General rules for the storage of medicinal substances. Medical and pharmaceutical merchandising

The order of storage of medicines and products medical purpose regulated by the Order of the Ministry of Health of the Russian Federation dated November 13, 1996 No. 377.

Compliance with the approved Instructions allows you to ensure the preservation High Quality medicines and create safe conditions labor of pharmacists when working with them.

Particular attention is paid to the storage, prescribing, recording and dispensing of poisonous and narcotic drugs.

Proper storage of medicines is based on the correct and rational organization warehousing, strict accounting of its movement, regular monitoring of the expiration dates of medicines.

It is also very important to maintain the optimum temperature and humidity of the air, to observe the protection of certain preparations from light.

Violation of the rules for storing medicines can lead not only to a decrease in the effectiveness of their action, but also to harm health.

Excessively long storage of drugs (even if the rules are observed) is unacceptable, as the pharmacological activity of the drugs changes.

An important condition for storage is the systematization of drugs by groups, types and dosage forms.

This avoids possible errors due to the similarity of drug names, simplify the search for drugs and control their expiration date.

Narcotic medicines(list A) should be stored in safes or in iron cabinets with secure locks. A printed list of poisonous drugs is kept in a cabinet with the indication of the highest single daily doses.

Rooms and safes with narcotic and especially poisonous drugs must have an alarm system, there must be metal bars on the windows.

The stock of poisonous and narcotic medicines should not exceed the general standard of commodity stocks established for this pharmacy.

Drugs from list B are stored in lockers with a list of drugs and higher single and daily doses.

Instructions for organizing the storage of medicines and medical products apply to all pharmacies and pharmacy warehouses.

The equipment of storage rooms should ensure the safety of medicines. These rooms are provided with fire-fighting equipment, they maintain the necessary temperature and humidity. Checking the parameters of humidity and temperature is carried out 1 time per day. Thermometers and hygrometers are fixed on internal walls away from heaters at a distance of 3 m from doors and 1.5 m from the floor.

To register the parameters of temperature and relative humidity, an accounting card is created in each department.

An important role is played by the cleanliness of the air in the premises for storing medicines; for this, they must be equipped with supply and exhaust ventilation or, in extreme cases, with vents, transoms, and lattice doors.

Heating of the room should be carried out by central heating devices, the use of gas appliances with an open flame or electrical appliances with an open coil is excluded.

If pharmacies are located in climatic zones with sharp fluctuations in temperature and humidity, they are equipped with air conditioners. Medicine storage areas should be enough cabinets, racks, pallets, etc. Racks should be at a distance of 0.5-0.7 m from the outer walls, at least 0.25 m from the floor and 0.5 m from the ceiling. The distance between the racks should be at least 0.75 m, the aisles should be well lit. The cleanliness of the premises of pharmacies and warehouses is ensured wet cleaning at least 1 time per day using approved detergents.

Medicines are placed according to toxicological groups.

Poisonous, narcotic drugs - list A. This is a group of highly toxic drugs.

Their storage and use require special care. Poisonous and addictive drugs are kept in a safe. especially toxic agents stored in the inner compartment of the safe, locked with a padlock.

List B - potent drugs.

Medicines of list B and ready-made products containing them are stored in separate lockers with the inscription “B”.

Storage of drugs depends on the method of their use (internal, external), these funds are stored separately.

Medicines are stored in accordance with the state of aggregation: liquid ones are separated from loose, gaseous, etc.

It is necessary to store separately in groups products made of plastic, rubber, dressings, medical equipment products.

At least once a month it is necessary to control external changes medicines, the state of the container. If the container is damaged, its contents must be transferred to another package.

On the territory of a pharmacy or a warehouse, if necessary, measures are taken to combat insects and rodents.

Article 58 federal law dated April 12, 2010 "On the circulation of medicines" (Collection of legislation Russian Federation, 2010, N 16, art. 1815; N 31, Art. 4161) I order:

1. Approve the Rules for the storage of medicinal products in accordance with the appendix.

2. Recognize as invalid:

sections 1 and 2, paragraphs 3.1 - 3.4, 3.6 and 3.7 of section 3, sections 4 - 7, 12 and 13 Instructions for organizing storage in pharmacies various groups medicines and medical devices, approved by order of the Ministry of Health of the Russian Federation dated November 13, 1996 N 377 "On approval of requirements for the organization of storage in pharmacies of various groups of medicines and medical devices" (registered by the Ministry of Justice of Russia on November 22, 1996 N 1202).

