RENCANA KEBUTUHAN OBAT PELAYANAN KESEHATAN PUSKESMAS

TAHUN 2021

STOK 30 JUNI RATA2 PMK RENCANA USULAN PENERIMAAN

KODE NO NAMA OBAT KEMASAN 2019 PER BULAN TAHUN 2018 KET
KEBUTUHAN 2021 KEBUTUHAN 2021

1 2 3 4 = ∑PMK / 10 5 = ( KLM 4 X 18 ) 6 = (KLM 5 - KLM 3) 7

A1 1 Acyclovir Salep Tube 4 1.33 24 20 5

A2 2 Acyclovir 400 mg Tab Tablet 100 10.00 240 140 100
A3
3 Air raksa dental use Botol - -
A4
4 Albendazol 400 mg tab Tablet - -
A5
5 Alprazolam 0.5 mg Tablet - -
A6
6 Alupurinol 100 mg tab / Selespurin/ Proxuric Tablet 20 53.33 1,280 1,260 200
A7
7 Ambroxol syr Botol 5 3.86 93 88 20
A8
8 Ambroxol tab 30 mg / Promukus Tablet 288 60.80 1,459 1,171 200
9 Aminofilina injeksi 24 mg/ ml. 10 ml Ampul
A9 - -

A10
10 Aminofilna tablet 200 mg Tablet - -
A11
11 Amitriptilina hcl tablet salut 25 mg Tablet - -
A12 12 Amoksilina kapsul 500 mg Tablet 270 40.14 963 693 600
A13
13 Amoksilna sirup kering 125 mg/ 5 mg Botol - -
A14
14 Antasida doen tablet kombinasi Tablet 126 135.70 3,257 3,131 900
A15
15 Anti hemmoroid suppositoria Supp - -
A16
16 Aqua pro injeksi streril. Bebas priogen 20 ml Vial 1.00 24 24
A17
17 Aquadest steril 500 ml Botol - -
A18
18 As salisilat 2% + belerang endap 4%(2-4 salep Pot - -
A19 19 As. Benzoat 3 % + as salisilat 6%(whitefield) Pot - -
A20
20 Asam askorbat (Vit. C) tablet 50 mg Tablet 50 5.00 120 70 200
21 Asam mefenamat 500 mg Tablet
132.50 3,180 3,180
A21 800
A22 22 Asetosal 100 mg Tablet - -
A23
23 Asetosal tablet 500 mg Tablet - -
A24 24 Atropina sulfat injeksi 0 .25 mg / ml - 1 ml Ampul - -
25 Basitrasin Polimiksin Tube - -
A25
26 Besi (II) sulfat tablet salut .kombinasi Tablet 280 15.00 360 80
A26 400
27 Betahistin tab Tablet 142 26.57 638 496
A27 210
28 Betametazon salep kulit Tube 4.00 96 96
A28 24
29 Captopril 12.5 mg tablet Tablet - -
A29
30 Captopril 25 mg tablet Tablet 126 50.40 1,210 1,084
A30 800
31 Carbamazepina 200 mg talet Tablet - -
A31
A32 32 Cefadroxil 125mg/5ml Sirup Botol - -
A33 33 Cefadroxill 500 mg tablet Tablet 50 20.00 480 430 300
A34 34 Cefotaxim 1 gr Injeksi Ampul - -
A35 35 Cetirizin10 mg tab Tablet 150 31.67 760 610 200
A36 36 Cimetidine/Selestidin Tablet - -
A37 37 Ciprofloxazin tablet 500 mg Tablet 44 40.00 960 916 200
A38 38 Deksametason injeksi 5 mg / ml - 1 ml Ampul - -
A39 39 Deksametason tablet 0.5 mg Tablet 338 138.60 3,326 2,988 1100
A40
40 Devitalisasi pasta Tube - -
A41
41 Diazepam 5 mg Tablet - -
A42
42 Diazepam injeksi 5 mg / ml - 2 ml Ampul - -
A43 43 Diazepam tablet 2 mg Tablet - -
A44
44 Difenhidramin HCL injeksi 10 mg / ml - ml Ampul - -
A45
45 Digoksina tablet 0. 25 mg Tablet - -
A46
46 Domperidon tablet 10 mg Tablet - -
A47
47 Doxycicline 100 mg tab Tablet - -
A48
