No ID No RM Nama Pasien JK Usia Diagnosa TD LOS Cilostazol 100 mg

1 832379 18.53.04 Ny. SI P 68 Th Stroke 150 / 74 3 hari 2

2 830746 14.32.02 Ny. NK P 69 TH Stroke 105 / 62 3 hari 1
3 829112 21.26.62 Ny. WI P 65 TH Stroke 127 / 89 6 hari 1
4 828342 21.24.98 Ny. MH P 60 TH Stroke 183 / 113 2 hari 2
5 827737 17.99.58 Tn. HM L 58 TH Stroke 150 / 98 2 hari 2
6 827334 21.17.29 Tn. KI L 51 TH Stroke 167 / 108 2 hari 2
7 825527 21.17.57 Tn. AI L 55 TH Stroke 152 / 102 2 hari 1
8 824457 21.16.71 Tn. JN L 53 TH Stroke 172 / 99 3 hari 2
9 824349 14.02.07 Tn. DN L 49 TH Stroke 150 / 88 3 hari 2
10 823638 20.76.98 Ny. SP P 65 TH Stroke 163 / 101 4 hari 2
11 821757 21.10.88 Ny. NH P 61 TH Stroke 171 / 103 2 hari 2
12 820326 21.07.24 Ny. HI P 60 TH Stroke 190 / 114 2 hari 2
13 820324 21.07.23 Tn. SN L 53 TH Stroke 90 / 62 3 hari 2
14 819500 05.52.14 Ny. PM P 59 TH Stroke 152 / 72 1 hari 2
15 817489 11.18.22 Ny. MF P 55 TH Stroke 110 / 64 1 hari 2
16 816504 06.96.82 Tn. SO L 64 TH Stroke 98/ 73 1 hari 2
17 816108 20.97.62 Ny. SH P 78 TH Stroke 118 / 75 2 hari 2
18 815059 17.83.86 Tn. DN L 75 TH Stroke 171 / 93 4 hari 2
19 814132 15.57.97 Tn. HK L 66 TH Stroke 121 / 73 4 hari 2
20 813098 20.93.24 Ny. PH P 73 TH Stroke 112 / 80 3 hari 2
21 834903 21.36.61 Tn. KN L 61 TH Stroke 210 / 108 6 hari 2
22 832671 17.25.72 Tn. SS P 49 TH Stroke 137 / 89 8 hari 2
23 832379 18.53.04 Ny. SU P 68 TH Stroke 150 / 74 4 hari 2
24 832257 12.69.93 Tn. TH L 55 TH Stroke 179 / 96 6 hari 2
25 830579 21.29.59 Tn. CI L 51 TH Stroke 170 / 70 5 hari 2
26 831812 12.93.33 Tn. SW L 71 TH Stroke 164 / 93 6 hari 2
27 829112 21.26.62 Ny. WI P 65 TH Stroke 127 / 89 5 hari 2
28 828927 13.25.45 Ny. ST P 51 TH Stroke 200 / 133 4 hari 2
29 828638 21.25.54 Tn. YO L 65 TH Stroke 179 / 90 3 hari 2
30 828480 21.25.18 Ny. SR P 56 TH Stroke 166 / 107 8 hari 2
31 827633 21.21.41 Ny. MI P 55 TH Stroke 125 / 90 5 hari 2
32 827334 21.17.29 Tn. KM L 51 TH Stroke 167 / 108 12 hari 2
33 826210 21.20.50 Ny. WJ P 65 TH Stroke 115 / 73 5 hari 2
34 825996 21.20.07 Tn. BO L 35 TH Stroke 154 / 98 3 hari 2
35 825705 21.19.40 Ny. SK P 59 TH Stroke 185 / 113 4 hari 2
36 825527 21.17.57 Tn. AM L 55 TH Stroke 152 / 102 6 hari 1
37 825541 14.32.02 Ny. NK P 69 TH Stroke 130 / 91 9 hari 2
38 824946 21.17.68 Ny. PI P 62 TH Stroke 157/ 88 6 hari 2
39 824928 17.88.78 Ny. SA P 60 TH Stroke 155 / 73 9 hari 1
40 824736 21.17.29 Tn. KS L 51 TH Stroke 140 / 87 10 hari 2
41 824457 21.16.71 Tn. JN L 53 TH Stroke 172 / 99 7 hari 2
42 824349 14.02.07 Tn. DN L 49 TH Stroke 150 / 88 3 hari 2
43 821327 11.18.68 Tn. NI L 57 TH Stroke 173 / 85 4 hari 2
44 820953 09.36.95 Ny. SW P 74 TH Stroke 142 / 103 10 hari 2
45 820564 21.08.03 Ny. SM P 52 TH Stroke 176 / 63 11 hari 2
46 819836 21.06.12 Ny. ST P 58 TH Stroke 148 / 96 4 hari 2
47 817208 21.00.06 Tn. SO L 73 TH Stroke 149 / 82 9 hari 2
48 816504 06.96.82 Tn. SJ L 64 TH Stroke 98 / 73 2 hari 1
49 816108 20.97.62 Ny. SH P 78 TH Stroke 118 / 75 4 hari 2
50 815006 20.95.62 Ny. TM P 50 TH Stroke 231 / 116 5 hari 2
51 815059 17.83.86 Tn. DA L 75 TH Stroke 171 / 93 12 hari 2
52 814208 20.94.66 Ny. IN P 60 TH Stroke 233 / 78 7 hari 2
53 813542 14.81.98 Tn. AD L 70 TH Stroke 152 / 82 5 hari 2
54 813098 20.93.24 Ny. PH P 73 TH Stroke 112 / 80 4 hari 2
55 812531 20.92.06 Ny. ST P 60 TH Stroke 157 / 81 6 hari 2
56 811838 10.86.76 Tn. WO L 58 TH Stroke 138 / 97 17 hari 2
57 810389 20.88.76 Tn. DM L 65 TH Stroke 149 / 78 10 hari 2
58 810184 20.88.57 Ny. FH P 54 TH Stroke 175 / 119 5 hari 2
59 809826 20.87.85 Ny. PI P 71 TH Stroke 138 / 89 8 hari 2
60 810123 20.88.35 Tn. DA L 41 TH Stroke 115 / 78 8 hari 2
61 809749 20.87.78 Tn. SY L 55 TH Stroke 175 / 110 9 hari 2
62 809321 11.28.55 Tn. TT L 43 TH Stroke 112 / 60 9 hari 2
63 827737 17.99.58 Tn. HL L 58 TH Stroke 150 / 98 2 hari 2
64 865049 18.37.52 Tn. SR L 53 TH Stroke 105 / 77 2 hari 2
65 864022 21.94.86 Tn. SL L 54 TH Stroke 202 / 180 10 hari 2
66 863592 21.92.53 Tn. MO L 61 TH Stroke 191 / 107 5 hari 2
67 863072 21.92.77 Ny. ST P 61 TH Stroke 168 / 75 7 hari 2
68 861854 21.90.64 Tn. SR L 55 TH Stroke 149 / 90 6 hari 2
69 861785 08.81.90 Ny. LT P 60 TH Stroke 166 / 122 7 hari 2
70 861749 21.90.53 Tn. SU L 67 TH Stroke 173 / 94 4 hari 2
71 862014 21.90.87 Tn. SY L 66 TH Stroke 102 / 91 8 hari 2
72 861586 07.24.83 Ny. SN P 70 TH Stroke 182 / 98 5 hari 2
73 861584 17.80.06 Ny. MR P 74 TH Stroke 94 / 75 4 hari 2
74 860334 21.87.86 Tn. KL L 60 TH Stroke 125 / 82 5 hari 2
75 860495 21.88.22 Ny. AE P 77 TH Stroke 141 / 82 7 hari 2
76 860077 21.87.19 Tn. MK L 55 TH Stroke 177 / 130 5 hari 2
77 860230 21.87.53 Tn. BD L 60 TH Stroke 139 / 78 4 hari 2
78 859820 21.40.11 Ny. SA P 57 TH Stroke 95 / 67 7 hari 2
79 859211 21.85.61 Tn. PT L 49 TH Stroke 179 / 146 5 hari 2
80 859104 21.85.44 Tn. LN L 59 TH Stroke 167 / 116 7 hari 2
81 857654 14.07.75 Ny. MY P 46 TH Stroke 197 / 111 5 hari 2
82 857444 21.82.26 Ny. SA P 62 TH Stroke 141 / 86 5 hari 2
83 856908 21.81.26 Ny. ST P 59 TH Stroke 185 / 120 4 hari 2
84 857032 21.81.44 Ny. SU P 70 TH Stroke 209 / 93 7 hari 2
85 855689 21.79.21 Tn. MP L 55 TH Stroke 130 / 68 6 hari 2
86 855524 21.73.91 Ny. SK P 62 TH Stroke 170 / 116 7 hari 2
87 855427 21.78.64 Ny. RN P 59 TH Stroke 191 / 120 4 hari 2
88 854952 20.87.07 Tn. ST L 65 TH Stroke 229 / 105 8 hari 2
89 854629 21.76.78 Ny. DH P 42 TH Stroke 207 / 121 9 hari 2
90 854198 21.76.08 Tn. MS L 51 TH Stroke 130 / 92 5 hari 2
91 854087 07.16.28 Tn. SU L 71 TH Stroke 175 / 89 5 hari 2
92 853974 14.38.06 Ny. SE P 75 TH Stroke 191 / 98 4 hari 2
93 853611 21.75.08 Tn. IM L 66 TH Stroke 136 / 86 5 hari 1
94 853482 17.36.43 Tn. MI L 72 TH Stroke 205 / 130 3 hari 2
95 852204 10.97.03 Ny. EA P 47 TH Stroke 172 / 82 4 hari 2
96 852319 21.72.18 Ny. PI P 50 TH Stroke 173 / 113 8 hari 1
97 851922 21.71.51 Ny. KS P 66 TH Stroke 89 / 66 8 hari 2
 98 851117 18.80.02 Ny. SY P 62 TH Stroke 217 / 110 9 hari 2
99 850962 21.69.59 Ny. RN P 85 TH Stroke 186 / 108 4 hari 2
100 850732 16.21.03 Tn. MD L 73 TH Stroke 156 / 116 4 hari 2
101 850143 21.67.56 Tn. MI L 59 TH Stroke 148 / 87 6 hari 2
102 849446 14.05.39 Ny. FH P 56 TH Stroke 162 / 98 8 hari 2
103 849147 21.65.55 Tn. MM L 58 TH Stroke 150 / 98 2 hari 2
104 848815 21.64.81 Ny. SA P 68 TH Stroke 224 / 100 4 hari 1
105 848714 21.64.42 Tn. MK L 48 TH Stroke 176 / 93 7 hari 1
106 848032 20.10.98 Tn. SB L 60 TH Stroke 207 / 100 6 hari 2
107 847843 21.62.64 Tn. SR L 64 TH Stroke 119 / 73 7 hari 2
108 846963 13.08.15 Tn. UO L 59 TH Stroke 95 / 102 8 hari 2

