FORMULARIUM OBAT PEMELIHARAAN KESEHATAN MASYARAKAT SURAKARTA (PKMS) 2011

1 ANALGETIKA

1.1

ANALGETIKA NARKOTIKA Fentanil Kodein 10mg Morfin Morfin 10mg Pethidin Sufentanil ANALGETIKA ANTIPYRETIK/ANTIINFLAMASI Asam Asetil Salycilat (Asetosal) Fenilbutason 200 mg Ibuprofen 200 mg Ibuprofen 400 mg Metampiron Metampiron injeksi Parasetamol Parasetamol Asam Mefenamat 500 mg Tramadol 50 mg Tramadol 50 mg Ketorolac 10 mg Ketorolac 30 mg Natrium Diklofenak 25 mg Natrium Diklofenac 50 mg Ketoprofen 100 mg Ketoprofen 100 mg Meloxicam 7.5 mg Meloxicam 15 mg Piroksikam 10 mg Piroksikam 20 mg

SEDIAAN Injeksi Tablet Injeksi Tablet Injeksi Injeksi

1.2

Tablet Tablet Tablet Tablet Tablet Vial Tablet Sirop Kaplet Kapsul Injeksi Injeksi Injeksi Tablet Tablet Tablet Supp Tablet Tablet Tablet Tablet

1.3

ANTIPIRAI Allopurinol 100 mg Kolkhisin 500mcg ANESTETIK Etil Klorida spray Bupivakain 0,5% 100ml (klaim per cc) Lidokain injeksi + Ephinefrin Lidokain injeksi Ketamin injeksi 10mg/ml Tiopental 1000 mg Atropin Atropin Injeksi Morphin 10 mg Morphin 10mg/ml
ANTI ALERGI DAN ANAFILAKSIS

Tablet Tablet

1.4

Spray Injeksi Ampul Ampul Vial Ampul Tablet Injeksi Tablet Injeksi

Deksametason Deksametason 5mg/ml Difenhidramin injeksi Epinefrin (Adrenalin) Klorfeniramin Maleat (CTM) Cetirizine Loratadine
3 ANTIDOTUM

Tablet Injeksi Ampul Ampul Tablet Tablet Tablet

Carbo adsorben Magnesium sulfat Magnesium sulfat 20% Magnesium sulfat 40% Kalsium gluconat Natrium tiosulfat inj

serbuk Injeksi Injeksi injeksi injeksi

ANTIEPILEPSI

Diazepam rectal 5mg/ml Diazepam injeksi Stesolid Diazepam 2 mg Fenitoin 100 mg Fenitoin 100mg injeksi Fenobarbital 30 mg Fenobarbital injeksi Karbamazepin 200 mg Na.Valproat 250 mg Na.Valproat 500 mg Na.Valproat sirup
5 ANTIINFEKSI

SEDIAAN rect tube injeksi injeksi Tablet Kapsul Injeksi Tablet Ampul Tablet Tablet Tablet Sirup

5.1

ANTHELMENTIK Albendazol 400 Mebendazol 500 Pirantel 125

tablet tablet tablet

5.2

ANTIFILARIA Dietilkarbamazin 50 Dietilkarbamazin 100 BETALAKTAM Amoksisilin 500 Amoksisilin sirup Amoksisilin 1 g injeksi Ampicillin 500 Ampicillin sirup kering Ampicillin 1 g injeksi Phenoksimetil Penicillin 500 Procain Benzylpenicillin 3jt IU Benzatin penicillin 1,2jt IU Benzatin penicillin 2,4jt IU TETRACYCLIN Tetracyclin 250 Tetracyclin 500 Oxytetracyclin 50mg/ml injeksi Doxicyclin 100 mg CHLORAMPHENICOL Chloramphenicol 250 Chloramphenicol sirup Chloramphenicol 1g injeksi Tiamfenicol 500 COTRIMOXAZOL Cotrimoxazol anak Cotrimoxazol sirup Cotrimoxazol dws

