KETERSEDIAAN OBAT TERHADAP FORMULARIUM

PUSKESMAS KUTASARI 2016

BULAN : SEPTEMBER 2016

NO NAMA OBAT SATUAN FORMULARIUM

ADA TIDAK
1 Acyclovir 400 mg tablet Tablet V
2 Alopurinol 100mg Tablet V
3 Ambroxol Tablet V
4 Ambroxol syrup Botol V
5 Aminofilin 200 mg Tablet V
6 Amitriptilin HCl 25 mg Tablet V
7 Amlodipin 10mg Tablet V
8 Amoksisilin 500 mg Caplet V
9 Amoksisilin Srp Krng 125mg/5ml Botol V
10 Amoksisilin Srp Krng 250mg/5ml Boto 60 ml V
11 Antalgin 500 mg Tablet V
12 Antasida Doen tab. Tablet V
13 Antasida sirop Botol V
14 As. Mefenamat 500 mg Kapsul V
15 Asam Askorbat (Vit.C) tab.50 mg Tablet V
16 Asetosal 100 mg Tablet V
17 Bekarbon Tablet V
18 Betahistin mesilat 6mg Tablet V
19 Captopril 25 mg Tablet V
20 Cefadroxil 500 mg Tablet V
21 Cefadroxil sirup 125 mg/5 ml Botol 60 ml V
22 Clozapine 25mg Tablet V
23 Cyprofloxacin 500 mg Tablet V
24 Deksametason tab.0,5 mg Tablet V
25 Diazepam tab. 2mg Tablet V
26 Digoxin 0,25mg Tablet V
27 Dimenhydrinat 50mg Tablet V
28 Doksisiklin 100 mg Kapsul V
29 Donperidon 10mg Tablet V
30 Donperidon 5mg/5ml suspensi Botol V
31 Erytromycin 500 mg Capsul V
32 Fenobarbital 30mg Tablet V
33 Fitomenadion Vit K 1 tab.10 mg Tablet V
34 Furosemid tab.40 mg Tablet V
35 Garam Oralit 200 ml air Bungkus V
36 Gemfibrozil 300 mg Kapsul V
37 Glibenklamid tab. 5 mg Tablet V
38 Gliseril Guaiakolat tab.100 mg Tablet V
39 Haloperidol 5 mg Tablet V
40 Hidroklorotiazid (HCT) tab. 25mg Tablet V
41 Ibuprofen tab.400 mg Tablet V
42 Iburofen suspensi 100mg/5ml Botol 60ml V
43 Isorbid Dinitrat 5mg Tablet V
 44 Kalsium Laktat (Kalk) tab.500 mg Tablet V
45 Ketokonasol 200mg Tablet V
46 Klindamicyn 300 mg Kapsul v
47 Kloramfenikol kap.250 mg Kapsul V
48 Kloramphenikol suspensi 125mg/5m
Botol v
49 Klorfeneramin Maleat(CTM) 4 mg (ATab/Box@10 V
50 Klorpromazin HCl 100mg tab. salut Tablet V
51 Kotrimoksazol Suspensi Botol V
52 Kotrimoksazol tab. Dws 480mg Tablet V
53 Loperamid Tablet V
54 Loratadin 10mg Tablet V
55 Meloksicam 15 mg Tablet V
56 Metformin 500mg Tablet V
57 Metil Prednisolon 4mg Tablet V
58 Metilergometrin Maleat 0,125 mg Tablet V
59 Metoklopropamid 10 mg Tablet V
60 Metronidazol 500 mg Tablet V
61 Na diklofenak 50 mg Tablet V
62 Neo Diaform/Stopdiar Tablet V
63 Nifedipin 10mg Tablet V
64 Nistatin tablet salut 500.000 IU/gr Tablet V
