The order of storage of medicines in medical organizations. Building a home first aid kit. Rules for storing drug groups
Storage room for basic supplies medicines and products medical purpose at the head nurse of the health care facility unit must meet the technical, sanitary, fire and other licensing requirements and conditions, be isolated from other premises of the unit. The internal surfaces of walls and ceilings must be smooth, allowing the possibility of wet cleaning. The floor of the room must have a dust-free coating that is resistant to the effects of mechanization and wet cleaning using disinfectants. The use of wooden unpainted surfaces is not allowed. Materials for interior decoration must meet the requirements of the relevant regulatory documents.
The premises for the storage of medicines and medical devices must be equipped with special equipment, allowing to ensure their storage and proper preservation, taking into account the physicochemical, pharmacological and toxicological properties, as well as the requirements of quality standards for medicines and the State Pharmacopoeia of the Russian Federation, namely:
· Cabinets, racks, trays for storing medicines and medical products, as well as lockable metal cabinets and safes for storing certain groups of medicines;
Refrigerators for storage of thermolabile medicines;
· Devices for recording air parameters (thermometers, hygrometers or psychrometers), which are placed on the inner wall of the room away from heating devices at a height of 1.5-1.7 m from the floor and at a distance of at least 3 m from the doors;
· Detergents and disinfectants to ensure sanitary conditions.
The equipment must be resistant to the effects of wet cleaning with the use of disinfectants and meet the sanitary and hygienic, fire safety and labor protection requirements.
General requirements for the storage of medicines and medical devices
Medicines and medical devices in departments should be stored in lockable cabinets, with the obligatory division into groups: “External”, “Internal”, “Injectable”, “Eye drops”, etc. In addition, in each compartment of the cabinet (for example, “ Internal”) there should be a division of medicines into tablets, medicines, etc.; powders and tablets are stored, as a rule, on the top shelf, and solutions - on the bottom.
Storage of finished medicinal products should be carried out in compliance with external conditions(modes of temperature, humidity, illumination) specified by the manufacturer in the instructions for the preparation, and general requirements. All finished medicinal products must be packed and installed in the original industrial or pharmacy packaging with the label (marking) facing out.
Tablets and dragees are stored separately from other medicines in a dry and, if necessary, protected from light place.
Dosage forms for injection should be stored in a cool, dark place in a separate cabinet (or cabinet compartment).
Liquid dosage forms (syrups, tinctures) should be stored in a place protected from light.
Plasma-substituting solutions are stored in isolation in a cool, dark place. Ointments, liniments are stored in a cool, dark place, in a tightly closed container. Preparations containing volatile and thermolabile substances are stored at a temperature not exceeding +10 C.
Suppositories are stored in a dry, cool, dark place.
Storage of most medicines in aerosol packages should be carried out at a temperature of +3 to +20 C in a dry, dark place, away from heating devices. Aerosol packages should be protected from shock and mechanical damage.
Infusions, decoctions, emulsions, serums, vaccines, organ preparations, solutions containing benzylpenicillin, glucose, etc., are stored only in refrigerators (+2 - +10 C).
Immunobiological preparations should be stored separately by name at the temperature indicated for each name on the label or in the instructions for use. Immunobiological preparations of the same name are stored in batches, taking into account the expiration date.
Medicinal plant materials should be stored in a dry, well-ventilated area.
Medicines that have strong smell(iodoform, lysol, ammonia etc.) and flammable (ether, ethanol), stored in a separate cabinet. Coloring medicines (iodine, brilliant green, etc.) are also stored separately.
Storage of medicines in the operating room, dressing room, procedural room is organized in glassed instrument cabinets or on surgical tables. Each vial, jar, package containing a medicinal product must have an appropriate label.
Narcotic drugs and psychotropic substances, potent and poisonous substances must be kept in safes. It is allowed to store narcotic drugs and psychotropic substances in metal cabinets in technically fortified premises. Safes (metal cabinets) must be kept closed. After the end of the working day, they must be sealed or sealed. Keys to safes, seals and ice-cream should be kept by financially responsible persons authorized to do so by order of the head physician of the healthcare institution.
