CHECKLIST KEPATUHAN PELABELAN OBAT HIGH ALERT

BULAN : SEPTEMBER 2022

Minggu ke-1 ( 1-7 September )
Label high
N Jumla alert
Nama obat yang termasuk high alert Sediaan Keterangan
o h stok Tida
Ada
k
1.33
1 Acarbose 100 MG Tablet 1.334
4
2 Acarbose 50 MG Tablet 488 488
3 AHEP 500 ML (AMINOFUSIN HEPAR) Botol 2 2
4 AMIODARONE 50 MG/ML INJ Ampul 5 5
5 BUCAIN INJ 20MG/4ML Ampul 50 50
6 CALCIUM GLUCONATE 10 ML INJ 24s Ampul 65 65
7 CLOPIDOGREL 75 MG TAB 30s Tablet 486 486
8 Digoxin Tab Tablet 159 159
9 DOBUTAMINE 250 MG/5ML INJ Ampul 5 5
10 DOLGESIK INJ (TRAMADOL) Ampul 7 7
11 EPHEDRINE HCL 50MG/ML INJ Ampul 67 67
12 Ephinefrine 0,1% Injeksi 30S Ampul 57 57
13 ETANYL 2 ML INJ 5s Ampul 17 17
14 Fentanyl Ampul 1 1
15 FRESOFOL Ampul 14 14
16 Glimepiride 1 Mg 100S Tablet 871 871
17 Glimepiride 2 MG TAB 100s Tablet 359 359
18 Glimepiride 3 Mg 100S Tablet 525 525
19 Glimepiride 4 MG TAB 100s Tablet 309 309
20 GLUCOPHAGE XR 500 MG Tablet 200 200
Infus/
21 INFUS D-40 OTSU 25 25
Cairan
22 INFUS D40% Vial 2 2
23 INFUS KCL Vial 4 4
Infus/
24 INFUS NACL 3% 500ML 9 9
Cairan
25 INSULIN HUMALOG KWIKPEN Pen Insulin 2 2
26 INSULIN HUMALOG MIX 25 KWIKPEN Pen Insulin 24 24
27 INSULIN LEVEMIR FLEXPEN Pen Insulin 30 30
28 INSULIN NOVOMIX-30 FLEXPEN 5s Pen Insulin 21 21
29 INSULIN NOVORAPID FLEXPEN Pen Insulin 19 19
30 KN-3B SOL/KK INFUS Botol 43 43
31 LAPIGIM 2/500 mg Kaplet 150 150
33 LIDOCAIN INJ Ampul 523 523
35 Magnesium Sulfat (MgSO4) inj 20% - 25ml Vial 16 16
36 Magnesium Sulfat (MgSO4) inj 40% - 25ml Vial 15 15
37 METFORMIN 850MG Tablet 768 768
1.77
38 METFORMIN HCL 500 MG TAB Tablet 1.776
6
39 MEYLON Vial 17 17
40 NOREPHINEFRIN INJ Ampul 17 17
41 OXYTOCIN INJ Ampul 329 329
42 PEHACAIN INJ ( LIDOCAIN HCL & EPINEPHRINE ) Ampul 123 123
43 PLETAAL 100 MG (CILOSTAZOL) Tablet 243 243
44 PLETAAL 50 MG (CILOSTAZOL) Tablet 819 819
45 SEDACUM INJ 5MG/5ML (MIDAZOLAM) Ampul 13 13
46 SIBITAL INJ (PHENOBARBITAL) Ampul 12 12
47 SIMARC 2MG TAB Tablet 341 341
48 Tramus 1% 2.5Ml 5s Ampul 10 10
49 VASCON INJ 5s Ampul 7 7
 CHECKLIST KEPATUHAN PELABELAN OBAT HIGH ALERT