65 Omepazole 20 mg Kapsul V
66 Papaverin 40 mg Tablet (A) Tab/Box@10 V
67 Parasetamol sirup 120 mg/5 ml Botol V
68 Parasetamol tab. 500 mg Tablet V
69 Piracetam 400 mg Kapsul V
70 Pirantel Pamoat tab.125 mg Tablet V
71 Piridoksin Hcl.(Vit B6) 10 mg Tablet V
72 Piroksikam 20 mg tab. Tablet V
73 Prednison tab.5 mg (A) Tab/Box@10 V
74 Propanolol tab 40 mg Tablet V
75 Ranitidin 150mg Tablet V
76 Risperidone 2 mg Tablet V
77 Salbutamol 2 mg Tablet V
78 Salbutamol 4 mg Tablet V
79 Sianocobalamin 50 mg/Vit B12 (A) Tab/Box@10 V
80 Simvastatin 10 mg Tablet V
81 Tablet Tambah Darah Tablet V
82 Thiamin Hcl (Vit.B1)tab.50 mg (A) Tab/Box@10 V
83 Thiampenicole 500mg Kapsul V
84 Traneksamik Acid 500 mg Kapsul V
85 Triheksifenidil (THP) 2mg Tablet V
86 Vitamin B Complx tab (A) Tab/Box@10 V
87 Zink Tablet Kotak V
0 INJEKSI / LARUTAN INFUS 0
1 Atropin Sulfat Inj 0,25mg/ml-1ml Ampul V
2 Deksametason inj 5mg/ml-1ml ampul V
3 Diazepam inj. 5mg/ml-2ml Ampul v
4 Difenhidramin HCl inj Ampul V
5 Ephineprin /Adrenalin inj Ampul V
6 Fenobarbital Inj. 50 mg /ml--2ml Ampul V
 7 Fitomenadion (Vit. K1) Inj.2mg/ml Ampul V
8 Glukosa larutan infus 5% steril Botol V
9 Lidocain Injeksi 2%-2ml Ampul V
10 Metilergometrin Inj 0,2mg/ml - 1ml Ampul V
11 Metoklopropamid 5mg/ml inj ampul V
12 MgSO4 40 % Botol 25 ml V
13 Na Cl Infus 0.9% Botol V
14 Oksitocin inj 10 UI/ml Ampul V
15 Pehacain Inj Ampul V
16 Ringer Laktat lar. infus steril Botol V
17 Ranitidin inj 25mg/2ml Ampul V
18 Serum Anti Tetanus 1500 IU/Amp. Ampul V
0 TOPIKAL 0
1 Acyclovir 5% Ceam Tube V
2 Anti Bakteri DOEN salep Tube V
3 Antihaemoroid supp Supp V
4 Betametason krim 0,1% Tube V
5 Bisakodil suppo 10mg Suppo V
Tube 2,5ml V
6 Diazepam lar. Rektal 5mg/2,5ml (ste
7 Etanol 70 % Botol 100 mlV
8 Ethyl chlorida spray Botol V
9 Gentamisin Salep Kulit Tube V
10 Gentian Violet larutan 1% Botol V
11 Hydrokortison Cream Tube V
12 Ketokonasole/Solinfec cream Tube V
13 Kloramfenikol tetes telinga 3% Botol V
14 Lisol/kresol tersaponofikasi 50% Botol 1 L V
15 Myconazole cream Tube V
16 Nistatin tablet vagina 100.000 IU Tablet V
17 Povidon Iodine 60 ml Botol V
18 Salep 2-4 Kombinasi Pot V
19 Salisil Bedak 2 % Botol V
0 OBAT MATA 0
1 Kloramfenikol salep mata 1% Tube V
2 Kloramfenikol tetes mata 10ml Botol 10ml V