Keterangan :

1. Menggunakan
2. Tidak Menggunakan
 Terapi Farma
Golongan Antiplatelet
Dosis Klopidogrel 75 mg Dosis Tikagrelor 90 mg Dosis Asam Acetil Salicylat 80 mg Dosis
1 1x1 2 2
2 2 2
2 2 2 1x1
1 1x1 2 2
2 2 2
2 2 2
2 x 1/2 2 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
2 2 2 1x1
1 1x1 2 2
2 2 2 1x1
2 2 2 1x1
2 2 2
1 1x1 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
2 2 2
2 2 2 1x1
1 1x1 2 2
2 x 1/2 2 2 2
2 2 2
2 2 2 1x1
2 x 1/2 2 2 2
2 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
2 2 2
2 2 2 1x1
 1 1x1 2 2
1 1x1 2 2
2 2 2 1x1
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2 1x1
2 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2 1x1
1 1x1 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
2 2 2
1 1x 1 2 2
1 1x1 2 2
2 2 2
2 2 2 1x1
2 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
2 2 2 1x1
2 2 2 1x1
2 2 2
2 2 2 1x1
2 2 2
2 2 2
2 2 2 1x1
2 2 2
3 x 1/2 2 2 2
2 2 2
2 1 1x1 2
2 x 1/2 1 1x1 2 2
2 2 2
 2 2 2
2 2 2
2 2 2 1x1
2 2 2
2 2 2
2 2 2 1x1
2 x 1/2 2 2 2
2 x 1/2 2 2 2
1 1x1 2 2
2 2 2
2 2 1 1x1
kologi
Golongan Statin
Atorvastatin 20 mg Dosis Atorvastatin 40 mg Dosis Simvastatin 10 mg Dosis
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
22 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
2 2 2
1 1 x 1/2 2 2
1 1x1 2 2
2 2 2
1 1 x 1/2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
2 2 2
2 2 1 1x1
1 1 x 1/2 2 2
1 1x1 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 2 2
2 2 2
2 2 2
1 1x1 2 2
1 1x1 2 2
2 1 1x1 2
1 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
Simvastatin 20 mg Dosis
1 1x1
2
2
2
2
2
2
1 1x1
1 1x1
2
2
2
2
2
2
2
2
2
2
2
2
1 1x1
1 1x1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1 1x1
1 1x1
2
2
2
2
2
2
2
2
2
2
1 1x1
2
1 1x1
1 1x1
2
1 1x1
2
2
1 1x1
2
2
2
2
1 1x1
2
1 1x1
2
1 1x1
2
1 1x1
2
2
2
1 1x1
2
2
1 1x1
2
2
2
2
2
1 1x1
1 1x1
2
1 1x1
2
2
1 1x1
1 1x1
2
1 1x1
2
2
2
2
1 1x1
2
1 1x1
2
2
2
2
2
2
2
 Lampiran : Obat Khusus

Golongan Antipl

Cilostazol Cilostazol Klopidogr

No Nama Pasien JK Usia TD LOS 100 150 el 75
mg/hari mg/hari mg/hari

1 Ny. SI P 68 Th 150 / 74 3 hari ─ ─ 

2 Ny. NK P 69 TH 105 / 62 3 hari ─ ─ ─
3 Ny. WI P 65 TH 127 / 89 6 hari ─ ─ ─
4 Ny. MH P 60 TH 183 / 113 2 hari ─ ─ 
5 Tn. HM L 58 TH 150 / 98 2 hari ─ ─ ─
6 Tn. KI L 51 TH 167 / 108 2 hari ─ ─ ─
7 Tn. AI L 55 TH 152 / 102 2 hari  ─ ─
8 Tn. JN L 53 TH 172 / 99 3 hari ─ ─ 
9 Tn. DN L 49 TH 150 / 88 3 hari ─ ─ ─
10 Ny. SP P 65 TH 163 / 101 4 hari ─ ─ 
11 Ny. NH P 61 TH 171 / 103 2 hari ─ ─ 
12 Ny. HI P 60 TH 190 / 114 2 hari ─ ─ ─
13 Tn. SN L 53 TH 90 / 62 3 hari ─ ─ 
14 Ny. PM P 59 TH 152 / 72 1 hari ─ ─ 
15 Ny. MF P 55 TH 110 / 64 1 hari ─ ─ ─
16 Tn. SO L 64 TH 98/ 73 1 hari ─ ─ 
17 Ny. SH P 78 TH 118 / 75 2 hari ─ ─ 
18 Tn. DN L 75 TH 171 / 93 4 hari ─ ─ ─
19 Tn. HK L 66 TH 121 / 73 4 hari ─ ─ ─
20 Ny. PH P 73 TH 112 / 80 3 hari ─ ─ ─
21 Tn. KN L 61 TH 210 / 108 6 hari ─ ─ 
22 Tn. SS P 49 TH 137 / 89 8 hari ─ ─ ─
23 Ny. SU P 68 TH 150 / 74 4 hari ─ ─ 
24 Tn. TH L 55 TH 179 / 96 6 hari ─ ─ ─
25 Tn. CI L 51 TH 170 / 70 5 hari ─ ─ 
26 Tn. SW L 71 TH 164 / 93 6 hari ─ ─ ─
27 Ny. WI P 65 TH 127 / 89 5 hari ─ ─ ─
28 Ny. ST P 51 TH 200 / 133 4 hari ─ ─ ─
29 Tn. YO L 65 TH 179 / 90 3 hari ─ ─ 
30 Ny. SR P 56 TH 166 / 107 8 hari ─ ─ 
31 Ny. MI P 55 TH 125 / 90 5 hari ─ ─ 
32 Tn. KM L 51 TH 167 / 108 12 hari ─ ─ ─
33 Ny. WJ P 65 TH 115 / 73 5 hari ─ ─ ─
34 Tn. BO L 35 TH 154 / 98 3 hari ─ ─ ─
35 Ny. SK P 59 TH 185 / 113 4 hari ─ ─ 
36 Tn. AM L 55 TH 152 / 102 6 hari  ─ ─
37 Ny. NK P 69 TH 130 / 91 9 hari ─ ─ ─
38 Ny. PI P 62 TH 157/ 88 6 hari ─ ─ ─
39 Ny. SA P 60 TH 155 / 73 9 hari  ─ ─
40 Tn. KS L 51 TH 140 / 87 10 hari ─ ─ ─
41 Tn. JN L 53 TH 172 / 99 7 hari ─ ─ 
42 Tn. DN L 49 TH 150 / 88 3 hari ─ ─ ─
43 Tn. NI L 57 TH 173 / 85 4 hari ─ ─ 
44 Ny. SW P 74 TH 142 / 103 10 hari ─ ─ 
45 Ny. SM P 52 TH 176 / 63 11 hari ─ ─ ─
46 Ny. ST P 58 TH 148 / 96 4 hari ─ ─ ─
47 Tn. SO L 73 TH 149 / 82 9 hari ─ ─ ─
48 Tn. SJ L 64 TH 98 / 73 2 hari ─ ─ 
49 Ny. SH P 78 TH 118 / 75 4 hari ─ ─ 
50 Ny. TM P 50 TH 231 / 116 5 hari ─ ─ ─
51 Tn. DA L 75 TH 171 / 93 12 hari ─ ─ ─
52 Ny. IN P 60 TH 233 / 78 7 hari ─ ─ ─
53 Tn. AD L 70 TH 152 / 82 5 hari ─ ─ ─
54 Ny. PH P 73 TH 112 / 80 4 hari ─ ─ ─
55 Ny. ST P 60 TH 157 / 81 6 hari ─ ─ ─
56 Tn. WO L 58 TH 138 / 97 17 hari ─ ─ ─
57 Tn. DM L 65 TH 149 / 78 10 hari ─ ─ 
58 Ny. FH P 54 TH 175 / 119 5 hari ─ ─ ─
59 Ny. PI P 71 TH 138 / 89 8 hari ─ ─ ─
60 Tn. DA L 41 TH 115 / 78 8 hari ─ ─ 
61 Tn. SY L 55 TH 175 / 110 9 hari ─ ─ ─
62 Tn. TT L 43 TH 112 / 60 9 hari ─ ─ ─
63 Tn. HL L 58 TH 150 / 98 2 hari ─ ─ ─
64 Tn. SR L 53 TH 105 / 77 2 hari ─ ─ ─
65 Tn. SL L 54 TH 202 / 180 10 hari ─ ─ 
66 Tn. MO L 61 TH 191 / 107 5 hari ─ ─ ─
67 Ny. ST P 61 TH 168 / 75 7 hari ─ ─ 
68 Tn. SR L 55 TH 149 / 90 6 hari ─ ─ ─
69 Ny. LT P 60 TH 166 / 122 7 hari ─ ─ 
70 Tn. SU L 67 TH 173 / 94 4 hari ─ ─ 
71 Tn. SY L 66 TH 102 / 91 8 hari ─ ─ ─
72 Ny. SN P 70 TH 182 / 98 5 hari ─ ─ 
73 Ny. MR P 74 TH 94 / 75 4 hari ─ ─ ─
74 Tn. KL L 60 TH 125 / 82 5 hari ─ ─ 
75 Ny. AE P 77 TH 141 / 82 7 hari ─ ─ 
76 Tn. MK L 55 TH 177 / 130 5 hari ─ ─ ─
77 Tn. BD L 60 TH 139 / 78 4 hari ─ ─ ─
78 Ny. SA P 57 TH 95 / 67 7 hari ─ ─ ─
79 Tn. PT L 49 TH 179 / 146 5 hari ─ ─ ─
80 Tn. LN L 59 TH 167 / 116 7 hari ─ ─ ─
81 Ny. MY P 46 TH 197 / 111 5 hari ─ ─ ─
82 Ny. SA P 62 TH 141 / 86 5 hari ─ ─ 
83 Ny. ST P 59 TH 185 / 120 4 hari ─ ─ ─
84 Ny. SU P 70 TH 209 / 93 7 hari ─ ─ 
85 Tn. MP L 55 TH 130 / 68 6 hari ─ ─ ─
86 Ny. SK P 62 TH 170 / 116 7 hari ─ ─ ─
87 Ny. RN P 59 TH 191 / 120 4 hari ─ ─ ─
88 Tn. ST L 65 TH 229 / 105 8 hari ─ ─ ─
89 Ny. DH P 42 TH 207 / 121 9 hari ─ ─ ─
90 Tn. MS L 51 TH 130 / 92 5 hari ─ ─ ─
91 Tn. SU L 71 TH 175 / 89 5 hari ─ ─ ─
92 Ny. SE P 75 TH 191 / 98 4 hari ─ ─ ─
 93 Tn. IM L 66 TH 136 / 86 5 hari ─  ─
94 Tn. MI L 72 TH 205 / 130 3 hari ─ ─ ─
95 Ny. EA P 47 TH 172 / 82 4 hari ─ ─ ─
96 Ny. PI P 50 TH 173 / 113 8 hari  ─ 
97 Ny. KS P 66 TH 89 / 66 8 hari ─ ─ ─
98 Ny. SY P 62 TH 217 / 110 9 hari ─ ─ ─
99 Ny. RN P 85 TH 186 / 108 4 hari ─ ─ ─
100 Tn. MD L 73 TH 156 / 116 4 hari ─ ─ ─
101 Tn. MI L 59 TH 148 / 87 6 hari ─ ─ ─
102 Ny. FH P 56 TH 162 / 98 8 hari ─ ─ ─
103 Tn. MM L 58 TH 150 / 98 2 hari ─ ─ ─
104 Ny. SA P 68 TH 224 / 100 4 hari  ─ ─
105 Tn. MK L 48 TH 176 / 93 7 hari  ─ ─
106 Tn. SB L 60 TH 207 / 100 6 hari ─ ─ 
107 Tn. SR L 64 TH 119 / 73 7 hari ─ ─ ─
108 Tn. UO L 59 TH 95 / 102 8 hari ─ ─ ─