48 Efedrina HCL (efedrina) tablet 25 mg Tablet - -
A49
49 Epinefrina HCL / bitartat (aderenalina) inj 01% Ampul - -
A50
50 Ergotamina tartrat 1 mg + kofeina 50 mg tab Tablet - -
A51
51 Erytromysin 200mg/5ml Syrup Botol - -
A52
52 Erytromysin tablet 500 mg Tablet - -
A53 53 Etakridina (rivanol) larutan 0.1 % Botol - -
A54
54 Etil klorida semprot Botol 3.00 72 72 5
A55
55 Eugenol cairan Botol - -
A56
56 Fenobarbital inj 50 mg /ml -2ml Ampul - -
A57
57 Fenobarbital tablet 100mg Tablet - -
58 Fenobarbital tablet 30 mg Tablet
- -
A58
A59 59 Fenol gliserol tetes telnga 10% Botol - -
A60
60 Fitomenadion (vit. K1) inj 10 / ml 1 ml Ampul - -
A61
61 Fitomenadion (vit. K1) tablet salut 10 mg Tablet - -
A62
62 Furosemida tablet 40 mg Tablet - -
A63 63 Garam Oralit untuk 200 ml air Sachet 11 3.25 78 67 10
A64
64 Gentamisin Salep Mata Tube 1.67 40 40 5
A65
65 Gentamysin SK Tube - -
A66
66 Gentamysin TM/Genoint TM Botol 19 4.50 108 89 40
A67
67 Gentian violet larutan 1 % Botol - -
A68
68 Glibenklamida tablet 5 mg Tablet - -
A69
69 Gliseril guayakolat tablet 10 mg Tablet - -
A70
70 Glukosa larutan infus 10 % steril Botol - -
A71
71 Glukosa larutan infus 40 % steril Botol - -
A72 72 Glukosa larutan infus 5 % steril Botol - -
 73 Griseofulvin tablet 125 mg. Mikronized Tablet - -
A73
74 Haloperidol 0,5 mg. Tablet Tablet - -
A74
75 Haloperidol 1,5 mg tablet Tablet - -
A75
76 Haloperidol 5 mg tablet Tablet - -
A76
77 Hidroklorotiasida (HCT) tablet 25 mg Tablet - -
A77
78 Hidrokortison krim 2.5 % Tube 13 4.44 107 94
A78 10
79 Ibuprofen tablet 400 mg Tablet 28.00 672 672
A79 500
80 Isoniazide 100 mg Tablet - -
A80
81 Isoniazide 300 mg Tablet - -
A81
82 Isosorbid dinitrat Tablet - -
A82
83 Kalsium hidroksida pasta Pot - -
A83
84 Kalsium laktat (kalk) tablet 500 mg Tablet - -
A84
85 Ketokonazole 200 mg tablet Tablet - -
A85
86 Kinina dihidroklorida (kinina) inj 25 % - 2 ml Ampul - -
A86
87 Kinina sulfat tablet 222 mg (7 h20 ) Tablet - -
A87
88 Kloramfenicol salep kulit Tube - -
A88
89 Kloramfenikol kapsul 250 mg Tablet - -
A89
90 Kloramfenikol salep mata 1 % Tube - -
A90
91 Kloramfenikol tetes Mata Botol - -
A91
92 Kloramfenikol tetes telinga 3 % Botol 2.25 54 54
A92 3
93 Klorfeniramina maleat (CTM) tablet 4 mg Tablet 220 91.33 2,192 1,972
A93 200
94 Klorpromazin 100 mg tablet Tablet - -
A94
95 Klorpromazina Hcl inj 25 mg / ml - 1 ml Ampul - -
A95
96 Klorpromazina Hcl inj 5 mg / ml - 2 ml Ampul - -
A96
97 Klorpromazina hcl tablet salut 25 mg Tablet - -
A97
98 Kodeina Hcl (kodeina) tablet 10 mg Tablet - -
A98
99 Kotrimoksasol suspensi Botol 2 4.50 108 106
A99
100 Kotrimoksasol tablet kombinasi Tablet 176 10.00 240 64
A100 200
101 Lidokain inj Ampul - -
A101
102 Lidokaina comp inj kombinasi Ampul - -
