Regulations 

New prescription drug law. Organization and dispensing of medicines

Plan

Introduction

1. Organization of a workplace for receiving prescriptions and dispensing drugs

2. The main duties of a pharmacist for taking prescriptions

2.1 Procedure for taking prescriptions

2.2 Forms of prescription forms

3. Organization of work on vacation medicines

3.2 Peculiarities of dispensing medicines to cancer patients and chronic patients

4. Norms one-time vacation individual medicines

Conclusion

the main goal pharmacy organization- providing the population with medicines, which means that the production function of any pharmacy is:

Control over the correct prescription of medicines;

Receiving prescriptions;

Manufacturing of medicines according to doctors' prescriptions;

Intra-pharmacy quality control;

Correct dispensing of medicines from pharmacy organizations.

A prescription production department (RPO) can be created to perform the functions of receiving prescriptions, making medicines according to prescriptions of doctors and the requirements of medical institutions, monitoring their quality, as well as dispensing manufactured medicines in pharmacies. To receive prescriptions and dispense finished medicinal products (FPP) in pharmacies, a department of ready-made forms (OGF) is created. Some pharmacies combine these two functions.

The management of the departments is carried out by the heads of departments and their deputies. The RPO staff includes the positions of pharmacists and pharmacists. Pharmacists are allocated for taking prescriptions for individually manufactured drugs and FPP, for monitoring the quality of prepared drugs, dispensing drugs, for monitoring drugs manufactured in a pharmacy. There may also be positions of pharmacists for conducting information work, control over the work of pharmacists, etc. In addition to the pharmaceutical staff, the RPO should have positions support staff: packers and cleaning attendants. The presence of a production function in a pharmacy is an indicator of quality drug supply the population, medical institutions, the availability of medical care, the breadth of the range of pharmaceutical services provided by pharmacies.


The workplace is organized in trading floor pharmacies. The area of ​​the department, the available equipment and equipment comply with the current building codes (SNiP), standards of technical and economic equipment.

Equipment and equipment of workplaces in a pharmacy depends on the volume of work of the pharmacy. The prescription and dispensing workplace is usually isolated from visitors, although modern equipment does not always provide for such isolation. At this workplace, standard equipment is installed, which includes a section table, cabinets for storing medicines, and spinners for storing manufactured dosage forms.

Besides, workplace for receiving and dispensing prescriptions, it is equipped with a refrigerator for storing thermolabile medicines, a cabinet for storing poisonous and potent medicines, as well as a computer. Currently, many pharmacies are equipped with automated workstations - recipe-ARM. It is well suited to speed up the sales process with bar coding.

Workplaces are equipped in accordance with the nature of the work performed. In this case, the following rules are observed:

The workplace should not have items that are not required in the process of work;

Every item must have a permanent place; - all objects frequently used in work should be on the floor by hand;

Pharmacist-technologist when using various subjects should not make unnecessary movements.

The workplace for receiving and dispensing drugs should be equipped with the necessary reference literature, in particular - the latest edition of the State Pharmacopoeia, tables of higher single and daily doses, literature on compatibility and interaction of medicines, orders of the Ministry of Health regulating the reception and dispensing of prescriptions and medicines for them ...

There are also reference books of medicines, including Vidal and Mashkovsky, the State Register of Medicines, price tables, tariffs for the manufacture of medicines, accounting documents, in particular, a prescription journal or receipt journal and a journal for recording incorrectly written prescriptions. In addition, the workplace for receiving and dispensing medicines must have labels and signatures.

When receiving and dispensing medicines, a pharmacy worker must be guided by a number of documents:

RF Laws "On Medicines", "On Narcotic Drugs and Psychotropic Substances", "On Protection of Consumer Rights", etc .;

The list of narcotic drugs, psychotropic substances and their precursors subject to control in Russian Federation;

The Standing Narcotics Control Board (PCCN) Lists;

List of medicines of lists A and B;

By current orders, regulatory documents the Ministry of Health of the Russian Federation and other departments;

Code of Ethics for the Pharmacist.

In addition, this list also includes Resolutions of the Government of regions and territories on pharmaceutical activities.


