1. Vacation rules medicines from pharmacies and enterprises (hereinafter - the Rules) determine the procedure for dispensing medicines from pharmacies and enterprises (hereinafter - pharmacies).

All medicines, with the exception of those permitted by the Ministry of Health of the Republic of Belarus for dispensing without a doctor's prescription, must be dispensed from pharmacies according to prescriptions of established forms, issued in accordance with the Rules for Prescribing Medicines.

2. If poisonous, narcotic and potent drugs are prescribed in a prescription mixed with other ingredients, then it is forbidden to dispense them not as part of a manufactured medicine.

3. If a doctor prescribes a poisonous, narcotic or potent drug in a dose exceeding the highest single dose without an appropriate prescription, the pharmacist (pharmacist) of the pharmacy is obliged to dispense this drug in half of the dose that is set as the highest single dose.

4. Narcotic medicines are dispensed from pharmacies according to prescriptions of territorial healthcare institutions attached to these pharmacies.

The list of health care institutions and pharmacies is determined by a joint order of the health authorities and the unitary enterprises "Pharmacy".

Pharmacies dispensing narcotic drugs on prescription should be provided with sample prints of seals, stamps, sample signatures of doctors prescribing narcotic drugs.

5. Psychotropic drugs, including combined ones, subject to subject-quantitative accounting, and ethyl alcohol are dispensed by all pharmacies within the city and districts of the region according to prescriptions from medical institutions located on their territory.

6. Cancer patients are assigned to pharmacies to receive narcotic drugs by written order of the head of the medical institution. Lists of patients are compiled by the medical institution annually as of the beginning of the year and are changed as necessary by separate written orders of the medical institution, certified by the signature of the head of the institution.

7. Disabled people and participants of the Great Patriotic War and persons equated to them in terms of benefits, dispensing medicines for free recipes, prescribed by doctors of medical institutions, is produced in any state pharmacy of the Republic of Belarus (regardless of the place where the prescription is issued), with the exception of narcotic drugs, psychotropic drugs, including combined ones, subject to subject-quantitative accounting, and ethyl alcohol.

8. Medicines listed in Appendix 7 to the Rules for Prescribing Medicines are dispensed from pharmacies in quantities not exceeding the allowable limits for one prescription.

It is allowed to increase the rate of one-time prescription medicines in the cases specified in paragraphs 31, 32, 33 of the Rules for Prescribing Medicines.

9. Controlled psychotropic medicinal products, for which the norms of one-time dispensing under one prescription are not established, are dispensed from pharmacies in quantities not exceeding a course of treatment for up to 1 month.

10. Dispensing of finished medicines containing codeine (pentalgin, solpadeine, spasmoveralgin and others), with the exception of medicines specified in Appendix 7 to the Rules for prescribing prescriptions for medicines, is carried out according to prescriptions from doctors in compliance with the one-time dispensing rate of not more than 0.2 codeine.

11. The release of medicines containing ephedrine hydrochloride is carried out according to the prescriptions of doctors within the norm of a one-time release (0.6) of ephedrine hydrochloride. An increase in the rate of one-time dispensing of medicines containing ephedrine hydrochloride is allowed in accordance with the conditions specified in paragraph 31 of the Rules for Prescribing Medicines.

12. When dispensing a medicinal product, including according to free and subsidized prescriptions, it is allowed to violate the original factory packaging, with the exception of the contour cell (blister) and contour non-cell packages, with the obligatory indication by the pharmacist (pharmacist) of the pharmacy number, name of the medicinal product, dosage, manufacturer, series and expiration date of the drug on the pharmacy packaging. The total amount of the dispensed medicinal product must correspond to the amount prescribed in the prescription, taking into account the dosage.

13. For external purposes, solutions of phenol, concentrated acids, perhydrol can be dispensed at a concentration prescribed by a doctor, with a mandatory indication on the prescription (requirement) in words of concentration and method of application. The label must be affixed to the packaging: "Handle with care".

14. Release from pharmacies of ethyl alcohol in pure form produced in weight measurement, and in a mixture with other ingredients - in volume.

15. pharmaceutical worker with the consent of the patient, in the absence of a medicinal product written out in prescriptions on a prescription form 1 for prescribing medicines dispensed from a pharmacy at full cost, and a prescription form 3 for prescribing and dispensing medicines free of charge or on preferential terms, to make a replacement for its synonym.

16. Dispensing of medicines to the population on preferential terms and free of charge is carried out only from state pharmacies and enterprises upon presentation to patients of a document confirming this right. Children under 3 years of age and categories of patients who, during outpatient treatment, medicines are dispensed free of charge according to the list of diseases approved by the Ministry of Health of the Republic of Belarus, do not need to present documents.