Keterangan :

1. Menggunakan
2. Tidak Menggunakan
 Terapi Farmakologi
atelet Golongan Statin
Asam
Tikagrelor Acetil Atorvasta Atorvasta Atorvasta Simvastati Simvastati
90 Salicylat tin 10 tin 20 tin 40 n 10 n 20
mg/hari 80 mg/hari mg/hari mg/hari mg/hari mg/hari
mg/hari
─ ─ ─ ─ ─ ─ 
─ ─ ─ ─ ─ ─ ─
─  ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─  ─ ─ 
─ ─ ─ ─ ─ ─ 
─ ─ ─  ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─  ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─  ─ ─ ─
─ ─ ─  ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ 
─ ─ ─ ─ ─ ─ 
─  ─ ─ ─ ─ ─
─ ─ ─  ─ ─ ─
─  ─ ─ ─ ─ ─
─  ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─  ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─  ─  ─ ─ ─
─ ─ ─  ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─   ─ ─ ─ ─
─ ─ ─  ─ ─ ─
─ ─ ─ ─ ─ ─ ─

─ ─ ─ ─ ─ ─ 
─ ─  ─ ─ ─ 

─ ─ ─ ─ ─ ─ 
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─  ─ ─ ─ ─ ─
─ ─ ─  ─ ─ ─
─ ─ ─ ─ ─ ─ ─
─  ─ ─ ─  ─
─ ─  ─ ─ ─ ─
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 Lampiran Obat Khusus
Terapi Farmakologi
Golongan Antiplatelet Golongan Statin
Cilostazol Cilostazol Asam Acetil
Nama Klopidogrel Tikagrelor Atorvastatin Atorvastatin Atorvastatin Simvastatin Simvastatin
No JK Usia TD 100 150 Salicylat 80
Pasien 75 mg/hari 90 mg/hari 10 mg/hari 20 mg/hari 40 mg/hari 10 mg/hari 20 mg/hari
mg/hari mg/hari mg/hari

1 Ny. SI P 68 Th 150 / 74 0 0 1 0 0 0 0 0 0 1
2 Ny. NK P 69 TH 105 / 62 0 0 0 0 0 0 0 0 0 0
3 Ny. WI P 65 TH 127 / 89 0 0 0 0 1 0 0 0 0 0
4 Ny. MH P 60 TH 183 / 113 0 0 1 0 0 0 0 0 0 0
5 Tn. HM L 58 TH 150 / 98 0 0 0 0 0 0 0 0 0 0
6 Tn. KI L 51 TH 167 / 108 0 0 0 0 0 0 0 0 0 0
7 Tn. AI L 55 TH 152 / 102 1 0 0 0 0 0 0 0 0 0
8 Tn. JN L 53 TH 172 / 99 0 0 1 0 0 0 1 0 0 1
9 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 1
10 Ny. SP P 65 TH 163 / 101 0 0 1 0 0 0 1 0 0 0
11 Ny. NH P 61 TH 171 / 103 0 0 1 0 0 0 0 0 0 0
12 Ny. HI P 60 TH 190 / 114 0 0 0 0 0 0 0 0 0 0
13 Tn. SN L 53 TH 90 / 62 0 0 1 0 0 0 0 0 0 0
14 Ny. PM P 59 TH 152 / 72 0 0 1 0 0 0 0 0 0 0
15 Ny. MF P 55 TH 110 / 64 0 0 0 0 0 0 0 0 0 0
16 Tn. SO L 64 TH 98/ 73 0 0 1 0 0 0 1 0 0 0
17 Ny. SH P 78 TH 118 / 75 0 0 1 0 0 0 0 0 0 0
18 Tn. DN L 75 TH 171 / 93 0 0 0 0 0 0 1 0 0 0
19 Tn. HK L 66 TH 121 / 73 0 0 0 0 0 0 1 0 0 0
20 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0
21 Tn. KN L 61 TH 210 / 108 0 0 1 0 0 0 0 0 0 0
22 Tn. SS P 49 TH 137 / 89 0 0 0 0 0 0 0 0 0 1
23 Ny. SU P 68 TH 150 / 74 0 0 1 0 0 0 0 0 0 1
24 Tn. TH L 55 TH 179 / 96 0 0 0 0 1 0 0 0 0 0
25 Tn. CI L 51 TH 170 / 70 0 0 1 0 0 0 1 0 0 0
26 Tn. SW L 71 TH 164 / 93 0 0 0 0 1 0 0 0 0 0
27 Ny. WI P 65 TH 127 / 89 0 0 0 0 1 0 0 0 0 0
28 Ny. ST P 51 TH 200 / 133 0 0 0 0 0 0 0 0 0 0
29 Tn. YO L 65 TH 179 / 90 0 0 1 0 0 0 0 0 0 0
30 Ny. SR P 56 TH 166 / 107 0 0 1 0 0 0 1 0 0 0
31 Ny. MI P 55 TH 125 / 90 0 0 1 0 0 0 0 0 0 0
32 Tn. KM L 51 TH 167 / 108 0 0 0 0 0 0 0 0 0 0
33 Ny. WJ P 65 TH 115 / 73 0 0 0 0 0 0 0 0 0 0
34 Tn. BO L 35 TH 154 / 98 0 0 0 0 1 0 1 0 0 0
35 Ny. SK P 59 TH 185 / 113 0 0 1 0 0 0 1 0 0 0
36 Tn. AM L 55 TH 152 / 102 1 0 0 0 0 0 0 0 0 0
37 Ny. NK P 69 TH 130 / 91 0 0 0 0 0 0 0 0 0 0
38 Ny. PI P 62 TH 157/ 88 0 0 0 0 1 1 0 0 0 0
39 Ny. SA P 60 TH 155 / 73 1 0 0 0 0 0 1 0 0 0
40 Tn. KS L 51 TH 140 / 87 0 0 0 0 0 0 ─ 0 0 0
 Lampiran Obat Khusus
Terapi Farmakologi
Golongan Antiplatelet Golongan Statin
Asam
Cilostazol Cilostazol Klopidogr
Nama Tikagrelor Acetil Atorvastatin Atorvastatin Atorvastatin Simvastatin Simvastatin
No JK Usia TD 100 150 el 75
Pasien 90 mg/hari Salicylat 80 10 mg/hari 20 mg/hari 40 mg/hari 10 mg/hari 20 mg/hari
mg/hari mg/hari mg/hari
mg/hari
41 Tn. JN L 53 TH 172 / 99 0 0 1 0 0 1 0 0 0 1
42 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 1
43 Tn. NI L 57 TH 173 / 85 0 0 1 0 0 0 0 0 0 0
44 Ny. SW P 74 TH 142 / 103 0 0 1 0 0 0 0 0 0 0
45 Ny. SM P 52 TH 176 / 63 0 0 0 0 0 0 0 0 0 0
46 Ny. ST P 58 TH 148 / 96 0 0 0 0 0 0 0 0 0 0
47 Tn. SO L 73 TH 149 / 82 0 0 0 0 1 0 0 0 0 0
48 Tn. SJ L 64 TH 98 / 73 0 0 1 0 0 0 1 0 0 0
49 Ny. SH P 78 TH 118 / 75 0 0 1 0 0 0 0 0 0 0
50 Ny. TM P 50 TH 231 / 116 0 0 0 0 1 0 0 0 1 0
51 Tn. DA L 75 TH 171 / 93 0 0 0 0 0 1 0 0 0 0
52 Ny. IN P 60 TH 233 / 78 0 0 0 0 0 0 1 0 0 0
53 Tn. AD L 70 TH 152 / 82 0 0 0 0 0 0 0 0 0 1
54 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0
55 Ny. ST P 60 TH 157 / 81 0 0 0 0 0 0 0 0 0 1
56 Tn. WO L 58 TH 138 / 97 0 0 0 0 0 0 0 0 0 1
57 Tn. DM L 65 TH 149 / 78 0 0 1 0 0 0 0 0 0 0
58 Ny. FH P 54 TH 175 / 119 0 0 0 0 0 0 0 0 0 1
59 Ny. PI P 71 TH 138 / 89 0 0 0 0 0 0 0 0 0 0
60 Tn. DA L 41 TH 115 / 78 0 0 1 0 0 0 0 0 0 0
61 Tn. SY L 55 TH 175 / 110 0 0 0 0 1 0 0 0 0 1
62 Tn. TT L 43 TH 112 / 60 0 0 0 0 0 0 0 0 0 0
63 Tn. HL L 58 TH 150 / 98 0 0 0 0 0 0 0 0 0 0
64 Tn. SR L 53 TH 105 / 77 0 0 0 0 0 0 0 0 0 0
65 Tn. SL L 54 TH 202 / 180 0 0 1 0 0 0 0 0 0 0
66 Tn. MO L 61 TH 191 / 107 0 0 0 0 1 0 0 0 0 1
67 Ny. ST P 61 TH 168 / 75 0 0 1 0 0 0 0 0 0 0
68 Tn. SR L 55 TH 149 / 90 0 0 0 0 0 0 0 0 0 1
69 Ny. LT P 60 TH 166 / 122 0 0 1 0 0 0 0 0 0 0
70 Tn. SU L 67 TH 173 / 94 0 0 1 0 0 0 0 0 0 1
71 Tn. SY L 66 TH 102 / 91 0 0 0 0 0 0 0 0 0 0
72 Ny. SN P 70 TH 182 / 98 0 0 1 0 0 0 0 0 0 1
73 Ny. MR P 74 TH 94 / 75 0 0 0 0 0 0 0 0 0 0
74 Tn. KL L 60 TH 125 / 82 0 0 1 0 0 0 0 0 0 0
 Lampiran : Obat Khusus
Terapi Farmakologi
Golongan Antiplatelet Golongan Statin
Cilostazol Cilostazol Asam Acetil
Nama Klopidogrel Tikagrelor Atorvastatin Atorvastatin Atorvastatin Simvastatin Simvastatin
No JK Usia TD 100 150 Salicylat 80
Pasien 75 mg/hari 90 mg/hari 10 mg/hari 20 mg/hari 40 mg/hari 10 mg/hari 20 mg/hari
mg/hari mg/hari mg/hari
76 Tn. MK L 55 TH 177 / 130 0 0 0 0 0 0 0 0 0 1
77 Tn. BD L 60 TH 139 / 78 0 0 0 0 1 0 0 0 0 0
78 Ny. SA P 57 TH 95 / 67 0 0 0 0 0 0 0 0 0 0
79 Tn. PT L 49 TH 179 / 146 0 0 0 0 0 0 0 0 0 1
80 Tn. LN L 59 TH 167 / 116 0 0 0 0 0 0 1 0 0 0
81 Ny. MY P 46 TH 197 / 111 0 0 0 0 0 0 1 0 0 0
82 Ny. SA P 62 TH 141 / 86 0 0 1 0 0 0 0 0 0 0
83 Ny. ST P 59 TH 185 / 120 0 0 0 0 0 0 0 0 0 0
84 Ny. SU P 70 TH 209 / 93 0 0 1 0 0 0 0 0 0 0
85 Tn. MP L 55 TH 130 / 68 0 0 0 0 1 0 1 0 0 1
86 Ny. SK P 62 TH 170 / 116 0 0 0 0 1 0 1 0 0 1
87 Ny. RN P 59 TH 191 / 120 0 0 0 0 0 0 0 1 0 0
88 Tn. ST L 65 TH 229 / 105 0 0 0 0 1 0 0 0 0 1
89 Ny. DH P 42 TH 207 / 121 0 0 0 0 0 0 0 0 0 0
90 Tn. MS L 51 TH 130 / 92 0 0 0 0 0 0 0 0 0 0
91 Tn. SU L 71 TH 175 / 89 0 0 0 0 1 0 0 0 0 1
92 Ny. SE P 75 TH 191 / 98 0 0 0 0 0 0 0 0 0 1
93 Tn. IM L 66 TH 136 / 86 0 1 0 0 0 0 0 0 0 0
94 Tn. MI L 72 TH 205 / 130 0 0 0 0 0 0 0 0 0 1
95 Ny. EA P 47 TH 172 / 82 0 0 0 0 0 0 0 0 0 0
96 Ny. PI P 50 TH 173 / 113 1 0 1 1 0 0 0 0 0 0
97 Ny. KS P 66 TH 89 / 66 0 0 0 0 0 0 0 0 0 0
98 Ny. SY P 62 TH 217 / 110 0 0 0 0 0 0 0 0 0 0
99 Ny. RN P 85 TH 186 / 108 0 0 0 0 0 0 0 0 0 1
100 Tn. MD L 73 TH 156 / 116 0 0 0 0 1 0 0 0 0 0
101 Tn. MI L 59 TH 148 / 87 0 0 0 0 0 0 0 0 0 1
102 Ny. FH P 56 TH 162 / 98 0 0 0 0 0 0 0 0 0 0
103 Tn. MM L 58 TH 150 / 98 0 0 0 0 1 0 0 0 0 0
104 Ny. SA P 68 TH 224 / 100 1 0 0 0 0 0 0 0 0 0
105 Tn. MK L 48 TH 176 / 93 1 0 0 0 0 0 0 0 0 0
106 Tn. SB L 60 TH 207 / 100 0 0 1 0 0 0 0 0 0 0
107 Tn. SR L 64 TH 119 / 73 0 0 0 0 0 0 0 0 0 0
108 Tn. UO L 59 TH 95 / 102 0 0 0 0 1 0 0 0 0 1
Jumlah 6 1 34 1 18 3 16 1 1 27
Total 108

