REKAPITULASI LAPORAN NARKOTIKA

Nama Unit Layanan: Rumah Sakit Rumah Sakit Tk.IV.04.07.01 Tegal

Provinsi, Kabupaten/Kota: Jawa Tengah, Kab. Tegal

NO NAMA SATUAN STOK AWAL PEMASUKAN

PBF
1 CODEINE 10 MG TABLET Tablet 0 3000
2 CODEINE 15 MG TABLET Tablet 0 0
3 CODEINE 20 MG TABLET Tablet 0 0
4 CODIPRONT CUM EXPECTORAN KAPSUL Kapsul 0 0
5 CODIPRONT KAPSUL Kapsul 0 0
6 CODIPRONT CUM EXPECTORAN SIRUP Botol 0 0
7 CODIPRONT SIRUP Botol 0 0
8 CODITAM TABLET Tablet 0 0
9 DUROGESIC MATRIX 25 MU Patch 0 0
10 DUROGESIC MATRIX 12 MU Patch 0 0
11 DUROGESIC MATRIX 50 MU Patch 0 0
12 FENTANYL 0.05 MG/ML 10 ML INJEKSI Ampul 0 0
13 FENTANYL 0.05 MG/ML 2 ML INJEKSI Ampul 11 0
14 JURNISTA 4 MG TABLET Tablet 0 0
15 JURNISTA 8 MG TABLET Tablet 0 0
16 JURNISTA 16 MG TABLET Tablet 0 0
17 JURNISTA 32 MG TABLET Tablet 0 0
18 METHADONE SYRUP 50 MG/5 ML SIRUP Mililiter 0 0
19 MORFINA 10 MG TABLET Tablet 0 0
20 MORFINA 10 MG/ML 1 ML INJEKSI Ampul 0 0
21 MST CONTINUS 10 MG TABLET Tablet 0 0
22 MST CONTINUS 15 MG TABLET Tablet 0 0
23 MST CONTINUS 30 MG TABLET Tablet 0 0
24 PETHIDIN 50 MG/ML 2ML INJEKSI Ampul 9 0
25 SUBOXONE 2 MG TABLET Tablet 0 0
26 SUBOXONE 8 MG TABLET Tablet 0 0
27 SUFENTA 0.005 MG/ML 10 ML INJEKSI Ampul 0 0
28 CLOPEDIN 50 MG/ML 2 ML INJEKSI Ampul 0 0
29 CODIKAF 10 MG TABLET Tablet 0 0
30 CODIKAF 15 MG TABLET Tablet 0 0
31 CODIKAF 20 MG TABLET Tablet 0 0
32 OXYNEO 10 MG TABLET Tablet 0 0
33 OXYNEO 15 MG TABLET Tablet 0 0
34 OXYNEO 20 MG TABLET Tablet 0 0
35 OXYNORM 10 MG/ML 2 ML INJEKSI Ampul 0 0
36 OXYNORM 10 MG/ML 1 ML INJEKSI Ampul 0 0
37 FENTANYL CITRATE 0.05 MG/ML 10 ML INJEKSI ampul 0 0
38 FENTANYL CITRATE 0.05 MG/ML 2 ML INJEKSI Ampul 0 0
39 ETANYL 0.05 MG/ML 10 ML INJEKSI Ampul 0 0
40 ETANYL 0.05 MG/ML 2 ML INJEKSI Ampul 0 0
41 REMIKAF 1 MG INJEKSI Vial 0 0
42 REMIKAF 2 MG INJEKSI Vial 0 0
43 OXYNORM 5 MG KAPSUL Kapsul 0 0
44 OXYNORM 10 MG KAPSUL Kapsul 0 0
45 OXYNORM 20 MG KAPSUL KAPSUL 0 0
RAN NARKOTIKA
al Tahun: 2019
Bulan: Mei

PEMASUKAN PENGELUARAN STOK AKHIR

SARANA RESEP SARANA PEMUSNAHAN
0 100 0 0 2900
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 11
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 9
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 Apoteker Penanggung Jawab