Narcotic drugs and psychotropic substances, potent and poisonous substances received by shift medical personnel must be stored in a closed and sealed safe attached to the floor or wall in a specially designated room. On inside the safe door contains a list of narcotic drugs and psychotropic substances, indicating the highest single and daily doses. Narcotic drugs and psychotropic substances for parenteral, internal and external use should be stored separately.
Responsible for organizing the storage and issuance of narcotic drugs and psychotropic substances to patients are the head of the health facility or his deputies, as well as persons authorized to do so by order of the health facility.
Units of healthcare facilities should have tables of higher single and daily doses of narcotic drugs and psychotropic substances, as well as tables of antidotes for poisoning by them, in places of storage and at the posts of doctors and nurses on duty. Medical products should be stored separately from medicines and in groups: rubber products, plastic products, dressings and auxiliary materials, medical equipment products.
REMINDER approved by Order of the Ministry of Health of the RSFSR of September 17, 1976 N 471
1. Procedure for obtaining medicines from pharmacies
1.1. Medicines for the treatment of patients with stationary conditions, are dispensed by pharmacies to the paramedic on duty or nurse only in the original factory or pharmacy packaging.
1.2. The representative of the department, receiving the medicine, is obliged to check its compliance with the prescription in the requirement.
2. Rules for storing medicines in departments
2.1. The head of the department (office) is responsible for the storage and consumption of medicines, as well as for the order in the places of storage, compliance with the rules for issuing and prescribing medicines. The direct executor of the organization of storage and consumption of medicines is the head nurse.
2.2. Storage of medicines in departments (offices) should be organized in lockable cabinets. Mandatory division into groups "External", "Internal", "Injection", "Eye drops". In addition, in each compartment of the cabinet, for example, "Internal", there should be a division into powders, potions, ampoules, which are placed separately, and the powders are stored, as a rule, on the top shelf, and the solutions on the bottom.
2.3. Odorous and coloring substances should be isolated in a separate cabinet.
2.4. Storage of medicines in the operating room, dressing room, procedural room is organized in instrumental glass cabinets or on surgical tables. Each bottle, jar, stem eye containing medicines must have an appropriate label.
2.5. Poisonous medicines must be stored in a separate locker.
Narcotic medicines should be stored in safes or iron cabinets. On the inside of the cabinet (safe) doors there should be an inscription "A" and a list poisonous agents with indication of higher single and daily doses.
Stocks of poisonous and narcotic drugs should not exceed the 5-day requirement for them.
2.6. Potent medicines (List B) should be stored in a separate (wooden) cabinet under lock and key.
Stocks of potent agents should not exceed a 10-day requirement.
2.7. The keys to cabinets "A" and "B" are kept only by persons appointed by order on medical institution responsible for the storage and issuance of poisonous and potent drugs, and at night these keys are handed over to the doctor on duty, about which an appropriate entry is made in a special journal and the signatures of the person who transferred and accepted the keys and the indicated medicines are put.
2.8. In places of storage and at the posts of doctors and nurses on duty, there should be tables of the highest single and daily doses of poisonous, narcotic and potent drugs, as well as tables of antidotes for poisoning.
2.9. In departments (offices) of institutions, the following material assets are subject to quantitative accounting:
a) poisonous medicines in accordance with the rules approved by the Order of the Ministry of Health of the USSR dated 03.07.68 N 523;
b) narcotic drugs in accordance with the rules approved by the Order of the Ministry of Health of the USSR dated 30.12.82 N 1311;
c) ethyl alcohol (Order of the Ministry of Health of the USSR dated 30.08.91 N 245);
d) new drugs for clinical trials and research in accordance with the current guidelines of the Ministry of Health;
e) scarce and expensive medicines and dressings in accordance with the list approved by the order of the head of the medical facility.
