Regulations 

Medicines of group a. Storage of poisonous and potent drugs

Rules for the storage of poisonous, narcotic and potent medicines in pharmacy warehouses, in medical institutions, control and analytical laboratories and other healthcare institutions are regulated by a special instruction approved by orders of the Ministry of Health.

Medicines of group A are divided into subgroups. Of the total number of drugs classified under the State Pharmacopoeia to list A, a certain part of the drugs is subject to subject-quantitative accounting in pharmacies. Salvarsan preparations are subject to special serial registration.

All drugs, and especially toxic agents: arsenic anhydride, crystalline sodium arsenate, strychnine nitrate, mercury dichloride (mercuric sublimate) and mercury oxycyanide - should be stored in pharmacies only in safes, and especially toxic agents - in the internal lockable compartment of the safe.

In pharmacies of categories V and VI, it is allowed to store narcotic and especially poisonous drugs only in a material room in safes or metal boxes screwed to the floor. It is not allowed to store these preparations in the assistant's rooms. In large pharmacies (categories I-IV), it is supposed to store a stock of narcotic and poisonous drugs in assistant rooms in quantities not exceeding a 5-day requirement, and storage should also be carried out in special safes.

General stocks of poisonous and drugs in city pharmacies should not exceed the monthly requirement. In other pharmacies, the stock of these drugs is determined by regional or regional pharmacy departments.

In duty pharmacies, poisonous and narcotic drugs are left overnight in a separate locked cabinet in the quantities and assortment necessary to provide urgent medical care. After duty, this cabinet is sealed.

All toxic drugs included in List A, but not related to narcotic and highly toxic drugs, are stored in isolation, in metal cabinets specially allocated for these purposes, under lock and key. In small pharmacies, all List A drugs (including narcotic and highly poisonous ones) can be stored in one safe.

Cabinets and safes containing poisonous and narcotic drugs are designed as follows:

1) on the inside of the doors of the safe and the cabinet, the inscription “A - Venena” (poison) is made;

2) below this inscription, on the same side of the door, there is a list of poisonous and narcotic drugs stored in a safe or cabinet, indicating the highest single and daily doses;

3) inscriptions on the barbells, in which poisonous and narcotic drugs are stored, are made on Latin in white on a black background (black label). Each barbell indicates the highest single and daily dose.

For the manufacture of drugs with toxic components in the safes and cabinets where they are stored, there must be hand scales, weights, mortars, cylinders and funnels. On the dishes used for the manufacture of medicines, it is desirable to be marked: “For sublimate”, “For silver nitrate”, etc. Washing of these dishes is carried out separately from the other under the supervision of a pharmacist.

The key to the cabinet with the means of list A, located in the assistant's room, in working time should be at the pharmacist - pharmacy technologist. After the end of the working day, the cabinet is sealed and the key, together with a seal or ice cream, is transferred to the head of the pharmacy or another responsible pharmacy employee authorized to do so by the order of the pharmacy.

Material rooms, as well as safes in which narcotic and especially poisonous drugs are stored, must have light and sound alarms. Windows of material rooms where poisonous and narcotic drugs are stored should be equipped with metal bars. At night, these rooms are locked and sealed. Only the head of the pharmacy or a person authorized by him can issue narcotic and especially poisonous drugs from the material to the assistant for current work.

Storage of poisonous and narcotic drugs in pharmacy warehouses, in control and analytical laboratories, in pharmaceutical enterprises, in research and development educational institutions It is also carried out in safes or metal cabinets under lock and key, in rooms whose windows must have iron bars.

In cases where it is provided for by the instructions, the doors of the rooms in which poisonous and narcotic drugs are stored are covered with iron, and the room itself is equipped with light and sound alarms. Rooms where narcotic and poisonous substances are stored should be locked and sealed or sealed after work is completed. The keys, ice cream or seal must be kept by the person responsible for the storage of poisonous and narcotic drugs. In rooms, cabinets, safes where poisonous medicines are stored, it is necessary to have scales, weights, funnels, cylinders, mortars and other utensils for work.

In all cases, employees responsible for the storage and distribution of poisonous and narcotic drugs must strictly adhere to the relevant instructions and regulations approved by the Ministry of Health.

Subject-quantitative accounting of poisonous and narcotic drugs is carried out in a special book, numbered, laced and sealed with the signature of the head of a higher organization with a round seal.

In the specified book, one page is allocated for each name of the registered medicinal product, on which balances and receipts are reflected on a monthly basis this drug, as well as the daily consumption of it.

The consumption of the drug is indicated for each day separately: dispensing according to outpatient prescriptions and dispensing to medical institutions, pharmacy departments and pharmacy points of group I. This is done so that at the end of the month, when checking the actual presence of poisonous and potent substances and reconciling them with the book balance, it was possible to apply the established norms natural loss. These norms are applied separately: for outpatient dispensing of poisonous and potent substances and for dispensing to medical and other organizations.

