27/03/2023

NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI

1 Ny. Cucu Nuraeni 301 dyspepsia dengan Vomitus RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg 2x1(prn) √
ondancetron iv 4mg 2x1 √
ceftriaxone iv 1g 2x1(ST) √
sucralfate susp 3x2cth √

2 Ny. Echa Yulia Febriana 302 VI , rhinofaringitis RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
sanmol infus 1g Prn √
sanmol f tab 650mg 3x1 √
N- Acetylcystein caps 200mg 3x1 √
rhinos SR caps 160mg 2x1 √

3 Tn. Muchlis Ramdhani T 303 vertigo perifer, vomitus, HT asering 20tpm √

ondancetron iv 4mg prn √
difenhidramin iv 1cc extra √
pantoprazole iv 40mg 1x1 √
betahistin tab 6mg 3x1 √
flunarizin tab 10mg 2x1 √
amlodipin tab 5mg 1x1 √

4 Ny. E. Rochaeti 304 asma exerbasi akut RL infus 20tpm √

inhalasi combivent + Pulmicort per 12jam √
N- Acetylcystein caps 200mg 3x1 √
candesartan tab 8mg 1x1 √

5 Tn. Ana Supriatna 306 Dyspepsia , susp ISK RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg 2x1(prn) √
sanmol tablet 500mg 3x2 √
urotractin caps 400mg 2x1 √

6 Tn. Asnam 309 GEA, vomitus, low intake, CAD RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
 ondancetron iv 4mg 3x1 √
ceftriaxone iv 1g 2x1 √
loperamide tab extra √
attapulgite tab 600mg 3x2 √
aspilet tab 80mg 1x1 √
nitrokaf caps 2,5mg 1x1 √
B- fluid 1kolf √

28/03/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Ny. Amelia Ganesti 304 OF H3, vertigo RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sanmol tablet 500mg 3x1 √
betahistin tab 6mg 3x1 √

2 Ny. Siti Badriah 308 post syncope, OF, cefalgia RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
neurobion iv 1x1 √
sanmol tablet 500mg 3x1 √
sucralfate susp 3x1C √

3 Ny. Irma Maharani 310 Hematoschezia RL infus 20tpm √

pantoprazole iv 40mg 2x1 √
ketorolac iv 30mg extra √
asam tranexamat iv 500mg 2x1 √
sucralfate susp 3x2cth √
laktulosa syrup 1x1C √

4 Ny. Nining Yuningsih 310 CKD pro HD NS infus 500cc per24jam √

ondancetron iv 4mg 2x1 √
rekonsiliasi obat saat admisi: Obat rutin dilanjut
furosemid tab 40mg 1x1 obat
clonidin tab 0.15mg 3x1 obat
candesartan tab 16mg 1x1 obat
 amlodipin tab 10mg 1x1 obat
anelat tab 1mg 3x1 obat
bicnat tab 3x1 obat
calitoz tab 500mg 3x1 obat

5 Ny. Windi Wahyuni 311 dyspepsia, vertigo RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
ketorolac iv 30mg 2x1 √
sucralfate susp 3x2cth √
betahistin tab 6mg 3x1 √

6 Ny. Lasini 311 OF H5 ec VI dd BI RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
neurobion iv extra √
sanmol f tab 650mg 3x1 √
N- Acetylcystein caps 200mg 3x1 √

29/03/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Tn. Mahmud Yunus 302 OF H2, dyspepsia, LBP, HT RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg 2x1 √
neurobion iv 1x1 √
sanmol tablet 500mg 3x1 √
sucralfate susp 3x2cth √
amlodipin tab 5mg 1x1 √

2 Ny. Rika Rosmawati 303 Febris H3, dyspepsia RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sanmol tablet 500mg 3x1 √

3 Tn. Deri Pratama 309 OF H3 ec Susp TF, vertigo RL infus 20tpm √

dyspepsia pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg extra √
difenhidramin iv 1cc extra √
 paracetamol tab 500mg 3x2 √
betahistin tab 6mg 3x1 √
flunarizin tab 5mg 2x1 √

4 Tn. Iwan Jamaludin 309 Febris H3 ec DF, BI, HT RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
sanmol infus 1g extra √
ceftriaxone iv 1g 2x1 (ST) √
fg troches tab 3x1 √
candesartan tab 8mg 1x1 √
sanmol tab 500mg 3x1 √

5 Tn. Heri Maylana 309 OF H4 ec DF, rhinofaringitis RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sanmol tablet 500mg 3x1 √
N- Acetylcystein caps 200mg 3x1 √
rhinos SR caps 120mg 1x1 √

6 Ny. Desy Setiawati 311 colic abdomen NS infus + neurobion iv 20tpm √

ketorolac iv 30mg extra √
ranitidin iv 50mg extra √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x2cth √
paracetamol tab 500mg 3x2 √