tablet tablet

5.3

tablet sirup krg injeksi tablet sirup krg injeksi tablet injeksi injeksi injeksi

5.4

kapsul kapsul injeksi kapusl

5.5

kapsul sirup injeksi kapsul

5.6

tablet tablet tablet

5.7

MAKROLIDA Erythromicin 250 Erythromicin sirup Spiramycin 500 Clindamycin 150 Clindamycin 300 Linkomisin 500 AMINOGLIKOSIDA Gentamycin 40mg/ml injeksi Streptomycin 1000mg injeksi QUINOLON Levofloxacin 500mg Ofloxacin 400

kapsul kapsul tablet kapsul kapsul kapsul SEDIAAN vial vial

5.8

5.9

tablet tablet

Ciprofloxacin 500 Ciprofloxacin infus 100ml 5.10 CEFALOSPORIN Cefadroxil 500 Cefadroxil sirup Cefixim 100 Cefotaxim 1000mg Ceftriaxone 1000mg ANTI BAKTERI LAIN Sulfasalazin 500

tablet btl

kapsul sirup kapsul injeksi injkesi

5.11

tablet

5.12

ANTI LEPRA/TBC Rifampisin 300 mg Rifampisin 450 mg Rifampisin 600 mg Ethambutol 250 mg Ethambutol 500 mg Isoniazide 100 mg Isoniazide 300 mg Pirazinamid 500 mg Streptomisin 1000 mg injeksi Streptomisin 1500 mg injeksi ANTIFUNGI Flukonazol 50mg Griseovulfin 125 Ketoconazol 200 Ketoconazol cream Nystatin 100.000 IU vag tab Nystatin tab Nystatyn suspensi Borax glycerin Gentian violet ANTI AMUBA Metronodazole 500 Metronidazole infus 5mg/ml ANTI MALARIA Chloroquin 250 mg Primaquin 15mg

kapsul tablet tablet tablet tablet tablet tablet tablet Vial Vial

5.13

kapsul tablet tablet krim vag.tab tablet oral susp liq liq

5.14

tablet btl

5.15

tablet tablet

5.16

ANTI VIRUS Acyclovir 200 mg Acyclovir 400 mg Acyclovir cream

ANTI MIGREN

tablet tablet krim SEDIAAN tablet

Ergotamin coffein 1mg

7 ANTI PARKINSON

Trihexiphenidil 2 mg Kombinasi : Levodopa 100mg + Benzarasid 25mg Pramipexole HCl 125mcg Kombinasi : Levodopa 100mg + Carbidopa 25mg + Entecapone 200mg
8 OBAT UNTUK DARAH DAN JARINGAN PEMBENTUK DARAH Anti Anemi

tablet tablet tablet tablet

8.1

Asam Folat 1 mg Besi(II) Sulfat 300mg Sianokobalamin 50mcg Sianokobalamin inj 500mcg/ml 8.2
Obat yang Mempengaruhi Koagulasi Dextran 70 6%

tablet tablet tablet ampul

Fitomenadion 10 mg

Infus tablet

Fitomenadion 10mg/ml inj Heparin Na 5000IU/ml Asam Traneksamat 250mg/5ml Asam Traneksamat 500mg Asam Traneksamat 500mg/5ml Enoxaparin Sodium 40mg/0,4ml Enoxaparin Sodium 60mg/0,6ml

ampul vial ampul kaplet ampul vial vial

ANTI SEPTIK dan DESINFEKTAN

9.1

ANTISEPTIK Povidon Iodida 10% 1000 ml Povidon Iodida 10% 30 ml Povidon Iodida 10% 60 ml Asam Pipemidat 400mg DESINFEKTAN Etakridin 0,1% Etanol 70% 100 ml
DIURETIK

sol sol kapsul

9.2

sol 300ml sol

10

Amilorid HCl 2,5mg Furosemid 40mg Furosemide inj 10mg/ml Hidroklorotiazide 25mg Spironolakton 25 mg Spironolakton 100 mg
11 ANTIDIABETIK

tablet tablet injeksi tablet tablet tablet

11.1

ANTIDIABETIK ORAL Glibenklamida Glipizid 5 mg Gliquidone 30 mg Glimepiride 1 mg Metformin 500 mg Metformin 850 mg ANTIDIABETIK LAIN Humulin R 100 IU Humulin N 100 IU
HORMON