Recipe- this is a written appeal from the specialist who wrote it out to the pharmacist (pharmacist) about the manufacture and dispensing of drugs. A prescription is simultaneously a medical, legal and financial document.

When accepting prescriptions and dispensing medicines, pharmacy workers should be guided by the order of the Ministry of Health of the Russian Federation No. 328 of 23.08.99. “On the rational prescription of medicines, the rules for writing prescriptions for them and the procedure for their dispensing by pharmacies (organizations”).

All medicines, with the exception of those named in the List of Medicines dispensed without a prescription, approved by the Ministry of Health of Russia, should be dispensed only on prescriptions in established forms. Medicines are prescribed in the presence of appropriate indications for citizens who sought medical help and, if necessary, treatment after discharge from the hospital. It is forbidden to write prescriptions for medicines:

Not allowed to medical use By the Ministry of Health of Russia and not registered in the Russian Federation;

Used only in health care facilities (anesthetic ether, chloroethyl, sombrevin, etc.);

In the absence of medical indications.

The following duties are assigned to the pharmacist-technologist for the receipt of prescriptions and dispensing of medicines:

Acceptance of prescriptions and requirements, checking the correctness of their design, compatibility of ingredients and the compliance of prescribed doses with the patient's age, determination of the cost of the drug and execution of the relevant documentation;

Accounting for incoming prescriptions and transferring them for the manufacture of prescribed medicines;

Control over the correctness of prescriptions prescribed by doctors and informing your immediate supervisor about all cases of violation by doctors of the rules for prescribing prescriptions;

Registration of medicines that are absent and refused by the population, daily information about this by the heads of the department or pharmacy;

Ready-to-use prescription drugs.

2.1 Procedure for taking prescriptions

When taking prescriptions and dispensing medicines, it is advisable to follow the following algorithm of actions:

1.Verification of compliance of the form of the prescription form of the prescription... Any prescription, regardless of the order of payment for the medicine and the nature of the action of the medicines included in it, must contain the following mandatory and additional details.

The required details include:

Medical facility stamp, indicating the name of the medical facility, its address and telephone number;

Prescription date;

FULL NAME. the patient and his age;

FULL NAME. a doctor;

Name and quantity of drugs;

Detailed way of using drugs;

Doctor's signature and stamp.

Additional prescription details depend on the composition of the medicinal product and the form of the prescription form. Prescriptions are written out on forms printed by typographic method according to the forms established by the Ministry of Health of Russia.

2. Checking the eligibility of the person who wrote the prescription. Prescription of medicines is carried out by the physician who is directly managing the patient. When providing an ambulance and emergency medical care medicines are prescribed by a doctor of the emergency medical team or a doctor of the department emergency care outpatient clinic. In some cases, medicines can be prescribed by a specialist with an average medical education(dentist, paramedic, midwife).

3. Checking the correctness of the prescription and the method of using drugs. The composition of the medicinal product, the designation of the dosage form and the doctor's appeal to the pharmaceutical worker about the manufacture and dispensing of the medicinal product are prescribed for Latin... The names of narcotic drugs, psychotropic and poisonous substances, as well as drugs of list A are written at the beginning of the prescription. The way of using the medicinal product is written in Russian, indicating the dose, frequency, time of their use in relation to food intake. If an emergency dispensing of a medicinal product is required, the cito or statum designations are placed at the top of the prescription form. Only allowed adopted by the rules abbreviations of designations.

4. Checking the compatibility of the ingredients in the recipe. In a recipe requiring individual production, the compatibility of the ingredients that make up the medicinal product is checked. If it is necessary to change the composition or quantity active ingredients, replacement of one dosage form with another, etc. necessary this question check with the prescribing doctor.

5. Checking the highest single and daily doses of drugs, taking into account the patient's age. When evaluating a drug prescription, a pharmacy worker must check the highest single and daily doses (WFD and VVD) of drugs, taking into account the patient's age. When dispensing narcotic, psychotropic and poisonous substances, he must be guided by clause 3.9 of Order No. 785 of December 14, 2005 of the Ministry of Health and “Requirements for the release of narcotic drugs and psychotropic substances; medicines subject to quantitative accounting; anabolic steroids ".