7 Tn. Apriana Setianto 312 OF H 1 dd BI, TF, cefalgia RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
sanmol infus 1g prn √
ceftriaxone iv 1g 2x1 √
ketorolac iv 30mg 2x1 √
sucralfate susp 3x2cth √
sanmol tablet 500mg 4x1 √

30/03/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Tn. Enuh Adi Hidayat 301 Hiperurisenia, AKI dd CKD RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg 2x1 √
ondancetron iv 4mg 2x1 √
ceftriaxone iv 1g 2x1 √
metronidazol infus 500mg 3x1 √
dexamethason iv 5mg 2x1 √
sucralfate susp 3x2cth √
nitrokaf caps 2,5mg 1x1 √
miniaspi tab 80mg 1x1 √
orinox caps 90mg 1x1 √
L-cisin tab 0.5mg 1x1 √
cetirizine tab 10mg 1x1 √
√
2 Ny. Sri Uni Amarwati 303 vomitus, DM RL infus 500cc per24jam √
azitromicin iv 500mg 1x1 √
ranitidin iv 50mg 2x1 √
ondancetron iv 4mg 2x1 √
ceftriaxone iv 1g 2x1 √
digoxin tab 0.25mg 1x1 √
sucralfate susp 3x2cth √
Riwayat Alergi Obat
Penicilin

3 Ny. Ghia Refiani 306 OF, vomitus RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
sanmol infus 1g prn √
ondancetron iv 4mg 2x1 √
ketorolac iv 30mg 2x1 √
sucralfate susp 3x2cth √
sanmol tab 500mg 4x1 √
cefixime caps 100mg 2x1 √
valisanbe tab 5mg 2x1/2 √
analsik tab 500mg 3x1 √
methylprednisolon tab 8mg 2x1 √

4 Ny. Endang Ratnasari N 306 G2P1A0, Susp ISK RL infus 20tpm √

 kaltrofen supp prn √
ranitidin iv 50mg 2x1 √
ondancetron iv 4mg 2x1 √
ceftriaxone iv 1g 2x1 √
sucralfate susp 3x2cth √
sanmol F tab 650mg 3x1 √

5 T. Rahmat Gunawan 309 Thyroid infection, vomitus RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
sanmol infus 1g prn √
ondancetron iv 4mg 2x1 √
ketorolac iv 30mg 2x1 √
sucralfate susp 3x2cth √
sanmol tab 500mg 4x1 √
bisoprolol tab 2.5mg 1x1 √
miniaspi tab 80mg 1x1 √
valisanbe tab 5mg 2x1/2 √

6 Tn. H. Aca 312 prolong febris, dd TB paru RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ceftriaxone iv 1g 2x1 √
sanmol F tab 650mg 3x1 √
azitromicin tab 500mg 1x1 √
N- Acetylcystein caps 200mg 3x1 √

7 Tn. Ali 313 cefalgia, gastropati, BI RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ceftriaxone iv 1g 2x1 √
ketorolac iv 30mg 2x1 √
sucralfate susp 3x2cth √
sanmol F tab 650mg 3x1 2x1000mg
rebamipide tab 100mg 2x1 √

8 Tn. Usin 313 hiperglikemia, DM, Vertigo NS infus 2000cc loading

NS infus 1000cc dalam loading
NS infus 20tpm √
pantoprazole iv 40mg 1x1 √
 ondancetron iv 4mg prn √
novorapid pen 8 IU bolus
> novorapid pen drip 6 Iu per jam
> novorapid pen 4 Iu per jam
sanmol tab 500mg 3x2 √
betahistin tab 6mg 3x1 √
flunarizin tab 10mg 3x1 v 2x1

03/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Tn. Abdullah Nazi 313 Obs. Dyspnea e CHF, vomitus RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
Obat Rutin ( riwayat Penyakit jantung)
furosemide tab 40ng 1x1
spironolacton tab 25mg 1x1
bisoprolol tab 5mg 1x1
Uperio (sacubitril+valsartan) 50mg 1x1

2 Ny. Atikah binti Junaedi 316 Colic Abdomen, dyspepsia RL infus 20tpm √
low intake, pantoprazole iv 40mg 1x1 √
kolicgon tab 3x1 √
attapulgite tab 3x2 3x1
sucralfate susp 3x2cth √
analsik tab 500mg 2x1 √

3 Tn. Wiyoso Hardi Sasmoro 309 Obs. Dyspnea ec Susp CHF RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
furosemide iv 20mg 2x1 √
miniaspi tab 80mg 1x1 √
spironolacton tab 25mg 1x1/2 √
atorvastatin tab 20mg 1x1 √