17. When dispensing medicinal products, the price, the number of dispensed packages, tablets (capsules, dragees, ampoules, and so on) must be indicated on the prescription.

The prescription spine contains the amount payable by the medical institution, the surname, initials and signature of the dispenser, the surname, initials and signature of the recipient of the medicine. Spine with filled in it necessary details sent with an invoice for payment to a medical institution.

18. When dispensing medicinal products, prescriptions for which remain in the pharmacy, instead of a prescription, patients are issued a signature with a yellow stripe or a label indicating the method of using the medicinal product. The signature form is given in Appendix 1.

19. It is prohibited to dispense to outpatients narcotic drugs for injection, anesthetic ether, chlorethyl, ketamine (calypsol, ketalar), halothane, sodium hydroxybutyrate in ampoules, lithium hydroxybutyrate in ampoules, barium sulfate for fluoroscopy.

expiration of the prescription;

incorrectly written and executed prescriptions.

All incorrectly written prescriptions are canceled with the "Invalid prescription" stamp and information about them is transferred to the heads of medical institutions for taking action against employees who violate the Rules for Prescribing Medicines.

21. Prescriptions for medicines remain in the pharmacy and are kept for deadlines according to appendix 2.

The roots of prescription forms of Form 3, received from pharmacy organizations, are stored in a medical institution in the manner prescribed by law.

22. After the expiration of the storage period, prescriptions are destroyed by a commission created by order of the head of the pharmacy, which includes at least 3 people, with the drawing up of an act in one copy, which is stored for 1 year, not counting the current one. The act indicates the pharmacological group of medicines, for what period the destruction is carried out and the date of destruction.

23. Packages in which medicines containing poisonous and narcotic medicines manufactured in pharmacies are dispensed are issued with an additional label "Handle with care", sealed by the person who tested the medicine, or sealed for running. They should be stored until vacation in a separate lockable cabinet.

24. Medicines listed in Appendix 3 are subject to special subject-quantitative accounting in pharmacies, pharmacy warehouses and healthcare facilities.

25. Payment for the cost of medicines dispensed by a pharmacy institution (enterprise) free of charge or on preferential terms according to the prescriptions of doctors of state medical institutions is made at the expense of the budgetary allocations of the healthcare institution that issued the Form 3 prescription.

Attachment 1
to the Vacation Rules
medicines from
pharmacies and enterprises

(from day 14 to day 23) Storage of finished medicinal products by pharmaceutical groups:

Scheme of storage cabinets for storage of finished medicinal products indicating the pharmacological group (Appendix No. 5)

Compliance of the form with the prescribed prescription

Making a prescription

Prescription expiration date

Make an issuance decision medicinal product on this recipe, indicate the reason for the refusal

* copies of recipes (if possible, the original) to attach to the diary (Appendix No. 6)

Storage of finished drugs by pharmaceutical groups. By pharmacological action LS are divided into the following drugs:

Antispasmodics - relieve spasms of smooth muscles internal organs and eliminate spasms of blood vessels;

Analgesics - medicinal substances of natural, semi-synthetic and synthetic origin, intended for the removal pain;

Antiallergic - medicinal substances that reduce the signs of allergies;

Anti-cold - used for coughs and colds;

Antifungal - designed to treat fungal diseases;

Cardiovascular - used to treat heart failure and disorders of vascular tone;

Hypotensive - cause a decrease in arterial blood pressure, used in the treatment of hypertension.

Compliance of the form with the prescribed prescription. When receiving prescriptions and dispensing drugs according to them, a certain algorithm of actions must be followed. The first step is to check the conformity of the form prescription form medicinal prescription, mandatory and additional details. Exist the following forms prescription forms:

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

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

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

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

5) Form No. 148 -1 / y - 06 (l) "Recipe".

The form "Special prescription form for a narcotic drug and psychotropic substance" is made on paper Pink colour watermarked and has a serial number.

On this form, write drugs and psychotropic substances. The prescription fully indicates the surname, first name and patronymic of the patient, the case history number, or the number of the patient's medical record, or the history of the development of the child, the history of the disease. The surname, name and patronymic of the doctor are indicated in full. The prescription is signed by the doctor who wrote out this prescription, after which it is certified by the personal seal of the doctor. Additionally certified by the round seal of the health facility and signed by the chief physician or his deputy.

On one form it is allowed to write out only one name of the drug, while corrections are not allowed. The recipe stays pharmacy organization for subject-quantitative accounting. The prescription is valid for 5 days from the date of issue.