Keterangan : Jk = Jenis Kelamin

TD = Tekanan Darah
 Lampiran : Obat Lain
Terapi Farmakologi
ACEi
No Nama JK Usia TD LOS Captopril 12,5 mg Captopril 25 mg Lisinopril 10 mg
1 Ny. SI P 68 Th 150 / 74 3 hari ─ ─ ─
2 Ny. NK P 69 TH 105 / 62 3 hari ─ ─ ─
3 Ny. WI P 65 TH 127 / 89 6 hari ─ ─ ─
4 Ny. MH P 60 TH 183 / 113 2 hari ─ ─ ─
5 Tn. HM L 58 TH 150 / 98 2 hari ─ ─ ─
6 Tn. KI L 51 TH 167 / 108 2 hari ─ ─ ─
7 Tn. AI L 55 TH 152 / 102 2 hari ─ ─ ─
8 Tn. JN L 53 TH 172 / 99 3 hari ─ ─ ─
9 Tn. DN L 49 TH 150 / 88 3 hari ─ ─ ─
10 Ny. SP P 65 TH 163 / 101 4 hari ─ ─ ─
11 Ny. NH P 61 TH 171 / 103 2 hari ─ ─ ─
12 Ny. HI P 60 TH 190 / 114 2 hari ─ ─ ─
13 Tn. SN L 53 TH 90 / 62 3 hari ─ ─ ─
14 Ny. PM P 59 TH 152 / 72 1 hari ─ ─ ─
15 Ny. MF P 55 TH 110 / 64 1 hari ─ ─ ─
16 Tn. SO L 64 TH 98/ 73 1 hari ─ ─ ─
17 Ny. SH P 78 TH 118 / 75 2 hari ─ ─ ─
18 Tn. DN L 75 TH 171 / 93 4 hari ─ ─ ─
19 Tn. HK L 66 TH 121 / 73 4 hari ─ ─ ─
20 Ny. PH P 73 TH 112 / 80 3 hari ─ ─ ─
21 Tn. KN L 61 TH 210 / 108 6 hari ─ ─ ─
22 Tn. SS P 49 TH 137 / 89 8 hari ─ ─ ─
23 Ny. SU P 68 TH 150 / 74 4 hari ─ ─ ─
24 Tn. TH L 55 TH 179 / 96 6 hari ─ ─ ─
25 Tn. CI L 51 TH 170 / 70 5 hari ─ ─ 
26 Tn. SW L 71 TH 164 / 93 6 hari ─ ─ ─
27 Ny. WI P 65 TH 127 / 89 5 hari ─ ─ ─
28 Ny. ST P 51 TH 200 / 133 4 hari ─ ─ ─
29 Tn. YO L 65 TH 179 / 90 3 hari ─ ─ ─
30 Ny. SR P 56 TH 166 / 107 8 hari ─ ─ ─
31 Ny. MI P 55 TH 125 / 90 5 hari ─ ─ ─
32 Tn. KM L 51 TH 167 / 108 12 hari ─ ─ ─
33 Ny. WJ P 65 TH 115 / 73 5 hari ─ ─ ─
34 Tn. BO L 35 TH 154 / 98 3 hari ─ ─ ─
35 Ny. SK P 59 TH 185 / 113 4 hari ─ ─ ─
36 Tn. AM L 55 TH 152 / 102 6 hari ─ ─ ─
37 Ny. NK P 69 TH 130 / 91 9 hari ─ ─ ─
38 Ny. PI P 62 TH 157/ 88 6 hari ─ ─ ─
39 Ny. SA P 60 TH 155 / 73 9 hari ─ ─ ─
40 Tn. KS L 51 TH 140 / 87 10 hari ─ ─ ─
41 Tn. JN L 53 TH 172 / 99 7 hari ─ ─ ─
42 Tn. DN L 49 TH 150 / 88 3 hari ─ ─ ─
43 Tn. NI L 57 TH 173 / 85 4 hari ─ ─ ─
44 Ny. SW P 74 TH 142 / 103 10 hari ─ ─ ─
45 Ny. SM P 52 TH 176 / 63 11 hari ─ ─ ─
46 Ny. ST P 58 TH 148 / 96 4 hari ─ ─ ─
47 Tn. SO L 73 TH 149 / 82 9 hari ─ ─ ─
48 Tn. SJ L 64 TH 98 / 73 2 hari ─ ─ ─
49 Ny. SH P 78 TH 118 / 75 4 hari ─ ─ ─
50 Ny. TM P 50 TH 231 / 116 5 hari ─ ─ ─
51 Tn. DA L 75 TH 171 / 93 12 hari ─ ─ ─
52 Ny. IN P 60 TH 233 / 78 7 hari ─ ─ ─
53 Tn. AD L 70 TH 152 / 82 5 hari ─ ─ ─
54 Ny. PH P 73 TH 112 / 80 4 hari ─ ─ ─
55 Ny. ST P 60 TH 157 / 81 6 hari ─ ─ ─
56 Tn. WO L 58 TH 138 / 97 17 hari ─ ─ ─
57 Tn. DM L 65 TH 149 / 78 10 hari ─ ─ ─
58 Ny. FH P 54 TH 175 / 119 5 hari ─ ─ ─
59 Ny. PI P 71 TH 138 / 89 8 hari ─ ─ ─
60 Tn. DA L 41 TH 115 / 78 8 hari ─ ─ ─
61 Tn. SY L 55 TH 175 / 110 9 hari ─ ─ ─
62 Tn. TT L 43 TH 112 / 60 9 hari ─ ─ ─
63 Tn. HL L 58 TH 150 / 98 2 hari ─ ─ ─
64 Tn. SR L 53 TH 105 / 77 2 hari ─ ─ ─
65 Tn. SL L 54 TH 202 / 180 10 hari ─ ─ ─
66 Tn. MO L 61 TH 191 / 107 5 hari ─ ─ ─
67 Ny. ST P 61 TH 168 / 75 7 hari ─ ─ ─
68 Tn. SR L 55 TH 149 / 90 6 hari ─ ─ ─
69 Ny. LT P 60 TH 166 / 122 7 hari ─ ─ ─
70 Tn. SU L 67 TH 173 / 94 4 hari ─ ─ ─
71 Tn. SY L 66 TH 102 / 91 8 hari ─ ─ ─
72 Ny. SN P 70 TH 182 / 98 5 hari ─ ─ 
73 Ny. MR P 74 TH 94 / 75 4 hari ─ ─ ─
74 Tn. KL L 60 TH 125 / 82 5 hari ─ ─ ─
75 Ny. AE P 77 TH 141 / 82 7 hari ─  ─
76 Tn. MK L 55 TH 177 / 130 5 hari ─ ─ ─
77 Tn. BD L 60 TH 139 / 78 4 hari ─ ─ ─
78 Ny. SA P 57 TH 95 / 67 7 hari ─ ─ ─
79 Tn. PT L 49 TH 179 / 146 5 hari ─ ─ ─
80 Tn. LN L 59 TH 167 / 116 7 hari ─ ─ ─
81 Ny. MY P 46 TH 197 / 111 5 hari ─ ─ ─
82 Ny. SA P 62 TH 141 / 86 5 hari ─ ─ ─
83 Ny. ST P 59 TH 185 / 120 4 hari ─ ─ ─
84 Ny. SU P 70 TH 209 / 93 7 hari ─ ─ ─
85 Tn. MP L 55 TH 130 / 68 6 hari ─ ─ ─
86 Ny. SK P 62 TH 170 / 116 7 hari ─ ─ ─
87 Ny. RN P 59 TH 191 / 120 4 hari ─ ─ ─
88 Tn. ST L 65 TH 229 / 105 8 hari ─ ─ ─
89 Ny. DH P 42 TH 207 / 121 9 hari  ─ ─
90 Tn. MS L 51 TH 130 / 92 5 hari ─ ─ ─
91 Tn. SU L 71 TH 175 / 89 5 hari ─ ─ ─
92 Ny. SE P 75 TH 191 / 98 4 hari ─ ─ ─
93 Tn. IM L 66 TH 136 / 86 5 hari ─ ─ ─
94 Tn. MI L 72 TH 205 / 130 3 hari ─ ─ ─
95 Ny. EA P 47 TH 172 / 82 4 hari ─ ─ ─
96 Ny. PI P 50 TH 173 / 113 8 hari ─ ─ ─
 97 Ny. KS P 66 TH 89 / 66 8 hari ─ ─ ─
98 Ny. SY P 62 TH 217 / 110 9 hari ─ ─ ─
99 Ny. RN P 85 TH 186 / 108 4 hari ─ ─ ─
100 Tn. MD L 73 TH 156 / 116 4 hari ─ ─ ─
101 Tn. MI L 59 TH 148 / 87 6 hari ─ ─ ─
102 Ny. FH P 56 TH 162 / 98 8 hari ─ ─ ─
103 Tn. MM L 58 TH 150 / 98 2 hari ─ ─ ─
104 Ny. SA P 68 TH 224 / 100 4 hari ─ ─ ─
105 Tn. MK L 48 TH 176 / 93 7 hari ─ ─ ─
106 Tn. SB L 60 TH 207 / 100 6 hari ─ ─ ─
107 Tn. SR L 64 TH 119 / 73 7 hari ─ ─ ─
108 Tn. UO L 59 TH 95 / 102 8 hari ─ ─ ─
 Analgesik Opioid Anemia Megalobastik Ansie
Codein 10 mg MST 10 mg Cobazim 3000 UI Forneuro Sianokobalamin Alprazolam 0,5 mg
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tas Antagonis Aldosteron Antagonis Reseptor Angiotensin II
Clobazam 10 mg Sprironolacton 25 mg Valsartan 160 mg Fenitoin 100 mg
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 Antiepilepsi
Gabapentin 300 mg Piracetam 800 mg Piracetam 1200 mg Pregabalin 75 mg
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 Antiemetik Antihistamin H3 Antimanik Antip
Metoclopamid 10 mg Betahistine 6 mg Asam valproat 250 mg Cepezet 100 mg
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sikosis Antiulcerant ARB Beta
Haloperidol 2 mg Sucralfat 500 mg Candesartan 8 mg Candesartan 16 mg Bisoprolol 5 mg
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Bloker Biguanida CCB Diuretik
Karvedilol 6,25 mg Metformin 500 mg Amlodipin 5 mg Amlodipin 10 mg Furosemid 40 mg
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 Fibrat
Fenovibrat 100 mg Fenofibrat 300 mg
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Lampiran : Obat Lain
Terapi Farmakologi
Antagonis
Reseptor
Angiotensin
Antagonis
II
ACEi Analgesik Cobaz Anemia Megalobastik Ansietas Aldosteron Antiepilepsi
Captopr Spriron Gabape
il 12,5 Captopril Lisinopril Codein MST 10 im Sianokob Alprazola Clobazam olacton Valsartan Fenitoin ntin Piracetam Piracetam Pregabali
No Nama JK Usia TD 3000 Forneuro alamin m 0,5 mg
mg 25 mg 10 mg 10 mg mg 10 mg 25 mg 160 mg 100 300 mg 800 mg 1200 mg n 75 mg
UI mg
1 Ny. SI P 68 Th 150 / 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
2 Ny. NK P 69 TH 105 / 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
3 Ny. WI P 65 TH 127 / 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
4 Ny. MH P 60 TH 183 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
5 Tn. HM L 58 TH 150 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tn. KI L 51 TH 167 / 108 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0
7 Tn. AI L 55 TH 152 / 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
8 Tn. JN L 53 TH 172 / 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
9 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
10 Ny. SP P 65 TH 163 / 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Ny. NH P 61 TH 171 / 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
12 Ny. HI P 60 TH 190 / 114 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Tn. SN L 53 TH 90 / 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ny. PM P 59 TH 152 / 72 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Ny. MF P 55 TH 110 / 64 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0
16 Tn. SO L 64 TH 98/ 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Ny. SH P 78 TH 118 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
18 Tn. DN L 75 TH 171 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
19 Tn. HK L 66 TH 121 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
20 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
21 Tn. KN L 61 TH 210 / 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
22 Tn. SS P 49 TH 137 / 89 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0
23 Ny. SU P 68 TH 150 / 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
24 Tn. TH L 55 TH 179 / 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
25 Tn. CI L 51 TH 170 / 70 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1
26 Tn. SW L 71 TH 164 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
27 Ny. WI P 65 TH 127 / 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
28 Ny. ST P 51 TH 200 / 133 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
29 Tn. YO L 65 TH 179 / 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
30 Ny. SR P 56 TH 166 / 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
31 Ny. MI P 55 TH 125 / 90 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
32 Tn. KM L 51 TH 167 / 108 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
33 Ny. WJ P 65 TH 115 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
34 Tn. BO L 35 TH 154 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 Ny. SK P 59 TH 185 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
Lampiran : Obat Lain
Terapi Farmakologi
ACEi Analgesik Opioid Anemia Megalobastik Ansietas gonis Aldos eseptor Antiepilepsi
Sprironola Gabape
Captopril Captopril Lisinopril Codein MST 10 Cobazim Sianokoba Alprazola Clobazam Valsartan Fenitoin
No Nama JK Usia TD Forneuro cton 25 ntin 300 Piracetam Piracetam Pregabalin
12,5 mg 25 mg 10 mg 10 mg 3000 UI lamin m 0,5 mg 10 mg 160 mg 100 mg mg
mg 800 mg 1200 mg 75 mg
mg
36 Tn. AM L 55 TH 152 / 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Ny. NK P 69 TH 130 / 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
38 Ny. PI P 62 TH 157/ 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Ny. SA P 60 TH 155 / 73 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
40 Tn. KS L 51 TH 140 / 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
41 Tn. JN L 53 TH 172 / 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
42 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
43 Tn. NI L 57 TH 173 / 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
44 Ny. SW P 74 TH 142 / 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
45 Ny. SM P 52 TH 176 / 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
46 Ny. ST P 58 TH 148 / 96 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Tn. SO L 73 TH 149 / 82 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0
48 Tn. SJ L 64 TH 98 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Ny. SH P 78 TH 118 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
50 Ny. TM P 50 TH 231 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
51 Tn. DA L 75 TH 171 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
52 Ny. IN P 60 TH 233 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
53 Tn. AD L 70 TH 152 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
55 Ny. ST P 60 TH 157 / 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
56 Tn. WO L 58 TH 138 / 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Tn. DM L 65 TH 149 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Ny. FH P 54 TH 175 / 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
59 Ny. PI P 71 TH 138 / 89 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 1
60 Tn. DA L 41 TH 115 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
61 Tn. SY L 55 TH 175 / 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Tn. TT L 43 TH 112 / 60 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0
63 Tn. HL L 58 TH 150 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
64 Tn. SR L 53 TH 105 / 77 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
65 Tn. SL L 54 TH 202 / 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lampiran : Obat Lain
Terapi Farmakologi
Antag
Antago onis
nis Resept
Aldoste or
ron Angiot
Sprironola Valsart Fenitoi
Captopril Captopril Lisinopril Codein 10 MST 10 Cobazim Sianokoba Alprazola Clobazam Gabapenti Piracetam Piracetam Pregabali
No Nama JK Usia TD Forneuro cton 25 an 160 n 100
12,5 mg 25 mg 10 mg mg mg 3000 UI lamin m 0,5 mg 10 mg n 300 mg 800 mg 1200 mg n 75 mg
mg mg mg
66 Tn. MO L 61 TH 191 / 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
67 Ny. ST P 61 TH 168 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Tn. SR L 55 TH 149 / 90 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
69 Ny. LT P 60 TH 166 / 122 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
70 Tn. SU L 67 TH 173 / 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
71 Tn. SY L 66 TH 102 / 91 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0
72 Ny. SN P 70 TH 182 / 98 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ny. MR P 74 TH 94 / 75 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0
74 Tn. KL L 60 TH 125 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
75 Ny. AE P 77 TH 141 / 82 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
76 Tn. MK L 55 TH 177 / 130 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0
77 Tn. BD L 60 TH 139 / 78 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0
78 Ny. SA P 57 TH 95 / 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
79 Tn. PT L 49 TH 179 / 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Tn. LN L 59 TH 167 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Ny. MY P 46 TH 197 / 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
82 Ny. SA P 62 TH 141 / 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
83 Ny. ST P 59 TH 185 / 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
84 Ny. SU P 70 TH 209 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
85 Tn. MP L 55 TH 130 / 68 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
86 Ny. SK P 62 TH 170 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
87 Ny. RN P 59 TH 191 / 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
88 Tn. ST L 65 TH 229 / 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
89 Ny. DH P 42 TH 207 / 121 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0
90 Tn. MS L 51 TH 130 / 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
91 Tn. SU L 71 TH 175 / 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
92 Ny. SE P 75 TH 191 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
93 Tn. IM L 66 TH 136 / 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