6. Checking the compliance of the amount of prescribed drugs with the order of the Ministry of Health of the Russian Federation dated 12.02.2007 No. 110. Upon receipt of the extemporaneous prescription at the pharmacy pharmaceutical worker is obliged to dispense the drug, which is on the PCU, in half of the highest one-time, in the event that the doctor did not comply with the established rules for issuing a prescription or exceeded the highest single dose. In some cases, an excess is provided. established norms, which is possible if there is a doctor's instruction on the prescription "On special purpose", Certified by the signature and seal of the doctor, as well as the seal" For prescriptions. " For incurable oncological and hematological patients, the number of drugs prescribed in one prescription can also be doubled against the established norms.

7. Checking the validity of the prescription. Based on Order No. 110 of February 12, 2007 of the Ministry of Health and social development RF are established following dates action of recipes.

Prescriptions written on a special prescription form on narcotic drug and a psychotropic substance, valid - 5 days from the date of discharge, on prescription form No. 148-1 / y-88 -10 days.

The prescription written on the prescription form No. 148-1 / y-88 is valid - 10 days, 1 month. The validity period is indicated by strikethrough.

The prescription written on the prescription form No. 107-1 / y is valid for 10 days, 2 months, 1 year. The validity period is indicated by strikethrough.

Prescriptions for all other medicines are valid for 2 months from the date of discharge.

Prescriptions written out on prescription forms of the form No. 148-1 / y-04 (l) and No. 148-1 / u-06 (l) are valid - 1 month from the date of discharge, with the exception of medicinal products that are subject to quantitative records ...

Recipes for derivatives of barbituric acid, ephedrine in pure form, pseudoephedrine in pure form, ephedrine and pseudoephedrine mixed with other substances, anabolic steroids, clozapine, tianeptine for the treatment of patients with lingering and chronic diseases can be discharged for a course of treatment up to 1 month.

In this case, the prescription must have an inscription - "For special purposes", which is sealed with the signature of the doctor and the seal of the medical institution "For prescriptions". Prescriptions that do not meet the above requirements remain in the pharmacy, are canceled with the stamp “Prescription invalid” and are registered in a special journal.

8. Recipe taxation. The correct recipe is then taxed. In pharmacies with an equipped workstation, this process takes place with the help of various software. If the prescription is executed incorrectly, then it is registered in the "Journal of Incorrectly Prescribed Prescriptions", previously canceled with the "Prescription invalid" stamp.

9.Registering the recipe.

10. Registration of the signature, if necessary.

11. Issuance of a receipt.

12.Payment for the prescription.

All these stages are carried out in a complex, since registration, payment and issuance of a receipt go as components of one process.

2.2 Forms of prescription forms

Currently, by order of the Ministry of Health and Social Development No. 110 of February 12, 2007 "On the procedure for prescribing and prescribing medicines, products medical purpose and specialized products health food»Approved following forms prescription forms:

1) Form "Special prescription form for a narcotic drug and psychotropic substance";

2) Form No. 148 -1 / u-88 "Prescription form";

3) Form No. 107 -1 / y "Prescription form";

4) Form No. 148 -1 / y - 04 (l) "Recipe";

5) Form No. 148 –1 / y - 06 (l) “Recipe”.

1. Form "Special prescription form for a narcotic drug and psychotropic substance" according to the instructions for order No. 110 "is made on paper color pink watermarked and has serial number... On the prescription form of this sample, narcotic drugs are prescribed and psychotropic substances included in List II of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation (according to the Decree of the Government of the Russian Federation No. 681 of June 30, 1998).

The prescription fully indicates the surname, first name, patronymic of the patient. It is obligatory to indicate the "Case history No." or "No. of the medical card" of the patient, or the history of the child's development, the case history. In addition, the surname, name and patronymic of the doctor are fully indicated. The prescription is signed by the doctor who wrote this prescription, after which it is certified by the doctor's personal seal. Additionally, it is certified by the round seal of the healthcare facility and signed by the chief physician or his deputy.