Naniek Nofiyanti.S.Farm.,Apt.
SIPA: 010/ SIPA-AP/ Dinkes/ 2015
 REKAPITULASI LAPORAN PSIKOTROPIKA
Nama Unit Layanan: Rumah Sakit Rumah Sakit Tk.IV.04.07.01 Tegal Tahun: 2019
Provinsi, Kabupaten/Kota: Jawa Tengah, Kab. Tegal Bulan: Mei

NO NAMA SATUAN STOK AWAL PEMASUKAN PENGELUARAN STOK AKHIR

PBF SARANA RESEP SARANA PEMUSNAHAN
1 ACTAZOLAM 1 MG TABLET Tablet 0 0 0 0 0 0 0
2 ALGANAX 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
3 ALGANAX 1 MG TABLET Tablet 0 0 0 0 0 0 0
4 ALGANAX 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
5 ALPRAZOLAM 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
6 ALPRAZOLAM 0.5 MG TABLET Tablet 0 5000 0 300 0 0 4700
7 ALPRAZOLAM 1 MG TABLET Tablet 0 0 0 0 0 0 0
8 ALVIZ 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
9 ALVIZ 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
10 ALVIZ 1 MG TABLET Tablet 0 0 0 0 0 0 0
11 ANALSIK TABLET Tablet 0 0 0 0 0 0 0
12 ANESFAR 5 MG/ML 3 ML INJEKSI Ampul 0 0 0 0 0 0 0
13 ANXIBLOC 10 MG TABLET Tablet 0 0 0 0 0 0 0
14 APAZOL 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
15 APAZOL 1 MG TABLET Tablet 0 0 0 0 0 0 0
16 APAZOL 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
17 APISATE TABLET Tablet 0 0 0 0 0 0 0
18 ASABIUM 10 MG TABLET Tablet 0 0 0 0 0 0 0
19 ATARAX 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
20 ATIVAN 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
21 ATIVAN 1 MG TABLET Tablet 0 0 0 0 0 0 0
22 ATIVAN 2 MG TABLET Tablet 0 0 0 0 0 0 0
23 BELLAPHEN TABLET Tablet 0 0 0 0 0 0 0
24 BRAXIDIN TABLET Tablet 0 0 0 0 0 0 0
25 CALMLET 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
26 CALMLET 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
27 CALMLET 1 MG TABLET Tablet 0 0 0 0 0 0 0
28 CALMLET 2 MG TABLET Tablet 0 0 0 0 0 0 0
29 CETABRIUM 10 MG TABLET Tablet 0 0 0 0 0 0 0
30 CETABRIUM 5 MG TABLET Tablet 0 0 0 0 0 0 0
31 CETALGIN TABLET Tablet 0 0 0 0 0 0 0
32 CETALGIN-T DOS 100 KAPLET Kaplet 0 0 0 0 0 0 0
33 CLIAD TABLET Tablet 0 0 0 0 0 0 0
34 CLOBAZAM 10 MG TABLET Tablet 0 0 0 0 0 0 0
35 CLOBIUM 10 MG TABLET Tablet 0 0 0 0 0 0 0
36 CLOFRITIS 10 MG TABLET Tablet 0 0 0 0 0 0 0
37 CONCERTA 18 MG KAPTAB Tablet 0 0 0 0 0 0 0
38 CONCERTA 36 MG KAPTAB Tablet 0 0 0 0 0 0 0
39 DALMADORM 15 MG TABLET Tablet 0 0 0 0 0 0 0