4 Tn. Sutisna 313 Obs. Chest pain RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg jam 21.00
Ranitidine Iv 50mg jam 21.01
5 Nn. Salma Sayyidatul Yaum 316 Post syncop, colic abdomen RL infus + neurobion iv 20tpm √
dyspepsia low intake pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x1C √
analsik tab 500mg 2x1 √
glutrop tab 1x1 √
laktulosa syr 1x2cth √
sucralfate susp 3x2cth √

6 Tn. Nopa Ariyanto 315 vertigo perifer, cefalgia dd TTH asering infus asnet √
dyspepsia low intake pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg 2x1 √
mecobalamin iv 500mg 2x1 √
sanmol F tablet 650mg 3x1 √
betahistin tab 6mg 3x1 √
flunarizin tab 5mg 2x1 √
amlodipin tab 5mg 1x1 √
sucralfate susp 3x2cth √

7 Tn. Dhani Somantri Praja 317 OF H4 ec VI/BI RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
levofloxacin iv 500mg 1x1 √
sanmol tablet 500mg 3x1 √
sucralfate susp 3x2cth √

8 Tn. H. ujang edi 317 CAD, APS, CCS, DM type II RL infus 20tpm √
ISDN tab 5mg Di IGD
clopidogrel tab 75mg Di IGD
miniaspi tab 80mg Di IGD
pantoprazole iv 40mg 1x1 √
novorapide insulin 3x6 iu √
levemir insulin 1x10 iu √
miniaspi tab 80mg 1x1 √
ISDN tab 5mg prn SL √
bisoprolol tab 2,5mg 1x1 √
atrovastatin tab 20mg 1x1 √
 pregabalin caps 75mg 1x1 √

9 Ny. Ria Ade Putri ICU ALO ec PPCM Perbaikan RL infus 8tpm √
CAP, SEPSIS, STROKE INFARK meropenem iv 1g 3x1 √
AKI, HIPOALBUMIN levofloxacin iv 750mg 1x1 √
Post SC dengan PEB Asam Tranexamat iv 500mg 3x1 stop
furosemide iv 20mg 2x1 √
citicholin iv 500mg 2x2amp √
mecobalamin iv 500mg 3x1 √
inhalasi combivent + Pulmicort per 8jam √
N- Acetylcystein caps 200mg 3x2 turun 3x1
VIP Albumin 3x1 √
codein tab 2x1 stop
candesartan tab 16mg 1x1 √
spironolacton tab 25 1x1 √
digoxin tab 0.25mg 1x1 √
clopidogrel tab 75mg 1x1 √
miniaspi tab 80mg 1x1 √

04/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Tn. Ismarizal 313 Gastropati, CKD stV, HT, HHD RL infus 500cc per24jam √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg prn √
furosemide iv 20mg 2x1 √
sucralfate susp 3x2cth √
rebamipide tab 100mg 2x1 √
rekonsiliasi obat saat admisi : obat dilanjut
bisoprolol tab 2.5mg 1x1 √
anelat tab 1mg 3x1 √

2 Tn. Rumsan 313 febris 1minggu,PPOK RL infus 20tpm √

DM type 2, HT sanmol infus 1g extra √
ceftriaxone iv 1g 2x1 (ST) √
inhalasi combivent + Pulmicort per 12jam √
N- Acetylcystein caps 200mg 3x1 √
sanmol tablet 500mg 3x1 √
 candesartan tab 8mg 1x1 √
metformin xr tab 500mg 2x1 √

3 Tn. Yayan Junariana 313 Dyspepsia vomitus NS infus 20tpm √

anemia gravis pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x2cth √
rebamipide 100mg 2x1 √

4 Ny. Nunung 314 NSTEMI, ACS, UAP RL infus 500cc per24jam √

pantoprazole iv 40mg 1x1 √
arixtra iv 2.5mg 1x1 √
ISDN tab 5mg prn SL √
clopidogrel tab 75mg 1x1 √
miniaspi tab 80mg 1x1 √
bisoprolol tab 2,5mg 1x1 √
atrovastatin tab 20mg 1x1 √
laktulosa susp 1x2cth √
alprazolam tab 0.25mg 1x1 √

5 Ny. Ade Rustiawati 314 Hiperglikemi, DM type 2 OF H5, RL infus 20tpm √

gastropati, low intake pantoprazole iv 40mg 1x1 √
ceftriaxone iv 1g 2x1 √
neurobion iv extra √
sanmol tablet 500mg 3x1 √
sucralfate susp 3x2cth √
rekonsiliasi obat saat admisi : obat dilanjut
furosemid tab 40mg 1x1/2 √
acarbose tab 50mg 2x1 dc √
bisoprolol tab 2.5mg 1x1 √
candesartan tab 8mg 1x1 √
miniaspi tab 80mg 1x1 √
glimepride tab 2mg 1x1 ac √

6 tn. M japar Nurdin 315 Gastropati, CKD, HT, HHD NS infus 500cc per24jam √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
 furosemide iv 20mg 2x2 √
candesartan tab 16mg 1x1 √
amlodipin tab 10mg 1x1 √