It is allowed to write out only one name of the medicinal product on one prescription form, and corrections are not allowed. The recipe remains in the pharmacy organization for subject-quantitative accounting.

2. Form No. 148 -1 / u-88 "Prescription form" has a series and a number. In addition, it must contain the following details: the address or number of the patient's medical record, the stamp of the medical institution “For prescriptions”, full name. the patient and the doctor completely. For free and preferential leave the prescription is issued in duplicate. This prescription form contains psychotropic substances of Schedule III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation (according to the Decree of the Government of the Russian Federation No. 681 of June 30, 1998), as well as other drugs that are subject to quantitative accounting and anabolic steroids.

On one prescription form, it is allowed to prescribe only one name of the medicinal product, and with back side prescription, a note is made about who prepared, checked and dispensed the drug. The prescription remains in the pharmacy organization for subject-quantitative accounting

3. Form No. 107 -1 / y "Prescription form". All medicines are prescribed on this prescription form, with the exception of those prescribed on the prescription form of form No. 148 -1 / y - 88 and on a special prescription form for a narcotic drug and a psychotropic substance. The prescription is signed by the doctor and certified by his personal seal.

No more than 3 names of medicines are written out on one prescription form, and corrections are also not allowed. Ethyl alcohol is prescribed on a separate form and is additionally certified by the seal of the medical institution "For prescriptions".

4. Form No. 148 -1 / y -04 "Recipe" and 5. and Form No. 148 -1 / y-06 "Recipe" are intended for prescribing medicines for preferential terms(free or with a discount), and the form No. 148 -1 / -06 is drawn up using computer technology... On the prescription form of the listed forms, medicines, medical products and specialized medical food products for disabled children are prescribed.

Prescription form is issued in 3 copies, having a single series and number, while the prescription is signed by a doctor (paramedic) and certified by his personal seal. When dispensing a medicinal product in a pharmacy, information on actually dispensed medicinal products is indicated on the prescription form, and the date of dispensing is stamped. This prescription blank has a tear line separating the blank and the spine that is issued to the patient. In this case, a mark is made on the spine about the name of the drug, dosage, quantity, method of application.

3.1 Dispensing of Prescription Drugs

When dispensing prescription drugs, the pharmacist must follow certain rules:

When dispensing narcotic drugs, psychotropic, potent and poisonous substances, ethyl alcohol and other medicines with special conditions for sale, it is required to comply with the order of the Ministry of Health and Social Development of the Russian Federation of 12.02.07 No. 110 and the Rules for the Dispensing of Medicines in Pharmacy Organizations, Standard OST 91500.05. 0007-2003. At the same time, the release of narcotic drugs and psychotropic substances according to doctors' prescriptions is carried out in accordance with Schedule II and Schedule III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation;

Based on the requirements of Order No. 785, Clause 3.2 of this Order, the right to work with narcotic drugs and psychotropic substances is given only to those pharmacy organizations and institutions that have a license for this type of activity;

Only those pharmacists who have been given the right to carry out such activities in accordance with the order of the Ministry of Health and Social Development of the Russian Federation of 13.05.05 can release narcotic drugs and psychotropic substances. # 330;

When dispensing narcotic drugs and psychotropic substances, as well as extemporal medicinal products containing medicinal substances that are on the PCU, instead of a prescription, patients are given a signature with a yellow stripe and an inscription in black font "Signature";

If the patient has a prescription long acting, then it is returned with an indication on the back of the amount of the dispensed drug and the date of release;

The release of narcotic drugs and psychotropic substances is allowed only on the basis of prescriptions from medical institutions located in the same settlement;

The release of narcotic drugs and psychotropic substances prescribed by a doctor is carried out to a patient or a person representing him only upon presentation of an identity document;

Narcotic drugs and psychotropic substances dispensed by doctor's prescription, as well as dispensed free of charge or at a discount, are dispensed upon presentation of a prescription written out on a special prescription form No. 148 -1 / y-04 (l). Also, psychotropic substances found on PKU and anabolic steroids are dispensed according to prescriptions of a doctor or paramedic, as well as on preferential terms upon presentation of 2 prescriptions - prescription form No. 148-1 / u-88 and form No. 148-1 / u-04 (l);