Storage and accounting of salvarsan preparations. The list A group of drugs also includes salvarsan drugs - miarsenol and novarsenol. They are under special control State Control Commission for testing such drugs under the Ministry of Health. This commission regulates the production of salvarsan preparations, establishes expiration dates, the procedure for their storage and accounting. Preparations are produced in sealed ampoules in a special package, on which the quantity, batch number and time of manufacture are indicated. In addition, on each package, the supplier indicates that the batch has passed chemical, biological and clinical testing, and the date of verification.

To account for the movement of salvarsan preparations in pharmacies a special journal is maintained. It contains information about the receipt and issuance of drugs in medical institutions. In the receipt part, the date of receipt of the drug at the pharmacy, the batch number, the dosage and the institution from which the drug was received are indicated. When issuing the drug, the journal indicates the name and address of the medical institution, date of issue, batch number, quantity and dosage.

Storage of potent drugs. Enough large group medicines refers to potent or, as they are commonly called, drugs of list B. These medicines should be stored in separate cabinets on the doors of which there is an inscription “B-Heroica” (strong) and a list of those included in list B

Preparations indicating the highest single and daily doses.

The inscriptions on the barbells, in which potent drugs are stored, are made in red on a white background. The barbells also indicate the highest single and daily doses. After work is completed, cabinets B are locked. During working hours they are open, they can be used by pharmacy workers involved in the manufacture of medicines.

Drugs that do not belong to lists A and B are stored in ordinary cabinets or on assistant turntables. The inscriptions on the barbells with these drugs are made in black on a white background.

In all cabinets where medicines are stored (List B or the usual list), a certain system for arranging barbells should be followed:

1) store liquid medicinal products separately from loose ones;

2) do not put medicines that are consonant in name next to each other, so as not to confuse them during the manufacture of the medicine. Therefore, it is impossible to arrange drugs on the shelves of cabinets in alphabetical order;

3) medicinal products for internal use that belong to list B should be placed in cabinets so that drugs with close higher doses are placed on the shelves (for example, drugs with doses of 0.1 g are stored on one shelf, and from 0.1 g on the other up to 0.5 git.d.), and place them on the shelves of cabinets, taking into account the pharmacological grouping.

As the experience of many pharmacies has shown, a single numbering of medicines brings significant benefits. For example, if shtangles and material cans with norsulfazol have No. 363, then under this number they are decorated in the assistant and material room. Thus, pharmacy workers clearly know that any barbell with this number contains norsulfazol.

Pharmacology is the science that studies how drugs act on human body how new drugs are made. Even the ancient Greeks and Indians, the inhabitants of the tundra and the southern edge of Africa, tried to defeat diseases, looked for ways to deal with them. People have always strived for this, making their obsession the main dream.

A little about pharmacological terminology

Drugs are substances or a combination of substances used by people to treat diseases or for preventive purposes.

Medicinal products are drugs that are ready to use. Medicines may have various forms, which makes their use convenient and creates the possibility of an individual approach to the treatment of each patient. A variety of forms of drug release allows you to deliver them to the body different ways, which helps to work with unconscious patients and treat patients who have been injured or burned.

The concept of lists: A and B

There is a division of all drugs into three main groups:

  • List A includes poisonous drugs.
  • To list B - strong drugs and analgesics.
  • To medicines available without a doctor's prescription - all the rest.

To receive in pharmacy chains medicines of classes A and B, a special prescription is required. They demand to be treated with increased attention: knew how to take correctly, as well as the conditions proper storage these medicines. Some of them decompose in sunlight or become toxic if stored in the light.

In addition, there is strict reporting on the use of certain drugs (such drugs include morphine). In this case, the drugs are given in ampoules nurses after the shift, which must be confirmed by a corresponding log entry. Medicines that are considered antipsychotics, vaccines, and drugs for anesthesia are also subject to accounting.

What is a recipe?

A prescription is a special note by a doctor to pharmacists or pharmacists, which indicates a request to allow the patient to purchase a medicine. The prescription indicates the form, dose, method and frequency of use of the drug.


The prescription form is both a medical, legal and monetary document in the case when the medicine is given free of charge and on a discount. Based on the existing legislative act governing the rules for issuing prescriptions, this can be done by a doctor of any specialty and position.

A drug can not only eliminate or prevent diseases. It can also be poisonous, so the doctor must be careful when writing a prescription: the dosage must be accurate and correct.