7 Ny. Erna Herawati 316 GEA DRS, DHF RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sanmol tab 500mg 3x1 √
attapulgite tab 600mg 3x2 √
L-Bio sachet 2x1 √

05/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Tn. Entang 315 Susp stroke ec Infark Asering infus 10 tpm √
citicholin iv 500mg 2x1 √
mecobalamin iv 500mg 2x1 √

2 Ny. Tarsih 316 Vertigo, HT, dyspesia RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
sanmol tablet 500mg 3x1 √
candesartan tab 8mg 1x1 √
betahistin tab 6mg 3x1 √
flunarizin tab 10mg 2x1 √
Alergi obat
lansoprazole caps 30mg
amlodipin tab

3 Ny. Eno binti Saelim 316 Penurunan kesadaran RL infus 20tpm √

ec hipoglikemi ec DM 2 pantoprazole iv 40mg 1x1 √
gastropati ceftriaxone iv 1g 2x1 √
candesartan tab 8mg 1x1 √
amlodipin tab 10mg 1x1 √
pregabalin caps 75mg 1x1 √
N- Acetylcystein caps 200mg 3x1 √
Rekonsiliasi obat saat admisi : ( obat distop)
amlodipin tab 5mg
glimepride tab 2mg
 histigo tab 6mg
paracetamol tab 500mg

4 Ny. Mardalina 316 colic abdomen RL infus 20tpm √

dyspepsia low intake pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 prn
ketorolac iv 30mg 2x1 √
kolicgon tab 3x1 √
sucralfate susp 3x1C √

5 Tn. Kanam Suhanam 318 Ascites, AKI dd CKD NS 0.9% infus asnet √
ondancetron iv 4mg 2x1 √
furosemide iv 20mg 2x1 √
rekonsiliasi obat saat admisi:
obat dilanjut
novorapide insulin 3x4 iu √
levemir insulin 1x13iu √
spironolactone tab 100mg 1x1 √
obat distop
furosemide tab 40mg 1x1
obat dalam konfirmasi
metformin tab 500mg 1x1
phytomenadion tab 10mg 3x1
sucralfate susp 3x1
lansoprazol 1x1

6 Tn. Daryana 318 Dyspepsia, HT, BI RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ceftriaxone iv 1g 2x1 (ST) √
ketorolac iv 30mg 2x1 √
amlodipin tab 5mg 1x1 √
sucralfate susp 3x2cth √

06/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Ny. Corry Crisnawati 303 cerebral infarction due to asering 20tpm √
thrombosis of cerebral citicholin iv 500mg 2x2amp √
 arteris mecobalamin iv 500mg 2x1 √
clopidogrel tab 75mg 1x1 √

2 Ny. Wita Rizki Novianty 306 gastropaty, HT RL infus + neurobion iv 20tpm √

pantoprazole iv 40mg 1x1 √
sucralfate susp 3x2cth √
amlodipin tab 10mg 1x1 √
candesartan tab 8mg 1x1 √
rekonsiliasi obat saat admisi: (obat distop)
domperidon tab 10mg
ranitidin tab 150mg
paracetamol tab 500mg
riwayat alergi obat
antibiotik sulfa (sulfonamid)

3 Tn. Imam Azhary 307 gastropaty, low intake RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x2cth √
rebamipide tab 100mg 2x1 √
rekonsiliasi obat saat admisi: (obat distop)
kolicgon tab
lansoprazol caps 30mg
domperidon tab 10mg

4 Tn. Iman 307 OF H2 dd VI, faringitis akut, HT RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
neurobion iv 1x1 √
sanmol iv 1gr prn √
sanmol tab 500mg 3x1 √
episan susp 3x2 √
N-acetylcistein 200mg 3x1 √
FG Troches 3x1 √
amlodipin tab 10mg 1x1 √
candesartan tab 8mg 1x1 √

5 Tn. Mochamad Raffi A 308 Rhinofaringitis akut, gastropati RL infus 20tpm √

 post syncope pantoprazole iv 40mg 1x1 √
drip neurobion iv per12jam √
ceftriaxone iv 1g 2x1 √
sanmol F tab 650mg 3x1 √
N-acetylcistein 200mg 3x1 √
sucralfate susp 3x1C √
rhinos SR 120mg 1x1 √

6 Tn. Atang Supriatna 308 GEA DRS, vomitus, AKI RL infus 30tpm √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
ciprofloxacin iv 200mg 2x2fls √
sanmol iv 1gr prn √
attapulgite 600mg 3x2 √
sanmol tab 500mg 3x1 √