Minister T. Golikova

Appendix

Rules for the storage of medicines

I. General provisions

1. These Rules establish requirements for premises for the storage of medicines for medical use(hereinafter - medicinal products), regulate the storage conditions of these medicinal products and apply to manufacturers of medicinal products, organizations wholesale trade medicines, pharmacy organizations, medical and other organizations operating in the circulation of medicines, individual entrepreneurs holding a license for pharmaceutical activities or a license for medical activity(hereinafter, respectively - organizations, individual entrepreneurs).

II. General requirements to the device

and operation of premises

storage of medicines

2. The device, composition, size of areas (for drug wholesalers), operation and equipment of premises for storing drugs should ensure their safety.

3. Premises for the storage of medicinal products must be maintained at a certain temperature and humidity to ensure the storage of medicinal products in accordance with the requirements of the medicinal product manufacturers indicated on the primary and secondary (consumer) packaging.

4. Premises for the storage of medicines must be equipped with air conditioners and other equipment to ensure the storage of medicines in accordance with the requirements of manufacturers of medicines indicated on the primary and secondary (consumer) packaging, or it is recommended that the premises be equipped with vents, transoms, second lattice doors.

5. Premises for the storage of medicines should be provided with racks, cabinets, pallets, and storage boxes.

6. Finishing of premises for storing medicines (internal surfaces of walls, ceilings) should be smooth and allow for wet cleaning.

III. General requirements for premises

for the storage of medicines

and organization of their storage

7. Premises for the storage of medicines must be equipped with devices for recording air parameters (thermometers, hygrometers (electronic hygrometers) or psychrometers). The measuring parts of these devices must be placed at a distance of at least 3 m from doors, windows and heating devices. Devices and (or) parts of devices from which visual readings are taken should be located in a place accessible to personnel at a height of 1.5-1.7 m from the floor.

The readings of these devices must be recorded daily in a special log (card) of registration on hard copy or in in electronic format with archiving (for electronic hygrometers), which is maintained by a responsible person. The log (card) of registration is stored for one year, not counting the current one. Control devices must be certified, calibrated and verified in the prescribed manner.

8. In storage rooms, medicines are placed in accordance with the requirements normative documentation indicated on the packaging of the medicinal product, taking into account:

physical and chemical properties medicines;

pharmacological groups(for pharmacy and medical organizations);

method of application (internal, external);

state of aggregation pharmaceutical substances (liquid, bulk, gaseous).

When placing medicines, it is allowed to use computer technologies (alphabetically, by codes).

9. Separately, in technically fortified premises that meet the requirements of the Federal Law of January 8, 1998 N 3-FZ "On Narcotic Drugs and Psychotropic Substances" (Collected Legislation of the Russian Federation, 1998, N 2, Art. 219; 2002, N 30 , Article 3033, 2003, No. 2, Article 167, No. 27 (part I), Article 2700; 2005, No. 19, Article 1752; 2006, No. 43, Article 4412; 2007, No. 30, Article 3748, N 31, item 4011; 2008, N 52 (part 1), item 6233; 2009, N 29, item 3614; 2010, N 21, item 2525, N 31, item 4192) are stored :

narcotic and psychotropic drugs;

potent and poisonous drugs under control in accordance with international legal regulations.

10. Shelves (cabinets) for storing medicines in the premises for storing medicines should be installed in such a way as to ensure access to medicines, free passage of personnel and, if necessary, loading devices, as well as accessibility of shelves, walls, floors for cleaning .

Racks, cabinets, shelves intended for storing medicines must be numbered.

Stored medicinal products must also be identified using a shelf card containing information about the stored medicinal product (name, form of release and dosage, batch number, expiration date, manufacturer of the medicinal product). When using computer technology, identification using codes and electronic devices is allowed.

11. In organizations and individual entrepreneurs, it is necessary to keep records of medicines with a limited shelf life on paper or in electronic form with archiving. Control over the timely sale of medicinal products with a limited shelf life should be carried out using computer technology, rack cards indicating the name of the medicinal product, series, expiration date or expiration date registers. The procedure for keeping records of these medicines is established by the head of the organization or individual entrepreneur.

12. If expired medicinal products are identified, they must be stored separately from other groups of medicinal products in a specially designated and designated (quarantine) area.

IV. Requirements for premises

for storage of flammable

and explosive drugs

and organization of their storage

13. Premises for the storage of flammable and explosive medicines must fully comply with current regulations.

14. In order to ensure the storage of flammable and explosive medicines according to the principle of uniformity in accordance with their physical and chemical, fire hazardous properties and the nature of the packaging, the storage rooms of drug wholesalers and drug manufacturers (hereinafter referred to as storage rooms) are divided into separate rooms (compartments) with a fire resistance limit of building structures of at least 1 hour.

15. Required for packaging and manufacturing medicines for medical use per one work shift, the number of flammable medicinal products may be kept in production and other premises. The remaining amount of flammable drugs at the end of the shift is transferred to the next shift or returned to the main storage place.