A102
103 Metakresol sulfonat dan metanol kondensai (Albotyl) Botol - -
A103
104 Metformin 500 mg tablet Tablet - -
A104
105 Metilergometrina maleat inj 0. 200 g / ml- ml Ampul - -
A105
106 Metilergometrina malet tablet salut 0. 125 mg Tablet - -
A106
107 Metilprednisolon tablet 4 mg Tablet 114 67.67 1,624 1,510
A107 400
108 Metoklopramide 10 mg tablet/Noristal Tablet 210 10.00 240 30
A108 100
109 Metronidazol 500 mg Tablet - -
A109
110 Metronidazol tablet 250 mg Tablet - -
A110
A111 111 Mikonazole salep Tube 4 2.00 48 44
112 Monoklorkamfer mentolcairan (CHKM) Botol - -
A112
 113 Mumifyng pasta Botol - -
A113
114 Natrium bikarbonat tablet 500 mg Tablet - -
A114
115 Natrium Diklofenak 50 (Nadifen/Prostanac) Tablet 330 215.20 5,165 4,835
A115 700
116 Natrium klorida larutan infus 0. 9 steril Botol - -
A116
117 Nifedipin tablet 10 mg Tablet - -
A117
118 Nistatin 100. 000 iu/g tablet vaginal Tab Vag - -
A118
119 Obat batuk hitam (OBH) cairan Botol 100 ml - -
A119
120 Ofloxacin tab 400mg Tablet - -
A120
121 Oksigen gas dalam tabung 3 m3 Tabung - -
A121
122 Oksigen gas dalam tabung 6 m3 Tabung - -
A122
123 Oksitetrasiklina hcl salep 3 % Tube - -
A123
124 Oksitetrasiklina hcl salep mata 1 % Tube - -
A124
125 Oksitosina inj 10 iu/ml - 1 ml Ampul - -
A125
126 Parasetamol sirup 120 mg / 5 ml Botol
8 1.25 30 22
A126 3
A127
127 Parasetamol tab 100 mg Tablet - -
A128
128 Parasetamol tablet 500mg Tablet 238 223.20 5,357 5,119 1900
A129
129 Pirantel pamoat (pirantel) tablet 125 mg basa Tablet - -
A130
130 Piroxicam 10 Mg Tablet - -
A131 131 Piroxicam 20 Mg Tablet - -
A132
132 Prednison tablet 5 mgn Tablet - -
133 Pridoksina hcl (vit. B 6) tablet 10 mg Tablet
A133 - -
134 Primakina tablet 15 mg Tablet
- -
A134
A135
135 Prokaina penisilina g inj 3 juta iu Vial - -
A136
136 Propiltionurasil tablet 100 mg Tablet - -
A137
137 Propranolol hcl (Propranolol) tablet 40 mg Tablet - -
A138
138 Pyridoxin injeksi Ampul - -
A139
139 Ranitidin inj 25 mg/2 ml Ampul - -
A140
140 Ranitidin tablet 150 mg Tablet 234 130.75 3,138 2,904 800
A141
141 Reserpina tablet 0, 10 mg Tablet - -
A142
142 Reserpina tablet 0, 25 mg Tablet - -
A143
143 Retinol (vit. A) kapsul lunak 200.000 iu Tablet - -
144 Retinol (vit. A) tablet salut 100. 000 iu Tablet
- -
A144
A145
145 Ringer laktat larutan infus steril Botol - -
A146
146 Risperidon Tablet - -
A147
147 Salbutamol tablet 2 mg Tablet - -
A148 148 Salbutamol tablet 4 mg Tablet 234 23.71 569 335 300
A149 149 Salisil bedak 2 % Bks 5 1.00 24 19
A150
150 Salisil spiritus 10 % Botol - -
 151 Semen seng fosfat serbuk dan cairan Botol - -
A151
152 Serum anti bisa ular polivalen inj. 5ml Ampul - -
A152
153 Serum anti tetanus inj. 1.500 iu Ampul - -
