1.

DAFTAR OBAT EMERGENCY

Tanggal
No Nama generik Nama Dagang Satuan Jml
kadaluarsa
1 Isosorbid Dinintrat 5 mg Farsorbid 5 mg Tablet 2
2 Isosorbid Dinintrat 10 mg Farsorbid 10 mg Tablet 2
3 Furosemid Inj Lasix Inj Ampul 2
4 Aspilet 80 Mg Tablet 4
5 Clopidogrel 75 Mg Tablet 4
6 Atropin sulfas Inj Ampul 10
7 Salbutamol Nebules Ventolin nebules Ampul 2
8 Terbutalin Inj Bricasma Inj Ampul 2
9 Aminophilin Inj Ampul 2
10 Diazepam Inj Valisanbe Inj Ampul 2
11 Dexamethasone Inj Ampul 2
12 Diazepam Supp 5 mg Stesolid 5 mg Tube 1
13 Diazepam Supp 10 mg Stesolid 10 mg Tube 1
14 Paracetamol Inf Botol 2
15 Metamizole Inj Santagesik Inj Ampul 2
16 Ketorolac 30 mg Ampul 2
17 Ketorolac 10 mg Ampul 2
18 Bisoprolol 5 mg Tablet 2
19 Digoxin 0.25 mg Fargoxin tab Tablet 2
20 Nicardipin 100 Inj Ampul 2
21 Dopamin Inj Ampul 2
22 Dobutamin Inj Ampul 2
23 Epinephrine Inj Ampul 10
24 Norepineprine Inj Raivas Inj Ampul 2
25 Nacl 0.9%Inf 500 ml Botol 1
26 D5% Inf 500 ml Botol 1
27 RL inf 500 ml Botol 1
28 Dispo 1/3/5/10/20/50 Biji 2/2/2/2/2/2

1. DAFTAR OBAT EMERGENCY AMBULANCE

Tanggal
No Nama generik Nama Dagang Satuan Jml
kadaluarsa
1 Isosorbid Dinintrat 5 mg Farsorbid 5 mg Tablet 2
2 Isosorbid Dinintrat 10 mg Farsorbid 10 mg Tablet 2
3 Furosemid Inj Lasix Inj Ampul 2
4 Aspilet 80 Mg Tablet 4
5 Clopidogrel 75 Mg Tablet 4
6 Atropin sulfas Inj Ampul 10
7 Salbutamol Nebules Ventolin nebules Ampul 2
8 Terbutalin Inj Bricasma Inj Ampul 2
 9 Aminophilin Inj Ampul 2
10 Diazepam Inj Valisanbe Inj Ampul 2
11 Dexamethasone Inj Ampul 2
12 Diazepam Supp 5 mg Stesolid 5 mg Tube 1
13 Diazepam Supp 10 mg Stesolid 10 mg Tube 1
14 Paracetamol Inf Botol 2
15 Metamizole Inj Santagesik Inj Ampul 2
16 Ketorolac 30 mg Ampul 2
17 Ketorolac 10 mg Ampul 2
18 Bisoprolol 5 mg Tablet 2
19 Digoxin 0.25 mg Fargoxin tab Tablet 2
20 Nicardipin 100 Inj Ampul 2
21 Dopamin Inj Ampul 2
22 Dobutamin Inj Ampul 2
23 Epinephrine Inj Ampul 10
24 Norepineprine Inj Raivas Inj Ampul 2
25 Nacl 0.9%Inf 500 ml Botol 1
26 D5% Inf 500 ml Botol 1
27 RL inf 500 ml Botol 1
28 Dispo 1/3/5/10/20/50 Biji 2/2/2/2/2/2

