DATA KELENGKAPAN OBAT

Yang bertanda tangan di bawah ini :

Nama Lengkap : Iis Isarah
Alamat : Kp. Pasirceuri, Rt/Rw. 18/03, Kel. Sukamelang, Kec/Kab. Subang
Nama Sarana : Klinik Utama Rawat Inap Mitra Medika Tambakan
Alamat : Jl. Raya Tambakan, KM. 12,7 Jalancagak Subang
RT/RW : 022/005
Kelurahan/Desa : Tambakan
Kecamatan : Jalancagak
Kabupaten : Subang
Adalah sebagai berikut :

NO NAMA OBAT KETERANGAN

1 Codein 10 mg
15 mg
20 mg
2 Asam Mefenamat 250 mg
500 mg
3 Ibuprofen 200 mg
400 mg
susp 100 mg/5ml
susp 200 mg/5ml
4 Ketorolak Inj 30 mg/ml
5 Natrium Diklopenak 25 mg
50 mg
6 Parasetamol 500 mg
syr 120/5 mg ml
drop 100 mg/ml
inf 10 mg/ml
7 Allopurinol 100 mg
300 mg
8 kolkisin 500 mg
9 Amitripilin 25 mg
10 Gabapentin 100 mg
300 mg
11 Lidokain inj 2%
12 Atropin inj 0,25 mg/ml (i.v/s.k)
13 Diazepam inj 5 mg/ml
14 Midazolam inj 1 mg/ml (i.v)
inj 5 mg/ml
15 Dexametason inj 5 mg/ml
16 difenhidramin inj 10 mg/ml
17 Epinefrin (adrenalin) inj 1 mg/ml
18 Klorfeniramin 4 mg
19 Loratadin 10 mg
20 Setirizin 10 mg
syr 5 mg/5 ml
21 Kalsium glukonat inj 10%
22 Natrium Bikarbonat 500 mg
inj 8,4% (i.v)
22 Magnesium Sulfat serbuk
23 Fenitoin 30 mg
100 mg
24 Valproat Tab lepaslambat 250 mg
Tab lepaslambat 500 mg
Tab salenterik 250 mg/5 ml
Syr 250 mg/5 ml
25 Albendazol 400 mg
susp 200 mg/5ml
26 Mebendazole 100 mg
250 mg
syr 100 mg/ 5 ml
27 Pirantel Pamoat 125 mg
250 mg
susp 125 mg/5 ml
28 Amoksisilin 250 mg
500 mg
drop 100 mg/ml
syr kering 125 mg/5ml
syr kering 250/5 ml
29 Ampisilin inj 250 mg (i.m/i.v)
inj 1.000 mg (i.v)
30 Kombinasi KDT/FDC a. amoksisilin 1.000 mg
b. as. Klavulanat 200 mg
31 Kombinasi KDT/FDC a. ampisilin 500 mg
b. sulbaktam 250 mg
32 Sefadroxil 250 mg
500 mg
syr kering 125 mg/5ml
syr kering 250/5 ml
33 Sefixim 100 mg
200 mg
syr 100 mg/ 5 ml
34 Sefoperazon serbuk inj 1.000 mg
35 Sefotaxim serbuk inj 1.000 mg
36 Seftazidim serbuk inj 1.000 mg
37 Seftriaxon serbuk inj 1.000 mg
38 Doksisiklin 50 mg
100 mg
39 Klorampenikol 250 mg
500 mg
susp 125 mg/5 ml
inj 1.000 mg
40 Kotrimoxsazole 400/80 mg
800/160 mg
200/40 mg per 5 ml
41 Azitromisin tab salut selaput 500 mg
42 Gentamisin inj 10 mg/ml
inj 40 mg/ml
43 Streptomisin serb inj 1.000 mg
44 Levofloxacin tab salut selaput 500 mg
inf 5 mg/ml
45 Siprofloksasin 500 mg
inf 2 mg/ml
46 Klindamisin 150 mg
300 mg
47 Meropenem serbuk inj 500 mg
serbuk inj 1.000 mg
49 Metronidazole 500 mg
susp 125 mg/5 ml
inf 5 mg/ml
50 Rifampisin 300 mg
450 mg
600 mg
51 Isoniazid 100 mg
52 OAT KDT Katagori 1 4KDT/FDC mengandung:
a. rifampisin 150 mg
b. isoniazid 75 mg
c. pyrazinamid 400 mg
d. etambutol 275 mg
2KDT/FDC mengandung:
a. rifampisin 150 mg
b. isoniazid 150 mg
53 OAT KDT Katagori 2 4KDT/FDC mengandung:
a. rifampisin 150 mg
b. isoniazid 75 mg
c. pyrazinamid 400 mg
d. etambutol 275 mg
 2KDT/FDC mengandung:
a. rifampisin 150 mg
b. isoniazid 150 mg
Etambutol 400 mg
Streptomisin serb inj 1.000 mg
54 OAT KTD Katagori Anak 3KDT/FDC mengandung:
a. rifampisin 75 mg
b. isoniazid 50 mg
c. pyrazinamid 150 mg
2KDT/FDC mengandung:
a. rifampisin 75mg
b. isoniazid 50 mg
55 Streptomisin inj 1.000
56 Griseofulvin 150 mg
250 mg
500 mg
57 Ketoconazol 200 mg
58 Nistatin 500.000 IU
susp 100.000 IU/ml
60 Asiklovir 400 mg
61 Valaksilovir 500 mg
62 Propanolol 10 mg
40 mg
63 Ergotamin 1 mg
64 Betahistin 6 mg
24 mg
65 Dexametasone 0,5 mg
inj 5 mg/ml
66 Metilpredinisolon 4 mg
16 mg
87 Levodopa 100 mg
89 Asam Folat 0,4 mg
1 mg
90 Asam Tranexamat 500 mg
inj 50 mg/ml
91 Furosemid 40 mg
inj 10 mg/ml (i.v/i.m)
92 Manitol inf 20 mg%
93 Spironolacton 25 mg
100 mg
94 Finasterid 5 mg
95 Tamsulosin 0,2 mg
96 Terazosin 1 mg
2 mg
97 Akarbose 50 mg
 100 mg
98 Glibenklamid 2.5 mg
5mg
99 Gliquidon 30 mg
100 Glimepirid 1 mg
2 mg
3 mg
4 mg
101 Glipizid 5 mg
10 mg
102 Metformin 500 mg
850 mg
103 Pioglitazon 15 mg
30 mg
104 Human Insulin 1. Short acting
inj 100 IU/ml (kemasan vial,
disposable catridge, penfill
cartridge)
2. Intermediate actinge
inj 100 IU/ml (kemasan vial,
disposable catridge, penfill
cartridge)
3. Mix insuline
inj 100 IU/ml (kemasan vial,
disposable catridge, penfill
cartridge)
104 Levotiroksin 50 mcg
100 mcg
105 Propiltiourasil 100 mg
106 Dexametason 0,5 mg
inj 5 mg/ml