BULAN : SEPTEMBER 2022

Minggu ke-2 ( 8-14 September )
Label high
N Jumla alert
Nama obat yang termasuk high alert Sediaan Keterangan
o h stok Tida
Ada
k
1.31
1 Acarbose 100 MG Tablet 1.316
6
2 Acarbose 50 MG Tablet 183 183
3 AHEP 500 ML (AMINOFUSIN HEPAR) Botol 2 2
4 AMIODARONE 50 MG/ML INJ Ampul 5 5
5 BUCAIN INJ 20MG/4ML Ampul 55 55
6 CALCIUM GLUCONATE 10 ML INJ 24s Ampul 65 65
7 CLOPIDOGREL 75 MG TAB 30s Tablet 333 333
8 Digoxin Tab Tablet 84 84
9 DOBUTAMINE 250 MG/5ML INJ Ampul 6 6
1
DOLGESIK INJ (TRAMADOL) Ampul 7 7
0
1
EPHEDRINE HCL 50MG/ML INJ Ampul 67 67
1
1
Ephinefrine 0,1% Injeksi 30S Ampul 65 65
2
1
ETANYL 2 ML INJ 5s Ampul 17 17
3
1
Fentanyl Ampul 2 2
4
1
FRESOFOL Ampul 9 9
5
1
Glimepiride 1 Mg 100S Tablet 605 605
6
1
Glimepiride 2 MG TAB 100s Tablet 899 899
7
1 1.29
Glimepiride 3 Mg 100S Tablet 1.295
8 5
1
Glimepiride 4 MG TAB 100s Tablet 279 279
9
2
GLUCOPHAGE XR 500 MG Tablet 200 200
0
2 Infus/
INFUS D-40 OTSU 29 29
1 Cairan
2
INFUS D40% Vial 2 2
2
2
INFUS KCL Vial 7 7
3
2 Infus/
INFUS NACL 3% 500ML 9 9
4 Cairan
2
INSULIN HUMALOG KWIKPEN Pen Insulin 2 2
5
2
INSULIN HUMALOG MIX 25 KWIKPEN Pen Insulin 17 17
6
2
INSULIN LEVEMIR FLEXPEN Pen Insulin 30 30
7
2
INSULIN NOVOMIX-30 FLEXPEN 5s Pen Insulin 21 21
8
2
INSULIN NOVORAPID FLEXPEN Pen Insulin 4 4
9
3
KN-3B SOL/KK INFUS Botol 45 45
0
3
LAPIGIM 2/500 mg Kaplet 150 150
1
3 LIDOCAIN INJ Ampul 485 485
2
3
Magnesium Sulfat (MgSO4) inj 20% - 25ml Vial 16 16
3
3
Magnesium Sulfat (MgSO4) inj 40% - 25ml Vial 48 48
4
3
METFORMIN 850MG Tablet 693 693
5
3 1.85
METFORMIN HCL 500 MG TAB Tablet 1.855
6 5
3
MEYLON Vial 18 18
7
3
NOREPHINEFRIN INJ Ampul 19 19
8
3
OXYTOCIN INJ Ampul 314 314
9
4 PEHACAIN INJ ( LIDOCAIN HCL &
Ampul 134 134
0 EPINEPHRINE )
4
PLETAAL 100 MG (CILOSTAZOL) Tablet 443 443
1
4
PLETAAL 50 MG (CILOSTAZOL) Tablet 714 714
2
4 SEDACUM INJ 5MG/5ML
Ampul 4 4
3 (MIDAZOLAM)
4
SIBITAL INJ (PHENOBARBITAL) Ampul 12 12
4
4
SIMARC 2MG TAB Tablet 299 299
5
4
Tramus 1% 2.5Ml 5s Ampul 10 10
6
4
VASCON INJ 5s Ampul 6 6
7

