DAFTAR STOK OBAT DAN BAHAN HABIS PAKAI RUANG FARMASI

KETERANGAN
No NAMA OBAT KETERANGAN No. Batch/ LOT Exp.date Jumlah Satuan
TANGGAL SUPPLIER
A DAFTAR OBAT PARENTERAL
1 Lidocaine HCl injeksi 2% √ RSIY PDHI PIG76848 Jun-23 100 ampul
3 Dexamethason inj √ RSIY PDHI F9G065 Jul-21 3 ampul
4 Aminophylin 24/ml √ RSIY PDHI 19IG006 Jul-21 1 ampul
5 RL √ RSIY PDHI 390816 Jul-24 22 flabot
6 NaCl 0.9% 500ml √ RSIY PDHI 1D0B008 Sep-23 5 flabot
7 Glucose 5% √ RSIY PDHI 290813 Jul-22 4 flabot
√ RSIY PDHI 200421 Mar-23 1 flabot
8 Glucose 10% √ RSIY PDHI 200104 Des-22 2 flabot
√ RSIY PDHI 200206 Jan-23 1 flabot
10 Paracetamol supp 250mg
Paracetamol supp 125mg √ RSIY PDHI R001J009 Feb-22 6 supp
11 Paracetamol supp 80mg √ RSIY PDHI
12 Ventolin inh √ RSIY PDHI FV0667 Sep-22 5 ampul
13 Ondansetron inj 4mg √ RSIY PDHI 2590675 Apr-21 4 ampul
14 Omeprazole inj √ RSIY PDHI IJ19029 Sep-21 4 ampul
15 MgSO4 20 √ RSIY PDHI 74J48D Okt-20 2 ampul
16 MgSO4 40 √ RSIY PDHI 70K48B Nov-20 2 ampul
17 Water for injeksi √ RSIY PDHI 88B50A Feb-23 6 ampul
18 Progesterone 3 ml 20 vial √ RSIY PDHI SC702102 Mar-21 20 vial