A153
154 Sianokobalamina (vit.b12) inj. 500 mcg Ampul - -
A154
155 Silver amalgam serbuk 65-75% Botol - -
A155
156 Simvastatin tab 10 mg Tablet 30.00 720 720
A156
157 Sulfacetamide tetes mata Botol - -
A157
158 Synthetic filing material larutan dan serbuk Set - -
A158
159 Temporary stopping fletcher serbuk dan cairan Set - -
A159
160 Tetrasiklina hcl (tetrasiklina) kapsul 250 mg Tablet
- -
A160
A161
161 Tetrasiklina hcl (tetrasiklina) kapsul 500 mg Tablet - -
A162
162 Thiamfenikol 500 Tablet - -
A163
163 Tiamin hcl /mononitrat (vit.b1) tablet 50 mg Tablet 63.33 1,520 1,520 1300
A164
164 Tiamina hcl (vit.b1) inj. 100 mg/ml Ampul - -
A165
165 Tramadol Tablet - -
A166
166 Trifluoperazine (Stelazin) Tablet - -
A167
167 Triheksfenidil hcl 2 mg tablet Tablet - -
A168
168 Trikresol formalin (tkf) cairan Botol - -
169 Vitamin B kompleks tablet Tablet
230 195.70 4,697 4,467
A169 1000
170 Yodium povidan larutan 10% 300 ml Botol - -
A170
171 Yodium povidon larutan 10% 30 ml Botol - -
A171
172 Zink tablet Tablet 90 15.00 360 270
A172 100
173 Amoksisillin dry syr 250mg/5ml Botol 2 1.00 24 22
A173
-
OBAT TAMBAHAN -
174 Aptil Botol - -
A174
175 (Lopinavir/Ritonavir)Aluvia Botol - -
A175
176 Abacavir Tablet - -
A176
177 Acyclovir tablet 200 mg Tablet - -
A177
178 Aleterol TM Botol - -
A178
179 Amlodipin 10 mg tab Tablet 140.00 3,360 3,360
A179
180 Amlodipin 5 mg tab Tablet 308 207.78 4,987 4,679
A180 420
181 Amox-clav Tablet - -
A181
182 Ampisilin Serbuk Injeksi i.m/i.v. 1000 mg/ml Ampul -
A182
183 Ampisillin injeksi i.m/i.v 1000 mg/ml Ampul -
A183
184 Antalgin injeksi Ampul - -
A184
185 Antasida syr Botol - -
A185
186 Arterakine Tablet - -
A186
 187 Artesunat inj Vial - -
A187
188 Asam Folat 1 mg Tablet - -
A188
189 Asam tranexamat 500 mg Tablet - -
A189
190 Asetosal 80/miniaspi tablet - -
A190
A191 191 Atripla(TDF+3TC+EFV) Botol - -
A192 192 Azitromisin+cefixim Tablet - -
A193 193 Azytromisin tablet 500 mg Tablet - -
A194 194 BD Vacuntainer Pcs - -
A195
195 Becefort Tablet 374 60.11 1,443 1,069 800
A196 196 Benzatin Penisillin Vial - -
A197
197 Bonding Set - -
A198
198 Bufacomb salep Tube - -
A199
199 Buscopan inj Ampul - -
A200
200 Caviton Tube - -
A201
201 Cefixim syr 100 mg/5 ml Botol - -
A202
202 Cefixim tablet 100 mg Tablet - -
A203
203 Cefixim tablet 200 mg Tablet - -
A204
204 Cefotaxim 0,5 g inj Vial - -
A205
205 Ceftriaxon inj Vial - -
A206
206 Clarithromysin 500 mg Tablet - -
A207
207 Clavamox inj Ampul - -
A208
208 Clindamisin 150 mg Tablet - -
A209
209 Clindamisin 300 mg Tablet - -
A210
210 Clobazam 10 mg Tablet - -
A211
211 Clozapine 25 mg Tablet - -
A212
212 Composite (tumpatan sinar)A3 Set - -
A213
213 Composite (tumpatan sinar)A3.5 Set - -
