Pharmacy of potent medicines. Poisonous and potent drugs

Among the extensive number medicinesused in modern medicine, there is a group of drugs, whose physiological effect on the body appears already at small and very small one-time doses. Such drugs are called poisonous and potent. Distinction between Yado-Vitami and potent means Mostly only quantitative: the first (usually applied in doses of the order of thousands and ten-thousand fractions of grams, and the potent - in the hundredths and tenths of grams.

What medicines are Yado-Vitami and which should be considered as potent - indicated in the pharmacopea. All poisonous drugs of the Sweanna in specialists, called the list A, are potent - in the list b, placed in the "introductory part" of the pharmacopoeia. On the adequacy of the drug tothis or a different list go lies, in addition, in pharmacopy articles in the heading "Store-Nie".

As the nomenclature changes are changed and the content of the lists A and B. in the GFH to the list A includes 116 items of poisonous drugs. Of the 116 items 26 POME-PERSON in the list with a sign D. This is the sign of narcotic and other substances, under-lying vacation from pharmacies according to special instructions Ministry of Health of the USSR.

List B includes 326 items.

The specified clauses are not covered by all actually meeting in the recipe poisonous and powerful substances. On the inside of the door of the cabinet, in which the Sylnode-General is stored medicinal substancesThere should be an inscription: "B Heroica". The inscriptions on the rods should be red on a white background with the highest one-time and daily doses. The wardrobe B after the end of the working day should be stored. Factory and potent drugs compared to the remaining trees will be especially cautious. In order to prevent accidents, as well as the abuses by the Ministry of Health and the USSR, special "Rules for storing, accounting and vacation of poisonous, drugs and potent drugs in household pharmacies" and "on pharmaceutical enterprises" are established.

The rules are pre-examined primarily the inlet of poisonous and potent drugs from all other. Under the conditions of the pharmacy, safes and special cabinets are highlighted for this purpose. Nar-quotic and especially poisonous means We must only be kept in this phax, while especially poisonous means (arsenic anhydride, sodium arsenate, strikhnina nitrate, mercury hydrochloride and mercury oxycianide) - in the internal, locked on the castle, the safe department. All other poisonous means of the list A are stored in a locking metallic cabinet. On the inside of the safe doors and this cabinet should be the inscription: "A. Venena ", and also attached a list of poisonous substances stored in a closet, indicating one-time and su-accurate doses. Inscriptions on rods with poisonous medicinal substances should be white color On a black background with a mandatory indication of the highest one-time and daily doses (Fig. 1).

In the closet, there must be manual scales, multiple, mortar, cylinders and crow, which required upon vacation or making drugs, which include poisonous substances. In the "Rules" refers to the fact that the washing and processing of listed items need to be necessary separately from other dishes under the supervision of pharmaceutical chief. The closet and should be constantly under the lock, and after the working day it is sealing or sealing. The keys to the cabinet, seal or print must be at the pharmacy manager or the person authorized by the order at the pharmacy. The cabinet and the pharmacy is, both in the separation of stocks and in the recipe-manufacturing department. The made medicines that include Yado-twisted substances, after checking, their recipe controller are sealed and stored before vacation in a separate locking locker.

Approved by Order No. 523 of July 3, 1968. In addition to the rules for pharmacies, similar rules for pharmacy warehouses, analytical la-borators, universities, medical and preventive and research institutions are simply approved.

In this regard, in the GFC (in notes to lists A and B) there is an indication that poisonous and potent drugs that are not placed in lists A and B, but those in pharmacies, store socially in the closet A (under the lock ) or in the closet b (with a presenter-stew, separate from other drugs).

Equally, the storage rules set for substances of lists A and B are applied to ready-made drugs (in tablets, ampoules, etc.) containing poisonous or potent things.

In the conditions of the manufacturing enterprise, they deal with large than in pharmacies, the amounts of poisonous and potent substances. In this regard, poisonous medicinal substances are stored in a specialty room with iron lattices on the windows and a piece of iron door. Narcotic and especially poisonous substances are stored in this room in a metal closet closet. For packaging, from the melting, hacking, measuring the poisonous substances in the storage room there should be special devices and dishes. The storage area for the substances of the list A is kept closed, and after the working day is sealing or sealing.