- Lain-lain
1 Obat Batuk Kombinasi Tablet V
2 Obat Flu Kombinasi Sirup Botol V
3 Hyosin Butilbromide tablet V
4 Glimepiride 2 mg Tablet V
TOPIKAL
1 Kloramfenikol salep kulit 2% Tube V
2 Perak Sulfadiazin krim 1% Tube V
3 Permetrin Krim 5% Tube V
4 Bisakodil suppo 5 mg suppo V

Ketersediaan obat terhadap formularium

124/134 x 100 = 92.54 %
 KETERSEDIAAN OBAT TERHADAP FORMULARIUM
PUSKESMAS KUTASARI 2016

BULAN : OKTOBER 2016

NO NAMA OBAT SATUAN FORMULARIUM

ADA TIDAK
1 Acyclovir 400 mg tablet Tablet V
2 Alopurinol 100mg Tablet V
3 Ambroxol Tablet V
4 Ambroxol syrup Botol V
5 Aminofilin 200 mg Tablet V
6 Amitriptilin HCl 25 mg Tablet V
7 Amlodipin 10mg Tablet V
8 Amoksisilin 500 mg Caplet V
9 Amoksisilin Srp Krng 125mg/5ml Botol V
10 Amoksisilin Srp Krng 250mg/5ml Boto 60 ml V
11 Antalgin 500 mg Tablet V
12 Antasida Doen tab. Tablet V
13 Antasida sirop Botol V
14 As. Mefenamat 500 mg Kapsul V
15 Asam Askorbat (Vit.C) tab.50 mg Tablet V
16 Asetosal 100 mg Tablet V
17 Bekarbon Tablet V
18 Betahistin mesilat 6mg Tablet V
19 Captopril 25 mg Tablet V
20 Cefadroxil 500 mg Tablet V
21 Cefadroxil sirup 125 mg/5 ml Botol 60 ml V
22 Clozapine 25mg Tablet V
23 Cyprofloxacin 500 mg Tablet V
24 Deksametason tab.0,5 mg Tablet V
25 Diazepam tab. 2mg Tablet V
26 Digoxin 0,25mg Tablet V
27 Dimenhydrinat 50mg Tablet V
28 Doksisiklin 100 mg Kapsul V
29 Donperidon 10mg Tablet V
30 Donperidon 5mg/5ml suspensi Botol V
31 Erytromycin 500 mg Capsul V
32 Fenobarbital 30mg Tablet V
33 Fitomenadion Vit K 1 tab.10 mg Tablet V
34 Furosemid tab.40 mg Tablet V
35 Garam Oralit 200 ml air Bungkus V
36 Gemfibrozil 300 mg Kapsul V
37 Glibenklamid tab. 5 mg Tablet V
38 Gliseril Guaiakolat tab.100 mg Tablet V
39 Haloperidol 5 mg Tablet V
40 Hidroklorotiazid (HCT) tab. 25mg Tablet V
41 Ibuprofen tab.400 mg Tablet V
42 Iburofen suspensi 100mg/5ml Botol 60ml V
43 Isorbid Dinitrat 5mg Tablet V
 44 Kalsium Laktat (Kalk) tab.500 mg Tablet V
45 Ketokonasol 200mg Tablet V
46 Klindamicyn 300 mg Kapsul v
47 Kloramfenikol kap.250 mg Kapsul V
48 Kloramphenikol suspensi 125mg/5m
Botol v
49 Klorfeneramin Maleat(CTM) 4 mg (ATab/Box@10 V
50 Klorpromazin HCl 100mg tab. salut Tablet V
51 Kotrimoksazol Suspensi Botol V
52 Kotrimoksazol tab. Dws 480mg Tablet V
53 Loperamid Tablet V
54 Loratadin 10mg Tablet V
55 Meloksicam 15 mg Tablet V
56 Metformin 500mg Tablet V
57 Metil Prednisolon 4mg Tablet V
58 Metilergometrin Maleat 0,125 mg Tablet V
59 Metoklopropamid 10 mg Tablet V