16. The floors of storage rooms and unloading areas should have a hard, even surface. It is forbidden to use boards and iron sheets to level the floors. Floors should provide convenient and safe movement of people, goods and Vehicle, have sufficient strength and withstand loads from stored materials, ensure simplicity and ease of cleaning the warehouse.

17. Warehouses for the storage of flammable and explosive medicines must be equipped with fireproof and stable racks and pallets designed for the appropriate load. Racks are installed at a distance of 0.25 m from the floor and walls, the width of the racks should not exceed 1 m and, in the case of storing pharmaceutical substances, have flanges of at least 0.25 m. Longitudinal aisles between the racks should be at least 1.35 m.

18. For storage of flammable and explosive medicines in pharmacy organizations and individual entrepreneurs are provided with isolated premises equipped with automatic fire protection and alarm systems (hereinafter referred to as premises for the storage of flammable and explosive medicines).

19. In pharmacies and individual entrepreneurs, it is allowed to store pharmaceutical substances with flammable and combustible properties in a volume of up to 10 kg outside the premises for storing flammable and explosive medicines in built-in fireproof cabinets. Cabinets must be removed from heat-removing surfaces and passages, with doors not less than 0.7 m wide and not less than 1.2 m high. Free access must be organized to them.

It is allowed to store explosive medicinal products for medical use (in secondary (consumer) packaging) for use for one work shift in metal cabinets outside the premises for storing flammable and explosive medicinal products.

20. The amount of flammable medicines allowed for storage in storage rooms for flammable and explosive medicines located in buildings for other purposes should not exceed 100 kg in bulk.

Premises for the storage of flammable and explosive medicinal products used for the storage of flammable pharmaceutical substances in quantities over 100 kg must be located in a separate building, and the storage itself must be carried out in glass or metal containers isolated from the premises for the storage of flammable medicinal products of other groups.

21. It is forbidden to enter the premises for the storage of flammable and explosive medicines with open sources of fire.

V. Features of the organization of storage of medicines

in warehouses

22. Medicinal products stored in warehouses should be placed on racks or on undercarriages (pallets). It is not allowed to place medicines on the floor without a pallet.

Pallets can be placed on the floor in one row or on racks in several tiers, depending on the height of the rack. It is not allowed to place pallets with medicines in several rows in height without the use of racks.

23. With the manual method of unloading and loading operations, the height of the stacking of medicines should not exceed 1.5 m.

When using mechanized devices for unloading and loading operations, medicinal products should be stored in several tiers. At the same time, the total height of placing medicines on the racks should not exceed the capabilities of mechanized handling equipment (lifts, trucks, hoists).

VI. Features of storage of certain groups of medicines depending on

on physical and physico-chemical properties, exposure to various environmental factors

Storage of medicines requiring protection from light

24. Medicines that require protection from the action of light are stored in rooms or specially equipped places that provide protection from natural and artificial lighting.

25. Pharmaceutical substances that require protection from light should be stored in containers made of light-protective materials ( glass container orange glass, metal containers, packaging made of aluminum foil or plastic materials dyed black, brown or orange colors), in a dark room or cabinets.

To store pharmaceutical substances that are especially sensitive to light (silver nitrate, prozerin), glass containers are pasted over with black opaque paper.

26. Medicinal products for medical use requiring protection from light, packed in primary and secondary (consumer) packaging, should be stored in cabinets or on shelves, provided that measures are taken to prevent direct contact with these medicinal products. sunlight or other bright directional light (use of reflective film, blinds, visors, etc.).

Storage of medicinal products requiring protection from moisture

27. Pharmaceutical substances that require protection from moisture should be stored in a cool place at temperatures up to + 15 degrees. C (hereinafter referred to as a cool place), in a tightly closed container made of materials impervious to water vapor (glass, metal, aluminum foil, thick-walled plastic containers) or in the manufacturer's primary and secondary (consumer) packaging.

28. Pharmaceutical substances with pronounced hygroscopic properties should be stored in a glass container with a hermetic closure, filled with paraffin on top.

29. In order to avoid damage and loss of quality, storage of medicinal products should be organized in accordance with the requirements indicated in the form of warning labels on the secondary (consumer) packaging of the medicinal product.