Form No. 148 -1 / y-88 "Prescription Form" has a series and number. On this form, psychotropic substances are prescribed, as well as other drugs that are on the subject-quantitative account and anabolic steroids. The prescription is signed by the doctor and certified by his personal seal and additionally certified by the seal of the medical institution "For prescriptions".

On one form, you can write out only one name of the drug, and with reverse side prescription, a note is made about who prepared, tested and dispensed the drug. The prescription remains in the pharmacy organization for subject-quantitative accounting. Validity - 10 days.

Form No. 107 -1 / y "Prescription form". All drugs are prescribed on this form, with the exception of those prescribed on the form No. 148 -1 / y - 88 and 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. On one form, no more than 3 names of drugs are prescribed, while corrections are not allowed. Validity - 10 days, 2 months, 1 year. The expiration date is indicated by a strikethrough. Prescriptions for all other medicines are valid for 2 months from the date of issue.

Form No. 148 -1 / y -04 "Recipe" and Form No. 148 -1 / y-06 "Recipe" are intended for prescribing drugs on preferential terms (free of charge or at a discount). Form No. 148 -1/-06 is drawn up using computer technology. On these forms, drugs are prescribed, products medical purpose and specialized products medical nutrition for disabled children. The 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. Validity - 1 month from the date of issue, with the exception of medicines that are on the subject-quantitative account.

When dispensing a medicinal product in a pharmacy, on the prescription form, information on actually dispensed medicines is indicated, and the date of issue is indicated. This prescription form has a tear line separating the form and the spine that is given to the patient. At the same time, a mark is made on the spine about the name of the drug, dosage, quantity, method of application.

When dispensing prescription drugs, the pharmacist must observe the following rules.

If the prescription contains narcotic drugs, psychotropic, potent, toxic substances, apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dicaine, silver nitrate, pachycarpine hydroiodide, anabolic hormones, mixed with other ingredients, it is forbidden to release them not as part of the manufactured medicinal product;

If the doctor prescribes the drugs listed above in a dose exceeding the highest single dose, the pharmacy worker is obliged to dispense this drug in half of the dose that is set as the highest single dose;

Pharmacy establishments are prohibited from dispensing the above listed funds under the prescriptions of veterinary medical organizations for the treatment of animals;

When dispensing extemporaneously manufactured medicinal products containing narcotic drugs, psychotropic, potent, poisonous substances, as well as apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dikain, silver nitart, pachycarpine hydroiodide, ethanol, instead of a prescription, patients are given a signature with a yellow stripe in the upper part and an inscription in black on it "Signature";

When dispensing ready-made medicinal products manufactured in pharmacies, the method of application is indicated on the label;

In the manufacture of extemporaneous medicinal products containing narcotic drugs, psychotropic, potent and toxic substances, according to the prescriptions of a doctor and the requirements of medical institutions, the pharmacist of the pharmacy is obliged to sign on the reverse side of the prescription or request for issuance, and the pharmacist of the pharmacy - in obtaining the required amount of narcotic drugs, psychotropic, potent and poisonous substances;

When medicines are dispensed under long-acting prescriptions, the prescription is returned to the patient with an indication of the amount of the dispensed drug and the date of issue on the back. At the next visit of the patient to the pharmacy, notes on the previous receipt of the drug are taken into account. Upon expiration of the prescription, the prescription is canceled with the stamp “Prescription invalid” and left at the pharmacy;

Prescriptions for drugs with anabolic activity, including steroid hormones, tranquilizers, antidepressants, neuroleptics, drugs containing 8-hydroxyquinoline derivatives, antihistamines are canceled with a stamp: “The drug is dispensed”;

When prescribing prescriptions for finished drugs to chronically ill patients, it is allowed to set the validity period of the prescription up to one year. The doctor must make a note “Chronic patient”, indicate the validity period of the prescription and the frequency of dispensing medicines from the pharmacy (weekly, monthly, etc.), certify this indication with his signature and personal seal, as well as the seal of the medical institution “For recipes."

A prescription that does not meet at least one of the listed requirements or contains incompatible medicinal substances is considered invalid, and the pharmacy worker has the right to refuse to issue drugs.

Registration of documentation for subject-quantitative accounting:

A copy of one selective list of medicinal products subject to PKU (Appendix No. 7)

Subject-quantitative accounting- documented operational accounting of the movement of goods for individual assortment items in natural meters. Narcotic and psychotropic drugs are subject to quantitative accounting; precursors; drugs included in the list of potent substances; drugs included in the list of toxic substances; substances of apomorphine hydrochloride, atropine sulfate, dicaine, homatropine hydrobromyl, sodium silver, pachycarpine hydroidide; ethanol. PKU medicines are kept in the Book of Accounting for Narcotic and Other Medicines, numbered, laced, sealed and certified by the signature and seal of the head of the territorial management body of pharmaceutical organizations.