40 DANALGIN TABLET Tablet 0 0 0 0 0 0 0
41 DECAZEPAM 2 MG TABLET Tablet 0 0 0 0 0 0 0
42 DECAZEPAM 5 MG TABLET Tablet 0 0 0 0 0 0 0
43 DIAZEPAM 2 MG TABLET Tablet 150 5000 0 150 0 0 5000
44 DIAZEPAM 5 MG TABLET Tablet 0 0 0 0 0 0 0
45 DIAZEPAM 5 MG/ML 2 ML INJEKSI Ampul 0 0 0 0 0 0 0
46 DITALIN TABLET Tablet 0 0 0 0 0 0 0
47 DORMICUM 5 MG/ML 3 ML INJEKSI Ampul 0 0 0 0 0 0 0
48 DORMICUM 1 MG/ML 5 ML INJEKSI Ampul 0 0 0 0 0 0 0
49 DUMOLID 5 MG TABLET Tablet 0 0 0 0 0 0 0
50 ESILGAN 1 MG TABLET Tablet 0 0 0 0 0 0 0
51 ESILGAN 2 MG TABLET Tablet 0 0 0 0 0 0 0
52 ESTALIN 1 MG TABLET Tablet 0 0 0 0 0 0 0
53 ESTALIN 2 MG TABLET Tablet 0 0 0 0 0 0 0
54 FEPRAX 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
55 FEPRAX 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
56 FEPRAX 1 MG TABLET Tablet 0 0 0 0 0 0 0
57 FORTANEST 1 MG/ML 5 ML INJEKSI Ampul 0 0 0 0 0 0 0
58 FORTANEST 5 MG/ML 3 ML INJEKSI Ampul 0 0 0 0 0 0 0
59 FRISIUM 10 MG TABLET Tablet 0 0 0 0 0 0 0
60 FRIXITAS 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
61 FRIXITAS 1 MG TABLET Tablet 0 0 0 0 0 0 0
62 GRAZOLAM 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
63 GRAZOLAM 1 MG TABLET Tablet 0 0 0 0 0 0 0
64 HEDIX TABLET Tablet 0 0 0 0 0 0 0
65 HIPNOZ 1 MG/ML 5 ML INJEKSI Ampul 0 0 0 0 0 0 0
66 HIPNOZ 5 MG/ML 3 ML INJEKSI Ampul 0 0 0 0 0 0 0
67 KLIDIBRAX TABLET Tablet 0 0 0 0 0 0 0
68 LEXOTAN 1.5 MG TABLET Tablet 0 0 0 0 0 0 0
69 LEXOTAN 3 MG TABLET Tablet 0 0 0 0 0 0 0
70 LEXOTAN 6 MG TABLET Tablet 0 0 0 0 0 0 0
71 LEXZEPAM 3 MG TABLET Tablet 0 0 0 0 0 0 0
72 LIBRAX TABLET Tablet 0 0 0 0 0 0 0
73 LIBRIUM 10 MG TABLET Tablet 0 0 0 0 0 0 0
74 LIBRIUM 5 MG TABLET Tablet 0 0 0 0 0 0 0
75 LIMBRITOL TABLET Tablet 0 0 0 0 0 0 0
76 LOXIPAS 1 MG TABLET Tablet 0 0 0 0 0 0 0
77 LOXIPAS 2 MG TABLET Tablet 0 0 0 0 0 0 0
78 MELIDOX TABLET Tablet 0 0 0 0 0 0 0
79 MENTALIUM 2 MG TABLET Tablet 0 0 0 0 0 0 0
80 MENTALIUM 10 MG TABLET Tablet 0 0 0 0 0 0 0
 81 MENTALIUM 5 MG TABLET Tablet 0 0 0 0 0 0 0
82 MERLOPAM 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
83 MERLOPAM 2 MG TABLET Tablet 0 0 0 0 0 0 0
84 METANEURON TABLET Tablet 0 0 0 0 0 0 0
85 MIDAZOLAM-HAMELN INJEKSI 5 MG/ML 1 ML INJAmpul 0 0 0 0 0 0 0
86 MIDAZOLAM-HAMELN INJEKSI 5 MG/ML 3 ML INJAmpul 0 0 0 0 0 0 0
87 MILOZ 1 MG/ML 5 ML INJEKSI Ampul 0 0 0 0 0 0 0