B. DAFTAR BAHAN HABIS PAKAI

1 Spuit 1cc √ RSIY PDHI 8042088 Mar-25 5 pcs
2 Spuit 3cc √ RSIY PDHI 1071988 Jun-24 100 pcs
3 Spuit 5cc √ RSIY PDHI 11101988 Sep-24 100 pcs
4 Spuit 10cc
5 Wing needle √ RSIY PDHI 190130 Dec-21 5 pcs
6 Infus set √ RSIY PDHI 190614K Nov-21 7 pcs
7 Abbocath 18 √ RSIY PDHI 190608SD May-24 3 pcs
8 Abbocath 20 √ RSIY PDHI 190616SD May-24 5 pcs
9 Abbocath 22 √ RSIY PDHI 190719SC Jun-24 5 pcs
10 Hypafix 15x5 cm √ RSIY PDHI 91070230 Feb-24 1 pcs
11 Alcohol swab √ RSIY PDHI 2091988 Aug-22 5 box
12 Kassa steril √ RSIY PDHI 031118 Nov-22 1 box
13 Kassa gulung 10cm √ RSIY PDHI 5 pcs
14 Sungkup dewasa √ RSIY PDHI (10)042219A Apr-24 2 pcs
15 Sungkup anak √ RSIY PDHI (10)102918 Oct-23 1 pcs
16 Nasal canul dewasa √ RSIY PDHI 06111988 Oct-23 2 pcs
17 Nasal canul pediatric
18 Urine bag √ RSIY PDHI 20160302 Mar-21 2 pcs
19 Folley cath no 16 √ RSIY PDHI 918181(19-G-10E) Apr-24 2 pcs
20 Folley cath no 18
21 Sarung tangan steril 6,5 √ RSIY PDHI 1902423604 Jan-22 4 pcs
22 Sarung tangan steril 7 √ RSIY PDHI 1702 4293 04 Feb-22 5 pcs
23 Handscoen dispo S Sensi √ RSIY PDHI 19082206 Aug-24 4 box
24 Handscoen dispo M Sensi √ RSIY PDHI 19056103 May-24 3 box
25 Face mask tali √ RSIY PDHI 3081987 Mei-25 2 box
√ RSIY PDHI 8068 Mei-25 4 box
26 Benang catgut 3.0 PC36 √ RSIY PDHI 180701BU Jul-23 4 pcs
27 Benang silk 3.0
28 Duk lubang besar
29 Duk lubang kecil
30 Tempat jarum
31 Scalpel ukuran 11
 32 KB kit (IUD,implan)
33 KB 3 bulanan
34 Enzimatic √ RSIY PDHI Agust-20 1 botol
35 elastic bandage 10 cm √ RSIY PDHI 31707103 Jul-22 2 pcs
36 elastic bandage 15 cm √ RSIY PDHI 7170101 Jul-22 2 pcs
37 Stardine 30ml √ RSIY PDHI ECH226 Aug-22 1 botol
38 Stardine 60ml √ RSIY PDHI ECI223 Sep-22 1 botol
39 Gell √ RSIY PDHI 99.800.20 1 botol
40 Handwash Biore √ RSIY PDHI 3 botol
41 Handrub Onemed √ RSIY PDHI 23042086 Mar-23 7 botol
42 Underpad
43 Mitela √ RSIY PDHI 122388MX 1 pcs
44 Guedal Airway size 40 ml √ RSIY PDHI 21101788 Sep-22 2 pcs
45 Guedal Airway size 70ml √ RSIY PDHI 26101788 Sep-22 2 pcs
46 Guedal Airway size 0 √ RSIY PDHI OP3/437 Jun-21 2 pcs
47 Guedal Airway size 004 √ RSIY PDHI OP3/1466 Jul-24 2 pcs
48 Tourniquet √ RSIY PDHI AKL11604412048 4 pcs
49 Tongue Spattle √ RSIY PDHI AKL10901716216 1 box
50 Meteran √ RSIY PDHI 1 pcs
51 Thermometer Digital √ RSIY PDHI 1 pcs
52 Kondom Sutra 3'S √ RSIY PDHI AKL21104512098 Jul-23 1 pcs
53 Kapas Potong √ RSIY PDHI 251119506 Nov-24 2 pack
54 Cotton Buds 100's √ RSIY PDHI 1 pack
55 Surgical nedle √ RSIY PDHI 1182228400 Agust-25 1 pack
56 Urinal laki-laki √ RSIY PDHI 2 pcs
57 Alkohol 70% 100ml √ RSIY PDHI 870200203 Feb-23 2 botol
58 Gelang nama:
Laki-laki √ RSIY PDHI 10 pcs
Perempuan √ RSIY PDHI 10 pcs
Bayi laki-laki
Bayi perempuan
Resiko jatuh √ RSIY PDHI 10 pcs
Alergi
59 Sendok syrup 5ml √ RSIY PDHI 80 pcs