A214
214 Crofed Tablet - -
A215
215 D1/2 NS botol - -
A216
216 D1/4 NS Botol - -
A217
217 Daryantulle Lembar - -
A218
218 Dermazine/Burnazin Tube - -
A219
219 Dextina / Dextamin/Dextamec/Polofar Plus Tablet - -
A220
220 Dextran 70% Botol - -
A221
221 Dextrofen syr Botol 3 1.75 42 39
A222
222 Diaform tablet/selesdiar Tablet - -
A223
223 Dormi/Scopma/Spashi tablet Tablet - -
A224
224 Dulcolac anak supp Supp - -
A225
225 Dulcolac dewasa supp Supp - -
A226
226 Dulkolak tablet Tablet - -
 227 Duviral(Zidovudin 300+Lamivudin 150) Botol - -
A227
228 Efavirenz Botol - -
A228
A229 229 Etambutol Tablet - -
230 ETSA Set - -
A230
231 Euthyrox 100mg Tablet - -
A231
232 Faktu Supp Supp - -
A232
233 Fluconasol tab Tablet - -
A233
234 Fluoxetin Tablet - -
A234
235 Forumen TT Fls - -
A235
236 Gentamisin Injeksi 80 mg/2ml Ampul - -
A236
237 Glass ionomer (Ketac Molar) Tube - -
A237
238 Glimepiride 2 tablet - -
A238
239 Glimepiride 4 tablet - -
A239
240 Glukonas Calcicus 10%- 10ml Ampul - -
A240
241 Haldol inj Ampul - -
A241
242 Hiviral (Lamivudin 150) Botol - -
A242
243 Ibuprofen syr btl - -
A243
A244 244 Iliadin TH flesh - -
A245 245 Isotic Neolisin TM Fls 3.75 90 90 5
246 Kalium Diklovenac tablet
- -
A246
A247
247 Kaltropen supp Supp - -
A248
248 Ketoconazole SK tube 3 1.00 24 21 5
A249
249 Ketoprofen inj 10 mg Ampul - -
A250
250 Ketoprofen tablet 100 mg Tablet - -
A251
251 Ketorolac inj Ampul - -
A252
252 Kombipak Anak Paket - -
A253
253 Lodomer 2 Tablet - -
A254
254 Lytamin syr botol - -
A255
255 Magnesium Sulfat 20% - 25 ml Botol - -
A256
256 Magnesium Sulfat 40% - 25 ml Botol - -
A257
257 Metil Prednisolon 16 mg Tablet - -
A258
258 Metil prednisolon inj 500 mg Vial - -
A259
259 Metronidazole 500 mg Infus/100 ml Botol - -
260 Meylon inj Botol
- -
A260
261 Microlax Supp
- -
A261
262 Miloxicam 7,5 mg tablet
50 128.60 3,086 3,036
A262 340
A263
263 Molexflu Tablet - -
 264 Multivitamin (Livron B plek) Tablet
248 208.44 5,003 4,755
A264 900
A265
265 Multivitamin sirup( Xanvit syr) Botol - -
A266
266 Neurotropik tablet Tablet - -
A267
267 Neviral (neviravin 200mg) Botol - -
A268
268 New antides tablet 170 6.50 156 (14) 200
A269
269 Nutrifar 5000 Tablet - -
A270
270 Obat anti tuberkulosis FDC katagori I Paket - -
A271
271 Obat anti tuberkulosis FDC anak Paket - -
A272
272 Obat anti tuberkulosis FDC katagori II Paket - -
A273
273 Obat anti tuberkulosis FDC sisipan Paket - -
A274
274 Obat anti tuberkulosis kategori I Paket - -
A275
275 Obat Batuk Kombinasi Botol - -
A276
276 Obat Flu kombinasi CTM, PPA (Anaflu), Demacolin Tablet 62.33 1,496 1,496 400
A277
277 Obat Flu Kombinasi/Mecofed/Quantidex Tablet - -
A278
278 OBH plus botol 2.00 48 48 5
A279