2. DAFTAR OBAT-OBAT HIGH ALERT DAN LASA/NORUM

1. DAFTAR OBAT- OBAT HIGH ALERT

KELAS NAMA BENTUK NAMA KETERAN

NO KEKUATAN
TERAPI GENERIK SEDIAAN DAGANG GAN
Preparat Insulin Pen Novorapid 100 IU/ ml
Insulin
Insulin Pen Lantus 100 IU/ ml
1
Insulin Pen Novomix 100 IU/ ml
Insulin Pen Humalog 100 IU/ ml
 Insulin Pen Apidra 100 IU/ ml
60 mg/ 0,6 ml
Natrium
Syringe Lovenox 40 mg/ 0,4 ml
Enoxaparin
20 mg/ 0,2 ml
4250 Axa iu/
0,4 ml
Parnaparin Syringe Fluxum
6400 Axa iu/
0,6 ml
Preparat Natrium 2,5 mg/ 0,5ml
2 Syringe Arixtra
Trombolitik Fondaparium 7,5 mg/ 0,6 ml
Heparin Sodium Vial Inviclot 5000 IU
Alteplase Vial Actilyse 50 mg
Streptokinase Vial Fibrion 1.500.000 IU
Monohidrat, 0,75 mg/ ml
Asam
Ampul Integrilin 2 mg/ m
Sitrat, Natrium
Hidroxida
Anticoagulan Warfarin Tablet Simarc 2 mg
3 Oral 15 mg
Rivaroxaban Tablet Xarelto
20 mg
Dextrosa Elektrolit
Dexrtrosa 40% Vial 40% 40% pekat tidak
Mgso4 40% Vial MgSo4 40% 40% boleh
disimpan di
Elektrolit Mgso4 20% Vial MgSo4 20% 20% ruang
4 KCL Vial KCl 7,46%
Pekat perawatan
Meylon 84 Vial Meylon 84 8,4% kecuali
IGD, VK,
Ca.Gluconas Vial Ca.Gluconas 10%
OK dan
Nacl 3% Fles NaCl 3% 3% ICU
Alprazolam 0,5 mg .
Feprax 0,5 mg
Alprazolam Tablet
Xanax 0,5 mg
Zypraz 0,5 mg
Clobazam Tablet Clobazam 2 mg
2mg
Tablet
5 mg
Valisanbe
Diazepam 5 mg/ 2ml
Ampul
Penurunan 10 mg/ 2ml
Kesadaran Tablet Analsik 0,5 mg
5
dan 1 mg
Relaksasi
Ativan 2 mg
Lorazepam Tablet
0,5 mg
Merlopam 1 mg
2 mg
Estazolam Tablet Esilgan
1 mg/ ml
5 mg/ml
Midazolam Ampul Anesfar
15 mg/ 3 ml
5 mg/ ml
Midazolam Ampul Sedacum
1 mg/ ml
 5 mg/ml
Midazolam Ampul Midazolam
10 mg
Zolpidem Tatrate Tablet Zolmia 50 mg
Eperisone Tablet Myonal 2 mg
Tizanidine Tablet Myores 100%
0,5 % (5,0
Sevoflurane Botol Sevorane mg/ml)
Chirocaine 5 mg/ ml
Levobupivacain Ampul
Vopicaine 10 mg/ ml
20 mg/ ml
Profopol Ampul Recofol
250 ml
6 Anestesi
Isoflurane Botol Isoflurane 7,5 m / ml
Ropivacain Ampul Naropin 10 mg/ml
Atracurium Ampul Tramus 10 mg/ ml
Recuronium
Ampul Belnium 0,5 g
Bromide
Thiopenta Ampul Tiopol 15 mg
Tab MST 10 mg/ml
Morfin
Ampul Morfin 0,05 mg/ ml
Ampul Fentanyl 12 mcg/ hr
25 mcg/hr
Fenthanil
Pach Durogesik 50 mcg/hr
10 mg
15 mg
Codein Tab Codein
20 mg
Codein 50 mg,
Opioid / Tab Codipront Phenyltoloxam
7 ine 10 mg
Narkotik
Codein 11,11
Codipront mg,
Phenyltoloxam
Syr Codipront
ine 103,67
mg / 5 mg
(60 ml)
Codein 50 mg,
Coditam Tab Coditam paracetamol
500 mg
Pethidin Ampul Pethidin 50 mg/ ml
Nalokson Ampul Nokoba 0,4 mg/ ml
Lohexal Botol Xolmetras 50 ml
7 Kontras 50 ml
Lopamidol Botol Lopamiro
30 ml
0,1 mg/ ml
Epinephrine Ampul Epinephrine
1mg/ ml
Norepinephri
1mg/ ml
Adrenergik Norepinephrine Ampul ne
8 Raivas 1 mg/ml
Ampul Digoxin 200 mg/ 5 ml
Digoxin Tab Digoxin 0,25 mg
Tab Fargoxin 0,25 mg
 Dobutamin –
Vial 250 mg/ 5 ml
Dobutamin hameln
Ampul Dobujek 250 mg/ 5 ml
Dopamin Ampul Dopamin 250 mg/ 5 ml
Tab Ephedrine 25 mg
Ephedrin
Ampul Ephedrine 50 mg/ ml
Cordaron 150 mg/ 3 ml
9 Antiaritmia IV Amiodarone Ampul
Tiaryt 150 mg/ 3 ml
2,5%
Neuromus-
Atracurium
10 cular Bloking Ampul Tramus
Besylate 5%
Agent

