DOBUTAMIN

PENGPLOS (cc) 50 cc
SEDIAAN (mCg/amp) 250000 1 Amp

BB (kg) 90 kg
DOSIS (mCg/kgBB/mnt) KECEPATAN (cc/jam)

1 1.1
2 2.2
3 3.2
4 4.3
5 5.4
6 6.5
7 7.6
8 8.6
9 9.7
10 10.8
 DOPAMIN
PENGPLOS (cc) 50 cc
SEDIAAN (mCg/amp) 200000 1 Amp
BB (kg) 60 kg
DOSIS KECEPATAN
(mCg/kgBB/mnt) (cc/jam)
1 0.9
2 1.8
3 2.7
4 3.6
5 4.5
6 5.4
7 6.3
8 7.2
9 8.1
10 9.0
11 9.9
12 10.8
13 11.7
15 13.5
16 14.4
17 15.3
18 16.2
19 17.1
20 18.0
 NOREPINEPHRINE
PENGPLOS (cc) 50 cc
SEDIAAN (mCg/amp) 8000 2 Amp

BB (kg) 60 kg
KECEPATAN
DOSIS (mCg/kgBB/mnt)
(cc/jam)
0.025 0.6
0.05 1.1
0.1 2.3
0.2 4.5
0.3 6.8
0.4 9.0
0.5 11.3
0.6 13.5
0.7 15.8
0.8 18.0
0.9 20.3
1 22.5
 NICARDIPINE
PENGPLOS (cc) 50 cc
SEDIAAN (mCg/amp) 10000 1 Amp

BB (kg) 50 kg
DOSIS (mCg/kgBB/mnt) KECEPATAN (cc/jam)

0.1 1.5
0.2 3
0.3 4.5
0.4 6
0.5 7.5
1 15
1.5 22.5
2 30
2.5 37.5
3 45
3.5 52.5
4 60
4.5 67.5
5 75
 DILTIAZEM
PENGPLOS (cc) 50 cc
SEDIAAN (mCg/amp) 25000 1 Amp

BB (kg) 60 kg
DOSIS (mCg/kgBB/mnt) KECEPATAN (cc/jam)

0.5 3.6
1 7.2
1.5 10.8
2 14.4
2.5 18
3 21.6
3.5 25.2
4 28.8
4.5 32.4
5 36
 PAKET INTUBASI + CVC
Nama Pasien : JAM PERMINTAAN : ….................
Ruangan : icu
Nomor RM :

JUMLAH JUMLAH
NO RESEP DIMINTA DIDAPAT TERPAKAI RETURN
1 ETT NO. …........................ 1
2 CVC NO….......................... 1
3 BREATHING CIRCUIT *ADULT / PEDIATRIC 1
4 ELBOW CONECTOR 1
5 BACTERIAL FILTER 2
6 CLOSE SUCTION SET *NO.12 / NO. 14 1
7 SUCTION CATH *NO. 12 / NO. 14 / NO. 16 2
8 NGT *NO. 14 / NO.16 1
9 OPA/MAYO HIJAU 1
10 HANDSCOON STERIL *NO. 7,5 / NO. 7,0 1
11 GAUN STERIL 1
12 UNDER PAD 2
13 KASSA BOX STERIL 1
14 DERMAFIX 2
15 AQUABIDEST 5
16 T.SILK NO. 3,0 1
17 SPUIT 50CC LUBANG KECIL 1
18 SPUIT 50 CC LUBANG BESAR 1
19 SPUIT 3CC/5CC/10CC *5/5/5
20 WIDA WI 1000ML 1
21 MEDITRES 5
22 EXTENTION TUBE 3
23 THREE WAY 3
24 SALEP MATA 1
25 ASEPTIC LIQUID + SPONGE 1
26 CYRUS NEBULIZER 1
27 NOTRIXUM 1
28 NOVERON 1
29 MIDAZOLAM/MILOZ 5
30 PROPOFOL 1
31 TIOPOL 1
32 ETANYL 5
33 LIDOCAINE 1
34 KETAMINE 1
35
*lingkari yang dibutuhkan
TGL, …..... / …..... / 2023
*RESEP BILA TERPAKAI Mengetahui,

PETUGAS FARMASI PETUGAS RUANGAN