7 Ny. Adah 314 pneumonia dd/TB, gastropati RL infus + neurobion iv 20tpm √

low intake, HT terkontrol ceftriaxone iv 1g 2x1 √
polimialgia ondancetron iv 4mg 2x1 √
pantoprazole iv 40mg 1x1 √
sucralfate susp 3x2cth √
sanmol tab 500mg 3x1 √
amlodipin tab 5mg 1x1 √
alprazolam tab 0.5mg extra √
N-acetylcistein 200mg 3x1 √
riwayat alergi obat
antibotik tetraxyclin

10/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Tn. Muhammad Ilman S 301 BI, dyspepsia futrolit infus 20tpm √
unspecified tonsilofaringitis esomax iv 40mg √
bioxon iv 1g 2x1 √
trovensis iv 4mg 2x1 √
mersibion iv 1x1(drip) √
tofedex 25mg 2x1 (drip) √
sanmol F tab 650mg 3x1 √
 magtral syrup 3x2cth √
FG troches 3x1 √
methylprednisolon tab 8mg 2x1 √
valisanbe tab 5mg 2x1 √

2 Ny. Nunung Nur Aeni 302 vertigo sentral dd perifer RL infus 20tpm √
neuropati pantoprazole iv 40mg 1x1 √
mecobalamin iv 500mg 2x1 √
difenhidramin iv 10mg 2ampul √
sanmol tablet 500mg 3x2 √
betahistin tab 6mg 3x1 √
flunarizin tab 10mg 3x1 √

3 Tn. Cholid Muhammad 307 GEA, vomitus RL infus + neurobion iv 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
attapulgite tab 600mg 3x2 √
zinc tab 20mg 1x1 √

4 Nn. Restu Juwitasari 308 colic abdomen, GERD RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
mersibion iv extra
ketorolac 30mg 2x1 √
sucralfate susp 3x2cth √
rebamipide tab 100mg 2x1 √
domperidon tab 10mg 3x1 √

5 Ny. Nani Sumaryani 308 post syncope, vertigo RL infus 20tpm √

dyspepsia, DM2 pantoprazole iv 40mg 1x1 √
mersibion iv extra √
ketorolac 30mg 2x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x2cth √
betahistin tab 6mg 3x1 √
flunarizin tab 10mg 1x1 √

6 Tn. Fajar Rizki Fauzi 309 GEA, vomitus RL infus + mersibion iv 20tpm √
 pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
attapulgite tab 600mg 3x2 √
sucralfate susp 3x2cth √

7 Tn. Saunim 309 gastropati low intake RL infus asnet √

OF H4 + ispa pantoprazole iv 40mg 1x1 √
mersibion iv extra
ketorolac 30mg 2x1 √
sucralfate susp 3x2cth √
amlodipin tab 10mg 1x1 √
sanmol tab 500mg 3x1 √
N- Acetylcystein caps 200mg 3x1 √

8 Tn. Encu samsudin 309 Vomitus RL infus + mersibion iv 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x2cth √
betahistin tab 6mg 3x2 √
flunarizin tab 10mg 2x1 √

11/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Ny. Nurayatun 303 GEA, vomitus, HT RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
amlodipin tab 5mg 1x1 √
attapulgite tab 600mg 3x1 √
paracetamol tab 500mg 3x1 √

2 Ny. Indrawati 305 colic abdomen, dispesia RL infus + mersibion iv 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 prn
ketorolac 30mg 2x1 √
sucralfate susp 3x2cth √
rekonsiliasi saat admisi (obat distop)
kolicgon tab
 lansoprazole caps 30mg
sucralfate susp

3 Ny. Yuli Handayani 306 VI, GEA RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
paracetamol infus 1g prn √
sucralfate susp 3x2cth √
attapulgite tab 600mg 2tab/diare √
paracetamol tab 500mg 3x1 √
zinc tab 20mg 1x1 √

4 Tn. Bambang Narita 307 OF H5 DF dd TF , ISPA RL infus 20tpm √

ceftriaxone iv 1g per 12jam √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg prn √
paracetamol infus 1g prn √
sucralfate susp 3x2cth √
paracetamol tab 500mg 3x1 √
N-acetylcistein 200mg 3x1 √
tremenza tab 60mg 2x1 √

5 Nn. Resma Rahmayanti 310 gastropati RL infus + mersibion iv 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 prn
rebamipide tab 100mg 2x1 √
sucralfate susp 3x2cth √
paracetamol tab 500mg prn √

6 Ny. Lia Yuliani 310 gastropati RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
rebamipide tab 100mg 2x1 √
sucralfate susp 3x2cth √
paracetamol tab 500mg prn √

7 Tn. Fajar Setia N 311 OF H7 ec susp TF, vertigo RL infus 20tpm √

 GEA DRS pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
ciprofloxacin tab 500mg 2x1 √
paracetamol tab 500mg 3x1 √
attapulgite tab 600mg 3x2 √
betahistin tab 6mg 3x1 √

12/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Nn. Nanda siti fatimah 305 GERD RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
sucralfate susp 3x2cth √
rebamipide tab 100mg 2x1 √
domperidon tab 10mg 3x1 √

