Evaluasi Penggunaan Obat Antihipertensi Pada Pasien Yang Menjalani Hemodialisis di Klinik Spesialis Ginjal dan Hipertensi Rasyida Kota Medan

Lampiran 1. Data Pengobatan Pasien

No.

NO. RM

Inisial

Jenis
Kelamin

Umur
(Tahun)

Nama Obat

Dosis Pemakaian

1

0009

TH

L

54

Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

2

0011

MS

L

62

Bisoprolol 5 mg
Cavit D3
Sangobion

1x1
1x1
1x1

3

0015

FS

L

53

Bisoprolol 5 mg
Sangobion

1 x 1/2
1x1

57

Amlodipin 10 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
1x1
1x1
1x1

2x1
1x1
1x1
2x1
1x1

4

0019

S

L

5

0021

JH

L

53

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

6

0022

HS

L

68

Bisoprolol 5 mg
ISDN
Sangobion

1 x 1/2
1x1
2x1
1x1

54
Universitas Sumatera Utara

7

8

9

10

0025

0026

0027

0031

ES

AR

ZK

EG

P

L

L

P

60

Adalat Oros 30 mg
Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
3x1
1x1

44

Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

57

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
2x1

3x1
1x1

54

Amlodipin 10 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
ISDN
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
3x1
3x1
1x1

1 x 1/2
2x1
3x1
1x1

55
Universitas Sumatera Utara

11

12

13

14

0033

0036

0037

0038

SH

ST

JE

SL

L

L

L

L

39

Amlodipin 10 mg
Bisoprolol 5 mg
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1

48

Amlodipin 10 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
ISDN
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
2x1
3x1
1x1

37

Adalat Oros 30 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
2x1
3x1
1x1

45

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1 x 1/2
1x1
2x1
1x1

56
Universitas Sumatera Utara

15

16

0042

0043

RO

RN

P

P

54

Amlodipin 10 mg
Lenal Ace
Sangobion

1x1
3x1
1x1

54

Amlodipin 10 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1
1x1
1x1
1x1
3x1
1x1

17

0047

CA

L

50

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

18

0052

RM

P

78

Bisoprolol 5 mg
Lenal Ace
Sangobion

1x1
3x1
1x1
1x1
2x1
1x1
1x1
2x1
1x1

19

0054

AT

P

64

Bisoprolol 5 mg
Cavit D3
Sangobion

20

0057

NS

L

45

Amlodipin 10 mg
Lenal Ace
Sangobion

57
Universitas Sumatera Utara

21

22

23

0058

0063

0065

FA

SA

YU

L

P

P

57

Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
2x1
2x1
1x1

73

Adalat Oros 30 mg
Candesartan 16 mg
ISDN
Lenal Ace
Sangobion

1x1
1x1
2x1
3x1
1x1

74

Amlodipin
Cavit D3
Lenal Ace
Sangobion

1x1
2x1
3x1
1x1
1x1
1x1
3x1
1x1

24

0066

LD

P

32

Amlodipin 10 mg
Bisoprolol 5 mg
Lenal Ace
Sangobion

25

0067

AU

L

75

Bisoprolol 5 mg
Candesartan 16 mg
Sangobion

1 x 1/2
1 x 1/2
1x1

58
Universitas Sumatera Utara

26

27

28

0068

0069

0072

ML

NR

SF

L

L

L

63

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1 x 1/2
2x1
3x1
1x1

55

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace

1x1
1x1
1x1
3x1
1x1

49

Amlodipin 10 mg
Candesartan 16 mg
Cavit D3
ISDN
Lenal Ace
Sangobion

1x1
1 x 1/2
1x1
2x1
1x1
1x1
1x½
1x1
2x1
1x1
1x1
1x1
1x1

29

0074

MW

L

74

Amlodipin 10 mg
Bisoprolol 5 mg
Lenal Ace
Sangobion

30

0082

RI

P

51

Amlodipin 10 mg
Bisoprolol 5 mg
Sangobion

59
Universitas Sumatera Utara

31

32

33

34

35

0083

0085

0092

0094

0100

MH

PT

NT

BK

MP

L

L

P

L

L

66

Bisoprolol 5 mg
ISDN
Sangobion

1x1
2x1
1x1

69

Amlodipin 10 mg
Bisoprolol 5 mg
ISDN
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1
1x1