88 MILOZ 5 MG/ML 3 ML INJEKSI Ampul 0 0 0 0 0 0 0
89 NEO PROTAL TABLET Tablet 0 0 0 0 0 0 0
90 NEURINDO TABLET Tablet 0 0 0 0 0 0 0
91 NEURODIAL TABLET Tablet 0 0 0 0 0 0 0
92 NEUROGEN TABLET Tablet 0 0 0 0 0 0 0
93 NEUROPYRON TABLET Tablet 0 0 0 0 0 0 0
94 NEUROVAL TABLET Tablet 0 0 0 0 0 0 0
95 OPINEURON TABLET Tablet 0 0 0 0 0 0 0
96 OPIZOLAM 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
97 OPIZOLAM 1 MG TABLET Tablet 0 0 0 0 0 0 0
98 PHENOBARBITAL 30 MG TABLET Tablet 0 0 0 0 0 0 0
99 PHENOBARBITAL 50 MG TABLET Tablet 0 0 0 0 0 0 0
100 PHENOBARBITAL 100 MG TABLET Tablet 0 0 0 0 0 0 0
101 PHENOBARBITAL 50 MG/ML 1 ML INJEKSI Ampul 0 0 0 0 0 0 0
102 PHENTAL 100 MG/ML 1 ML INJEKSI Ampul 0 0 0 0 0 0 0
103 PIPTAL DROP Botol 0 0 0 0 0 0 0
104 POTENSIK TABLET Tablet 0 0 0 0 0 0 0
105 PROCLOZAM 10 MG TABLET Tablet 0 0 0 0 0 0 0
106 PROHIPER 10 MG TABLET Tablet 0 0 0 0 0 0 0
107 PRONEURON TABLET Tablet 0 0 0 0 0 0 0
108 RENAGAS TABLET Tablet 0 0 0 0 0 0 0
109 RENAQUIL 1 MG TABLET Tablet 0 0 0 0 0 0 0
110 RIKLONA 2 MG TABLET Tablet 0 0 0 0 0 0 0
111 RITALIN 10 MG TABLET Tablet 0 0 0 0 0 0 0
112 RITALIN LA 20 MG KAPSUL Kapsul 0 0 0 0 0 0 0
113 SANMAG TABLET Tablet 0 0 0 0 0 0 0
114 SEDACUM 1 MG/ML 5 ML INJEKSI Ampul 0 0 0 0 0 0 0
115 SEDACUM 5 MG/ML 3 ML INJEKSI Ampul 0 0 0 0 0 0 0
116 SIBITAL 50 MG TABLET Tablet 0 0 0 0 0 0 0
117 SIBITAL 100 MG /ML 2 ML INJEKSI Ampul 0 0 0 0 0 0 0
118 SOXIETAS 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
119 SOXIETAS 1 MG TABLET Tablet 0 0 0 0 0 0 0
120 SOXIETAS 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
121 SPASMIUM TABLET Tablet 0 0 0 0 0 0 0
122 STESOLID 2 MG TABLET Tablet 0 0 0 0 0 0 0
123 STESOLID 5 MG TABLET Tablet 0 0 0 0 0 0 0
124 STESOLID 2 MG/5 ML 60 ML SIRUP Botol 0 0 0 0 0 0 0
125 STESOLID 10 MG/2.5 ML ENEMA Tube 0 0 0 0 0 0 0
126 STESOLID 5 MG/2.5 ML ENEMA Tube 0 0 0 0 0 0 0
127 STESOLID 10 MG TABLET Tablet 0 0 0 0 0 0 0
128 STILNOX 10 MG TABLET Tablet 0 0 0 0 0 0 0
129 TERONAC 1 MG TABLET Tablet 0 0 0 0 0 0 0
130 TRAZEP 5 MG/2.5 ML ENEMA Tube 0 0 0 0 0 0 0
131 TRAZEP 10 MG/2.5 ML ENEMA Tube 0 0 0 0 0 0 0
132 VALDIMEX 2 MG TABLET Tablet 0 0 0 0 0 0 0
133 VALDIMEX 5 MG TABLET Tablet 0 0 0 0 0 0 0
134 VALDIMEX 5 MG/ML 2 ML INJEKSI Ampul 0 0 0 0 0 0 0
135 VALIUM 5 MG TABLET Tablet 0 0 0 0 0 0 0