107 Metilpredisolon 4 mg
8 mg
16 mg
inj 125 mg

108 Triamsinolon asetonid inj 10 mg/ml

109 Amlodipin 5 mg
10 mg
110 Isosorbid Dinitrat 5 mg
10 mg
inj 1 mg/ml
111 Amiodaron 200 mg
inj 50 mg/ml
112 Propanolol 10 mg
inj 1 mg/ml
113 Bisoprolol 2,25 mg
5 mg
114 Irbesartan 150 mg
300 mg
115 Kandesartan 8 mg
16 mg
116 Kaptopril 12,5 mg
25 mg
117 Metildopa 250 mg
118 Nifedipin 10 mg
119 Nikardipin inj 1 mg/ml
120 Ramipril 2,25 mg
5 mg
10 mg
121 Valsartan 80 mg
160 mg
122 Asam Asetilsalisilat 80 mg
tab sal enterik 100 mg
123 klopidogrel 75 mg
124 Digoxin 0,25 mg
inj 0,25 mg/ml
125 Furosemid 40 mg
inj 10 mg/ml (i.v/i.m)
126 Dopamin inj 40 mg/ml
127 Epinefrin (adrenalin) inj 1 mg/ml
128 Norepinefrin inj 1 mg/ml
129 Atorvastatin 10 mg
20 mg
130 Rosuvastatin 10 mg
131 Simvastatin 10 mg
20 mg
132 Klorampenicol salep 2%
133 Ketokonazole krim 2%
134 Mikonazol serb 2%
krim 2%
135 Betametason Furoat krim 0,1%
134 Permetrin krim 5%
135 Bedak Salisil serb 2%
136 Zinc drop 10 mg/ml
137 Gentamisin salep mata 0,3%
tts mata 0,3%
tts mata 1%
138 Levofloksasin tts mata 0,5%
139 Alprazolam 0,25 mg
0,5 mg
1 mg
140 Diazepam 2 mg
5 mg
inj 5 mg/ml
141 Amitripilin 25 mg
142 Antasida tab kunyah
susp
143 Esomeprazole serb inj 40 mg (i.v)
144 Lansoprazole kaps 30 mg
145 Omeprazole kaps 20 mg
inj 40 mg
146 Ranitidin 150 mg
inj 25 mg/ml
147 Sukralfate 500 mg
susp 500 mg/5 ml
148 Domperidon 10 mg
500 mg

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