The concept of drug dosage

Filling out the prescription form, the doctor writes down, using Arabic numerals, the amount of the medicinal substance, indicating mass or volume units in the decimal system, separating grams with a comma (1.5). The drops that make up the medicinal substance are indicated by Roman numerals. The calculation of the composition of some antibiotics is made only in international or biological units, denoted by IU or ED.


There are various forms medicinal substances: solid, liquid, gaseous. To indicate the amount of liquids and gases in the prescription, milliliters are used, and for inhalation, doctors sometimes note doses of a dry medicinal substance. At the bottom of the prescription, the doctor puts his signature and personal seal. Also in the prescription it is necessary to indicate the surname, initials, age of the patient, put the date and expiration date of the prescription.

Prescriptions for purchase are written on special forms subsidized medicines, narcotic substances, sleeping pills, antipsychotics and painkillers. Such prescriptions are signed by the attending physician, the chief physician of the hospital, certifying with a seal. A round seal of the medical institution is also put.

It is forbidden in outpatient clinics to extract ether for anesthesia, fentanyl, chloroethane, ketamine and other sleeping substances. Doctors in most countries use Latin for writing prescriptions. Medication recommendations are written in language that patients can understand.

Permission to sell drugs and poisonous drugs issued for five days medical alcohol– within ten days, and prescriptions for other medicines have an expiration date of two months after discharge

What is the general classification?

Today there are many unusual drugs, so they need to be classified for proper orientation. There are the following conditional classification guides:

  1. Therapeutic action - a group of drugs that are used in the treatment of one disease.
  2. Pharmacological action - the effect produced by the drug.
  3. Chemical structure.
  4. Nosological principle, which is similar to the therapeutic, but with a narrow distinction.

The division of drugs into groups

The development of medicine has led to the fact that doctors had to deal with the systematization of medicines. The classification was made by chemists and pharmacists, using the principle of the application point. It consisted of the following categories:

  1. Psychotropic drugs and drugs that have therapeutic effect on the cells of the central nervous system(tranxilizers, neuroleptics, sedatives, antidepressants, antiepileptics, anti-inflammatory drugs).
  2. Medicines for the treatment of the peripheral nervous system (ganglion blockers, anticholinergics).
  3. Local anesthetics.
  4. Drugs that change vascular tone.
  5. Diuretic and choleretic agents.
  6. Medicines for the treatment of organs internal secretion and metabolism.
  7. Antibiotics and antiseptics.
  8. Anticancer drugs.
  9. Diagnostic tools (dyes, contrast agents, radionuclides).

With the help of this and similar divisions, young doctors study the medicines that exist today. With the help of classification into groups, doctors intuitively understand how a particular drug works and remember the doses.

Medicines are classified according to their chemical structure.

By given feature antiseptic and antimicrobial preparations are classified. Medicinal substances are bactericidal and bacteriostatic, and differ in their chemical structure, which underlies the mechanism of action of the drug on the body and names.

  • Halides. They are based on elements belonging to the halogen group (chlorine, fluorine, bromine, iodine).
  • Oxidizers. The mechanism of their action is the ability to form free oxygen in in large numbers(hydrogen peroxide, potassium permanganate, hydroperite).
  • Acids. AT medical purposes various acids are used, but salicylic and boric acids are most often used.
  • alkalis. These include sodium borate, ammonia.
  • Aldehydes that remove fluid from tissues (formalin, ethanol and others).
  • Salts of heavy metals.
  • Phenols, characterized by the provision of an irritating and cauterizing effect on the body (carbolic acid, lysol).
  • Dyes. Used for diagnostics, as well as a local irritant and antibacterial agent (methylene blue, brilliant green, and others).
  • Tars and resins in the form of Vishnevsky's balm, Wilkinson's ointment, ichthyol and others. They are used to improve local blood supply to tissues.

Solid drugs are drugs that are produced in the form of:

  • Tablets obtained by shaping a powder under pressure, which contains active and excipients.
  • Dragee - arranged in layers of active and auxiliary substances, which are pressed around the granules.
  • powder. They are used as powders for wounds, for intramuscular or intravenous injections(Saline solution is used to dilute the powder). Powders are undosed and dosed, simple and complex.
  • A capsule in a gelatin shell contains a medicine that can be liquid, granular, powder or paste.
  • The granules most commonly used for the manufacture of homeopathic medicines are small particles, the size of which does not exceed half a millimeter.

Medicines are available in liquid form

This method is used to prepare solutions, galenic and novogalenic preparations, balms, collodions and other liquid and semi-liquid preparations.

  • To form solutions, the drug substance is mixed with a solvent.
  • To obtain galenical preparations, plant extracts are heated.
  • For the preparation of infusions and decoctions, dry medicinal plants. Their composition is indicated in the prescription, and the solvent and its amount are also indicated so that the pharmacist correctly prepares the drug.
  • Infusions and extracts are liquids that contain alcohol. They can prepare for pure form, and there are also alcohol-water or alcohol-ether.
  • For the preparation of novogalenic preparations, raw materials and finished product exposed high degree cleaning.