It is forbidden to dispense narcotic drugs and psychotropic substances, medicines located on the PKU, as well as anabolic steroids according to prescriptions prescribed by veterinary medical organizations for the treatment of animals;

It is also prohibited to dispense separately the medicinal products on the PCU and dispense medicinal products that are part of the combined medicinal product according to extemporal prescriptions;

Replacement of a drug prescribed in a prescription with its synonym is made only by agreement with the buyer or with a doctor, while the trade name of the dispensed drug, as well as the signature and date of dispensing of this drug, are indicated on the back of the prescription;

When dispensing a medicinal product, the pharmacist must explain to the buyer the rules for taking the medicinal product, the methods of taking it, single and daily doses, the mode of administration and the rules for storing this medicinal product.


For the treatment of incurable oncological and hematological patients, the rate of prescription and dispensing of drugs subject to quantitative accounting, as well as drugs of List II and derivatives of barbituric acid, is allowed to be increased by 2 times compared to the amount specified in Appendix No. 1 of the Instruction approved by order of the Ministry of Health and Social Development No. 110 dated 12.02.07

Chronic patients for finished medicines and means of individual manufacture are allowed to set a prescription validity period of up to 1 year, with the exception of:

Medicines subject to quantitative accounting;

Anabolic drugs;

Medicines dispensed from a pharmacy organization on preferential terms (free or at a discount);

In this case, the doctor makes a note on the prescription "Chronic patient" and indicates the duration of the prescription, the frequency of dispensing drugs from pharmacy(monthly or weekly), certifies this indication with his signature and personal seal, as well as the seal of the healthcare facility "For prescriptions".

3.3 The procedure for the dispensing of drugs carried out free of charge or at a discount

One of the main tasks of the state policy in the field of health care is the provision of drugs to the category of citizens who enjoy benefits in the field of drug provision.

Currently, 30 million people enjoy benefits. financing is carried out at the expense of the federal budget, the budgets of the constituent entities of the Russian Federation, local budgets and the funds of the compulsory medical insurance fund.

The following are eligible to receive free drugs:

Children under 3 years old;

People with disabilities, participants in the Second World War and persons equated to them;

Citizens exposed to radiation at nuclear facilities;

Heroes Soviet Union, Heroes of the Russian Federation, holders of the Order of Glory;

Heroes of Socialist Labor, full holders of the Order of Labor Glory;

Cancer patients, patients mental illness, diabetes, leprosy, etc.

All these categories of patients receive free of charge all medicines and medical products, which are annually approved by the authorities of the constituent entities of the Russian Federation. Also, the government has defined categories of diseases for which certain medicines are given free of charge. Such diseases include tuberculosis, syphilis, bronchial asthma, Parkinson's disease, myocardial infarction and others.

Some groups of the population receive medicines with a 50% discount. These include:

Pensioners receiving the minimum pension;

Working disabled people of the 2nd group and unemployed disabled people of the 3rd group;

Persons who took part in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant;

Citizens awarded with medals for selfless work during the Second World War;

Honorary donors of the Russian Federation and others.

For preferential provision a system for the distribution of medicines and control over the prescription of medicines is being created. Dispensing drugs on preferential and free prescriptions carried out from pharmacy organizations that have an agreement with territorial body health department.

In order to streamline the provision of drugs to the population and exercise control in some regions, other models of provision of decreed groups are being introduced. Drug needs are determined by the County Health Department in conjunction with authorized pharmaceutical firms that negotiate tariff agreements.

The term for providing preferential prescriptions from pharmacies is:

Within 1 day for preferential cito prescriptions;

No more than 3 days for medicines included in the List;

Within 5 days for preferential prescriptions, written out according to the conclusion of the KEK.

