Roma AKoddk DY DougMeypre Rr = atone Koos > ASA FORM SOAP PHARMACEUTICAL CARE PATIENT PROFILE Ta. /NyeT Jenis Kelamin : Lol ~Lode, TeLMRS =: L Octo Loan Usia 275 komen ‘Tl. KRS. : Tinggi badan = 16} em Beratbadan = Veg ‘Presenting Complaint: Rye Sovage {auiten, Tool We ddra dor sca Saeckos geo Larosa ok fon Larpuns, BPE THOT! UP) tau Diagnosa kerja — OOK dom Wwyskeny Diagnosa banding = > Relevant Past Medical History: Faac ado cmovpl gst eraarcal ka NED Drug Allergies? \ oN Oda wwoyer oresey CookTanda-tanda Vital ‘al ‘el ‘al al al “Tekanan darah 20 /100 ‘Nadi ag Suhw 26°C RR 25Medication ‘No. | Nama Obat Indikasi Dosis yang Dosis Terapi digunakan (literatut) Rese congas ass Levopenanay vey Prasing, Poses salogna | XL \aos lomyason, “Sener x gory Seeote sesuor Seog ee (ooksoueno’) fyesitsiean ward [Ronakercesatoaty hago sdiag eo toy compton haga solu] ee Yer ASKS : FAKES Koastely |(\eksavero) Jmrorernrnc’ he ogoer I wos sslocopy aseg Crudoge + 1X Straw UES 5 (v malt jaro okow "DS de 80 69 gedorscres —_ [MOPSARETON | Caksovens remaprohes WoT x ac nay REBPRE. TE HON Ran us i 4 PD NOS Paw dort Sten [Ciskrovera) [RO ~ GO emg Neato, [AOAC G0 Tad (B00 os) Nlockene arse gS egrsiyor] BF BOO OSs aaa ce 5 Balcony ae . Mags ETRET Cragst’) ae AL gor WOON . UNL WMD) | x QE roy Aaeeshersr = Ve sero} Uatgok soon — fhagrkorss don Roms (mos 160 v9) 6 apap yerkuro, Catad) hastens: 2 KO mek 28.6 49D), DE HRT yldod st, ed DA fa ah [A aed 9-0 x Tl ceretant Aeactgnon [aR .R pen | S8eOed a we C&vasug)LABORATORY TEST Test (normal range) tgl WBC (4000-10000/mm') Be ¥/N Hb (L: 13-17 g/dl) TELA RBC (4-6x10'/mm’) 9 food Tet (1-40-54) an PLT (150000-450000/mm') 130 lew ‘Gala darah poasa (76-110 mg/dL) Gula darah 2 jam PP (90-130 mg/dl) Cholesterol (150-250 mg/dL) TG (50-200 mg/dl) Uric acid (L:3,4-7 mg/dl) ‘Albumin (3,5-5,0 g/dL) fate de SGOT (0-35 u/1) ‘SGPT (0-37 w/L) BUN (10-24 mg/dl) Kreatinin (0.5-1,5 mg/dl) ‘Natrium (135-15 mEq/L) rfaletafe Kalium 3,5-5,0 mEq/L) IMA Cas - 40 “7 mak [rave C= 26%) Ve ENN | BRA Coo - BOE) (AS l MCU (yo - 9 Sk) Mew Cb .5 <3 G99) BND Mec C&D = bio ‘be S> 5 YN “Non QWeAAKSCON SRN gore] ‘No | __ Further Information Required ‘Alasan Beever Cowen Ede wedi PANE VIBES GRE 7 Leeg 4 rprayeek BW SAV _|Bogpamroca Vee Ske Ssen'] MRT MAMEOKON dak Teg rusy Legos a PREY AGRON goSteN Kae ohetoy EAWOe MeneA® Onck [Lee Joook ckoy ronson, sy Neqos gd astenRgaude gosen Lidue Marappea UUW MRUOFRSAAT WORD A fae acl Rogen Rigoiectn aen, Sudcin ceebokeateod BALA AENERMOIN Taro QS) 5 leomen soon rena 7 Rogar 9 word 6 JAGAN GOMN VAMON 8 AWK Mernagrainur TOyPR Ean “Hyaduskar Lomead'd erogghersran Leog Agokar oder QHUSOCON, AWE WOE ARA AUDIGT 4 oosok Noten Montes gosnen Agokoln 2S SAMO MEKOHE [UNO Memoerlow ton § Way sakdon cntokSion Lon < oe een Raanaykstnun Novdar gosrony 5. Reavy cdo gota Salou wpa) UARGK MEOW WoL edorluon Roda osu’) MORdar QoH.eNProblem List (Actual Problem) ‘Medical Pharmaceutical A. my Aron, 4 Coragprs ofa Sdova LMAeHy, wy colskoanted BHokaTsore CBA Doren eo Any Melrngraasdor 3, Octawmgonosy AD WEA @ON D> Loa q ome rere, Wale® gpSO\ Be) Son le URL MOAUTEMON, WALOWAN dorco\n Vacktone Momss\ ACRE OT FRA HIN ERENCE ROCVAQOON > - ey 5 otgoksor® bathe, b. on Dados Comewor I PEAOBARDNION ENT DorofRans svn, GR Ws OW, PHARMACEUTICAL PROBLEM Subjective (smptom) + osien mengglon, Wohi WAtddook don SAK - Objective (signs) 2702130 [00 MEMO, + QR Lay 2 35 * Toren “Oa 286% Romeswsoon Vetors bots 5 Bromus“LEVINE 260% -REN 1 BOY COLD Osseswank Tsk (COV) .% se MMRC 1 Assesment (with eidenc Plan (including primary care implications) Monitoring © Efektivits * Efek Samping Obat