Lampiran 1.

Lembar pengumpulan data

No Identitas pasien L/P Usia Diagnosa Tekanan darah Nama obat Golongan Aturan Terapi tunggal Terapi Ket
Generik Paten
( NO. RM ) pasien obat pakai kombinasi
1 521371 L 84 th CAD 140/80 Farsorbid 10 Diuretik 3x1 Kombinasi 26

HT Indapamid Diuretik 0-0-1 jul

Heart faikul Furosemide Diuretik 2-2-0

Spironolacton25 Diuretik 1-1-0

Captopril 12,5 ACEI 3x1

Amlodipine 10 CCB 0-0-1

2 534538 P 69 th HT ST 2 170/ 100 Farbivent Diuretik 2x1 26

Iskemia lateral + Canderin ARB 0-16 jul

HF stB Farsorbid Diuretik 3x5mg

PUD Concor 5 BB 5mg-0

Amlodipine10 CCB 0-0-10
 Lisinopril 10 ACEI 1x10mg

3 428935 P 87th Heart faikul 170/90 Klonidin Diuretik 3x1 25

Dyspepsia sydo HCT Diuretik ½-0-0 jul

HT Amlodipine10 CCB 0-1-0

Irbesartan300 ARB 1-0-0

Farsorbid Diuretik 3x5mg

Herbesser cd Diuretik 100-0-0

4 451785 L 73th HT 170/90 Captopril 25 0-0-1 8/10

DM Candesartan16 1-0-0 /16

Anolexia Amlodipine10 0-0-1

 2se

5 418885 L 46th CKD 110/80 Bisoprolol5mg 1-0-0 p

HT Clonidin 3x1

Hipoglikemi

Aure enarpapsia Amlodipine10 0-0-1

Gasril ulum Irbesartan150 0-0-1 22/7

6 521772 P 59th Heart faikul 190/90 Bisoprolol5mg 1-0-0

HT st 2 Klonidin 3x2

CKD st 5 Irbesartan300 0-0-1

Choleilthiasimulti Gemfibrozil 1-0-1

ple 300mg 16/9

Dislipidemia Irbesartan150 1-0-0

7 423196 L 57th CKD st V 170/90 Glucosamine 0-1-0

HT Allopurinol 1x100

Hepar TG Callos 1x1

Irvebal 1x300

Gemfibrozil 1x300 4/12

 Digoxin 5/10

Amlodipine10 1-0-0

8 278563 P 62th HT 170/90 Bisoprolol 5 0-0-1

?? Irbesartan300 0-0-1

9 291298 L 68 th CKD stV 160/80 Gemfibrozil 0-0-1 4/10

HT st 2 Cpg 1-0-0

HFst C Fc I Bisoprolol5mg 1-0-0

Anemia Amlodipine 5 1-0-0

27/a

10 322128 P 68th CKD st V 150/90 gust

AF RVR us

HT

Hiperglikemia Irbesartan300 1x300

Bisoprolol 5 1x5mg

11 600043 P 44th HT st 2 160/80 Amlodipine10 1x10mg 28/a

CKD st IV Irbesartan300 Canderin 1x300 gust

KP Bisoprolol5 1x5mg 23/n

 Dyspepsia ov

syndrome 1x16mg

Etfusi pleura Bisopolol5 Herbesercd 1x5mg \

12 603675 L 60th Ht st 1 160/90 Gemfibrozil Glucobay 1x300 27/o

Anemia CPG 1x75mg ct

13 470911 P 60th HT 150/90 200

DM 2x50mg

Dyspepsia Irbesartan300 1x300mg

syndrome

14 461796 P 71th HT 210/ 170 14/9

Hipoglikemia,slig

ht dysarthria flank

pain,ISK, ISDN 5 3x5mg

cholelitiasis Captopril 12,5 3x12,5 3/12

Bisoprolol 1x2,5mg

15 467283 L 65th CKD st 5 150/90

Nephohthiar
 HT ST I Amlodipin10 2x10mg 14/1

Hiper Irbesartan300 0-0-300 1

Bisoprolol5 5mg-0-0

16 391781 P 66th HF. 140/80 Clonidin 3x1

AF Furosemide Micardis 1-1-0

Hipertensi Amlodipine 0-0-10 11/7

Sinus arrest Furosemide 1-0-0

Sunctional 80-0-0

17 509708 L 30th CKD st 5 220/110