94 Tn. MI L 72 TH 205 / 130 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0
95 Ny. EA P 47 TH 172 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
96 Ny. PI P 50 TH 173 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
97 Ny. KS P 66 TH 89 / 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
98 Ny. SY P 62 TH 217 / 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
99 Ny. RN P 85 TH 186 / 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
100 Tn. MD L 73 TH 156 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
101 Tn. MI L 59 TH 148 / 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
102 Ny. FH P 56 TH 162 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
103 Tn. MM L 58 TH 150 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
104 Ny. SA P 68 TH 224 / 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
105 Tn. MK L 48 TH 176 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
106 Tn. SB L 60 TH 207 / 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
107 Tn. SR L 64 TH 119 / 73 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 1 1
108 Tn. UO L 59 TH 95 / 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
Lampiran : Obat Lain
Terapi Farmakologi
Antiemetik tihistamin Antimanik Antipsikosis ntiulceran ARB Beta Bloker Biguanida CCB Diuretik Fibrat
Metoclop Asam Haloper Candesa
No Nama JK Usia TD amid 10 Betahistine valproat Cepezet 100 idol 2 Sucralfat rtan 8 Candesart Bisopro Karvedilol Metformin Amlodipin 5 Amlodipin Furosemid Fenovibrat Fenofibrat
mg 6 mg 250 mg mg mg 500 mg mg an 16 mg lol 5 mg 6,25 mg 500 mg mg 10 mg 40 mg 100 mg 300 mg
1 Ny. SI P 68 Th 150 / 74 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
2 Ny. NK P 69 TH 105 / 62 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
3 Ny. WI P 65 TH 127 / 89 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0
4 Ny. MH P 60 TH 183 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
5 Tn. HM L 58 TH 150 / 98 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0
6 Tn. KI L 51 TH 167 / 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Tn. AI L 55 TH 152 / 102 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
8 Tn. JN L 53 TH 172 / 99 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0
9 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Ny. SP P 65 TH 163 / 101 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
11 Ny. NH P 61 TH 171 / 103 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
12 Ny. HI P 60 TH 190 / 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Tn. SN L 53 TH 90 / 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ny. PM P 59 TH 152 / 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Ny. MF P 55 TH 110 / 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Tn. SO L 64 TH 98/ 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Ny. SH P 78 TH 118 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Tn. DN L 75 TH 171 / 93 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0
19 Tn. HK L 66 TH 121 / 73 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0
20 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Tn. KN L 61 TH 210 / 108 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
22 Tn. SS P 49 TH 137 / 89 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
23 Ny. SU P 68 TH 150 / 74 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0
24 Tn. TH L 55 TH 179 / 96 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
25 Tn. CI L 51 TH 170 / 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Tn. SW L 71 TH 164 / 93 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0
27 Ny. WI P 65 TH 127 / 89 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0
28 Ny. ST P 51 TH 200 / 133 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0
29 Tn. YO L 65 TH 179 / 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Ny. SR P 56 TH 166 / 107 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
31 Ny. MI P 55 TH 125 / 90 0 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0
32 Tn. KM L 51 TH 167 / 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Ny. WJ P 65 TH 115 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Tn. BO L 35 TH 154 / 98 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
35 Ny. SK P 59 TH 185 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lampiran : Obat Lain
Terapi Farmakologi
Antiemeti tihistamin Antimanik Antipsikosis ntiulceran ARB Beta Bloker Biguanida CCB Diuretik Fibrat
Metoclop Betahist Asam Metfor Fenovib
No Nama JK Usia TD amid 10 ine 6 valproat Cepezet Haloperid Sucralfat Candesart Candesart Bisoprolol Karvedilol min Amlodipin Amlodipin Furosemi rat 100 Fenofibra
mg mg 250 mg 100 mg ol 2 mg 500 mg an 8 mg an 16 mg 5 mg 6,25 mg 500 5 mg 10 mg d 40 mg mg t 300 mg
36 Tn. AM L 55 TH 152 / 102 0 0 0 0 0 0 0 0 0 0 mg
1 0 0 0 0 0
37 Ny. NK P 69 TH 130 / 91 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
38 Ny. PI P 62 TH 157/ 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Ny. SA P 60 TH 155 / 73 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0
40 Tn. KS L 51 TH 140 / 87 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
41 Tn. JN L 53 TH 172 / 99 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0
42 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
43 Tn. NI L 57 TH 173 / 85 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
44 Ny. SW P 74 TH 142 / 103 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
45 Ny. SM P 52 TH 176 / 63 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0
46 Ny. ST P 58 TH 148 / 96 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
47 Tn. SO L 73 TH 149 / 82 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0
48 Tn. SJ L 64 TH 98 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Ny. SH P 78 TH 118 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Ny. TM P 50 TH 231 / 116 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
51 Tn. DA L 75 TH 171 / 93 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0
52 Ny. IN P 60 TH 233 / 78 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0
53 Tn. AD L 70 TH 152 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
55 Ny. ST P 60 TH 157 / 81 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
56 Tn. WO L 58 TH 138 / 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Tn. DM L 65 TH 149 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Ny. FH P 54 TH 175 / 119 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0
59 Ny. PI P 71 TH 138 / 89 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0
60 Tn. DA L 41 TH 115 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Tn. SY L 55 TH 175 / 110 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
62 Tn. TT L 43 TH 112 / 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Tn. HL L 58 TH 150 / 98 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0
64 Tn. SR L 53 TH 105 / 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Tn. SL L 54 TH 202 / 180 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0
Lampiran : Obat Lain
Terapi Farmakologi
Antiulcera
nt
Antiemetik tihistamin Antimanik Antipsikosis ARB Beta Bloker Biguanida CCB Diuretik Fibrat
Metoclop Asam
amid 10 Betahistin valproat Cepezet Haloperid Sucralfat Candesart Candesart Bisoprolol Karvedilol Metformi Amlodipin Amlodipin Furosemi Fenovibra Fenofibrat
No Nama JK Usia TD
mg 250 mg
e 6 mg 100 mg ol 2 mg 500 mg an 8 mg an 16 mg 5 mg 6,25 mg n 500 mg 5 mg 10 mg d 40 mg t 100 mg 300 mg
66 Tn. MO L 61 TH 191 / 107 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
67 Ny. ST P 61 TH 168 / 75 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
68 Tn. SR L 55 TH 149 / 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Ny. LT P 60 TH 166 / 122 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0
70 Tn. SU L 67 TH 173 / 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
71 Tn. SY L 66 TH 102 / 91 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0
72 Ny. SN P 70 TH 182 / 98 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
73 Ny. MR P 74 TH 94 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Tn. KL L 60 TH 125 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Ny. AE P 77 TH 141 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 Tn. MK L 55 TH 177 / 130 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
77 Tn. BD L 60 TH 139 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Ny. SA P 57 TH 95 / 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
79 Tn. PT L 49 TH 179 / 146 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
80 Tn. LN L 59 TH 167 / 116 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Ny. MY P 46 TH 197 / 111 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0
82 Ny. SA P 62 TH 141 / 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Ny. ST P 59 TH 185 / 120 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0
84 Ny. SU P 70 TH 209 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Tn. MP L 55 TH 130 / 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
86 Ny. SK P 62 TH 170 / 116 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
87 Ny. RN P 59 TH 191 / 120 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
88 Tn. ST L 65 TH 229 / 105 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
89 Ny. DH P 42 TH 207 / 121 1 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0
90 Tn. MS L 51 TH 130 / 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Tn. SU L 71 TH 175 / 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
92 Ny. SE P 75 TH 191 / 98 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
93 Tn. IM L 66 TH 136 / 86 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
94 Tn. MI L 72 TH 205 / 130 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
95 Ny. EA P 47 TH 172 / 82 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
96 Ny. PI P 50 TH 173 / 113 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
97 Ny. KS P 66 TH 89 / 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Ny. SY P 62 TH 217 / 110 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
99 Ny. RN P 85 TH 186 / 108 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0
100 Tn. MD L 73 TH 156 / 116 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
101 Tn. MI L 59 TH 148 / 87 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
102 Ny. FH P 56 TH 162 / 98 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
103 Tn. MM L 58 TH 150 / 98 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0
104 Ny. SA P 68 TH 224 / 100 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0
105 Tn. MK L 48 TH 176 / 93 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0
106 Tn. SB L 60 TH 207 / 100 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0
107 Tn. SR L 64 TH 119 / 73 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0
108 Tn. UO L 59 TH 95 / 102 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0
 Terapi Farmakologi
Pengha
mbat
Asetilkol
inestera
se
Inhibitor Xanthine Pelemas Otot
Asam Asetilsist Lansopr
No Nama JK Usia TD Folat 400 ein 200 azol 30
Digoxin Ambroxol ISDN 5 Gliseril trinitrat Ranitidin 150 Allopurinol Allopurin Lioresal 10 Co-Amoxiclav Donezepil Hcl 5 Omeprazol
mcg mg mg
0,25 mg KSR 600 30 mg mg 2,5 mg mg 100 mg ol 300 mg mg 500 mg mg 20 mg
1 Ny. SI P 68 Th 150 / 74 0 0 0 mg 0 0 0 0 0 0 0 0 0 0 0 1
2 Ny. NK P 69 TH 105 / 62 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
3 Ny. WI P 65 TH 127 / 89 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Ny. MH P 60 TH 183 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Tn. HM L 58 TH 150 / 98 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
6 Tn. KI L 51 TH 167 / 108 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
7 Tn. AI L 55 TH 152 / 102 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
8 Tn. JN L 53 TH 172 / 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Ny. SP P 65 TH 163 / 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Ny. NH P 61 TH 171 / 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Ny. HI P 60 TH 190 / 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Tn. SN L 53 TH 90 / 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ny. PM P 59 TH 152 / 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Ny. MF P 55 TH 110 / 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Tn. SO L 64 TH 98/ 73 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0
17 Ny. SH P 78 TH 118 / 75 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
18 Tn. DN L 75 TH 171 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tn. HK L 66 TH 121 / 73 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
20 Ny. PH P 73 TH 112 / 80 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Tn. KN L 61 TH 210 / 108 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
22 Tn. SS P 49 TH 137 / 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Ny. SU P 68 TH 150 / 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
24 Tn. TH L 55 TH 179 / 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Tn. CI L 51 TH 170 / 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Tn. SW L 71 TH 164 / 93 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
27 Ny. WI P 65 TH 127 / 89 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Ny. ST P 51 TH 200 / 133 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
29 Tn. YO L 65 TH 179 / 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Ny. SR P 56 TH 166 / 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 Ny. MI P 55 TH 125 / 90 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
32 Tn. KM L 51 TH 167 / 108 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
33 Ny. WJ P 65 TH 115 / 73 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
34 Tn. BO L 35 TH 154 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 Ny. SK P 59 TH 185 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lampiran : Obat Lain
Terapi Farmakologi