The keys to the repository, printing and seal must be at the person responsible for storing poisons. Access to the repository (for packaging and other production operations) have only persons who have received written permission from the head of the enterprise. Potent substances of the list b "a pharmaceutical manufacturing enterprises Stored also in special premises or cabinets separately from other medicinal substances. The keys to the repository (and cabinets) must be at the person responsible for the storage of this group of substances.

The doctrine of doses of medicinal substances

Certain amounts of medicinal substances administered to the organ-bottom are called doses (DOSES). Doses of medicinal substances are empty in grams or milliliters, and in recipes after a digit expressing the dose, the designation "G" or "ML" is not being done.

The lowest dose of medicinal substance capable of causing a head-macological reaction is called the minimum acting. Doses that cause a reaction leaving outside the norm physiological reactions and wearer pathological features are called toxic. The smallest dose causing a similar reaction is called minimal toxic. With a further increase in the dose, toxic phenomena may end with death; Such doses are called lethal. It is clear that only doses from the minimum to minimal toxic can be used in therapeutic practice.

Since minimum toxic doses cannot be installed on a person, there has been a need to determine the weighted nature of the highest doses, which are always lower (for the purposes of self-esteem) minimum toxic doses. Higher doses are entered into a pharmacope. Since medicinal substances can be assigned to one reception - Pro DOSI (such doses are called one-time) or for receiving during the day - Pro DIE (daily doses), then in pharmaco-treats are given both the highest one and the highest daily doses of poisonous and potent medicinal substances. The highest doses of medicinal substances are constantly specified and re-examined before each new pharmacopoeia edition. At present, in our country, they are guided by higher doses, lead-denna in GFC.

In their practical activities, doctors use doses in pre-cases between the minimum and higher; All doses in this range are called average therapeutic doses. Average therapeutic doses usually make up CHG - X Uhighest dose. The choice of an effective dose depends on the nature of the disease, the localization of the floor process, age and other reasons.

Production regulatory and technical documentation

All medicines are prepared according to the appropriate, approved in the prescribed manner, regulatory and technical documentation. For the drugs of individual destination, prescribed by pharmacies, such a regulatory document is a recipe, or drugs mass production - Industrial Regulations.

Recipe

The recipe (medical) is called a written order of the medical institution of the pharmacy about the preparation of medicine on certain recipes and the vacation of its patient, indicating the method of use. Medications can either prepare in a pharmacy according to individual recipes intended for this patient, or to be released in finished video In accordance with standard inapplication placed in a pharmacopoeum or other regulatory document. Propasses of the first ro-yes are called trunk - Formula Magistrates (from lat. Magister - Mentor, teacher, in this case - a doctor who has up to a writer). Property placed in Pharmacopoeia is called pharmacopoeia, or official, - Formulae Officinales (from Lat. Offisina - Drug Workshop, or Pharmacy).

Property placed in manuals are called Manual - Formulae Manuales. Recipes are drawn up long-founded in most countries latinwhich has become international in this area.

In that medical documentation, which is drawn up in each case of the disease, the recipe belongs to a special place. And it is entirely not clear, because the recipe is prepared and lesmains are released, designed to stop this disease. The compilation of each recipe requires a very serious and thoughtful relationship from a doctor, as a careless or incorrectly written recipe may cause difficulties and delay in the manufacture and leave of drugs, and with coarse, the mistakes missed by pharmacist errors is the cause of the unpleasant case. Completely fair is the warning of old clinicians, that "such a small piece of paper can be sent to the unfortunate three people: a patient, doctor and pharmacist."

Recipes prescription rules

The issue of proper prescription recipes is paid to us. Instenced the outdated rules of 1959 by order No. 1230 dated December 27, 1976, "On the procedure for writing recipes for outpatient patients and holidays on them, the Ministry of Health of the USSR was approved and entered into force on July 1, 1977:

1) the rules for writing recipes for drugs for outpatient patients;

2) forms of recipes for 4 groups of drugs, taking into account categories of patients, the degree of payment of the cost of drugs and drugs that are narcotic;

3) instructions on the procedure for storing prescription forms;

4) Drug leave rules from pharmacy institutions.