Subject-quantitative accounting of the above material assets conducted in the form approved by the Order of the Ministry of Health of the USSR of 03.07.68 N 523, with the exception of narcotic drugs, which are kept in the book of narcotic drugs in departments and offices in the form 60-AP, approved by Order of the Ministry of Health of the USSR of 30.12.82 N 1311. The pages of the books must be laced, numbered, the books must be certified by the signature of the head of the institution.
Form of accounting for material assets listed in subparagraphs a, c, d, e.
Name of the product _____________________________________________
Book of registration of narcotic drugs funds in departments and offices
Name of the product __________________________________________
Unit of measurement______________________________________________
2.10. In places where medicines are stored, temperature and light conditions must be observed. Infusions, decoctions, emulsions, penicillin, serums, vaccines, organ preparations, solutions containing glucose, etc. should be stored only in refrigerators (temperature 2 - 10 degrees C).
3.It is forbidden:
3.1. Disinfectants, solutions for technical purposes (treatment of hands, tools, furniture, linen, etc.) should be stored together with medicines intended for the treatment of patients.
3.2. In departments and at posts, pack, hang, pour, transfer medicines from one package to another, replace labels.
3.3. Issuing medicines without a doctor's prescription, replacing one drug with another.
3.4. Prescribe, issue and store medicines under conditional, abbreviated names that are not approved by the Pharmacopoeia Committee (for example, cough syrup, hand disinfection solution, "triple solution", etc.).
4. Issuance of medicines containing poisonous and narcotic drugs to patients should be carried out only separately from other medicines.
5. In order to avoid mistakes, before opening the ampoule, the package, you should read the name of the drug, dosage aloud, check with the prescription and then release it to the patient.
6. The duration of storage of medicines manufactured in a pharmacy is limited to certain periods. To determine the expiration date, you need to know the release date. Factory-made medicines have a digital series designation, where the last two digits indicate the year, and the two preceding them indicate the month of release.
In accordance with the Order of the Ministry of Health of the USSR dated 10.29.68 N 768, for drugs manufactured in a pharmacy, next dates storage:
6.1. For aqueous solutions containing benzylpenicillin, glucose - 1 day.
6.2. For injection solutions- 2 days, for solutions of sodium chloride 0.9%, novocaine 0.25%, 0.5% in vials sealed without running, - 7 days. Once opened, use immediately.
6.3. For eye drops- 2 days.
6.4. For infusions, decoctions, mucus - 2 days.
6.5. For emulsions, suspensions - 3 days.
6.6. For other drugs - 10 days.
7. The head of the department (office) is obliged at least once a month to personally check the storage, accounting and consumption of medicines, expiration dates, paying attention to Special attention"A" list drugs.
8. The pharmacy is responsible for the quality of the medicine manufactured and dispensed by it to the department and its exact compliance with the prescription (requirements), provided that the integrity of the package (in an unopened state) and the content of the medicine are kept in conditions certain rules storage. After opening the package and the first use of the drug in the department, further responsibility for its quality lies with the staff of the department, headed by the head.
To treat many diseases, people every day buy a lot of medicines, herbs, decoctions, etc. A thousand pills, capsules, tablets and solutions help a person feel healthy on the most critical days.
But the effect of the tablets comes only when the drugs are stored correctly, and the deadlines for their implementation are observed.
When purchasing unfamiliar medicines, people quite often do not know how they should be stored correctly. To read the regulatory guidelines and find out the answers to questions related to storage and sale, just open the order of the Ministry of Health and Social Development of the Russian Federation, where General requirements to the premises for organizing the storage of medicines of different composition. There you can also find basic information about the rules for storing drugs at home, about temperature conditions, etc.
Medicines (psychotropic, explosive, volatile, narcotic, caustic) should be stored separately from other drugs. For them it is necessary to allocate special place, protected from light, moisture, etc. As a rule, such preparations are dispensed either by prescription or contain instructions. To store this separate group drugs should be provided with temperature and humidity conditions in accordance with the requirements of the Pharmacopoeia article.