CHECKLIST KEPATUHAN PELABELAN OBAT HIGH ALERT

BULAN : SEPTEMBER 2022

Minggu ke-3 ( 15-21 September )
Label high
N Jumla alert
Nama obat yang termasuk high alert Sediaan Keterangan
o h stok Tida
Ada
k
1.31
1 Acarbose 100 MG Tablet 1.316
6
2 Acarbose 50 MG Tablet 183 183
3 AHEP 500 ML (AMINOFUSIN HEPAR) Botol 2 2
4 AMIODARONE 50 MG/ML INJ Ampul 5 5
5 BUCAIN INJ 20MG/4ML Ampul 55 55
6 CALCIUM GLUCONATE 10 ML INJ 24s Ampul 65 65
7 CLOPIDOGREL 75 MG TAB 30s Tablet 333 333
8 Digoxin Tab Tablet 84 84
9 DOBUTAMINE 250 MG/5ML INJ Ampul 6 6
10 DOLGESIK INJ (TRAMADOL) Ampul 7 7
11 EPHEDRINE HCL 50MG/ML INJ Ampul 67 67
12 Ephinefrine 0,1% Injeksi 30S Ampul 65 65
13 ETANYL 2 ML INJ 5s Ampul 17 17
14 Fentanyl Ampul 1 1
15 FRESOFOL Ampul 9 9
16 Glimepiride 1 Mg 100S Tablet 605 605
17 Glimepiride 2 MG TAB 100s Tablet 899 899
1.29
18 Glimepiride 3 Mg 100S Tablet 1.295
5
19 Glimepiride 4 MG TAB 100s Tablet 279 279
20 GLUCOPHAGE XR 500 MG Tablet 200 200
Infus/
21 INFUS D-40 OTSU 29 29
Cairan
22 INFUS D40% Vial 2 2
23 INFUS KCL Vial 7 7
Infus/
24 INFUS NACL 3% 500ML 9 9
Cairan
25 INSULIN HUMALOG KWIKPEN Pen Insulin 2 2
26 INSULIN HUMALOG MIX 25 KWIKPEN Pen Insulin 17 17
27 INSULIN LEVEMIR FLEXPEN Pen Insulin 30 30
28 INSULIN NOVOMIX-30 FLEXPEN 5s Pen Insulin 21 21
29 INSULIN NOVORAPID FLEXPEN Pen Insulin 4 4
30 KN-3B SOL/KK INFUS Botol 45 45
31 LAPIGIM 2/500 mg Kaplet 150 150
32 LIDOCAIN INJ Ampul 485 485
33 Magnesium Sulfat (MgSO4) inj 20% - 25ml Vial 16 16
34 Magnesium Sulfat (MgSO4) inj 40% - 25ml Vial 48 48
35 METFORMIN 850MG Tablet 693 693
1.85
36 METFORMIN HCL 500 MG TAB Tablet 1.855
5
37 MEYLON Vial 18 18
38 NOREPHINEFRIN INJ Ampul 19 19
39 OXYTOCIN INJ Ampul 314 314
40 PEHACAIN INJ ( LIDOCAIN HCL & EPINEPHRINE ) Ampul 134 134
41 PLETAAL 100 MG (CILOSTAZOL) Tablet 600 600
42 PLETAAL 50 MG (CILOSTAZOL) Tablet 714 714
43 SEDACUM INJ 5MG/5ML (MIDAZOLAM) Ampul 4 4
44 SIBITAL INJ (PHENOBARBITAL) Ampul 12 12
45 SIMARC 2MG TAB Tablet 299 299
46 Tramus 1% 2.5Ml 5s Ampul 10 10
47 VASCON INJ 5s Ampul 6 6

CHECKLIST KEPATUHAN PELABELAN OBAT HIGH ALERT

BULAN : SEPTEMBER 2022

Minggu ke-4 (22-28 September)
Label high
N Jumla alert
Nama obat yang termasuk high alert Sediaan Keterangan
o h stok Tida
Ada
k
1.31
1 Acarbose 100 MG Tablet 1.316
6
2 Acarbose 50 MG Tablet 183 183
3 AHEP 500 ML (AMINOFUSIN HEPAR) Botol 2 2
4 AMIODARONE 50 MG/ML INJ Ampul 5 5
5 BUCAIN INJ 20MG/4ML Ampul 55 55
6 CALCIUM GLUCONATE 10 ML INJ 24s Ampul 65 65
7 CLOPIDOGREL 75 MG TAB 30s Tablet 333 333
8 Digoxin Tab Tablet 84 84
9 DOBUTAMINE 250 MG/5ML INJ Ampul 6 6
10 DOLGESIK INJ (TRAMADOL) Ampul 7 7
11 EPHEDRINE HCL 50MG/ML INJ Ampul 67 67
12 Ephinefrine 0,1% Injeksi 30S Ampul 65 65
13 ETANYL 2 ML INJ 5s Ampul 17 17
14 Fentanyl Ampul 1 1
15 FRESOFOL Ampul 9 9
16 Glimepiride 1 Mg 100S Tablet 605 605
17 Glimepiride 2 MG TAB 100s Tablet 899 899
18 Glimepiride 3 Mg 100S Tablet 1.295 1.29
 5
19 Glimepiride 4 MG TAB 100s Tablet 279 279
20 GLUCOPHAGE XR 500 MG Tablet 200 200
Infus/
21 INFUS D-40 OTSU 29
Cairan 29
22 INFUS D40% Vial 2 2
23 INFUS KCL Vial 7 7
Infus/
24 INFUS NACL 3% 500ML 9
Cairan 9
25 INSULIN HUMALOG KWIKPEN Pen Insulin 2 2
26 INSULIN HUMALOG MIX 25 KWIKPEN Pen Insulin 17 17
27 INSULIN LEVEMIR FLEXPEN Pen Insulin 30 30
28 INSULIN NOVOMIX-30 FLEXPEN 5s Pen Insulin 21 21
29 INSULIN NOVORAPID FLEXPEN Pen Insulin 4 4
30 KN-3B SOL/KK INFUS Botol 45 45
31 LAPIGIM 2/500 mg Kaplet 150 150
32 LIDOCAIN INJ Ampul 485 485
33 Magnesium Sulfat (MgSO4) inj 20% - 25ml Vial 16 16
34 Magnesium Sulfat (MgSO4) inj 40% - 25ml Vial 48 48
35 METFORMIN 850MG Tablet 693 693
1.85
36 METFORMIN HCL 500 MG TAB Tablet 1.855
5
37 MEYLON Vial 18 18
38 NOREPHINEFRIN INJ Ampul 19 19
39 OXYTOCIN INJ Ampul 314 314
PEHACAIN INJ ( LIDOCAIN HCL &
40 Ampul 134
EPINEPHRINE ) 134
41 PLETAAL 100 MG (CILOSTAZOL) Tablet 443 443
42 PLETAAL 50 MG (CILOSTAZOL) Tablet 714 714
43 SEDACUM INJ 5MG/5ML (MIDAZOLAM) Ampul 4 4
44 SIBITAL INJ (PHENOBARBITAL) Ampul 12 12
45 SIMARC 2MG TAB Tablet 299 299
46 Tramus 1% 2.5Ml 5s Ampul 10 10
47 VASCON INJ 5s Ampul 6 6