At the same time, this order approved the form of personal press of EKS-cha, which is issued by practitioners working in medical and preventive institutions and using the recipes.

The USSR Ministry of Health approved the following forms of recipes:

Form 1 - to leave drugs for the full cost to adults and children.

Form 2 - for vacation for free children up to a year and other categories of patients.

Form 3 - to leave drugs with disabilities Patriotic War and with payment 20%.

Form 4 - for vacation of narcotic drugs.

Blanks are printed by a typographic mode of 105x148 mm: forms 1-3 - on white paper, forms 4 - on paper pink colour. Forms 1-3 have graphs and text on the facial and back sides of the forms, form 4 is one-sided. On the front side of the blanks, all the main graphs of the recipe, and on the revolutions are: forms 1 - memorial dynamics, forms 2, 3 - instructions for encrypted the recipe form. Forms 2-3 provide filling copies of recipe forms that have the content of their facets.

The approved forms of prescription forms provide for the use of computational equipment for mechanization and autosatization of accounting and settlement operations for drug recipes released from pharmacies, as well as processing information contained in the recipes for assessing the rationality of pharmacotherapy and the perfect pharmaceutical technology. In this regard, compared with previously active (until 1977) forms of prescription blanks in the content of the front side of the forms included a number of special graphs for encrypting the necessary information.

The recipe must be written in ink parallers, with the mandatory fill in all the graph of the form. The correction to the recipe is not once solved; If errors are made, the recipe must be rewritten.

The names of drugs in recipes are written in Latin in the root case with capital letter And must be denoted by the n-menclature specified in the USSR GF, in order to avoid guesses and different interpretations of the written recipe. It is allowed to apply reductions, but only so that one name cannot be mixed with another. A number of accidents are registered, the cause of which were not-correct shortages of names when prescription prescriptions.

For example, it is difficult to understand that it is written in such a reduction in the names of drugs: NATR. sulf. In this case, it may be possible: Natrium Sulfurieum (sodium sulfate Na 2 SO 4), Natrium Sulfuratum (sodium sulfide Na 2 S), Natrium Sulfurosum (sodium sulfite Na 2 SO3). All these drugs have perfectly miscellaneous application: Sodium Sulfate (Glauberova Salt) is used as a laxative. Sodium sulfite is used as an antioxidant in the case of the preparation of some solutions for injection. Sodium sulfide is part of the Deputy Latory.

In each recipe, there should be exactly the dose and method of provese blood requirement (how many times a day it should be taken, kog-yes, i.e. before eating or after, on an empty stomach, etc.). It is forbidden to limit the general instructions: "As mentioned", "The method of consumption of isve-wall", "internal", etc. If the doctor needs to make an indication of the emergence of preparation of drug leave, he in the upper right corner of the recipe indicating "Cito" Soon, quickly or "Statim" - immediately, immediately. If there are several recipes with the designation "CITO", first of all, antidote, oxygen, etc. are taken.

We will analyze the structure of a correctly written recipe in shape 1 (Fig. 2). The recipe consists of the following sections and graph (on the facial I.side).

1. The name of the medical and prophylactic institution and its cipher (is usually printed by the typographical way, but you can use the stamp).

2. Age group Patient: Children or Adult. Unnecessary is overwhelmed.

3. Date of recipe statement (number, month, year).

4. Surname and patient initials - Nomen Aegroti (picking): For children and persons over 60 years old, their age is indicated. If the doctor himself prescribes the recipe itself is sick, it is indicated: Pro AUTORE or PRO ME (for the author, for me). In this case, the signature text may be abbreviated.

5. Surname and initials of the doctor - Nomen Medici (picking up). On the orders, the position and title of the person who issued a re-chart is also indicated.

6. Appeal of the doctor to the pharmacist (Invocatio). Written in Latin in the word "recipe" (take), designated abbreviated: "Rp.".

7. The composition of the medicine, the dosage is as follows - Designatio Materiarum, a list of medicinal substances, "cited in a certain intended. Initially, the main (poisonous, drug-source, potent) medicinal substance is Basis, then the mixture (or substances) contributing to the main substance in the manifestation of due therapeutic effect - Adjuvans, then indicate
There are substances that improve the taste and smell of medication - Corrigens, and the subframe is indicated by the forming substances that are medium or foundation for the distribution of the above substances - Stituens Vehiculum, Excipiens, Menstruum. Promotional and corrigar substances may not meet in all recipes.