Pengham
Pelemas bat
Inhibitor Xanthine Otot Asetilkolin
Glikosida Kalium Histamin
Skelet esterase
Jantung Oral H2 Oxidase
Asam Gliseril Co-
No Nama JK Usia TD Folat Digoxin KSR 600 Ambroxol Asetilsiste trinitrat Ranitidin Allopurin Allopurin Lioresal Amoxiclav Donezepil Lansopraz Omeprazo
400 mcg 0,25 mg 30 mg in 200 mg ISDN 5 mg 2,5 mg 150 mg ol 100 ol 300 10 mg 500 mg Hcl 5 mg ol 30 mg l 20 mg
36 Tn. AM L 55 TH 152 / 102 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
37 Ny. NK P 69 TH 130 / 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
38 Ny. PI P 62 TH 157/ 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Ny. SA P 60 TH 155 / 73 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
40 Tn. KS L 51 TH 140 / 87 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
41 Tn. JN L 53 TH 172 / 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
43 Tn. NI L 57 TH 173 / 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
44 Ny. SW P 74 TH 142 / 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Ny. SM P 52 TH 176 / 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Ny. ST P 58 TH 148 / 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Tn. SO L 73 TH 149 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Tn. SJ L 64 TH 98 / 73 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0
49 Ny. SH P 78 TH 118 / 75 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
50 Ny. TM P 50 TH 231 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Tn. DA L 75 TH 171 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Ny. IN P 60 TH 233 / 78 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
53 Tn. AD L 70 TH 152 / 82 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
54 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
55 Ny. ST P 60 TH 157 / 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Tn. WO L 58 TH 138 / 97 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
57 Tn. DM L 65 TH 149 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Ny. FH P 54 TH 175 / 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 Ny. PI P 71 TH 138 / 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Tn. DA L 41 TH 115 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Tn. SY L 55 TH 175 / 110 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
62 Tn. TT L 43 TH 112 / 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
63 Tn. HL L 58 TH 150 / 98 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
64 Tn. SR L 53 TH 105 / 77 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Tn. SL L 54 TH 202 / 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lampiran : Obat Lain
Terapi Farmakologi