The book runs for one year. The first page indicates the drugs subject to PKU. For each dosage form, dosage, packaging of medicinal product a separate sheet is assigned. It shows the units of accounting, income (for each receipt document separately, indicating the number and date), expense (daily entries) for each of its types. Corrections are crossed out and certified by the signature of the financially responsible person. On the first day of each month, the availability of medicines subject to PKU is checked against the balance in the Book of Accounts. Until the inventory is carried out, the book balance will be the opening balance. According to the finished LP, these residues should match. In case of discrepancy, the perpetrators are identified. In the event of a discrepancy between the book balance and the actual presence of drugs and ethyl alcohol, natural loss is calculated.

When carrying out any operation, as a result of which the number and condition of drugs subject to PKU are changed, these drugs are registered in the Book of Accounts by financially responsible persons. The specified Book is stored after the last entry is made in it in accordance with the established rules of state archiving.

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ORDER of the Ministry of Health of the Russian Federation dated 23-08-99 328 ON THE RATIONAL PURPOSE OF MEDICINES, RULES FOR PRESCRIBING THEM AND ... Relevant in 2018

PROCEDURE FOR DISPENSING OF MEDICINES IN PHARMACY INSTITUTIONS / ORGANIZATIONS

1. All medicines, with the exception of those named in the List of medicines dispensed without a doctor's prescription, approved by the Ministry of Health of Russia, must be dispensed in pharmacies / organizations only according to prescriptions of established forms (Appendix 2 of this Order).

The sale of medicines to the patient can also be carried out through the pharmacy at the feldsher - obstetric station by the head of this FAP.

2. If the prescription contains: narcotic drugs, psychotropic, potent, toxic substances, drugs: apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dikain, silver nitrate, pachycarpine hydroiodide, anabolic hormones, mixed with other ingredients, then they are prohibited release not as part of the manufactured medicinal product.

3. If a doctor prescribes medicines listed in paragraph 2 of this Procedure in a dose exceeding the highest single dose without a prescription in accordance with paragraph 2.10 of the Instructions on the procedure for prescribing medicines and the rules for writing prescriptions for them (Appendix 1), a pharmacy worker is obliged to release this drug in half of the dose, which is set as the highest single dose.

4. Only pharmacies / organizations that have received the appropriate licenses have the right to work with narcotic drugs and psychotropic substances.

The release of narcotic drugs and psychotropic substances of list II to patients in a pharmacy institution / organization is carried out in accordance with the outpatient clinic attached to it. Attachment of a medical and preventive institution to a pharmacy is established territorial authority management of health care and pharmaceutical organizations and the internal affairs body.

The right to work with potent and toxic substances is established by the license of the pharmacy institution / organization for pharmaceutical activity. Wholesalers of medicines need an additional opinion of the Standing Committee on Narcotics Control)

5. Pharmacy establishments are prohibited from dispensing narcotic drugs, psychotropic, potent, toxic substances, as well as medicines: apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dikain, silver nitrate, pachycarpine hydroiodide and anabolic hormones according to the prescriptions of veterinary medical organizations for the treatment of animals.

Pharmacy institutions are allowed to dispense narcotic drugs and psychotropic substances only on prescriptions of medical and preventive institutions located in the same locality, unless otherwise established by the executive authority of the constituent entity of the Russian Federation.

6. Prescriptions for medicinal products containing narcotic drugs, list II psychotropic substances are valid for 5 days, containing psychotropic substances List III, potent, toxic substances, drugs: apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dicain, silver nitrate, pachycarpine hydroiodide, anabolic hormones, valid for 10 days, the rest for 2 months from the date of issue of the prescription and up to 1 year in accordance with clause 2.19 of the Instructions on the procedure for prescribing medicines and the rules for writing prescriptions for them.

7. Dispensing in pharmacies / organizations of medicines listed in paragraphs. 2.11 and 2.12 of the Instructions on the procedure for prescribing medicines and the rules for writing prescriptions for them, is produced in quantities not exceeding the maximum allowable norms for 1 prescription established by paragraphs 2.11 and 2.12 of the above Instructions. The remaining drugs are dispensed from pharmacies in the quantities indicated in the prescription.

If necessary, it is allowed to violate the original factory packaging, with the exception of the blister, with the obligatory indication of the series and expiration date of the drug on the pharmacy packaging.