8. Designation dosage form and related technologies - Subscriptio. This part of the recipe is formulated in different ways, depending on the type of dosage form and the installed Latin abbreviations.

9. The method of application, the order of admission and storage of medication - Signatura - is indicated in Russian or Russian and national language.

10. Signature and personal printing of the doctor.

On the facial side The form, to the left of sections 6-9, there are two gras (for a taxation of drug recipes), as well as an indication of the SRO-KE of the recipe - 10 days or 2 months (unnecessary strokes).

On the back side The recipe, in addition to the doctor's memo, there are: Counts: Medication Number of Individual Manufacturing, APTH-KI Stamp, the names of pharmacy workers (who accepted the recipe that prepared, who checked and released the medicine for this recipe).

Blank form 1 allows you to register two medicines. It is allowed to take advantage if both drugs contain simple or potent drugs. If the medication includes a poisonous or narcotic 1 drug, the doctor has the right to write down only one medicine.

The Special List is not included in the USSR Ministry of Health.

Recipe forms forms 2 and 3 are designed for free from launch of drugs with an outpatient patient. The number of such recipes from go-yes per year increases, which is quite natural for health care of the developed socialist state.

The structure of these forms is more complicated. In both forms of 10 ciphers, which are filled in accordance with the instructions printed on the back of the form. Only one le key is written on the form.

Recipes in forms 2 and 3 are discharged with a copy of the copy. And the recipe, and the copy is certified by the signature and printing of the doctor, as well as the preparation of therapeutic and prophylactic institution: "For recipes". Recipes are taxed and serve as a monetary document for settlements between pharmacies, medical institutions.

Memo doctor

Cipher treatment and prophylactic institution (printed by a typographic way or put a stamp);

The recipe is discharged in Latin, picking up, clear, ink or ballpoint pen, corrections are prohibited;

On the same form: one medicine containing a poisonous substance or two is simple and potent means;

Allowed only adopted by the rules abbreviations;

If necessary, several recipes are issued for treatment;

Solid and bulk substances - in fractions of grams (g) or g; Liquid - in milliliters;

Method of application, in Russian or Russian and local languages, for sure; It is forbidden to be limited to general instructions: "internal", "known", etc.

The signature of the doctor must be certified by his personal seal; -After vacation drug recipe remains in a pharmacy.

From the indicated instructions "Children", "adult" unnecessary cross

Form 4 is a form for writing the recipe for drug-C, containing a narcotic substance. This form serves a document-volume of special accounting with literals and ordinal numbersprinted by typographic way. Recipe for a narcotic drug to discharge a doctor who signed it; The recipe must also be signed by the chief physician of the medical and prophylactic institution or the head of the department, fastened to the personal seal of the doctor and round seal of the institution.

If a drug containing a narcotic drug must be released for free or on preferential conditions, it is written out on the blanks? Forms 2 or 3 and to each of them, except for the copy, it is applied to the Redept ^ discharged on the form form 4.,

Prescriptions for medicines; containing poisonous substances list A (and ethanol), Must be fastened to the seal of medical care ("for recipes") and the personal seal of the doctor.

The instruction on the procedure for storing prescription forms approved by the USSR Ministry of Health belongs to therapeutic and proflic institutions.

Rules of vacation drugs from pharmacies for recipes

The prescription medicine is prepared only once. If it is necessary to carry out a patient course of treatment, you are allowed to write several recipes per and the same medicine, taking into account the US-tanted period of their action.

When receiving a pharmacy recipe checks:

The correctness of the doctor's fill in the doctor of all graph and sections of the recipe form;

The compliance of the prescribed drugs and equivalent to them lets with the list of these funds in order No. 1230 (at-provisions I and II) and the correctness of the registration of the recipe;

The correctness of the recipe for the prescribed drugs, containing poisonous drugs of the list A, listed in Order No. 1230 (Annex I, §15);

The correctness of the recipe for drugs containing ethyl alcohol;

Correctness of the dosing of poisonous. And a potent drug and prescribed by a dose doctor, exceeding one-multiple reception (a doctor is obliged to write a dose of this substance in words and put an exclamation mark);

The absence of a violation of the maximum permissible for vacation in one recipe for the number of drugs given in the list of Order No. 1230 (Appendix I, § 20), except special occasions - for oncologic patients, special courseworthy and others;

Compatibility among the designated drugs in the prescribed dosage form.

