2 mg botol 360
25 Difenhidramin HCL injeksi 10mg/ml tablet 9,000
26 Digoksin tablet 0,25 mg tablet 10,000
27 Epinefrina HCl/Bitartrat tablet 27,000
28 Eritromisin sirup 200mg amp 100
29 Etakridin/rivanol 0.1% larutan100ml tablet 1,000
30 Fenitoin Natrium kapsul 30mg tube 540
31 Fenilbutason tablet 200mg tablet 3,600
32 Fenol Gliserol tetes telinga 10% tablet 5,400
33 Fitomenadion (vit.K1)tab salut 10mg amp 100
34 Furosemid injeksi iv/im 10mg/ml tube 900
35 Garam oralit untuk 200ml air tab 1,800
36 Gentian violet larutan 1% botol 200
37 Glibenklamid tablet 5 mg kapsul 9,000
38 Gliserin amp 500
39 Glukosa larutan infuse 10%steril tablet 27,000
40 Glukosa larutan infuse 5%steril amp 500
41 Heloperidol tablet 0,5 mg tablet 2,000
42 Heloperidol tablet 1,5 mg amp 300
43 Hidrokortison krim 2,5% tab 1,800
44 Ibuprofen tablet 400mg tablet 3,600
45 Isosorbid Dinitrat tablet subligual 5mg botol 360
46 Kalsium laktat(kalk) tab 500mg tablet 1,000
47 Karbomazepin tablet 200mg amp 200
48 Ketoprofen inj 100mg kapsul 1,000
49 Kloramfenikol kapsul 250mg botol 300
50 Klorfeniramin maleat (CTM) tablet 4 mg botol 200
51 Klindamisin kap 300mg botol 200
52 Kotrimoksasol Suspensi komb. botol 200
53 Kotrimoksasol tablet 480mg botol 200
54 Kuinin (kina) tablet 200mg kapsul 1,800
55 Lansoprazole 30mg botol 180
56 Metilergometrin Maleate tablet amp 200
57 Metilergometrin maleate injeksi tablet 1,800
58 Metoklopamid 10mg tablet 3,600
59 Metronidazole 250mg vial 100
60 Metronidazole 500 mg kantong 3,600
61 Mikonazole krim 2% botol 360
62 Natrium Bikarbonate 500mg tube 360
63 Natrium Kloride lar infuse 0,9%steril botol 360
64 Nifedipine tab 10 mg tablet 9,000
65 Oksitoksine injeksi 10IU/ml-1ml tablet 36,000
66 Parasetamol Syrup 120mg/5ml botol 200
67 Parasetamol tablet 500 mg botol 500
68 Phenobarbital tablet 30mg tab 1,800
69 Phenobarbital injeksi 50mg/ml-2ml tab 1,800
70 Pirantel tablet 125 mg tab 1,800
71 Piridoksin HCL (vit B6)tablet 10mg tablet 5,400
72 Povidon Iodida 10% lar 30ml tube 450
73 Povidon Iodida 10% lar 300ml tab 36,000
74 Prednisone tablet 5mg tab 1,000
75 Ringger Laktat lar infuse steril tablet 9,000
76 salbutamol 2mg tablet 10,800
77 Salep 2-4 kombinasi tablet 36,000
78 Salisil bedak 2% tablet 36,000
 79 Sianokobalamin (vit.B12)inj 500mcg ampul 200
80 Ketoconazol tab 200mg tab 500
81 Ketoconazole 2% krim 10g tube 360
82 Kloramfenikol kapsul 250mg kapsul 5,400
83 Kloramfenikol suspensi 125mg botol 360
84 Kloramfenikol Salep Mata 1% tube 450
85 Kloramfenikol tetes telinga 3% botol 360
86 Klorfeniramin maleat (CTM) tablet 4mg tablet 36,000
87 Klorpromazin tablet salut 100 mg tablet 2,000
88 Klorpromazin inj i.m 5mg/ml 2ml(HCL) amp 100
89 Klindamycin kap 150mg kapsul 1,000
90 Klindamycin kap 300mg kapsul 1,800
91 Kotrimoksazol Suspensi komb botol 500
92 Kotrimoksazol tablet komb 480 mg tab 3,600
93 Lansoprazol 30mg kapsul 2,000
94 Lidokain Komp. Injeksi, Kombinasi: amp 1,800
95 Loperamid 2 mg tab 3,600
96 Loratadin 10mg tablet 1,800
97 Metformin tablet 9,000
98 Magnesium Sulfat inj 40%(Otsu MGSO4 vial 100
99 Magnesium Sulfat inj 20%(Otsu MGSO4 vial 100