60 Metronidazol 500 mg Tablet V
61 Na diklofenak 50 mg Tablet V
62 Neo Diaform/Stopdiar Tablet V
63 Nifedipin 10mg Tablet V
64 Nistatin tablet salut 500.000 IU/gr Tablet V
65 Omepazole 20 mg Kapsul V
66 Papaverin 40 mg Tablet (A) Tab/Box@10 V
67 Parasetamol sirup 120 mg/5 ml Botol V
68 Parasetamol tab. 500 mg Tablet V
69 Piracetam 400 mg Kapsul V
70 Pirantel Pamoat tab.125 mg Tablet V
71 Piridoksin Hcl.(Vit B6) 10 mg Tablet V
72 Piroksikam 20 mg tab. Tablet V
73 Prednison tab.5 mg (A) Tab/Box@10 V
74 Propanolol tab 40 mg Tablet V
75 Ranitidin 150mg Tablet V
76 Risperidone 2 mg Tablet V
77 Salbutamol 2 mg Tablet V
78 Salbutamol 4 mg Tablet V
79 Sianocobalamin 50 mg/Vit B12 (A) Tab/Box@10 V
80 Simvastatin 10 mg Tablet V
81 Tablet Tambah Darah Tablet V
82 Thiamin Hcl (Vit.B1)tab.50 mg (A) Tab/Box@10 V
83 Thiampenicole 500mg Kapsul V
84 Traneksamik Acid 500 mg Kapsul V
85 Triheksifenidil (THP) 2mg Tablet V
86 Vitamin B Complx tab (A) Tab/Box@10 V
87 Zink Tablet Kotak V
0 INJEKSI / LARUTAN INFUS 0
1 Atropin Sulfat Inj 0,25mg/ml-1ml Ampul V
2 Deksametason inj 5mg/ml-1ml ampul V
3 Diazepam inj. 5mg/ml-2ml Ampul V
4 Difenhidramin HCl inj Ampul V
5 Ephineprin /Adrenalin inj Ampul V
6 Fenobarbital Inj. 50 mg /ml--2ml Ampul V
 7 Fitomenadion (Vit. K1) Inj.2mg/ml Ampul V
8 Glukosa larutan infus 5% steril Botol V
9 Lidocain Injeksi 2%-2ml Ampul V
10 Metilergometrin Inj 0,2mg/ml - 1ml Ampul V
11 Metoklopropamid 5mg/ml inj ampul V
12 MgSO4 40 % Botol 25 ml V
13 Na Cl Infus 0.9% Botol V
14 Oksitocin inj 10 UI/ml Ampul V
15 Pehacain Inj Ampul V
16 Ringer Laktat lar. infus steril Botol V
17 Ranitidin inj 25mg/2ml Ampul V
18 Serum Anti Tetanus 1500 IU/Amp. Ampul V
0 TOPIKAL 0
1 Acyclovir 5% Ceam Tube V
2 Anti Bakteri DOEN salep Tube V
3 Antihaemoroid supp Supp V
4 Betametason krim 0,1% Tube V
5 Bisakodil suppo 10mg Suppo V
Tube 2,5ml V
6 Diazepam lar. Rektal 5mg/2,5ml (ste
7 Etanol 70 % Botol 100 mlV
8 Ethyl chlorida spray Botol V
9 Gentamisin Salep Kulit Tube V
10 Gentian Violet larutan 1% Botol V
11 Hydrokortison Cream Tube V
12 Ketokonasole/Solinfec cream Tube V
13 Kloramfenikol tetes telinga 3% Botol V
14 Lisol/kresol tersaponofikasi 50% Botol 1 L V
15 Myconazole cream Tube V
16 Nistatin tablet vagina 100.000 IU Tablet V
17 Povidon Iodine 60 ml Botol V
18 Salep 2-4 Kombinasi Pot V
19 Salisil Bedak 2 % Botol V
0 0 0
0 OBAT MATA 0
1 Kloramfenikol salep mata 1% Tube V
2 Kloramfenikol tetes mata 10ml Botol 10ml V