The recipe, discharged with a violation of the approved rules or the content of incompatible drugs, is not accepted for the execution of the pharmacy and is an abolished by the "Recipe defense" stamp. All such recipes remain in the pharmacy and are recorded in a special journal, followed by a message about them to the head of the appropriate medical and prophylactic institution. Doctor who issued such a recipe or chief doctor The medical institution is obliged to ensure timely resumption of the recipe required for the patient.

In the case of prescribing a doctor in a poisonous, narcotic or strong-skitting substance in a dose that exceeds the highest one-time reception, without the appropriate registration of the pharmacy recipe, it is obliged to separate this drug only in half the dose, which is set as the highest one. A prescription for a medicine containing a poisonous drug is valid for no more than 10 days from the date of its issuing, to a drug containing a narcotic agent - only 5 days, recipes for all other means - wage 2 months. On the course specified period The recipe is considered invalid and APTH-COA cannot be accepted.

Recipes for all released medicines remain in the pharmacy. Patients instead of recipes upon vacation of exempto-made drugs containing poisonous and narcotic substances and ethyl alcohol, a signature with a yellow stripe is issued at the top and the inscription: "signature", and upon vacation of ready-made drugs, if necessary, a label with the designation of the method of drug use.

The recipes left at the pharmacy are saved:

a) for medicines, vacation-free for free or preference - for 3 years on a par with other primary financial documents;

b) for drugs containing poisonous, narcotic and potent substances, as well as et-lovy alcohol - within 1 year;

c) on all other medicines - for 1 month. After the storage time is expired, recipes are subject to destroying in the prescribed manner.

Thus, summing up all the above, the recipe is a document:

1) medical;

2) technological, more precisely regulatory, timing, one-time;

3) a cash basis for settlements with therapeutic institutions in the event of a vacation for free or on preferential terms; the basis for writing off the consumption of medicines as mate-rial values;

4) legal (responsibility for the wrongness of the discharge, manufacture and vacation drug from the pharmacy);

5) economic and statistical (the basis for summation and processing to improve the dosage system - Vania).

Rules of vacation drugsaccording to the requirements of therapeutic and preventive institutions

The requirements of medical and filahylactic institutions for medicines are written in Latin.

Requirements for poisonous and narcotic drugs, as well as ethyl alcohol, should be discharged on separate blank kats with stamp, printing and signature of the head of the institution or his deputy on therapeutic part. In the requirement, a department or the Cabinet of the Medical Institution must be specified, as well as the prescription of the drug (for injection, for external use, for use inside, eye drops, etc.); For alcohol, its concentration is indicated.

Powerful drugs are included in common requirements and are issued as usual in accordance with the approved requirements for issuing requirements.

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Theme of the issue on all topics Licensing pharmaceutical activity Licensing of medical activities Quality control and certification Pricing Taxation Organization of the work of pharmaceutical enterprises Organization of work of medical enterprises Employees of pharmaceutical enterprises Medical workers The turnover of narcotic, potent, poisonous, psychotropic substances turnover of dietary products of alcohol products

Important documents:

• Resolution of October 12, 2017 № 130 On the suspension of the retail trade of alcohol-containing non-food products, alcohol-containing food additives and flavors A.Yu.Popova
• Letter of October 24, 2017 № 3095 / 25-4 On additional explanations of the norms of the order of the Ministry of Health of Russia from 11.07.2017 N 403n Director of the Department of Medicinal Support and Regulation of Creating Medical Products of the Ministry of Health of Russia E.A. Maximkina
• Order of September 1, 2017 No. 585n On approval of the administrative regulations of the execution by the Federal Service for Supervision of Health of the State Function on the Implementation of Licensed Control of Pharmaceutical Activities Minister V.I.Skvortsova

Recent questions:

Question: In stock wholesale drugs, several dozen sensors are installed in medicines. temperature modewhich every minute fix the temperature with humidity and make information into an electronic database. During the inspection, the controls require themselves to give them information on the temperature regime on paper carriers for certain period. In the current situation, this will lead to multi-volume costs of paper and time. Tell me how to properly provide the temperature report to the controlling authorities? Is there a practice how to properly do in such situations? Are there any requirements for the number of temperature measurements on pharmaceutical warehouses?