2 Ny. Eneng rita nurlaeni 308 Dyspepsia D10 : RL 02:01 √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
ketorolac iv 30mg 2x1 √
mersibion iv drip 1x1 √
N-acetylcistein 200mg 3x1 √
attapulgite tab 600mg 3x2 prn
ursodeocycholic caps 250mg 3x1 √
xepazym 2x1 √

3 Tn. Ounur Rofiq 313 ISPA, VI, Colic abdomen RL infus + mersibion iv 20tpm √
pantoprazole iv 40mg 1x1 √
paracetamol infus 1g prn suhu>38,5
sanmol F tablet 650mg 3x1 √
sucralfate susp 3x2cth √

4 Ny. Uken Keniawati 314 Obs. Dyspneu ec CHF, DM NS 0,9% 500cc 24jam √
dyspepsia pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
ketorolac 30mg 1x1 prn
ceftriaxone iv 1g 2x1 √
 furosemide iv 20mg 2x2 √
sucralfate susp 3x2cth √
candesartan tab 8mg 1x1 √

5 Ny. Susiliawati 306 dyspepsia, GEA RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg prn √
ranitidin iv 50mg prn √
attapulgite tab 600mg 3x2 √
rekonsiliasi saat admisi (obat distop)
lansoprazole caps 30mg

6 Nn. Tria Qurottaaini 318 vertigo, dyspepsia RL infus + mersibion iv 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x1C √
paracetamol tablet 500mg 3x1 √
betahistin tab 6mg 3x1 √
flunarizin tab 10mg 1x1 √

7 Ny. Tuti 316 Obs palpitasi gastropati HT RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
paracetamol tablet 500mg 3x1 √
amlodipin tab 5mg 1x1 √
rebamipide tab 100mg 2x1 √
sucralfate susp 3x1C √

13/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Tn. Diki Ramlan 301 colic abdomen, polimialgia RL infus + mersibion iv 20tpm √
pantoprazole iv 40mg 1x1 √
ketorolac 30mg 2x1 √
sucralfate susp 3x2cth √
paracetamol tab 500mg 3x1 √
N-acetylcistein 200mg 3x1 √
valisanbe tab 5mg 2x1 √
2 Tn. Teguh Buldansyah 304 Pneumonia dextra, RL infus 20tpm √
angina pectoris, gastropati cefotaxim iv 1g 3x1 √
CAD OMI interior azithromicin tab 500mg 1x1 √
nitrokaf caps 2.5mg 1x1 √
bisoprolol tab 2.5mg 1x1 √
miniaspi tab 80mg 1x1 √
lansoprazole caps 30mg 1x1 √
laktulosa syrup 1x1C √
paracetamol tab 500mg 3x1 √
simvastatin tab 20mg 1x1 √

3 Nn. Nadia Salsabila 305 GEA, dyspepsia D10% : RL 02:01 √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
mersibion iv extra
attapulgite tab 600mg 2tab/diare √
L-bio sachet 2x1 √
rekonsiliasi obat saat admisi: (obat distop)
omegdiar (kaolin / pectin)
triocid tab

4 Tn. Farid haddad 307 TFA, BI, cefalgia RL infus 20tpm √

ceftriaxone iv 1g 2x1 √
mersibion iv 1x1 √
paracetamol infus 1g 3x1 √
ketorolac iv 30mg 2x1 √
paracetamol tab 500mg 3x1 √
FG troches tab 3x1 √
methylprednisolon tab 8mg 2x1 √

5 Tn. Rifa zikri fadillah 307 vertigo, dyspepsia RL infus + mersibion iv 20tpm √
riwayat sinusitis maksilaris pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
ketorolac iv 30mg 2x1 √
methylprednisolon tab 8mg 1x1 √
betahistin tab 6mg 3x1 √
flunarizin tab 5mg 2x1 √
 sanmol F tab 650mg 3x1 √

6 Ny. Meilani wulandari 308 VI, DM T2 NS 0,9% 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
paracetamol tab 500mg 3x1 √
N-acetylcistein 200mg 3x1 √
attapulgite tab 600mg 3x1 √
rhinos sr caps 120mg 1x1 √
bisoprolol tab 5mg 1x1 √
acarbose tab 100mg 2x1dc √
glimepiride tab 4mg 1x1ac √
metformin tab 500mg 2x1 √

7 Ny. Atik Sri lestari 310 gastropati, susp cholelitiasis RL infus 20tpm √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x1C √
glutrop tab 1x1 √
rebamipide tab 100mg 2x1 √