Prescriptions for medicines to be obtained from pharmacies free of charge or with a 50% discount are issued only for outpatient treatment by the attending physician of the polyclinic. Privileged prescriptions for medicines are issued in accordance with the standards and within the framework of the territorial formulary, with the exception of cases of prescription:

When one patient prescribes five or more medicines or more than ten medicines at one time within one month;

Narcotic drugs, psychotropic, potent and poisonous substances, anabolic hormones;

Medicines according to the analog substitution formulas in cases of an atypical course of the disease, in the presence of complications of the underlying disease or concomitant diseases, when prescribing dangerous combinations medicines, as well as in case of intolerance or absence of medicines included in the territorial formulary in the pharmacy;

Special drugs: immunomodulators, antineoplastic, antituberculosis, antidiabetic and other drugs that affect the activity of the endocrine system.

The right to independently write prescriptions for receiving at a pharmacy on preferential terms is reserved for doctors working in a polyclinic on a part-time basis, doctors of departmental polyclinics of federal subordination, dentists, private practitioners (working under an agreement with a territorial health authority) and in special cases concessional prescriptions can be prescribed by a paramedic or midwife.

Prescribing prescriptions for psychotropic, potent and toxic substances, anabolic hormones, immunomodulators, antidiabetic, anti-tuberculosis, drugs for patients who do not suffer from cancer / hematological disease, is carried out by the attending physician only by decision of the medical commission of the polyclinic or on the recommendation of a specialist doctor.

It is not allowed to prescribe preferential prescriptions by doctors of hospitals, as well as doctors of polyclinics during the period when patients are in inpatient treatment.

On one prescription form of the 148-1 / y-88 form, it is allowed to prescribe one name of medicinal products subject to quantitative accounting, for receipt on preferential terms. When filling out the form, you must emphasize the form of payment (free of charge or with a 50% discount on the cost). The prescription must indicate the phone number by which the pharmacist can agree with the attending physician to replace the drug, the cost of which is more than 30% higher than the cost of the prescribed drug. If the difference is more than 30%, the pharmacist has the right to independently replace the drug.

The patient who has received the drug on preferential terms is marked in the preferential leave accounting card.

Schedule II narcotic drugs and psychotropic substances must be prescribed preferential categories citizens on special prescription forms for a narcotic drug that have a stamp of a medical institution, a serial number and degree of protection, as well as in addition to a special prescription form a prescribed form, a prescription is written out on a form accounting form N 148-1 / y-04 (l) (Appendix 2).

The period of validity of a preferential prescription is up to 1 month, with the exception of prescriptions for narcotic drugs and psychotropic substances of list II - 5 days, for those containing psychotropic substances List III, potent, toxic substances, drugs: apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dicaine, silver nitrate, pachicarpine hydroiodide, other drugs subject to quantitative accounting, anabolic hormones - 10 days.

To attach a patient to a pharmacy at the place of residence to provide him with narcotic drugs, a written order of the head of a medical and prophylactic institution is drawn up, registered in the prescribed manner. Lists of cancer patients assigned to the pharmacy for the provision of narcotic drugs are updated monthly.


The maximum permissible number of medicines for prescription per prescription is given in Appendix No. 1 to the Instruction on the procedure for prescribing medicines and issuing prescriptions and invoices, approved by the order of the Ministry of Health and Social Development of the Russian Federation of 12.02.07. No. 110:

According to the same appendix of Order No. 110, "when prescribing narcotic drugs that are not provided for in this appendix, their maximum permissible amount for prescription in one prescription may be five times higher than the dose specified in the instructions for medical use of the prescribed drug."

The rules for taxing recipes and requirements of healthcare facilities are as follows:

After a pharmaceutical examination, the prescription is taxed, that is, the retail price of the prescription and the requirements are determined;

The retail price for extemporal dosage forms and intra-pharmaceutical stock consists of the following components:

From the cost of the original ingredients;

From the cost of pharmaceutical utensils;

From the tariff for the manufacture of a medicine.

Pharmacy like entity, independently develops tariffs for the manufacture and packaging of medicines, after which they are approved by the order for the pharmacy.

Tariffication is based on:

Standards for the time spent on individual operations for the manufacture, control, packaging and dispensing of extremporal forms and intra-pharmaceutical preparations, which were previously developed by VNIIF;

The cost of 1 minute of working time, calculated taking into account the average wage.

Examples of taxing extemporal recipes.

Rp. Sol. Natrii bromidi

MDS. 1 table. spoon 3 times a day after meals.