Answer "

• Question: Recepture drug Not included in PKU lists. Disposable to prescription Blanco № 107. One package is written. The duration of the recipe for two months. Patient must redeem this one packing within two months? Or within two months, he buys the drug, i.e. Not one package. Those. Recipe action (in this case two months) is the period for which the patient redeems the medicine or does it buy one package every month?

  The question relates to the topic:

  Licensing of pharmaceutical activities (total 3101 Answer (s))
  Organization of the work of pharmaceutical enterprises (total 4643 response (s))
  Answer "

• Question: In accordance with paragraph 15 of the Rules approved by the Order of the Ministry of Health of the Russian Federation of July 11, 2017, N 403N, recipes issued in violation of the established rules are recorded in the journal in which the identified violations are indicated, full name medical workerwriting a recipe, name medical organization, taken measures, A stamp "Recipe is invalid" is noted and returned to the face that submitted the recipe. On the facts of violation of the rules for registration of recipes, the retail trade subject informs the head of the relevant medical organization. BUT drug Treatment Is this recipe released? Patients are not to blame for the mistakes of doctors!

  The question relates to the topic.

All drugs, depending on pharmacological activity, were allocated in three groups: poisonous, potent and non-agitative. Such a separation is important to prevent the danger of overdose in the process of preparation of drugs and their use. In general, the concept of toxicity of drugs relatively. Many unsalted drugs during overdose may be poisonous.

Poisonous drugs (Venena.) - These are funds, appointment, application, dosing and storage of which due to high toxicity should be made with extreme caution. These include drugs causing drug addiction - narcotic drugs,which are approved by special authorities.

Pilot drugs (Heroica.) - These are funds, appointment, application, dosing and storage of which should be made by precaution.

The difference between poisonous and potent means mostly only quantitative: poisonous substances usually apply in doses of the order of thousandth and ten-thousand shares of grams, and potent - in the hundredths and tenths of grams.

The drug belonging to the list of potent or poisonous substances is determined by the State Pharmacological Center for Medicines. The content of these lists varies depending on the change in the nomenclature of drugs. For example, in the GF X in the "introductory part" lists of the poisonous (list A) and the potent (List b) substances are placed. The list B includes 326 drug items, to the list A - 116. By order of the Ministry of Health of Ukraine No. 233 of July 25, 1997, six listings of drugs registered in Ukraine, including lists of potent, toxic, narcotic and psychotropic drugs, were approved Parats 1.

1 In the textbook, the designation of potent and poisonous substances adopted by GF X is given: List B and List A.

Storage, accounting and vacation of poisonous, narcotic and potent drugs in pharmacies is carried out in compliance with the rules established by the orders of the Ministry of Health of Ukraine.

Rules for the storage of poisonous and potent substances.

Poisonous drugs must be stored isolated, in specially allocated metal cabinets for this purpose under the lock. On the inside of the door of the safe and the cabinet should be inscription Venena. with the list of stored substances, their one-time and daily doses.

Particularly poisonous drugs - arsenic anhydride, sodium arsenate crystalline, strikhnina nitrate, mercury dichloride (SUMMA), mercury cyanide and oxycianide - should be stored only in the internal, locked on the castle, the safe department.

In the cabinet for poisonous substances should be manual scales, variations, weights, mortars, cylinders, funnels that are needed for the preparation of drugs. On such a dishes make marking: "For atropine", "for sublifting", etc. They wash and processed these items separately from the rest of the dishes under the supervision of the pharmacist.

Powerful drugs, as well as lipis pencils, should be stored in separate cabinets. On the inside of the door should be inscription « Heroica.» and a list of potent substances indicating the highest one-time and daily doses.

Inscriptions on rods, in which poisonous medicinal substances are stored, should be white on a black background, and on rods containing potent drugs - red on a white background, in both cases the highest and daily doses must be indicated on the sac . On rods with conventional inscription medicines make black color on a white background.