8 Ny. Betty Sri Sumiati 310 GEA DRS, gastropati, HT HHD RL infus 20tpm √
PJK, Hiperurisemia ciprofloxacin tab 500mg 2x1 √
lansoprazole caps 30mg 1x1 √
loperamid tab 2mg 2x1 √
miniaspi tab 80mg 1x1 √
bisoprolol tab 5mg 1x1 √
candesartan tab 8mg 1x1 √
amlodipin tab 10mg 1x1 √
allopurinol tab 100mg 1x1 √
zinc tab 20mg 1x1 √
rekonsiliasi obat saat admisi: (obat distop)
lansoprazole caps 30mg 1x1
miniaspi tab 80mg 1x1
bisoprolol tab 5mg 1x1
candesartan tab 8mg 1x1
amlodipin tab 10mg 1x1
 allopurinol tab 100mg 1x1

14/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Tn. Rangga Pramesti 302 GEA DRS ec BI RL infus + mersibion iv 20tpm √
pantoprazole iv 40mg 1x1 √
ketorolac 30mg 2x1 √
ondancetron iv 4mg 2x1 √
ciprofloxacin inf 200mg 2x2 √
attapulgite tab 600mg 3x2 √
sucralfate susp 3x2cth √
paracetamol tab 500mg 3x1 prn

2 Ny. Mila Yuliani 303 Asma eksaserbasi RL infus 20tpm √

ceftriaxone iv 1g 2x1 √
ondancetron iv 4mg 2x1 √
ranitidin iv 50mg 2x1 √
inhalasi combivent + Pulmicort per 8jam √
N- Acetylcystein caps 200mg 3x1 √
meptin mini tab 2x1 √
cetirizine tab 10mg 1x1 √

3 Ny. Enen Sujayeti 305 colic abdomen, dyspepsia, RL infus + mersibion iv 20tpm √
vertigo pantoprazole iv 40mg 1x1 √
ketorolac 30mg 2x1 √
sucralfate susp 3x1cth √
betahistin tab 6mg 3x1 √

4 Ny. Cicin Nudianah 310 GEA, Colic abdomen, ISPA RL infus + mersibion iv 20tpm √
pantoprazole iv 40mg 1x1 √
ketorolac 30mg 2x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x1cth √
N- Acetylcystein caps 200mg 3x1 √
attapulgite tab 600mg 3x1 √
loperamid tab 2mg 2x1 √
5 Ny. Edah 311 CKD on HD, asites NS 0,9% asnet √
pantoprazole iv 40mg 1x1 √
furosemmide iv 20mg 2x2 √
ondancetron iv 4mg 2x1 √
ketorolac 30mg prn √
cefixime caps 200mg 2x1 √
anelat tab 1mg 3x1 √
calitoz 500mg 3x1 √
bicnat 3x1 √
amlodipin tab 10mg 1x1 √
gentamycin zalf 2x ue √

6 Ny. Euis Suhartini 311 colic abdomen, dyspepsia asering infus + mersibion iv 20tpm √
vertigo pantoprazole iv 40mg 1x1 √
ketorolac 30mg 1x1 √
ondancetron iv 4mg 2x1 √
sucralfate susp 3x1cth √
betahistin tab 6mg 3x1 √
flunarizin tab 10mg 2x1 √

17/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
NO Nama pasien No Kamar Diagnosa Terapi Obat dosis frekuensi
1 Tn. Sarwin ICU CHF, PPOK susp TB paru terapi obat dari dr. Iman Fatullah Sp.JP
efusi pleura kiri, AKI Rl infus 500cc /24jam
furosemide iv 20mg 1x1
spironolacton tab 25mg 1x1
candesartan tab 16mg 1x1
amlodipin tab 5mg 1x1
digoxin tab 0.25mg 1x1
terapi obat dari dr. Rudi Darmawa Sp.P
ceftriaxone iv 1g 1x2vial
inhalasi combivent 2x1
asam tranexamat iv 500mg 3x1
Erysanbe tab 500mg 2x1/2 250mg
N- acetylcystein 200mg 3x1
 vit K tab 3x1
terapi obat dari dr. Susilo Admojo Sp.PD
keto G tab 3x2
anelat tab 1mg 3x1
calitoz tab 500mg 3x1
tambahan
pantoprazol iv 40mg 1x1

2 Tn. Budi Santoso ICU STEMI inteoposterior RL infus 20tpm

pantoprazole iv 40mg 1x1
drip dopamin 5mcg/kgbb/m
arixtra iv 2.5mg 1x1
clopidogrel tab 75mg 1x1
miniaspi tab 80mg 1x1
ISDN tab 5mg 3x1prn TDS>100
laxadin syrup 1x2cth
KSR tab 600mg 2x1

3 Ny. Dian Cahyati 304 OF H5 ec BI dd/pnemonia RL infus 20tpm

pantoprazole iv 40mg 1x1
paracetamol infus 1g extra
cefotaxime iv 1g 3x1
azithromicyn tab 500mg 1x1
paracetamol tab 500mg 3x1
N- acetylcystein 200mg 3x1