Storage of medicines requiring protection

from volatilization and drying

30. Pharmaceutical substances that require protection from volatilization and drying (actually volatile drugs; drugs containing a volatile solvent (alcohol tinctures, liquid alcohol concentrates, thick extracts); solutions and mixtures of volatile substances ( essential oils, solutions of ammonia, formaldehyde, hydrogen chloride over 13%, carbolic acid, ethanol various concentrations, etc.); medicinal plant materials containing essential oils; medicines containing crystallization water - crystalline hydrates; drugs that decompose with the formation of volatile products (iodoform, hydrogen peroxide, sodium bicarbonate); medicines with a certain lower limit of moisture content (magnesium sulfate, sodium paraaminosalicylate, sodium sulfate) should be stored in a cool place, in a hermetically sealed container made of impervious materials for volatile substances (glass, metal, aluminum foil) or in primary and secondary (consumer) manufacturer's packaging. The use of polymer containers, packaging and capping is allowed in accordance with the requirements state pharmacopoeia and regulatory documentation.

31. Pharmaceutical substances - crystalline hydrates should be stored in hermetically sealed glass, metal and thick-walled plastic containers or in the manufacturer's primary and secondary (consumer) packaging under conditions that comply with the requirements of regulatory documentation for these medicinal products.

Storage of medicinal products requiring protection from exposure elevated temperature

32. Storage of medicines requiring protection from exposure to elevated temperatures (thermolabile medicines), organizations and individual entrepreneurs should carry out in accordance with temperature regime indicated on the primary and secondary (consumer) packaging of the medicinal product in accordance with the requirements of regulatory documentation.

Storage of medicinal products requiring protection from exposure low temperature

33. Storage of medicines that require protection from exposure to low temperatures (medicines whose physical and chemical state changes after freezing and is not restored upon subsequent warming to room temperature (40% formaldehyde solution, insulin solutions) organizations and individual entrepreneurs must carry out in accordance with the temperature regime indicated on the primary and secondary (consumer) packaging of the medicinal product in accordance with the requirements of regulatory documentation.

34. Freezing of insulin preparations is not allowed.

Storage of medicinal products requiring protection from environmental gases

35. Pharmaceutical substances that require protection from exposure to gases (substances that react with atmospheric oxygen: various aliphatic compounds with unsaturated intercarbon bonds, cyclic compounds with side aliphatic groups with unsaturated intercarbon bonds, phenolic and polyphenolic, morphine and its derivatives with unsubstituted hydroxyl groups; sulfur-containing heterogeneous and heterocyclic compounds, enzymes and organ preparations; substances that react with carbon dioxide air: salts of alkali metals and weak organic acids (sodium barbital, hexenal), drugs containing polyhydric amines (eufillin), magnesium oxide and peroxide, caustic sodium, caustic potassium), should be stored in a hermetically sealed container made of materials impervious to gases filled to the top if possible.

Storage of odorous and coloring medicines

36. Odorous drugs (pharmaceutical substances, both volatile and practically non-volatile, but having strong smell) should be stored in a hermetically sealed, odor-tight container.

37. Coloring medicinal products (pharmaceutical substances that leave a colored mark that is not washed off by ordinary sanitary and hygienic treatment on containers, closures, equipment and inventory (brilliant green, methylene blue, indigo carmine) should be stored in a special cabinet in a tightly closed container.

38. To work with coloring medicines, it is necessary to allocate special scales, a mortar, a spatula and other necessary equipment for each item.

Storage of disinfectants

39. Disinfectant medicines should be stored in hermetically sealed containers in an isolated room away from the storage of plastic, rubber and metal products and rooms for obtaining distilled water.

Storage of medicines

for medical use

40. Storage of medicinal products for medical use is carried out in accordance with the requirements of the state pharmacopoeia and regulatory documentation, as well as taking into account the properties of the substances that make up them.

41. When stored in cabinets, on racks or shelves, medicinal products for medical use in secondary (consumer) packaging must be placed with the label (marking) outward.

42. Organizations and individual entrepreneurs must store medicinal products for medical use in accordance with the requirements for their storage indicated on the secondary (consumer) packaging of the specified medicinal product.

Medicinal storage

vegetable raw materials

43. Bulk medicinal plant materials should be stored in a dry (no more than 50% humidity), well-ventilated area in a tightly closed container.

44. Bulk medicinal plant materials containing essential oils are stored in isolation in a well-closed container.

45. Bulk medicinal plant materials should be subject to periodic control in accordance with the requirements of the state pharmacopoeia. Grass, roots, rhizomes, seeds, fruits that have lost their normal color, smell and the required amount active ingredients, as well as those affected by mold, barn pests, are rejected.

46. ​​Storage of medicinal plant materials containing cardiac glycosides is carried out in compliance with the requirements of the State Pharmacopoeia, in particular, the requirement for repeated control for biological activity.