CHECKLIST KEPATUHAN PELABELAN OBAT HIGH ALERT

BULAN : SEPTEMBER 2022

Minggu ke-5 (29-30 September)
Label high
N Jumla alert
Nama obat yang termasuk high alert Sediaan Keterangan
o h stok Tida
Ada
k
1.31
1 Acarbose 100 MG Tablet 1.316
6
2 Acarbose 50 MG Tablet 183 183
3 AHEP 500 ML (AMINOFUSIN HEPAR) Botol 2 2
4 AMIODARONE 50 MG/ML INJ Ampul 5 5
5 BUCAIN INJ 20MG/4ML Ampul 55 55
6 CALCIUM GLUCONATE 10 ML INJ 24s Ampul 65 65
7 CLOPIDOGREL 75 MG TAB 30s Tablet 333 333
8 Digoxin Tab Tablet 84 84
9 DOBUTAMINE 250 MG/5ML INJ Ampul 6 6
10 DOLGESIK INJ (TRAMADOL) Ampul 7 7
11 EPHEDRINE HCL 50MG/ML INJ Ampul 67 67
12 Ephinefrine 0,1% Injeksi 30S Ampul 65 65
13 ETANYL 2 ML INJ 5s Ampul 17 17
14 Fentanyl Ampul 1 1
15 FRESOFOL Ampul 9 9
 16 Glimepiride 1 Mg 100S Tablet 605 605
17 Glimepiride 2 MG TAB 100s Tablet 899 899
1.29
18 Glimepiride 3 Mg 100S Tablet 1.295
5
19 Glimepiride 4 MG TAB 100s Tablet 279 279
20 GLUCOPHAGE XR 500 MG Tablet 200 200
Infus/
21 INFUS D-40 OTSU 29 29
Cairan
22 INFUS D40% Vial 2 2
23 INFUS KCL Vial 7 7
Infus/
24 INFUS NACL 3% 500ML 9 9
Cairan
25 INSULIN HUMALOG KWIKPEN Pen Insulin 2 2
26 INSULIN HUMALOG MIX 25 KWIKPEN Pen Insulin 17 17
27 INSULIN LEVEMIR FLEXPEN Pen Insulin 30 30
28 INSULIN NOVOMIX-30 FLEXPEN 5s Pen Insulin 21 21
29 INSULIN NOVORAPID FLEXPEN Pen Insulin 4 4
30 KN-3B SOL/KK INFUS Botol 45 45
31 LAPIGIM 2/500 mg Kaplet 150 150
32 LIDOCAIN INJ Ampul 485 485
33 Magnesium Sulfat (MgSO4) inj 20% Vial 16 16
34 Magnesium Sulfat (MgSO4) inj 40% - 25ml Vial 48 48
35 METFORMIN 850MG Tablet 693 693
1.85
36 METFORMIN HCL 500 MG TAB Tablet 1.855
5
37 MEYLON Vial 18 18
38 NOREPHINEFRIN INJ Ampul 19 19
39 OXYTOCIN INJ Ampul 314 314
PEHACAIN INJ ( LIDOCAIN HCL &
40 Ampul 134 134
EPINEPHRINE )
41 PLETAAL 100 MG (CILOSTAZOL) Tablet 443 443
42 PLETAAL 50 MG (CILOSTAZOL) Tablet 714 714
43 SEDACUM INJ 5MG/5ML (MIDAZOLAM) Ampul 4 4
44 SIBITAL INJ (PHENOBARBITAL) Ampul 12 12
45 SIMARC 2MG TAB Tablet 299 299
46 Tramus 1% 2.5Ml 5s Ampul 10 10
47 VASCON INJ 5s Ampul 6 6