Pengham
Pelemas bat
Otot Asetilkoli
Glikosida Kalium Histamin Inhibitor Xanthine
Skelet nesterase
Jantung Oral H2 Oxidase
Asam Gliseril Co-
No Nama JK Usia TD Folat 400 Digoxin KSR 600 Ambroxol Asetilsiste ISDN 5 trinitrat Ranitidin Allopurin Allopurin Lioresal Amoxicla Donezepil Lansopraz Omepraz
mcg 0,25 mg mg 30 mg in 200 mg mg 2,5 mg 150 mg ol 100 mg ol 300 mg 10 mg v 500 mg Hcl 5 mg ol 30 mg ol 20 mg
66 Tn. MO L 61 TH 191 / 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Ny. ST P 61 TH 168 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Tn. SR L 55 TH 149 / 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Ny. LT P 60 TH 166 / 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Tn. SU L 67 TH 173 / 94 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
71 Tn. SY L 66 TH 102 / 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Ny. SN P 70 TH 182 / 98 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
73 Ny. MR P 74 TH 94 / 75 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0
74 Tn. KL L 60 TH 125 / 82 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Ny. AE P 77 TH 141 / 82 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
76 Tn. MK L 55 TH 177 / 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Tn. BD L 60 TH 139 / 78 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
78 Ny. SA P 57 TH 95 / 67 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
79 Tn. PT L 49 TH 179 / 146 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
80 Tn. LN L 59 TH 167 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Ny. MY P 46 TH 197 / 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
82 Ny. SA P 62 TH 141 / 86 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
83 Ny. ST P 59 TH 185 / 120 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
84 Ny. SU P 70 TH 209 / 93 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
85 Tn. MP L 55 TH 130 / 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
86 Ny. SK P 62 TH 170 / 116 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
87 Ny. RN P 59 TH 191 / 120 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
88 Tn. ST L 65 TH 229 / 105 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
89 Ny. DH P 42 TH 207 / 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Tn. MS L 51 TH 130 / 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Tn. SU L 71 TH 175 / 89 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
92 Ny. SE P 75 TH 191 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Tn. IM L 66 TH 136 / 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Tn. MI L 72 TH 205 / 130 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
95 Ny. EA P 47 TH 172 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
96 Ny. PI P 50 TH 173 / 113 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
97 Ny. KS P 66 TH 89 / 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Ny. SY P 62 TH 217 / 110 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
 99 Ny. RN P 85 TH 186 / 108 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
100 Tn. MD L 73 TH 156 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
101 Tn. MI L 59 TH 148 / 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
102 Ny. FH P 56 TH 162 / 98 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0
103 Tn. MM L 58 TH 150 / 98 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
104 Ny. SA P 68 TH 224 / 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
105 Tn. MK L 48 TH 176 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
106 Tn. SB L 60 TH 207 / 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
107 Tn. SR L 64 TH 119 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
108 Tn. UO L 59 TH 95 / 102 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
Lampiran
Obat Lain
:
Terapi Farmakologi
Sefalosporin Serangan Akut Sulfonilurea Vitamin
Cefixime Colchicine Glimepirid 1 Glimepirid Gliquidone Curcuma Curcuma syr Chelecalciferol Mecobala Vitamin Vitamin E
No Nama JK Usia TD
100 mg 0,5 mg mg 2 mg 30 mg 100 mg 600 ml 5000 UI min 500 B6 10 mg 200 Ui
Imunos Kurkumex Neulin PS Pritavit
1 Ny. SI P 68 Th 150 / 74 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
2 Ny. NK P 69 TH 105 / 62 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0
3 Ny. WI P 65 TH 127 / 89 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
4 Ny. MH P 60 TH 183 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Tn. HM L 58 TH 150 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tn. KI L 51 TH 167 / 108 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
7 Tn. AI L 55 TH 152 / 102 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0
8 Tn. JN L 53 TH 172 / 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Ny. SP P 65 TH 163 / 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Ny. NH P 61 TH 171 / 103 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Ny. HI P 60 TH 190 / 114 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
13 Tn. SN L 53 TH 90 / 62 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
14 Ny. PM P 59 TH 152 / 72 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
15 Ny. MF P 55 TH 110 / 64 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
16 Tn. SO L 64 TH 98/ 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Ny. SH P 78 TH 118 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Tn. DN L 75 TH 171 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tn. HK L 66 TH 121 / 73 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
20 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0
21 Tn. KN L 61 TH 210 / 108 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
22 Tn. SS P 49 TH 137 / 89 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
23 Ny. SU P 68 TH 150 / 74 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
24 Tn. TH L 55 TH 179 / 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Tn. CI L 51 TH 170 / 70 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
26 Tn. SW L 71 TH 164 / 93 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
27 Ny. WI P 65 TH 127 / 89 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
28 Ny. ST P 51 TH 200 / 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
29 Tn. YO L 65 TH 179 / 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Ny. SR P 56 TH 166 / 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 Ny. MI P 55 TH 125 / 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Tn. KM L 51 TH 167 / 108 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
33 Ny. WJ P 65 TH 115 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Tn. BO L 35 TH 154 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 Ny. SK P 59 TH 185 / 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lampiran : Obat Lain
Terapi Farmakologi
Sefalospo Seranga
rin n Akut Sulfonilurea Vitamin
Chelecalci Mecobala
No Nama JK Usia TD Cefixime Colchicine Glimepi Glimepi Gliquido Curcuma Curcuma ferol 5000 min 500 Vitamin Vitamin E
100 mg 0,5 mg rid 1 mg rid 2 mg ne 30 mg 100 mg syr 600 ml UI mcg B6 10 mg 200 Ui
Imunos Kurkumex Neulin PS Pritavit
36 Tn. AM L 55 TH 152 / 102 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0
37 Ny. NK P 69 TH 130 / 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Ny. PI P 62 TH 157/ 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Ny. SA P 60 TH 155 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Tn. KS L 51 TH 140 / 87 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
41 Tn. JN L 53 TH 172 / 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Tn. DN L 49 TH 150 / 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
43 Tn. NI L 57 TH 173 / 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
44 Ny. SW P 74 TH 142 / 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Ny. SM P 52 TH 176 / 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Ny. ST P 58 TH 148 / 96 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0
47 Tn. SO L 73 TH 149 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Tn. SJ L 64 TH 98 / 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Ny. SH P 78 TH 118 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Ny. TM P 50 TH 231 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Tn. DA L 75 TH 171 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Ny. IN P 60 TH 233 / 78 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
53 Tn. AD L 70 TH 152 / 82 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
54 Ny. PH P 73 TH 112 / 80 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0
55 Ny. ST P 60 TH 157 / 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Tn. WO L 58 TH 138 / 97 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
57 Tn. DM L 65 TH 149 / 78 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0
58 Ny. FH P 54 TH 175 / 119 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0
59 Ny. PI P 71 TH 138 / 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Tn. DA L 41 TH 115 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Tn. SY L 55 TH 175 / 110 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0
62 Tn. TT L 43 TH 112 / 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
63 Tn. HL L 58 TH 150 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
64 Tn. SR L 53 TH 105 / 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Tn. SL L 54 TH 202 / 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lampiran : Obat Lain
Terapi Farmakologi
Sefalos Serangan
porin Akut Sulfonilurea Vitamin
Colchic Glimepi Gliquido Chelecalci Mecobala
No Nama JK Usia TD Cefixime ine 0,5 Glimepirid rid 2 ne 30 Curcuma Curcuma ferol 5000 min 500 Vitamin Vitamin E
100 mg mg 1 mg mg mg 100 mg syr 600 ml UI mcg B6 10 mg 200 Ui
Imunos Kurkumex Neulin PS Pritavit
66 Tn. MO L 61 TH 191 / 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Ny. ST P 61 TH 168 / 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Tn. SR L 55 TH 149 / 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Ny. LT P 60 TH 166 / 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Tn. SU L 67 TH 173 / 94 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
71 Tn. SY L 66 TH 102 / 91 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
72 Ny. SN P 70 TH 182 / 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ny. MR P 74 TH 94 / 75 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Tn. KL L 60 TH 125 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Ny. AE P 77 TH 141 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 Tn. MK L 55 TH 177 / 130 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
77 Tn. BD L 60 TH 139 / 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Ny. SA P 57 TH 95 / 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Tn. PT L 49 TH 179 / 146 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
80 Tn. LN L 59 TH 167 / 116 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0
81 Ny. MY P 46 TH 197 / 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
82 Ny. SA P 62 TH 141 / 86 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
83 Ny. ST P 59 TH 185 / 120 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
84 Ny. SU P 70 TH 209 / 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Tn. MP L 55 TH 130 / 68 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
86 Ny. SK P 62 TH 170 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
87 Ny. RN P 59 TH 191 / 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Tn. ST L 65 TH 229 / 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Ny. DH P 42 TH 207 / 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Tn. MS L 51 TH 130 / 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Tn. SU L 71 TH 175 / 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
92 Ny. SE P 75 TH 191 / 98 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0
93 Tn. IM L 66 TH 136 / 86 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
94 Tn. MI L 72 TH 205 / 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Ny. EA P 47 TH 172 / 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
96 Ny. PI P 50 TH 173 / 113 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
97 Ny. KS P 66 TH 89 / 66 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
98 Ny. SY P 62 TH 217 / 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
99 Ny. RN P 85 TH 186 / 108 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Tn. MD L 73 TH 156 / 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
101 Tn. MI L 59 TH 148 / 87 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
102 Ny. FH P 56 TH 162 / 98 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0
103 Tn. MM L 58 TH 150 / 98 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
104 Ny. SA P 68 TH 224 / 100 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
105 Tn. MK L 48 TH 176 / 93 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
106 Tn. SB L 60 TH 207 / 100 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
107 Tn. SR L 64 TH 119 / 73 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0
108 Tn. UO L 59 TH 95 / 102 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
 Folic Acid Glikosida Jantung Kalium Oral
No Nama JK Usia TD LOS Asam Folat 400 mcg Digoxin 0,25 mg KSR 600 mg
1 Ny. SI P 68 Th 150 / 74 3 hari ─ ─ ─
2 Ny. NK P 69 TH 105 / 62 3 hari ─ ─ 
3 Ny. WI P 65 TH 127 / 89 6 hari  ─ ─
4 Ny. MH P 60 TH 183 / 113 2 hari ─ ─ ─
5 Tn. HM L 58 TH 150 / 98 2 hari ─ ─ 
6 Tn. KI L 51 TH 167 / 108 2 hari ─ ─ 
7 Tn. AI L 55 TH 152 / 102 2 hari ─ ─ ─
8 Tn. JN L 53 TH 172 / 99 3 hari ─ ─ ─
9 Tn. DN L 49 TH 150 / 88 3 hari ─ ─ ─
10 Ny. SP P 65 TH 163 / 101 4 hari ─ ─ ─
11 Ny. NH P 61 TH 171 / 103 2 hari ─ ─ ─
12 Ny. HI P 60 TH 190 / 114 2 hari ─ ─ ─
13 Tn. SN L 53 TH 90 / 62 3 hari ─ ─ ─
14 Ny. PM P 59 TH 152 / 72 1 hari ─ ─ ─
15 Ny. MF P 55 TH 110 / 64 1 hari ─ ─ ─
16 Tn. SO L 64 TH 98/ 73 1 hari ─  ─
17 Ny. SH P 78 TH 118 / 75 2 hari ─ ─ 
18 Tn. DN L 75 TH 171 / 93 4 hari ─ ─ ─
19 Tn. HK L 66 TH 121 / 73 4 hari ─ ─ 
20 Ny. PH P 73 TH 112 / 80 3 hari  ─ ─
21 Tn. KN L 61 TH 210 / 108 6 hari ─ ─ 
22 Tn. SS P 49 TH 137 / 89 8 hari ─ ─ ─
23 Ny. SU P 68 TH 150 / 74 4 hari ─ ─ ─
24 Tn. TH L 55 TH 179 / 96 6 hari ─ ─ ─
25 Tn. CI L 51 TH 170 / 70 5 hari ─ ─ ─
26 Tn. SW L 71 TH 164 / 93 6 hari ─ ─ 
27 Ny. WI P 65 TH 127 / 89 5 hari  ─ ─