47. Bulk medicinal plant materials included in the lists of potent and toxic substances approved by Decree of the Government of the Russian Federation of December 29, 2007 N 964 "On approval of the lists of potent and toxic substances for the purposes of Article 234 and other articles of the Criminal Code of the Russian Federation, as well as large size of potent substances for the purposes of Article 234 of the Criminal Code of the Russian Federation" (Sobranie Zakonodatelstva Rossiyskoy Federatsii, 2008, No. 2, Art. 89; 2010, No. 28, Art. 3703), is stored in a separate room or in a separate cabinet under lock and key.

48. Packaged medicinal herbal raw materials are stored on racks or in cabinets.

Storage medicinal leeches

49. Storage of medical leeches is carried out in a bright room without the smell of medicines, for which a constant temperature regime is established.

Storage of flammable

medicines

51. Storage of flammable medicines (medicines with flammable properties (alcohol and alcohol solutions, alcohol and ether tinctures, alcoholic and ether extracts, ether, turpentine, lactic acid, chloroethyl, collodion, cleol, Novikov liquid, organic oils); drugs with flammable properties (sulfur, glycerin, vegetable oils, medicinal plant materials) should be carried separately from other drugs.

52. Flammable medicines are stored in tightly sealed strong glass or metal containers to prevent the evaporation of liquids from the vessels.

53. Bottles, cylinders and other large containers with flammable and easily combustible medicines should be stored on the shelves of racks in one row in height. It is forbidden to store them in several rows in height using different cushioning materials.

It is not allowed to store these medicines near heating devices. The distance from the rack or stack to the heating element must be at least 1 m.

54. Storage of bottles with flammable and flammable pharmaceutical substances should be carried out in containers that protect against impacts, or in cylinder-tilters in one row.

55. At the workplaces of industrial premises allocated in pharmacy organizations and individual entrepreneurs, flammable and easily combustible medicines can be stored in quantities not exceeding the shift requirement. At the same time, the containers in which they are stored must be tightly closed.

56. It is not allowed to store flammable and easily combustible medicines in fully filled containers. The degree of filling should be no more than 90% of the volume. Alcohols in large quantities stored in metal containers, filled no more than 75% of the volume.

57. Joint storage of flammable medicines with mineral acids (especially sulfuric and nitric acid), compressed and liquefied gases, flammable substances ( vegetable oils, gray, dressing material), alkalis, as well as with inorganic salts that give explosive mixtures with organic substances (potassium chlorate, potassium permanganate, potassium chromate, etc.).

58. Medical ether and ether for anesthesia are stored in industrial packaging, in a cool, dark place, away from fire and heating devices.

Storage of explosive

medicines

59. When storing explosive drugs (drugs with explosive properties (nitroglycerin); drugs with explosive properties (potassium permanganate, silver nitrate), measures should be taken to prevent contamination with dust.

60. Containers with explosive medicines (barrels, tin drums, flasks, etc.) must be tightly closed to prevent vapors of these medicines from getting into the air.

61. Storage of bulk potassium permanganate is allowed in a special compartment of storage facilities (where it is stored in tin drums), in barbells with ground stoppers separately from others. organic matter- in pharmacies and individual entrepreneurs.

62. Bulk solution of nitroglycerin is stored in small, well-closed bottles or metal containers in a cool, dark place, taking fire precautions. Move dishes with nitroglycerin and weigh this drug should be in conditions that exclude spillage and evaporation of nitroglycerin, as well as its contact with the skin.

63. When working with diethyl ether shaking, blows, friction are not allowed.

Storage of narcotic

and psychotropic drugs

65. Narcotic and psychotropic drugs are stored in organizations in isolated rooms, specially equipped with engineering and technical means protection, and in places of temporary storage, subject to the requirements in accordance with the Rules for the storage of narcotic drugs and psychotropic substances established by Decree of the Government of the Russian Federation of December 31, 2009 N 1148 (Collected Legislation of the Russian Federation, 2010, N 4, Art. 394; N 25, article 3178).

Storage of potent and poisonous medicines,

medicines subject to

subject-quantitative accounting

66. In accordance with Decree of the Government of the Russian Federation of December 29, 2007 N 964 "On approval of the lists of potent and toxic substances for the purposes of Article 234 and other articles of the Criminal Code of the Russian Federation, as well as large quantities of potent substances for the purposes of Article 234 of the Criminal Code of the Russian Federation" potent and poisonous drugs include drugs containing potent and toxic substances included in the lists of potent substances and toxic substances.

67. Storage of potent and poisonous drugs under control in accordance with international legal norms (hereinafter referred to as potent and toxic drugs under international control) is carried out in premises equipped with engineering and technical security equipment similar to those provided for the storage of narcotic and psychotropic drugs.

68. Potent and poisonous medicines under international control and narcotic and psychotropic medicines may be stored in one technically fortified room.

At the same time, the storage of potent and poisonous medicines should be carried out (depending on the volume of stocks) on different shelves of the safe (metal cabinet) or in different safes (metal cabinets).