136 VALIUM 2 MG TABLET Tablet 0 0 0 0 0 0 0
137 VALIUM 5 MG/ML 2 ML INJEKSI Ampul 0 0 0 0 0 0 0
138 VALISANBE 2 MG TABLET Tablet 0 2500 0 2000 0 0 500
139 VALISANBE 5 MG TABLET Tablet 0 0 0 0 0 0 0
140 VALISANBE 5 MG/ML 2 ML INJEKSI Ampul 31 0 0 2 0 0 29
141 XANAX 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
142 XANAX 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
143 XANAX 1 MG TABLET Tablet 0 0 0 0 0 0 0
144 XANAX XR 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
145 XANAX XR 1 MG TABLET Tablet 0 0 0 0 0 0 0
146 ZOLASTIN 1 MG TABLET Tablet 0 0 0 0 0 0 0
147 ZOLASTIN 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
148 ZOLMIA 10 MG TABLET Tablet 0 0 0 0 0 0 0
149 ZYPARON TABLET Tablet 0 0 0 0 0 0 0
150 ZYPRAZ 0.25 MG TABLET Tablet 0 0 0 0 0 0 0
151 ZYPRAZ 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
152 ZYPRAZ 1 MG TABLET Tablet 0 0 0 0 0 0 0
153 ANESFAR 1 MG/ML 5 ML INJEKSI Ampul 0 0 0 0 0 0 0
154 FRIXITAS 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
155 PANSTOP-T TABLET Tablet 0 0 0 0 0 0 0
156 PROZEPAM 5 MG/ML 2 ML INJEKSI Ampul 0 0 0 0 0 0 0
157 ZOLTA 10 MG TABLET Tablet 0 0 0 0 0 0 0
158 ACTAZOLAM 0.5 MG TABLET Tablet 0 0 0 0 0 0 0
159 CONCERTA 54 MG KAPTAB Tablet 0 0 0 0 0 0 0
160 STESOLID 5 MG/ML 2ML INJEKSI Ampul 0 0 0 0 0 0 0
161 ELGRAN 1 MG TABLET Tablet 0 0 0 0 0 0 0
162 ELGRAN 2 MG TABLET Tablet 0 0 0 0 0 0 0
163 SLEPZOL 10 MG TABLET Tablet 0 0 0 0 0 0 0
164 CLIDIAZ TABLET 0 0 0 0 0 0 0
165 ZUDEM TABLET Tablet 0 0 0 0 0 0 0
166 CLIXID TABLET SALUT 5 MG Mg 0 0 0 0 0 0 0
167 STESOLID 10 MG/ML 2ML INJEKSI Ampul 0 0 0 0 0 0 0
168 NEURALGAD TABLET Tablet 0 0 0 0 0 0 0
169 CLONAZEPAM 2 MG TABLET Tablet 0 0 0 0 0 0 0
170 ALENA 1 MG TABLET MG 0 0 0 0 0 0 0
171 ALENA 2 MG TABLET MG 0 0 0 0 0 0 0
172 RIVOTRIL 2 MG TABLET TABLET 0 0 0 0 0 0 0
173 LAVOL TABLET TABLET 0 0 0 0 0 0 0
174 LORAZEPAM 2 MG TABLET TABLET 0 0 0 0 0 0 0
175 YEKALGIN KAPTAB KAPTAB 0 0 0 0 0 0 0
176 ATARAX 1 MG TABLET Tablet 0 0 0 0 0 0 0
177 METHYLPHENIDATE HCl 10 MG TABLET Tablet 0 0 0 0 0 0 0
178 MIDANEST 1 MG/ML 5 ML INJEKSI Ampul 0 0 0 0 0 0 0
179 MIDANEST 5 MG/ML 3 ML INJEKSI Ampul 0 0 0 0 0 0 0
180 FRIXITAS XR 1 MG TABLET Tablet 0 0 0 0 0 0 0

Apoteker Penanggung Jawab

Naniek Nofiyanti.S.Farm.,Apt.
SIPA: 010/ SIPA-AP/ Dinkes/ 2015