28 Ny. ST P 51 TH 200 / 133 4 hari ─ ─ 

29 Tn. YO L 65 TH 179 / 90 3 hari ─ ─ ─
30 Ny. SR P 56 TH 166 / 107 8 hari ─ ─ ─
31 Ny. MI P 55 TH 125 / 90 5 hari ─ ─ 
32 Tn. KM L 51 TH 167 / 108 12 hari ─ ─ 
33 Ny. WJ P 65 TH 115 / 73 5 hari ─ ─ 
34 Tn. BO L 35 TH 154 / 98 3 hari ─ ─ ─
35 Ny. SK P 59 TH 185 / 113 4 hari ─ ─ ─

36 Tn. AM L 55 TH 152 / 102 6 hari ─ ─ ─

37 Ny. NK P 69 TH 130 / 91 9 hari ─ ─ ─
38 Ny. PI P 62 TH 157/ 88 6 hari ─ ─ ─
39 Ny. SA P 60 TH 155 / 73 9 hari ─ ─ ─
40 Tn. KS L 51 TH 140 / 87 10 hari ─ ─ 
41 Tn. JN L 53 TH 172 / 99 7 hari ─ ─ ─
42 Tn. DN L 49 TH 150 / 88 3 hari ─ ─ ─
43 Tn. NI L 57 TH 173 / 85 4 hari ─ ─ ─
44 Ny. SW P 74 TH 142 / 103 10 hari ─ ─ ─
45 Ny. SM P 52 TH 176 / 63 11 hari ─ ─ ─
46 Ny. ST P 58 TH 148 / 96 4 hari ─ ─ ─
47 Tn. SO L 73 TH 149 / 82 9 hari ─ ─ ─
48 Tn. SJ L 64 TH 98 / 73 2 hari ─  ─
49 Ny. SH P 78 TH 118 / 75 4 hari ─ ─ 

50 Ny. TM P 50 TH 231 / 116 5 hari ─ ─ ─

51 Tn. DA L 75 TH 171 / 93 12 hari ─ ─ ─
52 Ny. IN P 60 TH 233 / 78 7 hari ─ ─ 
53 Tn. AD L 70 TH 152 / 82 5 hari ─ ─ ─
54 Ny. PH P 73 TH 112 / 80 4 hari ─ ─ ─
55 Ny. ST P 60 TH 157 / 81 6 hari ─ ─ ─
56 Tn. WO L 58 TH 138 / 97 17 hari ─ ─ ─
57 Tn. DM L 65 TH 149 / 78 10 hari ─ ─ ─
58 Ny. FH P 54 TH 175 / 119 5 hari ─ ─ ─
59 Ny. PI P 71 TH 138 / 89 8 hari ─ ─ ─
60 Tn. DA L 41 TH 115 / 78 8 hari ─ ─ ─
61 Tn. SY L 55 TH 175 / 110 9 hari ─ ─ ─
62 Tn. TT L 43 TH 112 / 60 9 hari ─ ─ ─
63 Tn. HL L 58 TH 150 / 98 2 hari ─ ─ 
64 Tn. SR L 53 TH 105 / 77 2 hari ─  ─
65 Tn. SL L 54 TH 202 / 180 10 hari ─ ─ ─
66 Tn. MO L 61 TH 191 / 107 5 hari ─ ─ ─
67 Ny. ST P 61 TH 168 / 75 7 hari ─ ─ ─
68 Tn. SR L 55 TH 149 / 90 6 hari ─ ─ ─
69 Ny. LT P 60 TH 166 / 122 7 hari ─ ─ ─
70 Tn. SU L 67 TH 173 / 94 4 hari ─ ─ 
71 Tn. SY L 66 TH 102 / 91 8 hari ─ ─ ─
72 Ny. SN P 70 TH 182 / 98 5 hari ─ ─ ─
73 Ny. MR P 74 TH 94 / 75 4 hari ─ ─ ─
74 Tn. KL L 60 TH 125 / 82 5 hari  ─ ─
75 Ny. AE P 77 TH 141 / 82 7 hari ─ ─ 
76 Tn. MK L 55 TH 177 / 130 5 hari ─ ─ ─
77 Tn. BD L 60 TH 139 / 78 4 hari ─ ─ 
78 Ny. SA P 57 TH 95 / 67 7 hari ─ ─ 
79 Tn. PT L 49 TH 179 / 146 5 hari ─ ─ ─

80 Tn. LN L 59 TH 167 / 116 7 hari ─ ─ ─

81 Ny. MY P 46 TH 197 / 111 5 hari ─ ─ ─
82 Ny. SA P 62 TH 141 / 86 5 hari ─ ─ 
83 Ny. ST P 59 TH 185 / 120 4 hari ─ ─ 
84 Ny. SU P 70 TH 209 / 93 7 hari ─ ─ 
85 Tn. MP L 55 TH 130 / 68 6 hari ─ ─
86 Ny. SK P 62 TH 170 / 116 7 hari ─ ─ 
87 Ny. RN P 59 TH 191 / 120 4 hari ─ ─ 

88 Tn. ST L 65 TH 229 / 105 8 hari ─ ─ 

89 Ny. DH P 42 TH 207 / 121 9 hari ─ ─ ─
90 Tn. MS L 51 TH 130 / 92 5 hari ─ ─ ─
91 Tn. SU L 71 TH 175 / 89 5 hari ─ ─ 
92 Ny. SE P 75 TH 191 / 98 4 hari ─ ─ ─
93 Tn. IM L 66 TH 136 / 86 5 hari ─ ─ ─
94 Tn. MI L 72 TH 205 / 130 3 hari ─ ─ 
95 Ny. EA P 47 TH 172 / 82 4 hari ─ ─ ─
96 Ny. PI P 50 TH 173 / 113 8 hari ─ ─ 
97 Ny. KS P 66 TH 89 / 66 8 hari ─ ─ ─
98 Ny. SY P 62 TH 217 / 110 9 hari ─ ─ 
99 Ny. RN P 85 TH 186 / 108 4 hari ─ ─ 
## Tn. MD L 73 TH 156 / 116 4 hari ─ ─ ─
## Tn. MI L 59 TH 148 / 87 6 hari ─ ─ ─
## Ny. FH P 56 TH 162 / 98 8 hari ─ ─ 
## Tn. MM L 58 TH 150 / 98 2 hari ─ ─ ─
## Ny. SA P 68 TH 224 / 100 4 hari ─ ─ ─
## Tn. MK L 48 TH 176 / 93 7 hari ─ ─ ─
## Tn. SB L 60 TH 207 / 100 6 hari ─ ─ ─
## Tn. SR L 64 TH 119 / 73 7 hari ─ ─ ─
## Tn. UO L 59 TH 95 / 102 8 hari ─ ─ ─
 Mukolitik Nitrat Histamin H2
Ambroxol 30 mg Asetilsistein 200 mg ISDN 5 mg Gliseril trinitrat 2,5 mg Ranitidin 150 mg
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 Inhibitor Xanthine Oxidase Pelemas Otot Skelet Penicillin
Allopurinol 100 mg Allopurinol 300 mg Lioresal 10 mg Co-Amoxiclav 500 mg
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Penghambat Asetilkolinesterase PPI Sefalosporin
Donezepil Hcl 5 mg Lansoprazol 30 mg Omeprazol 20 mg Cefixime 100 mg
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 Serangan Akut Sulfonilurea
Colchicine 0,5 mg Glimepirid 1 mg Glimepirid 2 mg Gliquidone 30 mg Curcuma 100 mg
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 Vitamin
Curcuma syr 600 ml Chelecalciferol 5000 UI Imunos Kurkumex Mecobalamin 500 mcg
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Neulin PS Pritavit Vitamin B6 10 mg Vitamin E 200 Ui
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