69. Storage of potent and poisonous medicines not under international control is carried out in metal cabinets sealed or sealed at the end of the working day.

70. Medicines subject to subject-quantitative accounting in accordance with the order of the Ministry of Health and social development of the Russian Federation dated December 14, 2005 N 785 "On the procedure for dispensing medicines" (registered with the Ministry of Justice of the Russian Federation on January 16, 2006 N 7353), with the exception of narcotic, psychotropic, potent and poisonous medicines, are stored in metal or wooden cabinets sealed or sealed at the end of the working day.

"On approval of the Rules for the storage of medicines"

Rules for the storage of medicines

I. General provisions

• drug manufacturers,
• organization of wholesale trade in medicines,
• pharmacy organizations,
• medical and other organizations carrying out activities in the circulation of medicines,
• individual entrepreneurs who have a license for pharmaceutical activity or a license for medical activity (hereinafter, respectively - organizations, individual entrepreneurs).

II. General requirements for the arrangement and operation of storage facilities for medicines

III. General requirements for premises for the storage of medicinal products and the organization of their storage

• physico-chemical properties of medicines;
• pharmacological groups (for pharmacy and medical organizations);
• method of application (internal, external);
• aggregate state of pharmaceutical substances (liquid, bulk, gaseous).

• narcotic and psychotropic drugs;
• potent and poisonous drugs that are controlled in accordance with international legal norms.

IV. Requirements for premises for the storage of flammable and explosive medicines and the organization of their storage

V. Features of the organization of storage of medicines in warehouses

VI. Features of storage of certain groups of medicines, depending on the physical and physico-chemical properties, the impact on them of various environmental factors

Storage of medicines requiring protection from light

Storage of medicinal products requiring protection from moisture

Storage of medicinal products requiring protection from volatilization and drying out

• actually volatile drugs;
• medicinal products containing a volatile solvent

1. alcohol tinctures,
2. liquid alcohol concentrates,
3. thick extracts;

• solutions and mixtures of volatile substances

1. essential oils,
2. ammonia solutions,
3. formaldehyde solutions,
4. solutions of hydrogen chloride over 13%,
5. solutions of carbolic acid,
6. ethyl alcohol of various concentrations, etc.;

• medicinal plant materials containing essential oils;
• medicines containing crystallization water - crystalline hydrates;
• drugs that decompose to form volatile products

1. iodoform,
2. hydrogen peroxide,
3. sodium bicarbonate;

• medicinal products with a defined lower moisture content limit

1. magnesium sulfate,
2. sodium paraaminosalicylate,
3. sodium sulfate,

Storage of medicines requiring protection from exposure to elevated temperatures

Storage of medicines requiring protection from exposure to low temperatures

Storage of medicinal products requiring protection from environmental gases

• substances that react with air oxygen:

1. various compounds of the aliphatic series with unsaturated intercarbon bonds,
2. cyclic with side aliphatic groups with unsaturated intercarbon bonds,
3. phenolic and polyphenolic,
4. morphine and its derivatives with unsubstituted hydroxyl groups;
5. sulfur-containing heterogeneous and heterocyclic compounds,
6. enzymes and organ preparations;

• substances that react with carbon dioxide in the air:

1. salts of alkali metals and weak organic acids (sodium barbital, hexenal),
2. drugs containing polyhydric amines (eufillin), magnesium oxide and peroxide, caustic sodium, caustic potassium,

Storage of odorous and coloring medicines

• brilliant green,
• methylene blue,
• indigo carmine

Storage of disinfectants

Storage of medicinal products for medical use

Storage of medicinal plant materials

Storage of medical leeches

Storage of flammable medicines

• medicines that have flammable properties

1. alcohol and alcohol solutions,
2. alcohol and ether tinctures,
3. alcohol and essential extracts,
4. ether,
5. turpentine,
6. lactic acid,
7. chloroethyl,
8. collodion,
9. cleol,
10. novikov liquid,
11. organic oils

• medicines that have flammable properties

1. sulfur,
2. glycerol,
3. vegetable oils,
4. medicinal herbs)

• mineral acids (especially sulfuric and nitric acids),
• compressed and liquefied gases,
• flammable substances (vegetable oils, sulfur, dressings),
• alkalis,
• as well as with inorganic salts, giving explosive mixtures with organic substances

1. potassium chlorate,
2. potassium permanganate,
3. potassium chromate, etc.

Storage of explosive medicines

Storage of narcotic and psychotropic medicines

Storage of potent and poisonous medicines, medicines subject to subject-quantitative accounting

Subject: Medical treatment in nursing practice

Prepared by the teacher

Aforkina A.N.