4 Tn. M. ridwan 306 cefalgia, vomitus RL infus + mersibion iv 20tpm

pantoprazole iv 40mg 1x1
ketorolac iv 30mg 2x1
ondancetron iv 4mg 2x1
paracetamol tab 500mg 3x1

5 Tn.TB Iman Mulyana 306 HT urgensi, AKI, gastropati DM NS 0.9% infus 20tpm
vertigo central pantoprazole iv 40mg 1x1
ondancetron iv 4mg 2x1
difenhidramin iv extra
insulin levemir 1x10iu
 sucralfate susp 3x2cth
candesartan tab 16mg 1x1
amlodipin tab 10mg 1x1
betahistin tab 6mg 3x1
captopril tab 25mg sl ext TD170

6 Tn. Sukamto 309 gastropati, PVC trigemini RL infus 20tpm

pantoprazole iv 40mg 1x1
ondancetron iv 4mg 2x1
sucralfate susp 3x2cth
bisoprolol tab 2.5mg 1x1
rekonsiliasi obat saat admisi: (obat distop)
lansoprazole caps 30mg
sucralfate susp
amoxsan caps 500mg
mucosta tab 100mg
vosedon tab 10mg

18/04/2023
NO NAMA PASIEN NO DIAGNOSA TERAPI OBAT DOSIS FREKUEN PEMBERI
1 Ny. Siti Saodah 304 DM hiperglikemi terapi obat dr. Andri SpPD
cefalgia RL infus 20tpm √
susp retinopati mata pantoprazole iv 40mg 1x1 √
insulin novorapid 3x8iu v
Insulin levemir 0-0-27iu √
ketorolac iv 30mg 2x1 √
valisanbe tab 5mg 2x1/2 √
terapi obat dr. Anna Sp.M
cendo polynel 6x1 distop
cendo tropin 3x1 √
cendo p pred 4x1 √
nutriflam caps 2x1 √

2 Tn. Sandi Yuda Permana 307 OF H7 ec VI dd BI futrolit infus 20tpm √

dyspepsia low intake drip mersibion injek extra √
ranitidin iv 50mg 2x1 √
ondancetron iv 4mg prn √
 paracetamol tab 500mg 3x1 √
N- Acetylcystein caps 200mg 3x1 √

3 Ny. Nurwidharti 308 anemia ec penyakit kronik NS 0,9% infus 20tpm √

HT st 2 asam folat 1mg 3x1 √
transfusi 2 kolf---> post transfusi --->
Ca Gluconas Iv 1ampul extra √
furosemide iv 20mg 1x1/2 √

4 Ny. Iis Maemunah 308 gastropaty NS 0,9% infus 500cc 24jam √

CKD st V on HD pantoprazole iv 40mg 1x1 √
HT HHD furosemide iv 20mg 2x1 √
ondancetron iv 4mg prn √
sucralfate susp 3x2cth √
rebamipide tab 100mg 2x1 √
anelat 1mg 3x1 √
bicnat 3x1 √
calitoz 500mg 3x1 √
meptin mini tab 0.025mg 2x1 √
nitrokaf caps 2.5 1x1 √
amlodipin tab 10mg 1x1 √

5 Tn. Ahnum 309 OF H2 ec VI RL infus 20tpm √

cefalgia pantoprazole iv 40mg 1x1 √
ketorolac iv 30mg 2x1 √
mersibion iv 1x1 √
paracetamol tab 500mg 3x1 √
N- Acetylcystein caps 200mg 3x1 √

6 Ny. Entin Suhartini 310 krisis hiperglikemi, DM 2 NS 0,9% infus 30tpm √

HT terkontrol insulin novorapid iv drip 3iu--> √
gastropati DM ceftriaxone iv 1g 2x1 √
selulitis pedi extra metronidazol infus 500mg 3x1 √
pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg prn √
sucralfate susp 3x2cth √
sanmol F tab 650mg 3x1 √
 rebamipide tab 100mg 2x1 √
rekonsiliasi obat saat admisi
insulin novorapid stop
Insulin levemir 0-0-20iu dilanjut
candetartan tab 8mg 1x1 dilanjut

7 Ny. Sintia Monik 310 parapligia, susp GBS asering infus 20tpm √
mersibion injek extra √
ranitidin iv 50mg 2x1 √
ketorolac iv 30mg 2x1---> prn
methylprednisolon iv 125mg /6jam √
mecobalamin iv 2ampul per 12jam √
pantoprazole iv 40mg 1x1 √

8 Ny. Yoely Rosnawilianty 310 BI, gastropati RL infus 20tpm √

pantoprazole iv 40mg 1x1 √
ondancetron iv 4mg 2x1 √
cefotaxim iv 1g 3x1 √
sucralfate susp 3x2cth √
rebamipide tab 100mg 2x1 √
rekonsiliasi obat saat admisi
omeprazole caps 20mg stop