Tablet Tablet Tablet Tablet Tablet Tablet

11.2

Injeksi Injeksi

12

12.1

ESTROGEN Bromocriptine 2,5 mg PROGESTERON Noretisteron 5 mg TIROID DAN ANTITIROID Larutan Lugol Natrium tiroksin 0,1 mg Propiltiourasil 100 mg KORTIKOSTEROID Deksametason 0,5 mg Deksametason inj Metil prednisolon 4 mg Metil prednisolon 16 mg Metil prednisolon 125 mg/2ml, Predison 5 mg
OBAT JANTUNG

Tablet SEDIAAN Tablet

12.2

12.3

Botol Tablet Tablet

12.4

Tablet Ampul Tablet Tablet vial Tablet

13

13.1

ANTIANGINA Diltiazem HCL 30 mg Diltiazem inj Isosorbid dinitrat 5 mg ANTIARITMIA Epinefrin 0,1% inj Propranolol 10 mg

Tablet Ampul Tablet

13.2

Injeksi Tablet

Propranolol 40 mg Disopiramid 100mg

Tablet Kapsul

13.3

ANTIHIPERTENSI Kaptopril 12,5 mg Kaptopril 25 mg Lisinopril 5 mg Lisinopril 10 mg Ramipril 5 mg

Tablet Tablet Tablet Tablet Tablet

13.4

BETA BLOKER Propranolol 10 mg Propranolol 40 mg Atenolol 50 mg Atenolol 100 mg Bisoprolol 5 mg KALSIUM ANTAGONIS Nifedipin 10 mg Amlodipin 5mg Verapamil 80 mg Verapamil 2,5 mg inj ANTIHIPERTENSI LAIN Klonidin 0,15 mg inj Klonidin 0,15 mg Metildopa 250 mg Reserpin 0,10 mg Reserpin 0,25 mg GAGAL JANTUNG Digoxin injeksi Digoksin 0,25 mg Bisoprolol 5 mg ANTITROMBOTIK Asam asetilsalisilat 80 mg Asam asetilsalisilat 100 mg
OBAT UNTUK SYOK

Tablet Tablet Tablet Tablet Tablet

13.5

Tablet Tablet Tablet Injeksi

13.6

Injeksi Tablet Tablet Tablet Tablet

13.7

Ijneksi Tablet Tablet

13.8

Tablet Tablet

14

14.1

VASODILATOR Pentoksifilin 400 mg Pentoksifilin inj 300mg/15ml ANTIHIPERLIPIDEMIA Simvastatin 10 mg Pravastatin 20 mg Gemfibrozil 300 mg Gemfibrozil 600 mg

Tablet Injeksi

14.2

Tablet Tablet Kapsul Kapsul

15

OBAT TOPIKAL UNTUK KULIT

15.1

ANTIAKNE Lotio kummerfeldi ANTIBAKTERI Framisetin Natrium fusidat krim Enbatic ANTIFUNGI Antifungsi DOEN Salep Mikonazol krim/salep 2% ANTIINFLAMASI Betametason 0,1% Betametason Hidrokortison 2,5%

Lotio

15.2

Kasa Steril Krim Serbuk

15.3

Salep Krim/Salep

15.4

Krim 10 g Tablet Krim

15.5

ANTISKABIES DAN ANTIPEDIKULOSIS Salep 2-4

Salep

15.6

KERATOLITIK DAN KERATOPLASTIK Asam Salisilat Salep 2% Asam Salisilat Salep 5% Urea 10% LAIN-LAIN Bedak Salycil Liquor faberl