Chairman of the Central Committee

Osmirko E.K.

Orenburg -2015

I. Ways and means of introducing drugs into the body.

Medical therapy is an essential part of the entire healing process.

Medicinal substances have both local and general (resorptive) effects on the body.

Drugs are introduced into the human body in various ways. How the drug is introduced into the body depends on:

1) the speed of the onset of the effect,

2) effect size,

3) duration of action.

Tab.1 Ways and means of drug administration

II. Rules for prescribing, receiving, storing, recording and distributing medicines.

Rules for prescribing medicines for the department.

1. The doctor, conducting a daily examination of patients in the department, writes down in the medical history or prescription list the medicines necessary for this patient, their doses, frequency of administration and routes of administration.

2. The ward nurse makes a daily selection of prescriptions, copying the prescribed drugs into the "Book of prescriptions" separately for each patient. Information about the injections is transmitted to the procedural nurse who performs them.

3. The list of prescribed drugs that are not at the post or in treatment room, served to the head nurse of the department.

4. The head nurse (if necessary) writes out, in a certain form, an invoice (requirement) for receiving medicines from a pharmacy in several copies, which is signed by the head. department. The first copy remains in the pharmacy, the second is returned materially responsible person. The invoice f. No. 434 must indicate the full name of medicines, their sizes, packaging, dosage form, dosage, packaging, quantity.

Order of the Ministry of Health of the Russian Federation of August 23, 1999 N 328 "On the rational prescription of medicines, the rules for writing prescriptions for them and the procedure for their dispensing by pharmacies (organizations)", as amended on January 9, 2001, May 16, 2003

Medicines are dispensed by the pharmacy to departments in the amount of the current need for them: poisonous - 5 day supply, narcotic - 3 day supply (in the intensive care unit), all others - 10 day supply.

Order of the Ministry of Health of the Russian Federation No. 330 dated November 12, 1997 “On measures to improve the accounting, storage, prescribing and use of NLS”.

5. Requirements for poisonous (for example, strophanthin, atropine, prozerin, etc.) and narcotic drugs(for example, for promedol, omnopon, morphine, etc.), as well as for ethyl alcohol, they are issued on separate forms of the senior m / s on Latin. These requirements are stamped and signed by the chief physician of the health facility or his deputy for the medical unit, indicating the route of administration, the concentration of ethyl alcohol.

6. In the requirements for acutely scarce and expensive medicines, indicate the full name. patient, case history number, diagnosis.

7. Receiving medicines from the pharmacy, the head nurse checks their compliance with the order. When issuing ampoules with narcotic drugs from a pharmacy, the integrity of the ampoules is checked.

On the dosage forms manufactured in a pharmacy should be certain color labels:

for external use - yellow;

for internal use - white;

For parenteral administration - blue (on vials with sterile solutions).

The labels should contain clear names of drugs, designations of concentration, dose, dates of manufacture and the signature of the pharmacist (manufacturer's details) who manufactured these dosage forms.

Rules for the storage of medicines in the department.

1. To store medicines at the nurse's station, there are cabinets that must be locked with a key.

2. In the cabinet, medicinal substances are placed in groups (sterile, internal, external) on separate shelves or in separate cabinets. Each shelf should have a corresponding indication ("For external use", "For internal use", etc.).

3. Medicinal substances for parenteral and enteral administration should be placed on the shelves according to their intended purpose (antibiotics, vitamins, antihypertensive drugs etc.).

4. Larger dishes and packages are placed behind, and smaller ones in front. This makes it possible to read any label and quickly take the right medicine.

6. Medicinal substances included in List A, as well as expensive and acutely scarce drugs are stored in a safe. On the inner surface the safe should contain a list of them indicating the highest daily and single doses, as well as a table antidote therapy. Inside any cabinet (safe), medicines are divided into groups: external, internal, eye drops, injection.

7. Preparations that decompose in the light (therefore they are produced in dark vials) are stored in a place protected from light.

8. Strong-smelling drugs (iodoform, Vishnevsky ointment, etc.) are stored separately so that the smell does not spread to other drugs.

9. Perishable preparations (infusions, decoctions, potions), as well as ointments, vaccines, serums, rectal suppositories and other drugs are stored in the refrigerator.

10. Alcoholic extracts, tinctures are stored in bottles with tightly ground stoppers, as due to the evaporation of alcohol, they can become more concentrated over time and cause an overdose.

11. Shelf life sterile solutions, made in a pharmacy, is indicated on the bottle. If during this time they are not sold, they must be poured out, even if there are no signs of unsuitability.

Temperature and light conditions must be observed. Infusions, decoctions, emulsions, serums, vaccines, organ preparations should be stored only in the refrigerator.