During the working hours, the key to the cabinet "for poisonous substances", located in the assistant room, should be at the provisor-technologist. Safes and cabinets after the end of the working day are sealing or segged, and the keys to them, printing or seal must be from the pharmacy manager or in persons who are authorized by order at a pharmacy. Cabinets "For potent substances" after the end of the working day should be shoved. Materials in which narcotic and especially poisonous drugs are stored must have light and sound alarms. The windows must be lattice. After the end of the work, these rooms are locked and sealed.

Rules for writing poisonous and potent substances.To write down narcotic drugs in pure form or in the mixture with the indifferent substances (on the list, approved by the Ministry of Health of Ukraine), the F-3 form is provided. Poisonous and potent substances, including ethyl alcohol, are written out on the F-1 prescription form.

Narcotic and infant drugs in pure form or with indifferent substances are allowed to write out only doctors who work in public health facilities.

The names of the poisonous (the list of which is approved by the Ministry of Health of Ukraine) and the narcotic drugs are written at the beginning of the recipe, then - all other medicines.

Recipe for Form No. 3 is additionally signed by the head of the health institution or its deputy for medical part and is assigned to the seal of health institutions (coat of arms). Recipes for dosage forms containing poisonous substances, and ethyl alcohol must be fastened with the seal of a medical institution "for recipes" and personal seal of a doctor.

Identifying poisonous or potent drugs in doses exceeding the highest one-time dose, the doctor is obliged to write a dose of this means in words and deliver an exclamation mark.

Rules of vacation drugs containing poisonous drugs.Taking a prescription for a drug containing a poisonous substance, the pharmacist must show special care and accuracy: it is necessary to specify the age of the patient, check the correctness of the dosing, compatibility of the ingredients registered and emphasize the red pencil the name of the poisonous means. In the preparation of drugs, a toxic substance is having a provisional technologist in the presence of a pharmacist. The poisonous drug obtained by the pharmacist is immediately used to prepare a drug. It is forbidden to let you go to the recipe, narcotic and potent drugs not in the composition of the prepared dosage form.

In the case of prescribing a poisonous, narcotic or potent drug in a dose that exceeds the highest one-time dose without appropriate recipe design, the pharmaceutical worker must release the discharged drug in the amount of 50% of the dose installed as the highest one.

Narcotic drugs that are discharged on special recipes F-3 are released only from a pharmacy attached to these purposes to territorial treatment and preventive institutions.

Ethylmorphine hydrochloride, codeine, codeine phosphate, sodium etame, Barbamil in a mixture with other drugs are released by pharmacies within the city or rural administrative district on the recipes of therapeutic and preventive institutions that are posted on their territory.

On vacation of exempturally prepared medicines containing poisonous, narcotic substances and ethyl alcohol, a signature is issued for a patient instead of the recipe (Fig. 5).

Recipes for released drugs are stored in pharmacies, without considering this year, throughout:

In five years - on narcotic drugs issued on special recipe forms F-3;

Surname, initials of the doctor

Coke

Checked

Let go

Date price

For repeated medication, a new doctor's recipe is required

Fig. five.Sample signature

In three years - for medicines released for free or on preferential terms;

In one year - on drugs to be subject to subject and quantitative accounting (with the exception of narcotic), anabolic steroids;

One month is on the rest of the drugs.

At the end of the storage period, all recipes are to be destroyed in the prescribed manner.

Cooked medicines containing poisonous means are sealed by a person who checked the medicine (or shackled "under running").

Vials in which mercury solutions dichloride (sunels), cyanide and oxycianide are vacuized, are made to the "poison" labels with the image of crossed bones and skulls, "Careful Care", and the name of a poisonous drug in Russian (or local) and the concentration of the solution.

The solution of mercury of dichloride (sulea), designed for disinfection, is stained with eosin or fuchsin; On the signature or label should be indicated than the solution is tinted.

On the package of other drug preparations prepared in the pharmacy containing poisonous means, as well as phenol in pure form, or on solutions with a concentration above 5%, strong acids, perhydrails and other similar funds, A label "Handle Care" should be placed.

All prepared drugs containing poisonous substances are stored before vacation in a separate locking cabinet.