279 Omeprasole tablet 20 mg Tablet - -
A280
280 Ondancentron inj Ampul - -
A281
281 Ondancetron 4 mg Tablet - -
A282
282 Orpen Tablet - -
A283
283 Oseltamivir Tablet - -
A284
284 Paket bonding Set - -
A285
285 Pamol 125 mg Supp Supp - -
A286
286 Pamol 250 mg Supp Supp - -
A287 287 Pantocain Tetes Mata Botol - -
A288
288 Parasetamol drop Botol - -
A289
289 Pehacain Injeksi Ampul - -
290 Pehatrim Forte (Kotrimoksasol tab forte 960 mg) Tablet
- -
A290
A291
291 Perhidrol (H2O2) Botol - -
A292
292 Phenitoin tab Tablet - -
A293
293 Piracetam 400 mg Tablet - -
A294
294 Piracetam inj 200mg/1ml Ampul - -
A295
295 Pirimethamine tablet Tablet - -
A296
296 Prenatin DF Tablet 90.00 2,160 2,160 420
A297
297 Prenatin plus tablet tablet - -
A298
298 Primaquin Tablet - -
A299
299 Primperan inj Ampul - -
A300
300 Procurma sirup botol 5 1.71 41 36 3
A301
301 Prokain Benzil Penicillin G Injeksi 3 jt IU/vial Vial - -
A302 302 Proris supp Supp - -
 303 Pularex Tablet - -
A303
304 Scabimite cream tube - -
A304
305 Sikzonoate inj Ampul - -
A305
306 Simvastatin tab 20 mg Tablet - -
A306
307 Spashi inj Ampul - -
A307
308 Spashi tab Tablet - -
A308
309 Stelosi tab 5 mg Tablet - -
A309
310 Stesolid rectal Supp - -
A310
311 Strop indra Botol - -
A311
312 Sulfadiazin tablet Tablet - -
A312
313 Tenofovir (Tenofovir 300mg) Botol - -
A313
314 Tetagam Ampul - -
A314
315 Tramadol inj 50 mg/ml Ampul - -
A315
316 Tranexid inj (Asam tranexamat inj) Ampul - -
A316
317 Urotractin tablet - -
A317
318 Ventolin Nebulizer Ampul - -
A318
319 Vitamin B12 tab Tablet - -
A319
320 Vitamin Neurotropik inj Ampul - -
A320
321 Vitamin Neurotropik tablet (Nutrifar, Sohobion) Tablet - -
A321
322 VitKa infan Ampul - -
A322
323 Xylocain Gel Ampul
A323 - -

A324
324 Zidovudine 100 mg Tablet - -
A325
325 Sucralfat sup Supp - -
A326
326 Clopidogrel bisulfat - -
A327
327 Levofloxacin 500 - -
A328
328 Spironolactone 25mg - -
A329
329 Domperidon syr - -
A330
330 Ceterizine syr - -
A331
331 Albendazole syr - -
A332
332 Zink syr - -
333 Cazetin drop Botol
- -
A333
A334
334 Lacto B Sachet - -
A335
335 Scopma Plus - -
A336
336 Nebacetine powder Botol - -
A337
337 Metronidazole syr 125 - -
A338
338 Salbutamol syr - -
A339
339 Furosemid inj. - -
A340
340 Parasetamol infus - -
A341
341 Colortusin Tablet 190 53.20 1,277 1,087
 342 Coparcetine - -
A342
343 TB tahap intensif - -
A343
344 TB tahap Lanjutan - -
A344
345 Solathim Syr - -
A345
346 Antiseptic Liq - -
A346
347 Tenofovir -emtricitabin - -
A347
348 Cavit G - -
A348
349 Ketros sup - -
A349
350 Harnal - -
A350
351 Metronidasole infus - -
A351
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Mengetahui
Ka. Puskesmas Marga II

(dr. I Ketut Indra Wiguna Cakera)