- Lain-lain
1 Obat Batuk Kombinasi Tablet V
2 Obat Flu Kombinasi Sirup Botol V
3 Hyosin Butilbromide tablet V
4 Glimepiride 2 mg Tablet V
TOPIKAL
1 Kloramfenikol salep kulit 2% Tube V
2 Perak Sulfadiazin krim 1% Tube V
3 Permetrin Krim 5% Tube V
4 Bisakodil suppo 5 mg suppo V

Ketersediaan obat terhadap formularium

124/134 x 100 = 92.54 %
 KETERSEDIAAN OBAT TERHADAP FORMULARIUM
PUSKESMAS KUTASARI 2016

BULAN : NOVEMBER 2016

NO NAMA OBAT SATUAN FORMULARIUM

ADA TIDAK
1 Acyclovir 400 mg tablet Tablet V
2 Alopurinol 100mg Tablet V
3 Ambroxol Tablet V
4 Ambroxol syrup Botol V
5 Aminofilin 200 mg Tablet V
6 Amitriptilin HCl 25 mg Tablet V
7 Amlodipin 10mg Tablet V
8 Amoksisilin 500 mg Caplet V
9 Amoksisilin Srp Krng 125mg/5ml Botol V
10 Amoksisilin Srp Krng 250mg/5ml Boto 60 ml V
11 Antalgin 500 mg Tablet V
12 Antasida Doen tab. Tablet V
13 Antasida sirop Botol V
14 As. Mefenamat 500 mg Kapsul V
15 Asam Askorbat (Vit.C) tab.50 mg Tablet V
16 Asetosal 100 mg Tablet V
17 Bekarbon Tablet V
18 Betahistin mesilat 6mg Tablet V
19 Captopril 25 mg Tablet V
20 Cefadroxil 500 mg Tablet V
21 Cefadroxil sirup 125 mg/5 ml Botol 60 ml V
22 Clozapine 25mg Tablet V
23 Cyprofloxacin 500 mg Tablet V
24 Deksametason tab.0,5 mg Tablet V
25 Diazepam tab. 2mg Tablet V
26 Digoxin 0,25mg Tablet V
27 Dimenhydrinat 50mg Tablet V
28 Doksisiklin 100 mg Kapsul V
29 Donperidon 10mg Tablet V
30 Donperidon 5mg/5ml suspensi Botol V
31 Erytromycin 500 mg Capsul V
32 Fenobarbital 30mg Tablet V
33 Fitomenadion Vit K 1 tab.10 mg Tablet V
34 Furosemid tab.40 mg Tablet V
35 Garam Oralit 200 ml air Bungkus V
36 Gemfibrozil 300 mg Kapsul V
37 Glibenklamid tab. 5 mg Tablet V
38 Gliseril Guaiakolat tab.100 mg Tablet V
39 Haloperidol 5 mg Tablet V
40 Hidroklorotiazid (HCT) tab. 25mg Tablet V
41 Ibuprofen tab.400 mg Tablet V
42 Iburofen suspensi 100mg/5ml Botol 60ml V
43 Isorbid Dinitrat 5mg Tablet V
 44 Kalsium Laktat (Kalk) tab.500 mg Tablet V
45 Ketokonasol 200mg Tablet V
46 Klindamicyn 300 mg Kapsul v
47 Kloramfenikol kap.250 mg Kapsul V
48 Kloramphenikol suspensi 125mg/5m
Botol v
49 Klorfeneramin Maleat(CTM) 4 mg (ATab/Box@10 V
50 Klorpromazin HCl 100mg tab. salut Tablet V
51 Kotrimoksazol Suspensi Botol V
52 Kotrimoksazol tab. Dws 480mg Tablet V
53 Loperamid Tablet V
54 Loratadin 10mg Tablet V
55 Meloksicam 15 mg Tablet V
56 Metformin 500mg Tablet V
57 Metil Prednisolon 4mg Tablet V
58 Metilergometrin Maleat 0,125 mg Tablet V
59 Metoklopropamid 10 mg Tablet V
60 Metronidazol 500 mg Tablet V
61 Na diklofenak 50 mg Tablet V
62 Neo Diaform/Stopdiar Tablet V
63 Nifedipin 10mg Tablet V
64 Nistatin tablet salut 500.000 IU/gr Tablet V