To prepare the solution, 6g is required. sodium bromide and 200 ml of water. First, the cost of the ingredients is determined:

The cost of 1 g of sodium bromide 0.21x 6 = 1.26

Purified water 0.00 x 0.2 l = 2.00

Add the cost of the bottle and the tariff to the cost of the ingredients.

Bottle 0.25 L 4-00

tariff 10-00

total 17-26

Rp. Acidi ascorbinici 0.1

Sachari albi 0.2

M., ut fiat pulvis

S. For 1 pore. 3 times a day for 30 minutes. before meals.

The cost of the ingredients is determined:

Ascorbic acid 2 g x 0.72 = 1.44

White sugar 4 g. X 0.05 = 0.2

2. Rate for 10 days. = 14.50

3. Rate for every subsequent 10 days.

0.5 x 10 = 5.00

Box price 1.00

Total - 22.14

workplace pharmacist prescription medicine


In order for any pharmacy organization to fulfill its main task - to provide the population with medicines, it is necessary:

To organize a pharmacist's workplace for receiving prescriptions and dispensing medicines, for which it is necessary to equip and equip workplaces in the prescription-production department;

A pharmacist who accepts prescriptions and dispenses medicines according to them must be guided by the laws of the Russian Federation, existing orders, regulatory documents, the ethical code of the pharmacist;

When accepting prescriptions, a pharmacy employee must follow the rules and procedure for accepting prescriptions, ensure that the prescriptions meet the forms established by the Ministry of Health of Russia;

Pharmacist - the technologist is obliged, when accepting prescriptions, to check the correctness of their registration, the presence, in addition to the name of the medicinal product, mandatory and additional details;

The pharmacist must check the recipe for the compatibility of ingredients, the highest single and daily doses of the drug, check the compliance of the amount of the prescribed drug with the established orders of the Ministry of Health of the Russian Federation of 12.02.2007 No. 110;

When dispensing medicinal products, the pharmacist is guided by the order of the Ministry of Health and Social Development of the Russian Federation dated February 12, 2007 No. 110, "Rules for the Dispensing of Medicines in Pharmacy Organizations", OST Standards 91500.05.0007-2003.


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Medicines approved for use in our country can be purchased at pharmacies and pharmacy kiosks. A significant number medicinal preparations sold over the counter. They are listed on special approved lists. You can get acquainted with them from the managers of pharmacies. The rest of the drugs are prescription-only. Prescription rights are reserved for medical practitioners only.

A recipe is a document. Its form and design must comply with the orders of the Ministry of Health.

The structure and design of recipes

The prescription must contain the following information: date of discharge, surname, initials and age of the patient, in some cases his home address or medical card number; surname and initials of the doctor who wrote the prescription; the name of the medicine, its amount and dosage form as well as the method of application.

The prescription must be issued with the stamp of the medical institution, the signature and personal seal of the doctor, and in some cases the additional seal of the medical institution and special inscriptions.

There are three forms of prescription forms for different groups medicines and different categories sick.

The validity of the prescription and the possibility of replacing drugs that are not available in pharmacies

It must be remembered that the prescription has a limited validity period: for most drugs - within 2 months, for certain groups, for example, poisonous drugs, sleeping pills, tranquilizers, ethanol and others - 10 days, narcotic drugs - 5 days. Certain medicines, such as eye drops for cataracts and glaucoma, are valid for 1 year.

When dispensing drugs on long-term prescriptions, the prescription is returned to the patient with an indication on the back of the amount of the dispensed drug and the date of dispensing. At the next visit of the patient to the pharmacy, a note about the previous receipt of the medicine is taken into account. Upon expiration of the validity period, the prescription is canceled with the stamp "Prescription invalid" and left at the pharmacy.

If the pharmacy does not have the necessary medicine, the pharmacy employee can replace it with the same medicine produced by another company, but under a different name, that is, a synonym. Replacement necessary medicine on a drug similar in action, that is, an analogue, can be carried out only after consulting a doctor, on the basis of a new prescription.

If the drug is temporarily unavailable at the pharmacy and it cannot be replaced with another, the patient can order the drug at the pharmacy. When the required medication is received, it can be obtained on the basis of a prescription in a first-order manner.