Medicines of special forms

These include balms. Balm is an oily liquid that has deodorizing and antiseptic properties.

Collodion is obtained by dissolving nitrocellulose in alcohol and ether. A combination of one to six. Used for external use.

Any cream has a semi-liquid consistency and consists of plant extracts that are mixed with a base in the form of glycerin, wax, paraffin.

It is better for children to give medicines in the form of lemonades and syrups. Little patients take them with pleasure and they like this treatment process.

Injections are made with sterile water and oil solutions which are both simple and complex. When writing a prescription, the doctor must indicate the dose of the medicinal substance and its volume, which contains one ampoule, and recommend the place of administration of the drug.

Soft drugs

A mild form of the drug is obtained by using a fatty or fat-like substance as a base. They are defined, classified, manufactured by chemists and pharmacists. The doctor should only specify the dose and indication for use in the prescription.

Medicinal ointments should contain at least twenty-five percent of solids. The appropriate consistency can be achieved by mixing the powder and animal fat, wax, vegetable oils, petroleum jelly or polyethylene glycol.

The same conditions are used when making pastes, with the difference that they are more viscous. The consistency of the liniments, on the contrary, should be more liquid. In addition, they are shaken before use in order to allow the settled powder to be evenly distributed in the solvent.

Suppositories or suppositories have a solid form, however, when they enter the human body, they quickly melt and turn into liquid.

The patches have solid form while they are in the room with room temperature. Once on the skin, they melt and stick to it, which contributes to the formation of a tight contact.

Most medicines are substances plant origin to which chemical or physical treatment is applied for better absorption by the body of an unhealthy person.

Storage of over-the-counter medicines is possible on open shelves

Medicines on the "a" list

C, the list of medicines of lists "A" and "B" was approved by Order of the Ministry of Health of the Russian Federation No. 472 dated December 31, 1999. In May 2010, this order was canceled, but the storage of medicines of list "A" and "B" is not.

The latest list of medicinal substances assigned to lists "A" and "B" and the definitions of these concepts are given in the Global Philosophy X ed. (1968) Order of the Ministry of Health of the Russian Federation No. 388 dated November 1, 2001 established that the pharmacopoeia is published once every 5 years and the validity of a pharmacopoeial article cannot exceed 5 years. Is it possible in this case to consider the GF (1968) as a valid regulatory document - this is a question.

In GF XII ed. (2007) there are no "A" and "B" list concepts.

Therefore, it can be assumed that the belonging of medicines to these lists for pharmacy and wholesale organizations can only be determined by the instructions for use, since in accordance with federal law No. 61 dated April 12, 2010 "On the circulation of medicines" manufacturers

when labeling medicinal products, they must indicate the storage conditions and conditions of dispensing medicinal product("dispensed without a doctor's prescription", List "B", List "A")

 Medicines of the list "A" are stored in isolation, in locked metal cabinets under lock and key

 On the inside of the cabinet doors there should be an inscription "A"

("Venena") and a list of drug lists indicating higher

single and daily doses

 The inscriptions on the barbells, in which medicines of list "A" are stored, must be white color on a black background and their highest single and daily doses should be indicated

 During working hours, the keys to the metal cabinet with medicines ( drugs) list "A", located in the assistant's room, must be kept by an authorized employee of the pharmacy organization. After the end of the working day, the cabinets are sealed or sealed, and the keys to them, the seal and the ice cream must be kept by the head of the pharmacy organization or by persons authorized to do so by order of pharmacy organization

 In duty pharmacies, medicines of lists "A" are left overnight, which are kept by the pharmacy employee on duty in a separate cabinet, locked, in the quantities and assortment necessary for emergency medical care. After the end of duty, this cabinet is sealed or sealed.

 Reagents containing medicines of lists "A" and located on the table of a pharmacist-analyst or pharmacist-technologist during work, after work should be stored in a locked cabinet.

Medicines of the list "b"

List B medicines are kept isolated in wooden cabinets under lock and key

On the inside of the cabinet doors where medications(drugs) of the "B" list should have the inscription "B" ("Heroica") and a list of drugs indicating the highest single and daily doses

The inscriptions on the barbells in which the medicines of the "B" list are stored should be red on a white background and indicate their highest single and daily doses

Wooden cabinets for storing medicines ( drugs) list "B" after the end of the working day must be locked

In duty pharmacies, medicines of lists "B" are left for the night, which are kept by the pharmacy employee on duty in a separate locker, in the quantities and assortment necessary for emergency medical care. After the end of duty, this cabinet is sealed or sealed;