Salep Salep Krim

15.7

Bedak Liquor

16

LARUTAN ELEKTROLIT DAN NUTRISI

16.1

ORAL Garam Oralit Kalium klorida 600 mg

Serbuk Effervescent

16.2

PARENTERAL Aminofusin Paediatrik Aminovel 500 Glukosa 5% inf Glukosa 10% inf Glukosa 40% inf Kidmin Natrium Klorida infus 0,9% 500ml Natrium Klorida infus 0,9% 1000ml Ringer Laktat infus 500 ml Ringer Laktat infus 1000ml Natrium Bikarbonat inj Natrium Bikarbonat inj Larutan Nutrisi DOEN IV Kombinasi (D1/2S) Larutan Nutrisi DOEN V Kombinasi Larutan Nutrisi DOEN VI Kombinasi Air Untuk Injeksi Air Untuk Irigasi
OBAT MATA

Larutan Infus Larutan Infus Larutan Infus Larutan Infus Larutan Infus Larutan Infus Larutan Infus Larutan Infus Larutan Infus Larutan Infus Injeksi 25ml Injeksi 100ml Larutan Infus Larutan Infus Larutan Infus Injeksi 25ml 1000ml

17

17.1

SISTEMIK Azetazolamida 250 mg TOPIKAL ANESTETIK LOKAL Tetrakain TM ANTIMIKROBA Amfoterisin 3% Gentamisin Idoksuridin Kloramfenikol 3,5g Kloramfenikol 5g Kloramfenikol 0,5% Kloramfenikol 1% Oksitetrasiklin Sulfasetamid MIDRIATIK Atropin 0,5% Homatropin Tropikamida 1% MIOTIK DAN ANTIGLOUKOMA Pilokarpin Timolol 0,25% Timolol 0,5%

SEDIAAN Tablet

17.2

Tetes mata

17.3

Salep mata Salep Mata Tetes mata salep mata salep mata Tetes mata Tetes mata salep mata Tetes mata

17.4

Tetes mata Tetes mata Tetes mata

17.5

tts mata tts mata tts mata

17.6

LAIN-LAIN Metiselulosa

lar

18

OBAT THT

18.1

ANTIBAKTERI TOPIKAL Kloramfenikol 3%

tetes telilnga

18.2

LAIN-LAIN Karbogliserin 10%

tetes telilnga

19

OKSITOSIK DAN RELAKSAN UTERUS

19.1

OKSITOSIK Metilergometrin Metilergometrin Oktitosin RELAKSAN UTERUS Magnesium sulfat 20% 20ML Magnesium sulfat 40% 20 ML

tab salut inj inj

19.2

inj inj

20

PSIKOFARMAKA

20.1

ANTIANSIETAS DAN ANTIINSOMNIA Alprazolam 0.5mg Clobazam Alprazolam 1mg Diazepam 2ml Diazepam 2 mg ANTIDEPRESI DAN ANTIMANIA Amitriptilin Cepezet inj Klopromazin 100mg Klopromazin 25mg/ml

tablet tablet tablet inj Tablet

20.2

tablet salut Injeksi tablet salut inj

20.3

ANTIOBSESIF KOMPULSIF Klomipramin ANTIPSIKOSIS Flufenazin 2,5mg Haloperidol 0.5mg Haloperidol 1,5mg Haloperidol 5mg Haloperidol Haldol decanoat inj 5mg/ml Trifluoperazin 5mg Risperidon 1mg Risperidon 2mg

SEDIAAN tablet

20.4

tablet tablet tablet tablet INJ Injeksi tablet tablet tablet

21

OBAT SALURAN CERNA

21.1

ANTASIDA DAN ANTIULKUS Antasida DOEN I Antasida DOEN II Ranitidin 150mg Ranitidin Lanzoprazole Omeprazole Cimetidin ANTIEMETIK Dimenhidrinat Domperidon 10 mg Metoklopramid 10mg Metoklopramid Metoklopramid

tablet kunyah susp tablet inj kaps kaps tablet

21.2

tablet tablet tablet inj sir

Betahistine mesilat 8mg Ondansetron 4mg/2ML Ondansetron 8mg/2ML 21.3 ANTIHEMOROID Antihemoroid DOEN

tablet inj inj

sup

21.4

ANTISPASMODIK Papaverin HCl Loperamid Cisapride 5mg Atropin 0,25mg/ml Hyoscine-N-butil bromide

tablet tablet tablet inj tablet

21.5

OBAT DIARE Garam Oralit

21.6

KATARTIK Bisakodil 5mg Bisakodil 10mg

sup sup

22

OBAT SALURAN NAFAS

22.1

ANTIASMA Aminofilin 200mg Aminofilin Efedrin Efedrin Salbutamol 2mg Salbutamol 4mg Terbutalin sulfat 2,5mg Terbutalin sulfat Terbutalin sulfat Teofilin Ventolin inhaler Ventolin nebulizer Pulmicort respules Bricasma respules