Narcotic drugs are dispensed only from pharmacies attached for these purposes to territorial medical and prophylactic institutions.

The pharmacy retains prescriptions for narcotic, poisonous substances, ethyl alcohol, sleeping pills, tranquilizers and some other drugs, as well as prescriptions for which drugs are dispensed on preferential terms or free of charge. Instead of a prescription, the patient is given a label, or the so-called signature, indicating the method of administration of the medicine. In addition, the pharmacy is left with incorrectly written prescriptions, which are canceled with the stamp "Prescription is invalid".

A prescription that does not meet at least one of the requirements of the orders of the Ministry of Health and contains incompatible medicinal substances is considered invalid. In this case, the Aztec worker must contact the doctor who wrote the prescription, clarify the name of the drug, its dosage, pharmacological compatibility, and then release the patient.

"You can't help letting go." Where to put the comma?

The problem indicated in the title of the article should be understood as follows, pharmacists are often left with a dilemma: leave without a prescription and help the patient or follow the rules and leave the person without medication. Every adult has bought medicine from a pharmacy at one time or another, and most of these customers have purchased medicines without a prescription. Prescription drugs were among them, of course.

Prescription and non-prescription drugs.

First of all, let's decide which drugs are prescription and which are non-prescription drugs. By definition, prescription medicinal products include all medicinal products that require a doctor's prescription and a prescription (document) confirming that it was you who were prescribed this drug in a strictly defined dose.
Such means can be both factory-made medicines and medicines prepared directly at the pharmacy. The main differences between prescription drugs and over-the-counter drugs are as follows:

  • They are always prescribed by a specialist doctor;
  • Much stronger than over-the-counter drugs
  • Designed for a specific person.

All others are called OTC drugs. medications... Their main advantage: over-the-counter, that is, the purchase without restrictions (except for certain categories of drugs). This is understandable, because basically these are drugs that are necessary in extreme cases, when you need quick help (sharpest pain, heat, allergic reactions). Their main difference from prescription drugs is the relative safety of administration, subject to the instructions for them.

It seems that everything is simple and clear, pharmacy workers should follow a clear algorithm: if there is a prescription, we dispense the drug, if there is no prescription, we issue it only without prescription drugs... But in our country (as well as in other CIS countries) there is a “tradition” to come to a pharmacy without a prescription. Many people manage to come without them, even if the prescription is written out.



According to surveys of pharmacy workers, about 60% of people ask to sell them drugs from the controlled list, without a prescription. There are many reasons.

  • Most people consider themselves to be quite literate and prescribe treatment and drugs for themselves. Advertising also plays a significant role in this. They think that the clinic will give them a prescription for this particular drug.
  • Doctors also do not adhere to the established rules and “write” prescriptions arbitrarily (on pieces of paper, on medicine boxes) and even prescribe the drug orally.
  • Likewise, chronic patients who have already received prescription drugs do not find it necessary to wear a prescription every time.

What should the pharmacists do in this case?

Almost 70% of pharmacists dispense prescription drugs without a prescription.They also have many reasons to dispense drugs without a prescription:

  • In the first place is the desire to help a sick person.
  • Out of habit (released until now), making a profit or increasing sales.
  • In the last place is personal benefit, when a pharmacist sells codeine-containing drugs, psychotropic substances.



What is the responsibility of pharmacists for dispensing drugs without a prescription?

Currently, for non-compliance with the rules for dispensing medicines, administrative liability is provided in the form of a fine for executive(pharmacist) in the amount of 4 to 5 thousand rubles; for a legal entity (pharmacy) - from 40 to 50 thousand rubles or the termination of the pharmacy for a certain period(up to three months). Recently, deputies submitted a bill to the State Duma, according to which fines for over-the-counter leave should be increased 10 times, that is, up to half a million rubles. The authors of this bill explain their position by the fact that pharmacies have multimillion-dollar profits precisely due to trade. drug-containing drugs no prescriptions. And these are thousands of deaths from poisoning with such substances. Dozens of such cases are considered in the courts every month.