Jumlah sediaan obat

Jumlah sediaan obat
hight alert yang
High Alert yang
ditandai dengan label N/D x
No. Nama obat yang termasuk high alert Sediaan tersedia dalam 1
high alert dalam 1 100 %
bulan
bulan
(D)
(N)
1 Acarbose 100 MG Tablet 1334 1334 100%
2 Acarbose 50 MG Tablet 525 525 100%
3 AHEP 500 ML (AMINOFUSIN HEPAR) Botol 10 10 100%
4 AMIODARONE 50 MG/ML INJ Ampul 5 5 100%
5 BUCAIN INJ 20MG/4ML Ampul 50 50 100%
CALCIUM GLUCONATE 10 ML INJ
Ampul 65 65 100%
6 24s
7 CLOPIDOGREL 75 MG TAB 30s Tablet 490 490 100%
8 Digoxin Tab Tablet 204 204 100%
9 DOBUTAMINE 250 MG/5ML INJ Ampul 5 5 100%
10 DOLGESIK INJ (TRAMADOL) Ampul 10 10 100%
11 EPHEDRINE HCL 50MG/ML INJ Ampul 67 67 100%
12 Ephinefrine 0,1% Injeksi 30S Ampul 57 57 100%
13 ETANYL 2 ML INJ 5s Ampul 3 3 100%
14 Fentanyl Ampul 2 2 100%
15 FRESOFOL Ampul 15 15 100%
16 Glimepiride 1 Mg 100S Tablet 907 907 100%
17 Glimepiride 2 MG TAB 100s Tablet 370 370 100%
18 Glimepiride 3 Mg 100S Tablet 565 565 100%
19 Glimepiride 4 MG TAB 100s Tablet 309 309 100%
20 GLUCOPHAGE XR 500 MG Tablet 200 200 100%
21 INFUS D-40 OTSU Infus/Cairan 25 25 100%
22 INFUS D40% Vial 2 2 100%
23 INFUS KCL Vial 4 4 100%
24 INFUS NACL 3% 500ML Infus/Cairan 11 11 100%
25 INSULIN HUMALOG KWIKPEN Pen Insulin 2 2 100%
INSULIN HUMALOG MIX 25
Pen Insulin 3 3 100%
26 KWIKPEN
27 INSULIN LEVEMIR FLEXPEN Pen Insulin 30 30 100%
28 INSULIN NOVOMIX-30 FLEXPEN 5s Pen Insulin 47 47 100%
29 INSULIN NOVORAPID FLEXPEN Pen Insulin 29 29 100%
30 KN-3B SOL/KK INFUS Botol 49 49 100%
31 LAPIGIM 2/500 mg Kaplet 150 150 100%
32 LIDOCAIN INJ Ampul 489 489 100%
Magnesium Sulfat (MgSO4) inj 20% -
Vial 16 16 100%
33 25ml
Magnesium Sulfat (MgSO4) inj 40% -
Vial 15 15 100%
34 25ml
35 METFORMIN 850MG Tablet 768 768 100%
36 METFORMIN HCL 500 MG TAB Tablet 2241 2241 100%
37 MEYLON Vial 17 17 100%
38 NOREPHINEFRIN INJ Ampul 17 17 100%
39 OXYTOCIN INJ Ampul 371 371 100%
PEHACAIN INJ ( LIDOCAIN HCL &
Ampul 123 123 100%
40 EPINEPHRINE )
41 PLETAAL 100 MG (CILOSTAZOL) Tablet 328 328 100%
42 PLETAAL 50 MG (CILOSTAZOL) Tablet 819 819 100%
SEDACUM INJ 5MG/5ML
Ampul 16 16 100%
43 (MIDAZOLAM)
44 SIBITAL INJ (PHENOBARBITAL) Ampul 12 12 100%
45 SIMARC 2MG TAB Tablet 342 342 100%
46 Tramus 1% 2.5Ml 5s Ampul 10 10 100%
47 VASCON INJ 5s Ampul 7 7 100%

VALIDATOR PIC

Apt. Fitrotul Uyun, S. Farm Aan Bakhrul Ulum, S. Farm

SUPERVISOR

TIM PMKP