Places in which drugs are stored should be regulated by a thermometer. Keep in mind that the temperature regime in the refrigerator is different. As a rule, the temperature on the upper shelves of the refrigerator is lower than on the lower shelves.
Temperature conditions
Not all drugs should be stored in boxes, boxes, many drugs should only be stored in the refrigerator. Often, consumers do not know how to provide a dry place to store medicines. Temperature regimes for medicines today have a standardized form. It is worth highlighting several temperature ranges:
- room temperature (usually + 20- + 22 degrees Celsius);
- cold place for storage (storage in the refrigerator +5 C);
- a cool storage place for medicines at a temperature of +8-+11 C;
- room temperature for storing medicines +18-+21 C;
- warm mode + 35- + 40 С;
- hot mode +75-+80 С.
Do not leave drugs in the bathroom, as excessive moisture can change their composition and make the tablets unsuitable for further use.
A dry place for storing medicines should be equipped with air conditioning or ventilation hoods. Vaporizing products must not be placed next to flammable substances. Essential medicines should be kept close to or separate from other medicines.
The humidity in the room is controlled by a psychrometer. Each drug needs its own level of humidity.
Building a home first aid kit
It is no wonder that the first-aid kit should be formed not only on the basis of the characteristics of your body, but also on the basis of the season of the year. In the summer, you should keep close anti-burn and cooling ointments, bandages, tourniquets, iodine, brilliant green, hydrogen peroxide, painkillers, etc. Antibiotics, antiviral and warming drugs are suitable for the autumn and winter periods.
Do not overfill your first aid kit with unnecessary drugs.. It will only take up a lot of space and increase the search the right medicines. So that in case emergency do not look for what you need among a pile of drugs, you need to fold them compactly.
It is recommended to store everything in different containers. You can select several sealed boxes and divide medicines depending on their composition. Tablets can be in one container, gels, ointments, anti-burn agents, etc., in another. The instructions can be put in a separate file, tablets in another place, and the tablet packaging can be thrown away so that it does not take up much space.
If you suddenly need to leave for a long time, and you need to take medicine every day, then here on help will come a cooler bag that will ensure the safety of all medicines. You can put anything in the bag: from bandages, scissors, iodine, tourniquets to medicines that are sensitive to temperature changes. To store the tablets, you can purchase a special box with a timer, which is divided into 4 parts: morning, afternoon, evening, night. These containers are very convenient and compact.
Thus, proper storage and the use of medicines will ensure safety in taking drugs, as well as relieve negative consequences for the body.
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3. In the premises for the storage of medicines must be maintained certain temperature and air humidity, allowing to ensure the storage of medicines in accordance with the requirements of medicine 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 to equip the premises 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.
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 paper or in electronic form 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. Medicinal products are placed in the storage rooms in accordance with the requirements of the regulatory documentation indicated on the packaging of the medicinal product, taking into account:
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).
When placing medicines, it is allowed to use computer technologies (alphabetically, by codes).
9. Separately, in technically reinforced premises that meet the requirements federal law of January 8, 1998 N 3-FZ "On Narcotic Drugs and Psychotropic Substances" (Collected Legislation Russian Federation, 1998, N 2, art. 219; 2002, No. 30, art. 3033; 2003, N 2, art. 167, No. 27 (part I), Art. 2700; 2005, N 19, art. 1752; 2006, N 43, art. 4412; 2007, N 30, Art. 3748, No. 31, Art. 4011; 2008, N 52 (part I), art. 6233; 2009, N 29, art. 3614; 2010, No. 21, Art. 2525, No. 31, Art. 4192) are stored:
narcotic and psychotropic drugs;
potent and poisonous drugs that are controlled in accordance with international legal norms.
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 rack 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 medicines with a limited shelf life should be carried out using computer technology, rack cards indicating the name of the medicine, 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.