65 Omepazole 20 mg Kapsul V
66 Papaverin 40 mg Tablet (A) Tab/Box@10 V
67 Parasetamol sirup 120 mg/5 ml Botol V
68 Parasetamol tab. 500 mg Tablet V
69 Piracetam 400 mg Kapsul V
70 Pirantel Pamoat tab.125 mg Tablet V
71 Piridoksin Hcl.(Vit B6) 10 mg Tablet V
72 Piroksikam 20 mg tab. Tablet V
73 Prednison tab.5 mg (A) Tab/Box@10 V
74 Propanolol tab 40 mg Tablet V
75 Ranitidin 150mg Tablet V
76 Risperidone 2 mg Tablet V
77 Salbutamol 2 mg Tablet V
78 Salbutamol 4 mg Tablet V
79 Sianocobalamin 50 mg/Vit B12 (A) Tab/Box@10 V
80 Simvastatin 10 mg Tablet V
81 Tablet Tambah Darah Tablet V
82 Thiamin Hcl (Vit.B1)tab.50 mg (A) Tab/Box@10 V
83 Thiampenicole 500mg Kapsul V
84 Traneksamik Acid 500 mg Kapsul V
85 Triheksifenidil (THP) 2mg Tablet V
86 Vitamin B Complx tab (A) Tab/Box@10 V
87 Zink Tablet Kotak V
0 INJEKSI / LARUTAN INFUS 0
1 Atropin Sulfat Inj 0,25mg/ml-1ml Ampul V
2 Deksametason inj 5mg/ml-1ml ampul V
3 Diazepam inj. 5mg/ml-2ml Ampul V
4 Difenhidramin HCl inj Ampul V
5 Ephineprin /Adrenalin inj Ampul V
6 Fenobarbital Inj. 50 mg /ml--2ml Ampul V
 7 Fitomenadion (Vit. K1) Inj.2mg/ml Ampul V
8 Glukosa larutan infus 5% steril Botol V
9 Lidocain Injeksi 2%-2ml Ampul V
10 Metilergometrin Inj 0,2mg/ml - 1ml Ampul V
11 Metoklopropamid 5mg/ml inj ampul V
12 MgSO4 40 % Botol 25 ml V
13 Na Cl Infus 0.9% Botol V
14 Oksitocin inj 10 UI/ml Ampul V
15 Pehacain Inj Ampul V
16 Ringer Laktat lar. infus steril Botol V
17 Ranitidin inj 25mg/2ml Ampul V
18 Serum Anti Tetanus 1500 IU/Amp. Ampul V
0 TOPIKAL 0
1 Acyclovir 5% Ceam Tube V
2 Anti Bakteri DOEN salep Tube V
3 Antihaemoroid supp Supp V
4 Betametason krim 0,1% Tube V
5 Bisakodil suppo 10mg Suppo V
Tube 2,5ml V
6 Diazepam lar. Rektal 5mg/2,5ml (ste
7 Etanol 70 % Botol 100 mlV
8 Ethyl chlorida spray Botol V
9 Gentamisin Salep Kulit Tube V
10 Gentian Violet larutan 1% Botol V
11 Hydrokortison Cream Tube V
12 Ketokonasole/Solinfec cream Tube V
13 Kloramfenikol tetes telinga 3% Botol V
14 Lisol/kresol tersaponofikasi 50% Botol 1 L V
15 Myconazole cream Tube V
16 Nistatin tablet vagina 100.000 IU Tablet V
17 Povidon Iodine 60 ml Botol V
18 Salep 2-4 Kombinasi Pot V
19 Salisil Bedak 2 % Botol V
0 OBAT MATA 0
1 Kloramfenikol salep mata 1% Tube V
2 Kloramfenikol tetes mata 10ml Botol 10ml V

- Lain-lain
1 Obat Batuk Kombinasi Tablet V
2 Obat Flu Kombinasi Sirup Botol V
3 Hyosin Butilbromide tablet V
4 Glimepiride 2 mg Tablet V
TOPIKAL
1 Kloramfenikol salep kulit 2% Tube V
2 Perak Sulfadiazin krim 1% Tube V
3 Permetrin Krim 5% Tube V
4 Bisakodil suppo 5 mg suppo V

Ketersediaan obat terhadap formularium

125/134 x 100 = 93.28 %