100 Metilergometrin Maleat tablet 0,125mg tab 1,800
101 Metilergometrin Maleat inj.0,200mg-1ml amp 100
102 Metilprednisolone 8mg tab 9,000
103 Metronidazol tablet 250 mg tablet 700
104 Metronidazol tablet 500mg tablet 1,800
105 Mikonazol krim/salep 2% (nitrat) tube 360
106 Molasma tab 2,5mg tab 1,000
107 Multivitamin Kombinasi Dewasa ( Ramat tab 1,000
108 Multivitamin Anak Plus DHA sirup (Bionic botol 300
109 Multivitamin Bayi Drop (Bionick Sirup Dr botol 200
110 Natrium Bikarbonat tablet 500mg tablet 5,000
111 Natrium Diklofenak 50mg tablet 9,000
112 Natrium Klorida larutan infus 0,9% steril botol 1,800
113 Neuritropik Plus Vit E ( Neurovit E) tab 1,800
114 Nifedipine tablet 1,000
115 Nistatin Tablet salut 100.000 IU/g tab 1,000
116 Obat Batuk Pilek Kombinasi (Hustab) tablet 3,600
117 Obat Batuk Flu Anak Kombinasi Sirup (flu botol 750
118 Obat Anti Diare (Diapecta) tablet 1,000
119 Obat infeksi Kulit dan Peradangan (Chlo tube 200
120 Obat Herbal Vitamin Penambah Asi tablet 2,700
121 Obat Anti Neuralgia (Neurodial) tablet 2,000
122 Obat Neurotropik Injeksi (Mersibion) ampul 100
123 Ofloxacin 400mg tab sal sel tab 300
124 Obat Batuk Hitam (OBH) cairan botol 630
125 Oksitetrasklin HCI salep mata 1% tube 450
126 Oksitosin injeksi 10 IU/ml-1ml amp 500
127 Ondansetron 4mg inj amp 2,700
128 Ondansetron 4mg tab tablet 2,500
129 Omeprazole 20mg kapsul 2,000
130 Paracetamol Syrup 120 mg/5ml botol 3,600
131 Parasetamol drops botol 250
132 Paracetamol Tablet 500 mg tablet 126,000
133 Phenobarbital inj inta vena amp 200
134 Phenobarbital 30 mg tablet 2,000
135 Piracetam inj amp 100
137 Pirantel tablet 125 mg tablet 1,800
137 Pirantel Syr botol 100
138 Piridoksin HCI (Vit.B6) tablet 10 mg tablet 9,000
139 Piroxicam 20 mg kapsul 9,000
140 Povidon Iodida 10% 30 ml botol 200
141 Povidon Iodida 10% 300 ml botol 100
142 Prednisone tablet 5 mg tablet 9,000
143 Propiltiouracyl tablet 2,000
144 Ranitidine inj amp 2,700
145 Ranitidine tab tablet 10,800
146 Ringer Laktat Larutan infus steril plabot 6,000
147 Salbutamol 2mg tablet 3,600
148 Salbutamol Inhalasi/Aerosol 100 mcg/dos botol 50
148 Salbutamol 2mg/ 5ml syr botol 360
149 Salep 2-4 , 30g pot 100
150 Salisil bedak 2% kotak 360
151 Sefadroxyl 500 mg kapsul 5,400
152 Sefadroxyl syr botol 360
153 Sefotaxim inj vial 900
154 Seftriaxone Serbuk Inj 1 g vial 900
155 Serum anti bisa ular Polivalen inj 5ml (AB vial 100
156 Serum Anti Tetanus Injeksi 1.500 IU/ampu ampul 540
157 Sianokobalamin (Vit. B12) Injeksi 500 m amp 500
158 Simetidin tablet tablet 2,000
159 Simvastatin 20mg tablet 1,800
160 Siprofloksasin tablet 500 mg tablet 3,600
161 Spironolakton tablet 1,000
162 Thiamphenikol kap 500 mg kapsul 3,600
163 Thiamin HCI (Vit.B1) injeksi 100 mg/ml-1 amp 200
164 Thiamin HCI/Mononitrat (Vit.B1) tablet 5 tablet 9,000
165 Tramadol inj 50mg/ml amp 100
166 Tramadol kapsul 50mg kapsul 900
167 Trihexyphenidil tab 1,800
168 Vaksin Rabies Vero kuur 100
169 Vitamin B komplek tablet tablet 27,000
170 Vitamin Peningkat Sistem Imun (Fituno) tablet 1,800
171 Zinkid 10mg/5ml syr botol 300