8. Ethyl alcohol is dispensed to outpatients according to doctors' prescriptions:

In its pure form - up to 50 gr. according to prescriptions with the inscription "For applying compresses" (indicating the necessary dilution) or "For treating the skin";

In a mixture with other ingredients in the individual manufacture of medicines - no more than 50 gr.;

Patients with a chronic course of the disease - up to 100 gr. prescriptions labeled "By special purpose", separately sealed by the doctor's signature and the seal of the medical and preventive institution "For prescriptions".

9. When selling extemporaneously manufactured drugs containing narcotic drugs, psychotropic, potent, toxic substances, as well as drugs: apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dikain, silver nitrate, pachycarpine hydroiodide, ethyl alcohol, patients are issued a signature instead of a prescription with a yellow stripe in the upper part and the inscription in black on it "Signature" (Appendix to this Procedure).

When dispensing finished pharmaceutical products, the method of application (if necessary) is indicated on the label.

10. When dispensing medicinal products under long-acting prescriptions, the prescription is returned to the patient with an indication of the amount of the dispensed drug and the date of dispensing on the back.

At the next visit of the patient to the pharmacy institution / organization, notes on the previous receipt of the drug are taken into account.

After the expiration date, the prescription is canceled with the stamp "Prescription invalid" and left at the pharmacy.

11. In exceptional cases (the departure of the patient out of town, the inability to regularly visit the pharmacy, etc.), pharmacy workers are allowed to produce one-time leave a drug prescribed by a doctor according to long-acting prescriptions in the amounts necessary for treatment within 2 months (with the exception of narcotic drugs and psychotropic substances).

12. In the absence of a prescribed medicinal product in a pharmacy / organization, a pharmacy worker can perform its synonymous replacement with the consent of the patient.

13. Prescriptions for medicines issued on forms N 148-1 / y-88, and for ethyl alcohol on forms N 107 / y remain in the pharmacy. Prescriptions are stored in a safe or metal cabinets.

The shelf life of prescriptions is:

For drugs dispensed on preferential terms - 5 years;

For narcotic drugs and psychotropic substances - 5 years;

For potent, toxic substances of the PKKN lists, drugs: apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dikain, silver nitrate, pachycarpine hydroiodide, ethyl alcohol, anabolic hormones - within 1 year.

After the expiration of the storage period, prescriptions are subject to destruction on a commission basis, about which an act is drawn up. The procedure for the destruction of prescriptions left in the pharmacy after the expiration of the established storage period is determined by the territorial management bodies of pharmaceutical organizations.

14. Pharmacy establishments / organizations are prohibited from accepting individuals medicines they have previously purchased.

15. Prescriptions for drugs with anabolic activity, including steroid hormones, tranquilizers (not included in the list of potent substances), antidepressants, neuroleptics, drugs containing 8-hydroxyquinoline derivatives, antihistamines are canceled with a stamp: "The drug is dispensed" .

For re-vacation, you must write new recipe.

16. Dispensing of medicines under free and subsidized prescriptions is carried out from pharmacies / organizations that have an agreement with the territorial health authority on reimbursement of expenses for subsidized drug supply of the population, and in cases where the funds of compulsory health insurance- also an agreement with the Territorial Compulsory Medical Insurance Fund on financing preferential distribution of medicines to the population.

17. Mandatory dispensing of medicines under free and subsidized prescriptions is carried out in accordance with the minimum range of medicines necessary to provide medical care approved for pharmacy institutions / organizations by the health management authority and pharmaceutical organizations of the subject of the Russian Federation.

18. An employee of a pharmacy institution / organization can independently carry out a synonymous replacement of a medicinal product prescribed on preferential terms in case of its absence, if the difference in the cost of the prescribed and available medicinal product is less than 30%.

A synonymous replacement of a medicinal product, the cost of which exceeds the cost of the prescribed medicinal product by more than 30%, can be carried out only in agreement with medical worker, who wrote out the prescription, or the CEC of this outpatient - polyclinic institution.

Pharmacy workers must inform at least once a month the management of the medical and preventive institution in which the preferential prescription was issued about the case of a synonymous replacement of the drug.

19. In the absence of a medicine prescribed by a doctor on preferential terms, and it is impossible to make its synonymous replacement in the manner specified in clause 17 of this Procedure, patients (disabled people and war veterans, citizens over 80 years old, citizens with limited mobility, etc. .) are taken for service by a pharmacy institution / organization (notification by phone or postcard about the receipt of a drug in a pharmacy).

20. A patient who has received a medicinal product on preferential terms is marked in the registration card for the preferential supply of medicinal products (Appendix 6).

Appendix
to the Vacation Rules
medicines from
pharmacy institutions / organizations