HT st 2 Adalatoros

Anemia Irvebal

Canderin 1/10

0-30

18 555311 P 63th Heart failu st 5 220/110 300-0

Koma 0-8mg

hypoglikema Propanolol 2x10mg

DM 19/8
 HT Micardis

Celulit Spironalocton herbesercd 0-25

ISDN 3x5

19 604188 P 53th Hipertensi 200/100 0-0-40

urgency st 2 100-0-0

Struma 25/7

Thyrad heart

disease

Amlodipine 10-0-0 26/1

20 553588 L 63th HF st C Fc IV 130/90 Irbesartan 0-0-300 1

AF RVR Valsartan Canderin 0-0-160

Trombositopenia

HT st 1 Bisoprolol 0-5 mg

Iskemia inferior 16-0

ISPA

1/12

21 574963 L 61th CKD st V 130/90

 Anemia

HT 14/1

22 456494 L 58th HT st 2 150/100

PUD

Trombositopenia 1/10

Acute Bisoprolol 1x5mg

inflammatory Irbesartan 1x300mg

diarhea

30/1

23 362214 L 80th HT 150/90 Bisoprolol 0-5mg 1

???? Clonidin 3x0,15

24 363960 L 64th HT st 2 140/80 Canderin 30/8

DM T 2,diabetic Spironolacton 0-25

foot Bisoprolol 5-0

 0-16

25 329868 P 54th CKD ST V 100/70 Canderin 2/7

HT ST 2 Concor

Anemia Bisoprolol 5mg-0

DM 0-16mg

Canderin 5mg-0

26 548740 L 59th HT st 2 170/90 3/8

Anemia

IBD 0-16

DM Furosemide 1-0-0 12/8

27 619623 L 59th CKD st V 160/90

HT st 2

Cystitis Amlodipine Canderin 1-0

Anemia Captopril Fasorbid 3x25mg 14/7

Herbesercd

28 619623 L 59th CKD st V 150/90 0-16

 HT st 1 3x5mg

Anemia 200-0 24/8

DM T 2 Clonidin Canderin 3x1

Bisoprolol Fasorbid 1x5mg

29 621367 L 50th HT 170/100

Vertigo 8-0 9/7

2x5mg

30 618525 P 53 th CKD st V 150/110 Valsartan 0-0-80

HT st 2 Furosemide 1-0-0

HF st B Micardis 1/8

Spironolacton 0-25-0

Furosemide 1-0-0

0-0-80

31 613375 L 44th Heart faikul st C 140/90

HT st 1 30/8

PVC mal??? ???

 Concor

32 423381 P 62th HF 120/80

HT Diltiazem 3x30mg

Dispepsia 0-0-5

3/12

33 408924 L 73th HT st 1 150/90 Canderin

Dyspepsia Bisoprolol farsorbid 5-0

syndrome Clonidin 3x0,15

0-16mg 10/1

34 508261 P 55th HT st 2 160/90 3x5mg 2

Fatty liver

DM T 2 ??????

Flank pain 5 4/10

35 553903 L 46th CKD st V 210/110 Micardis

HT St 2 Amlodipine Adalatoros 1x1 4/8

 Gouty arthritis Bisoprolol 0-5mg

Ca Buli Concor 0-80

30

36 637762 L 56th HT st 1 140/90 3/10

HF st B 0-2,5

HHD

Selulity cruris

37 638567 L 63th Gastrit 165/100 Micardis

HT st 2 Amlodipine 1x10 9/8

Hiperurisemia Bisoprolol Micardis 5mg-0

0-80mg

38 639269 P 73 th DM 160/90 0-80mg

HT Amlodipine Irvebal 300 10-0-0

Diare akut Furosemide Concor 5 1-0-0

Adalatoros

39 564031 L 57th CKD st 5 220/120 Farsix 0-1

 HT st 2 Farsorbid 1-0

1-0(30)

3x1(40)

40 562168 P 70th Heart fail 170/100 3x5mg

HT Clonidin 3x1

Captopril 3x25

3x50

41 631899 L 46th CKD st V 180/100 Amlodipine 1x10

HT 2x10

Anemia Clonidin 3x0.15

42 631339 P 48 th HT emergency 230/160