60

Adalat Oros 30 mg
Bisoprolol 5 mg
Cavit D3
Sangobion

1x1
1x1
1x1
1x1

58

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
2x1
1x1

52

Amlodipin 10 mg
Cavit D3
Lenal Ace
Sangobion

1x1
2x1
3x1
1x1

60
Universitas Sumatera Utara

36

37

38

39

0105

0106

0107

0110

SY

PP

NZ

PW

P

L

P

L

46

Amlodipin 10 mg
Candesartan 16 mg
Cavit
Lenal
Sangobion

1x1
1x1
2x1
1x1
1x1

54

Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
ISDN
Lenal Ace
Sangobion

1x1
1 x 1/2
1x1
1x1
3x1
1x1

54

Amlodipin 10 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
3x1
1x1

52

Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1

61
Universitas Sumatera Utara

40

41

0112

0114

LC

IS

P

L

43

Amlodipin 10 mg
Bisoprolol 5 mg
Candesartan 16 mg
Lenal Ace
Sangobion

1x1
1x1
1x1
2x1
1x1

35

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
3x1
1x1
1x1
1x1
1x1
3x1
1x1

42

0116

SM

L

55

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

43

0123

MN

L

41

Amlodipin 10 mg
Bisoprolol 5 mg
Sangobion

1x1
1x1
1x1

70

Amlodipin 10 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1

44

0135

SP

L

62
Universitas Sumatera Utara

45

46

47

48

49

0138

0139

0142

0148

0157

MK

JS

IP

MU

MI

L

L

L

L

L

60

Amlodipin 10 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1 x 1/2
1x1
3x1
1x1

44

Amlodipin 10 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
3x1
1x1

48

Bisoprolol 5 mg Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

74

Adalat Oros 30 mg
Glikuidon 30 mg
Lenal Ace
Sangobion

1x1
2x1
3x1
1x1

24

Amlodipin 10 mg Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
3x1
1x1

1x1
1 x 1/2
1x1
3x1
1x1

63
Universitas Sumatera Utara

50

51

52

0174

0174

0175

AN

TA

AW

L

L

L

46

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
3x1
1x1

67

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
1x1

62

Adalat Oros 30 mg
Cavit D3
Glikuidon 30 mg
ISDN
Lenal Ace
Sangobion

1x1
2x1
2x1
2x1
2x1
1x1
1x1
1x1
3x1
1x1

53

0176

WS

L

58

Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

54

0205

SM

L

55

Amlodipin 10 mg
Candesartan 16 mg
Sangobion

1x1
1 x 1/2
1x1

64
Universitas Sumatera Utara

55

56

57

58

59

0208

0211

0216

0243

0244

EL

SB

GB

SI

NM

P

L

L

L

L

42

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
3x1
1x1

64

Amlodipin 10 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1

50

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
2x1
2x1
1x1

46

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Sangobion

1x1
1x1
1x1
1x1

57

Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1

65
Universitas Sumatera Utara

60

61

62

63

0249

0252

0285

0286

SS

MR

ME

SG

P

L

P

L

43

Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
2x1
2x1
1x1

52

Amlodipin 10 mg
Bisoprolol 5 mg
Cavit D3
Glikuidon 30 mg
Lenal Ace
Sangobion

1x1
1x1
2x1
1x1
1x1
1x1

42

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1
3x1
1x1

70

Amlodipin 10 mg
Glikuidon 30 mg
Lenal Ace
Sangobion

1x1
2x1
3x1
1x1

66
Universitas Sumatera Utara

64

65

66

67

68

0289

0292

0294

0299

0304

YN

SR

MA

AL

TS

P

P

L

L

L

48

Amlodipin 10 mg
Cavit D3
Lenal Ace
Sangobion

1x1
2x1
2x1
1x1

60

Amlodipin 10 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
2x1
1x1

64

Adalat Oros 30 mg
Cavit D3
Lenal Ace
Sangobion

1x1
2x1
2x1
2x1

52

Adalat Oros 30 mg
Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1 x 1/2
1x1
3x1
1x1