2. DAFTAR OBAT-OBAT LASA/ NORUM

NO KEMASAN MIRIP

1 Cefotaxime Inj. Ceftriaxone Inj.

2 Epexol syr 100 ml Episan Syr 100ml
3 Infusan D5 + 1/4 NS Infusan M20
4 Levofloxacin inf. Ciprofloxacin inf.
5 Pantoprazole Inj. (berno) Omeprazole Inj. (berno)
6 Thrombo aspilet tab Aspilet 80 tab
7 Vosedon Syr. Santagesik Syr.

NO
NAMA OBAT SAMA KEKUATAN BEDA
1 Acyclovir 200 mg Tab Acyclovir 400 mg Tab
2 Allopurinol 100 mg Allopurinol 300 mg
3 Amlodipin 5 mg Tab Amlodipin 10 mg Tab
4 Canderin 8 mg Canderin 16 mg
5 Captopril 12.5 mg Captopril 25mg, 50mg
6 Cefixime 100 mg Cefixime 200 mg
7 Cefspan 100 mg Cefspan 200 mg
8 Celebrex 100 mg Celebrex 200 mg
9 Clindamycin 150 mg Clindamycin 300 mg
10 Clopidogrel 75 mg Clopidogrel 300 mg
Codein 15 mg
11 Codein 10 mg
Codein 20 mg
12 Cygest 200 mg supp Cygest 400 mg supp
13 Eflagen 25 mg Eflagen 50 mg
14 Farsorbid 5 mg (subbilingual) Farsorbid 10 mg
15 Flamar 25 mg Flamar 50 mg
16 Forbetes 500 mg Forbetes 850 mg
17 Gabexal 100 mg Gabexal 300 mg
 Glimipiride 2 mg Tab
31 Glimipiride 1mg Tab
Glimepiride 4 mg
Gluvas 2 mg
33 Gluvas 1mg Gluvas 3 mg
Gluvas 4 mg
34 Gratizin 5 mg Gratizin 10 mg
35 Harnal D Harnal OCAS
36 Herbesser CD 100 mg Herbesser CD 200 mg
39 Ketorolac 1% Ketorolac 3%
43 Maltofer tab Maltofer Fol Tab
44 Mefinal 250 mg Mefinal 500 mg
45 Meloxicam 7.5 mg Meloxicam 15 mg
46 Meptin 0,025 mg Meptin 0,05 mg
47 Meropenem 0,5 g Meropenem 1 g
48 Merosan 0,5 g Merosan 1 g
49 Mertigo SR Mertigo
50 Methylprednisolone 4 mg Methylprednisolone 16 mg
52 Na. Diklofenak 25 mg Na. Diklofenak 50 mg
55 Ondansetron 4 mg Ondansetron 8 mg
Piracetam 800 mg
58 Piracetam 400 mg
Piracetam 1200 mg
62 Pronalges 50mg Pronalges 100 mg
63 Propanolol 10 mg Propanolol 40 mg
68 Salbutamol 2 mg Salbutamol 4 mg
Sanexon 8 mg,
69 Sanexon 4 mg
Sanexon 16 mg
70 Sanmol 500mg Sanmol Forte 650 mg
71 Simvastatin 10 mg Simvastatin 20 mg
72 Sporetik 100 mg, Sporetik 200 mg
73 Stator 10 mg Stator 20 mg
74 Stesolid 5 mg supp Stesolid 10 mg supp
75 Tensivask 5 mg Tensivask 10 mg
77 Thyrozol 5mg Thyrozol 10 mg
78 Trolip 100 mg Trolip 300 mg
79 Valemia 5 mg Valemia 10 mg
80 Valisanbe 2 mg Valisanbe 5 mg

NO NAMA OBAT MIRIP UCAPAN

1. Asam Mefenamat Asam Traneksamat

2. Ephedrine Inj Eprineprine Inj
3. Folamil Tab Folavit Tab
4. Lansoprazol Pantoprazol
5. Nifedipin Amlodipin
6 Vertikaf Ericaf