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 medicinal products according to the principle of uniformity in accordance with their physical and chemical, flammable properties and the nature of the packaging, the premises for the storage of drug wholesalers and drug manufacturers (hereinafter referred to as warehouse premises) are divided into separate premises (compartments) with a fire resistance limit of building structures of at least 1 hour.
15. Necessary for packaging and manufacturing of medicines for medical use for one work shift, the number of flammable medicines is allowed to 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. Floors storage facilities and unloading areas must 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 medicines for medical use (in secondary (consumer) packaging) for use for one work shift in metal cabinets outside the premises for storing flammable and explosive medicines.
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 exceeding 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 fire.
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. When manual way unloading and loading operations, the height of the stacking of medicines should not exceed 1.5 m.
Using mechanized devices for carrying out 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).
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 (orange glass containers, metal containers, aluminum foil or polymer materials painted black, brown, or orange), in a dark room or closet.
For the storage of pharmaceutical substances that are especially sensitive to light (silver nitrate, prozerin), glass containers are pasted over with black opaque paper.
26. Medications for medical use requiring protection from light, packed in primary and secondary (consumer) packaging, should be stored in cabinets or on racks, 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.).
27. Pharmaceutical substances that require protection from moisture should be stored in a cool place at temperatures up to +15 degrees. C (hereinafter - a cool place), in a tightly closed container made of materials impermeable 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.
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, ethyl alcohol of various concentrations, etc.); medicinal plant materials containing essential oils; medicines containing water of crystallization - crystalline hydrates; drugs that decompose with the formation of volatile products (iodoform, hydrogen peroxide, sodium bicarbonate); medicines with a certain lower moisture content limit (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 of the 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.
32. Storage of medicinal products requiring protection from exposure elevated temperature(thermolabile medicines), organizations and individual entrepreneurs must 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.
33. Storage of medicinal products requiring protection from exposure low temperature(drugs, the physico-chemical state of which changes after freezing and upon subsequent warming to room temperature not recoverable (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.
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 potash) should be stored in hermetically sealed containers made of materials impervious to gases, if possible filled to the top.
36. Odorous medicinal products (pharmaceutical substances, both volatile and practically non-volatile, but with a strong odor) should be stored in a hermetically sealed container, impervious to odor.
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.
39. Disinfectants should be stored in hermetically sealed containers in an isolated room away from plastic, rubber and metal storage facilities and distilled water production facilities.
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.
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 must 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 substances, 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 potent substances for the purposes of Article 234 of the Criminal Code of the Russian Federation" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2008, N 2, Art. 89; 2010, N 28, Art. 3703), is stored in separate room or in a separate locker.
48. Packaged medicinal herbal raw materials are stored on racks or in cabinets.
49. Storage medicinal leeches carried out in a bright room without the smell of drugs, for which a constant temperature regime is set.
51. Storage of flammable medicines (medicines with flammable properties (alcohol and alcohol solutions, alcohol and essential tinctures, alcohol and essential 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 closed 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. Distance from rack or stack to heating element must be at least 1 m.
54. Storage of bottles with flammable and highly combustible 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 drugs 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 medicinal products 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.
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 drugs (barrels, tin drums, bottles, etc.) must be tightly closed to prevent vapors of these drugs 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 other organic substances - in pharmacies and individual entrepreneurs.
62. Bulk nitroglycerin solution 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 is not allowed.
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).
66. Pursuant to Decree of the Government of the Russian Federation No. 964 of 29 December 2007 “On Approval of Lists of Potent and Poisonous Substances for the Purposes of Article 234 and Other Articles of the Criminal Code of the Russian Federation, Federation" potent and toxic drugs include drugs containing potent and toxic substances included in the lists of potent 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.
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 the treatment room is submitted 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 to the financially 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 from a pharmacy ampoules with drugs check the integrity of the ampoules.
On dosage forms manufactured in a pharmacy should be certain color labels:
for external use - yellow;
for internal use - white;
For parenteral administration- blue (on bottles 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 closet 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 inner surface the safe should have a list of them indicating the highest daily and single doses, as well as a table of 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. The shelf life of 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.