C. DAFTAR OBAT ORAL

1 Acyclovir 400mg √ RSIY PDHI HTACVB01068 Feb-22 30 tablet
2 Diagit √ RSIY PDHI T100I013 Apr-23 100 tablet
3 Allopurinol 100mg √ RSIY PDHI HTALOA93099 Jun-21 100 tablet
4 Allopurinol 300mg √ RSIY PDHI HTALOB02226 Mar-22 100 tablet
5 Ambroxol tab √ RSIY PDHI 1812035 Jan-21 300 tablet
6 Amlodipine 5mg √ RSIY PDHI 61639 Jun-21 300 tablet
7 Amlodipine 10mg √ RSIY PDHI 60409 May-21 300 tablet
8 Amoxicillin 500mg √ RSIY PDHI TCAMXA94009 Aug-21 200 tablet
9 Antasida √ RSIY PDHI A80194 Feb-20 300 tablet
10 Alpara √ RSIY PDHI A06BL097 Jul-22 100 tablet
11 Asam mefenamat 500mg √ RSIY PDHI A90648 Mar-22 300 tablet
12 Asam tranexamat 500mg
13 Asam folat √ RSIY PDHI 19TG013 Jul-21 200 tablet
14 Vit B complex √ RSIY PDHI D90269T Apr-22 300 tablet
15 Betahistine √ RSIY PDHI 5060352 Jun-21 300 tablet
16 Captopril 12.5mg
17 Captopril 25mg/ Farmoten 25mg √ RSIY PDHI MI1261 Sep-21 100 tablet
18 Farmabex √ RSIY PDHI LD1771 Apr-22 100 tablet
19 Cefixime 100mg √ RSIY PDHI KCFMB90745 Jul-21 100 tablet
20 Oralit √ RSIY PDHI 26373004CC Jan-23 100 sachet
21 Lansoprazole √ RSIY PDHI 19LP1039 Jul-23 300 tablet
22 Omeprazole √ RSIY PDHI 1906-07-53 Jun-21 210 tablet
23 Ranitidine √ RSIY PDHI HTRNTB94162 Jul-22 300 tablet
24 Gludepatic √ RSIY PDHI ME1911 May-23 300 tablet
 25 Glimepiride 1mg √ RSIY PDHI 50F0536 May-22 300 tablet
26 Simvastatin 10mg √ RSIY PDHI HTSVND94059 Jul-21 300 tablet
27 Furosemide √ RSIY PDHI C90651B Feb-22 200 tablet
28 Dymenhidrinate √ RSIY PDHI B90180B Jan-24 200 tablet
29 Cetirizine √ RSIY PDHI 19RBSG54 Aug-21 100 tablet
30 methylprednisolone 4mg √ RSIY PDHI 50B0527 Jan-23 300 tablet
31 Dexamethason 0.5mg √ RSIY PDHI C90446B Feb-24 300 tablet
32 cefadroxil 500mg √ RSIY PDHI KCFDC90904 Jul-23 300 tablet
33 Ciprofloxacin √ RSIY PDHI HTCFXC94610 Jul-21 200 tablet
34 Erythromicyn √ RSIY PDHI B2545LV Dec-20 100 tablet
35 Amoxicillin DS √ RSIY PDHI PDAMXA86014 Dec-20 10 botol
36 Diclofenac Sodium 50mg √ RSIY PDHI 16365160 Dec-20 300 tablet
37 Ibuprofen 400mg √ RSIY PDHI A2211CW Mar-21 200 tablet
38 Meloxicam 7.5mg √ RSIY PDHI TMLXA90246 Jul-21 300 tablet
39 Meloxicam 15mg √ RSIY PDHI TMLXB90244 Jul-21 300 tablet
40 Paracetamol 500mg √ RSIY PDHI A92094 Aug-22 500 tablet
41 Piroxicam 20mg √ RSIY PDHI 1811061 Nov-20 120 tablet
42 OBH Berlico √ RSIY PDHI HEA080180 Aug-21 10 botol
43 Sucralfate √ RSIY PDHI 9DH081 Aug-21 10 botol
44 Allylestrenol 5mg/ Prestrenol √ RSIY PDHI T1031001 Feb-22 10 tablet
45 Misoprostol 200 µg/Gastrul √ RSIY PDHI MI2021 Sep-21 10 tablet
46 Calcium Lactate √ RSIY PDHI A2770 Okt-22 100 tablet

D. DAFTAR SEDIAAN TOPIKAL

1 Acyclovir cr 5g √ RSIY PDHI 1802013 Feb-22 5 tube
2 Betamethason cr 5g
3 Gentamicyn cr
4 Hydrocortison 1% cr
5 Hydrocortison 2.5% cr
6 Ketoconazole 2% cr