52

Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
2x1
3x1
1x1

67
Universitas Sumatera Utara

69

0307

SO

L

56

Adalat Oros 30 mg
Candesartan 16 mg
Cavit D3
Sangobion

1x1
1 x 1/2
1x1
1x1
1x1
1 x 1/2
1 x 1/2
1x1
2x1
1x1

70

0321

TF

L

43

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

71

0326

RB

L

59

Amlodipin 10 mg
Sangobion

1x1
1x1

46

Amlodipin 10 mg
Candesartan 16 mg
Glikuidon 30 mg
Sangobion

1x1
1x1
1x1
1x1

65

Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1 x 1/2
1x1
3x1
1x1

72

73

0336

0337

CS

AD

L

L

68
Universitas Sumatera Utara

74

75

76

77

78

0359

0365

0392

0393

0397

NL

SZ

YE

RG

JT

P

L

P

L

L

43

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Lenal Ace
Sangobion

1x1
1x1
1x1
2x1
1x1

42

Adalat Oros 30 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
1x1
1x1

45

Adalat Oros 30 mg
Bisoprolol 5 mg
Candesartan 16 mg
Lenal Ace
Sangobion

1x1
1x1
1 x 1/2
3x1
1x1

64

Adalat Oros 30 mg
Candesartan 16 mg
Lenal Ace
Sangobion

1x1
1x1
2x1
1x1

45

Bisoprolol 5 mg
Cavit D3
Lenal Ace
Sangobion

1 x 1/2
1x1
3x1
1x1

69
Universitas Sumatera Utara

79

0404

AK

L

49

Candesartan 16 mg
Lenal Ace
Sangobion

1x1
3x1
1x1

80

0408

SN

P

56

Amlodipin 10 mg
Sangobion

1x1
1x1

34

Adalat Oros 30 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1 x 1/2
1x1
3x1
1x1
1x1
1x1
3x1
1x1

81

0410

RA

L

82

0418

LI

P

42

Adalat Oros 30 mg
Glikuidon 30 mg
Lenal Ace
Sangobion

83

0440

AW

P

55

Amlodipin
Glikuidon 30 mg
Sangobion

1x1
1x1
1x1

84

0443

LS

P

43

Amlodipin 10 mg
Lenal Ace
Sangobion

1x1
1x1
1x1

70
Universitas Sumatera Utara

85

86

0465

0515

MT

ZH

L

L

44

Adalat Oros 30 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1

78

Candesartan 16 mg
Lenal Ace
Sangobion

1 x 1/2
1x1
1x1
1x1
1x1
1x1
2x1
1x1

87

0523

RS

P

48

Amlodipin 10 mg
Bisoprolol 5 mg
Candesartan 16 mg
Lenal Ace
Sangobion

88

0527

FO

L

31

Amlodipin
Lenal Ace
Sangobion

1x1
2x1
1x1
1x1
1x1
1x1
1x1
1x1
1x1

89

0528

WL

L

58

Amlodipin
Lenal Ace
Sangobion

90

0535

SU

L

81

Candesartan 16 mg
Lenal Ace
Sangobion

71
Universitas Sumatera Utara

91

0540

AR

L

74

Amlodipin 10 mg
Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

92

0558

OS

L

64

Adalat Oros 30 mg
Sangobion

1x1
1x1

50

Bisoprolol 5 mg
Lenal Ace
Sangobion

1x1
1x1
1x1

75

Candesartan 16 mg
Lenal Ace
Sangobion

1x1
2x1
1x1
1x1
1x1
3x1
1x1
1x1
1x1
1x1

93

94

0563

0570

SD

MY

L

L

95

0622

ST

L

52

Adalat Oros 30 mg
Candesartan 16 mg
Lenal Ace
Sangobion

96

0628

TP

L

56

Adalat Oros 30 mg
Candesartan 16 mg
Sangobion

1x1
1x1
1x1
3x1
2x1

72
Universitas Sumatera Utara

97

98

99

100

1960

2178

2262

2267

ED

BH

AS

AO

L

L

L

L

54

Adalat Oros 30 mg
Candesartan 16 mg
Glikuidon 30 mg
Lenal Ace
Sangobion

1x1
1x1
2x1
2x1
1x1

58

Adalat Oros 30 mg
Candesartan 16 mg
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1

33

Candesartan 16 mg
Cavit D3
Lenal Ace
Sangobion

1x1
2x1
3x1
1x1

29

Adalat Oros 30 mg
Candesartan 16 mg
Lenal Ace
Sangobion

1x1
1x1
3x1
1x1

73
Universitas Sumatera Utara

Lampiran 2. Surat Penunjukan Dosen Pembimbing 2 dan Judul Penelitian

Universitas Sumatera Utara

Lampiran 3. Surat Perubahan Judul Penelitian

Universitas Sumatera Utara

Lampiran 4. Surat Izin Penelitian di Klinik Spesialis Ginjal dan Hipertensi
Rasyida Medan dari Dekan Fakultas Farmasi

Universitas Sumatera Utara

Lampiran 5. Surat Telah Selesai Melaksanakan Penelitian di Klinik Spesialis
Ginjal dan Hipertensi Rasyida Meda

Universitas Sumatera Utara

Lampiran 6. Surat Ethical Clearance dari Komisi Etik FK USU

Universitas Sumatera Utara