SEDIAAN tablet inj tablet inj tablet tablet tablet inj Sir tablet Inhaler Nebulizer Respules Respules

22.2

ANTITUSIF Dekstrometorfan 15 mg Dekstrometorfan Kodein 10mg Sirop timi majemuk

tablet syr tablet cairan

22.3

EKSPEKTORAN Ambroxol 30mg Ambroxol sirup Bromhexin HCl Gliseril guaiakolat OBH 100 ml
SISTEM IMUN

tablet btl 60 ml tablet tablet sirup

23

23.1

SERUM DAN IMUNOGLOBULIN ABU I ABU II 20.000 IU ABU II 1.500 IU VAKSIN

BCG Campak Polio DPT TT

Inj Inj inj

23.2

inj inj inj inj inj

24

THT

24.1

ANTIBAKTERI Kloramfenikol LAIN-LAIN Fenol gliserol Karbogliserin Oksimetazolin 0,025% Oksimetazolin 0,05%

Tts telinga

24.2

Tts Tts Tts Tts

telinga telinga hidung hidung

25

VITAMIN DAN MINERAL

Asam askorbat (vit C) 50mg Kalsium laktat Piridoksin(vit B6) Piridoksin(vit B6) Retinol 50.000 IU Tiamin Tiamin Vitamin B komplek Zink elemental Calcium Gluconat inj
26 LAIN LAIN

tablet tablet tablet inj tablet tablet inj tablet Tablet Injeksi SEDIAAN inj tablet

Kalsium glukonat Kalsium karbonat

27

ANTINEOPLASTIK, IMUNOSUPRESAN DAN TERAPI PALIATIF

27.1

ANTI HORMON Tamoksifen 20mg Testosteron 40mg IMUNOSUPRESAN Azatioprin Siklosporin 25 mg SITOTOKSIK 5 FU 250 mg 5 FU 500 mg Asparaginase 10.000 IU Bleomycin 15mg Capecitabin 500mg Dacarbasin 200mg Doxorubicin 10mg Doxorubicin 50mg Etoposid 20mg Etoposid 100mg Calcium Folinat 15mg Calcium Folinat 50mg Levamizol 25mg Merkaptopurin Methotrexate 2,5mg Methotrexate 5mg Methotrexate 50mg Plaxicasel 30mg Citabarin 100mg

tablet kapsul

27.2

tablet kapsul

27.3

tablet tablet Inj Inj Tablet Inj Vial 10ml Inj Kapsul Tablet Inj Kapsul Tablet Inj Inj Inj Inj

Ciclofosfamid 50mg Ciclofosfamid 200mg Ciclofosfamid 500mg Ciclofosfamid 1000mg Cisplatin 10mg Cisplatin 50mg Vinblastin 10mg Vincristin 1mg 27.4 TERAPI PALIATIF Morphin 10mg

Tablet Inj Inj Inj Inj Inj Inj Inj

Tablet

Morphin 10mg
28 KONTRAS

Inj

Iopamiro 370mg/30ml Iopamiro 300mg/50ml

28 LIVE SAVING

Injeksi Injeksi

Albumin 20% 50ml Albumin 20% 100ml Albumin 25% 50ml Albumin 25% 20ml Pethidin inj Fentanil 0,05mg Plasmanat Dopamin 40mg/ml Dobuject 250mg Streptokinase 1.500.000 IU Tracrium 10mg@2,5 ml Calcium Gluconat inj ATS 1500 ATS 20000

Infus Infus Infus Infus

Injeksi Injeksi

Infus Ijneksi Injeksi Injeksi Injeksi Injeksi Injeksi Injeksi