Signs of unsuitability are:

In sterile solutions - a change in color, transparency, the presence of flakes;

Infusions, decoctions - turbidity, discoloration, appearance bad smell;

In ointments - discoloration, delamination, rancid smell;

In powders, tablets - discoloration.

The nurse is not allowed to:

Change the form of medicines and their packaging;

Combine the same medicines from different packages into one;

Replacing and correcting labels on medicines:

Store medicinal substances without labels.

an important role in providing quality and efficient medical care plays proper storage medicines in healthcare facilities. AT medical organization stocks of medicines that provide a 5–10-day requirement are placed in offices and premises run by a senior (chief) nurse, and stocks of drugs that provide daily requirement, - in the departments and at the posts of nurses. Need to create right conditions for the storage of medicines, taking into account their quantity and physical and chemical properties, as well as to ensure the safety from unwanted or illegal use of drugs, especially potent, poisonous and narcotic drugs, psychotropic substances and their precursors.

Main normative documents according to the rules for the storage of medicines in the Russian Federation are:

§ Order of the Ministry of Health and Social Development of Russia dated August 23, 2009 No. 706n “On approval of the rules for the storage of medicines” (hereinafter - Order of the Ministry of Health and Social Development of Russia dated August 23, 2010 No. 706n);

§ Order of the Ministry of Health and Social Development of Russia dated May 16, 2011 No. 397n “On approval of special requirements for the storage conditions of narcotic drugs and psychotropic substances duly registered in the Russian Federation as medicines intended for medical use, in pharmacies, medical institutions, scientific -research, educational organizations and organizations of wholesale trade in medicines”;

§ Decree of the Government of the Russian Federation of December 31, 2009 No. 1148 “On the procedure for storing narcotic drugs, psychotropic substances and their precursors”.

To store medicines at the nurse's station, there are cabinets that must be locked with a key.

1. Medicines for external and internal use are stored at the nurse's station in a lockable cabinet on different shelves marked "For external use", "For internal use".

2. The nurse groups medicinal substances for internal use: in one cell of the cabinet she places drugs that lower blood pressure, in another - diuretics, in the third - antibiotics.

3. Strong-smelling medicines (Vishnevsky's liniment, Finalgon ointment) are stored separately so that the smell does not spread to other medicines. Flammable substances (alcohol, ether) are also stored separately.

4. Alcohol tinctures and extracts are stored in vials with tightly lapped or well-screwed stoppers, as due to the evaporation of alcohol, they can become more concentrated over time and cause an overdose. The preparations are stored in a cool place at a temperature of + 8 to + 15 ° C in the primary and secondary (consumer) packaging of the manufacturer.

5. Drugs requiring protection from light (eg prozerin, silver nitrate) should be stored away from light. Avoid exposure of these medicinal products to direct sunlight or other bright directional light, as well as ultraviolet rays you need to use reflective film, blinds, visors, etc.

6. Perishable products (water infusions, decoctions, medicines, serums, vaccines, rectal suppositories) are stored in a refrigerator at a temperature of + 2 ... + 10 ° C. The shelf life of infusions, decoctions, mixtures in the refrigerator is no more than 2 days.

7. All sterile solutions in ampoules and vials are stored in the treatment room.

8. Separately, in technically fortified premises that meet the requirements of the Federal Law of January 8, 1998 No. 3-FZ “On Narcotic Drugs and Psychotropic Substances”, the following are stored:

§ narcotic and psychotropic drugs;

§ strong and poisonous medicines controlled in accordance with international legal norms.

9. The shelf life of sterile solutions made in a pharmacy for parchment rolling is three days, and for metal rolling - 30 days. If during this time they are not implemented, they should be returned to the head nurse.

10. Signs of unsuitability are:

ü in sterile solutions- change in color, transparency, the presence of flakes;

ü in infusions, decoctions- turbidity, discoloration, the appearance of an unpleasant odor;

ü at ointments- discoloration, delamination, rancid smell;

ü in powders, tablets- color change.

11. A nurse has no right:

ü change the form of medicines and their packaging;

ü the same medicines from different packages are combined into one;

ü replace and correct labels on medicines;

ü store medicinal substances without labels.

Premises or places of storage of medicines should be equipped with air conditioners, refrigerators, vents, transoms, second lattice doors - all this is necessary to create temperature conditions.

In the premises where medicines are stored, it is necessary to have devices for recording air parameters: thermometers, hygrometers, psychrometers. Nurse branches during work shift once a day should record the readings of these devices in a special journal in the places of storage of medicines.

At home, a separate place should be allocated for the storage of medicines, inaccessible to children and people with mental disorders. But at the same time, medicines that a person takes for pain in the heart or suffocation should be available at any time.