E. SEDIAAN OPTHALMIC
1 Chloramphenicol TM
2 Chloramphenicol SM
poli 1

IGD 5
IGD 5

IGD 2
IGD 2
IGD 2
IGD 2
IGD 1

IGD 1

IGD 1

IGD 1

IGD 1
IGD 1

IGD 1
IGD 1
Poli 1 VK 1 Lab 1
IGD 1 Gigi 1
Lab 1
Poli 1
VK 1

poli 1 vk 1

IGD 1 Poli 1
IGD 1
IGD 1
Poli 1
VK 1
VK 1 Lab 1
VK 1
KEBUTUHAN SUSULAN RUANG FARMASI
NO JENIS BARANG STOK JAN FEB MART
F FARMASI
1 Timbangan analog 1
2 Mortir-stamper 1
3 shaker 1
4 Gelas ukur 10cc 1
Gelas ukur50cc 1
5 Pipet berskala 1
6 kertas perkamen 1 pak
7 plastik obat 3 pak
8 Cangkang kapsul
9 sendok syrup 5 ml 1 pak
10 sendok takar obat 15 ml
11 aquades
12 buku penerimaan obat dan BHP 1
13 buku pengeluaran obat dan BHP 1
14 kartu stock obat 1
15 blanko SP reguler, prekursor
16 etiket obat oral (syrup),luar
17 blanko resep
18 formulir berita acara pemusnahan resep
19 kresek obat 1 pak
20 Jam dinding 1
21 Meja untuk ruang PIO
22 Kursi untuk ruang PIO (kursi lipat)
23 Sketsel
24 Termometer ruang&kulkas 1
DAFTAR INVENTARIS KLINIK UTAMA RAWAT INAP PDHI

APRL MEI JUN JUL AGST SEPT OCT NOV DES

 INVENTARIS RUANG FARMASI

FARMASI
1 Rak obat 1 unit
2 Meja racik 1 unit
3 Lemari es dua pintu 1 unit
4 Lemari narkotika-psikotropika 1 unit
5 Meja 2 unit
6 Kursi 2 unit
7 Komputer dan CPU 1 set
8 AC + remot kontrol 1 set
9 Jam dinding 1 unit
10 Wastafel + rak pengering 1 unit
11 Tempat sampah medis 1 unit
12 Tempat sampah non medis 1 unit
13 ATK 1 set
14 Timbangan analog 1 unit
15 Termometer lemari es 1 unit
16 Termometer ruang 1 unit
17 Peralatan racik:
a. Gelas ukur 10 cc 1 unit
b. Gelas ukur 50 cc 1 unit
c. Batang pengaduk 1 unit
d. Pipet berskala
e. kertas perkamen 1 pak
f. plastik klip obat 1 pak
g. Cangkang kapsul
h. Sendok syrup 5 ml,15 ml 1 set
i. Etiket obat oral dan luar
j. Aquades
k. Kresek obat 3 pak
l. Pipet tetes 2 unit
18 buku penerimaan obat dan BHP 1 unit
19 buku pengeluaran obat dan BHP 1 unit
20 kartu stock obat 1 pak
21 Blanko SP reguler, prekursor 1 pak
22 Blanko copy resep 1 pak
23 Blanko resep 1 pak
24 formulir berita acara pemusnahan resep
 OBAT, BHP DAN ALKES YANG BELUM ADA

KETERANGAN
No NAMA OBAT KETERANGAN No. Batch/ LOT
TANGGAL SUPPLIER
A DAFTAR OBAT PARENTERAL
1 Paracetamol supp 250mg
2 Paracetamol supp 80mg

B. DAFTAR BAHAN HABIS PAKAI

1 Spuit 10cc
2 Nasal canul pediatric
3 Folley cath no 18
4 Benang silk 3.0
5 Duk lubang besar
6 Duk lubang kecil
7 Tempat jarum
8 Scalpel ukuran 11
9 KB kit (IUD,implan)
10 KB 3 bulanan
11 Underpad
12 Gelang nama:
13 Bayi laki-laki
14 Bayi perempuan
15 Alergi
16 Pipet drop

C. DAFTAR OBAT ORAL

1 Antasida √ RSIY PDHI A80194
2 Asam tranexamat 500mg
3 Captopril 12.5mg

D. DAFTAR SEDIAAN TOPIKAL

1 Betamethason cr 5g
2 Gentamicyn cr
3 Hydrocortison 1% cr
4 Hydrocortison 2.5% cr
5 Ketoconazole 2% cr

E. SEDIAAN OPTHALMIC
1 Chloramphenicol TM
2 Chloramphenicol SM
Exp.date Jumlah Satuan

Feb-20 300 tablet