The procedure for dispensing medicines according to doctors' prescriptions. Rules for dispensing prescription drugs
1. Vacation rules medicines from pharmacies and enterprises (hereinafter - the Rules) determine the procedure for dispensing medicines from pharmacies and enterprises (hereinafter - pharmacies).
All medicines, with the exception of those authorized by the Ministry of Health of the Republic of Belarus for dispensing without a doctor's prescription, must be dispensed from pharmacies according to prescriptions in established forms, written out in accordance with the Rules for Prescribing Medicines.
2. If the prescription contains poisonous, narcotic and potent medicines mixed with other ingredients, then it is prohibited to dispense them other than as part of the manufactured medicine.
3. If a doctor prescribes a poisonous, narcotic or potent drug in a dose exceeding the highest single dose without an appropriate prescription, the pharmacist (pharmacist) of the pharmacy is obliged to dispense this drug in half the dose that is established as the highest single dose.
4. Narcotic drugs are dispensed from pharmacies according to prescriptions from territorial health care institutions attached to these pharmacies.
The list of healthcare institutions and pharmacies is determined by a joint order of healthcare authorities and unitary enterprises "Pharmacia".
Pharmacies dispensing narcotic drugs according to prescriptions must be provided with samples of seals, stamps, and sample signatures of doctors prescribing narcotic drugs.
5. Psychotropic drugs, including combination drugs, subject to subject-quantitative accounting, and ethyl alcohol are dispensed by all pharmacies within the city and regions of the region according to prescriptions from medical institutions located on their territory.
6. Oncology patients are assigned to pharmacies to receive narcotic drugs by written order of the head of the medical institution. Lists of patients are compiled by the medical institution annually at the beginning of the year and are changed as necessary by separate written orders of the medical institution, certified by the signature of the head of the institution.
7. Disabled people and participants of the Great Patriotic War and persons equal to them in terms of benefits, dispensing of medicines according to free recipes prescribed by doctors of medical institutions, is produced in any state pharmacy of the Republic of Belarus (regardless of the place where the prescription was issued), with the exception of narcotic drugs, psychotropic drugs, including combination drugs, subject to subject-quantitative accounting, and ethyl alcohol.
8. Medicines listed in Appendix 7 to the Rules for Prescribing Medicines are dispensed from pharmacies in quantities not exceeding acceptable standards one recipe.
It is permitted to increase the rate of one-time dispensing of prescription drugs in the cases specified in paragraphs 31, 32, 33 of the Rules for Prescribing Medicines.
9. Controlled psychotropic drugs, for which standards for one-time dispensing according to one prescription are not established, are dispensed from pharmacies in quantities not exceeding a course of treatment for a period of up to 1 month.
10. The dispensing of finished medicinal products containing codeine (pentalgin, solpadeine, spasmoveralgin and others), with the exception of the medicinal products specified in Appendix 7 to the Rules for Prescribing Medicines, is carried out according to doctor’s prescriptions in compliance with the one-time dispensing rate of no more than 0.2 codeine.
11. Dispensing of medicines containing ephedrine hydrochloride is carried out according to doctor’s prescriptions within the limits of the one-time dispensing rate (0.6) of ephedrine hydrochloride. An increase in the rate of one-time dispensing of medicines containing ephedrine hydrochloride is allowed in accordance with the conditions specified in paragraph 31 of the Rules for Prescribing Medicines.
12. When dispensing a medicinal product, including for free and preferential prescriptions, it is allowed to violate the original factory packaging, with the exception of contour cell (blister) and contour cell-free packaging, with the obligatory indication by the pharmacist (pharmacist) of the pharmacy number, name of the drug, dosage, manufacturer, series and expiration date of the drug on the pharmaceutical packaging. Total quantity The drug dispensed must correspond to the amount prescribed in the prescription, taking into account the dosage.
13. For external purposes, solutions of phenol, concentrated acids, perhydrol can be dispensed in the concentration prescribed by the doctor, with the obligatory indication on the prescription (requirement) of the concentration and method of use. The package must bear the label: “Handle with care.”
14. Ethyl alcohol is dispensed from pharmacies in pure form in weight measurement, and in a mixture with other ingredients - in volumetric measurement.
15. A pharmacist, with the consent of the patient, has the right, in the absence of a medicine prescribed in prescriptions, to prescription form Form 1 for prescribing medicines dispensed from a pharmacy at full cost, and prescription form Form 3 for prescribing and dispensing medicines free of charge or on preferential terms, replace it with its synonym.
16. Medicines are dispensed to the population on preferential terms and free of charge only from state pharmacies and enterprises upon presentation of a document confirming this right to patients. Children under 3 years of age and categories of patients for whom outpatient treatment Medicines are dispensed free of charge according to the list of diseases approved by the Ministry of Health of the Republic of Belarus; no documents are required.
17. When dispensing medicines, the price, number of packages, tablets (capsules, dragees, ampoules, etc.) must be indicated on the prescription.
The receipt of the prescription contains the amount to be paid by the medical institution, the surname, initials and signature of the dispenser, the surname, initials and signature of the person who received the medicine. The counterfoil with the necessary details filled in is sent with an invoice for payment to the medical institution.
18. When dispensing medicines for which prescriptions remain in the pharmacy, instead of a prescription, patients are given a signature with a yellow stripe or a label indicating the method of use of the medicine. The signature form is given in Appendix 1.
19. It is prohibited to dispense narcotic drugs for injection, anesthetic ether, chlorethyl, ketamine (calypsol, ketalar), fluorotane, sodium hydroxybutyrate in ampoules, lithium hydroxybutyrate in ampoules, barium sulfate for fluoroscopy to outpatients.
expiration of the prescription;
incorrectly written and executed prescriptions.
All incorrectly written prescriptions are canceled with the stamp “Prescription is invalid” and information about them is transferred to the heads of medical institutions for taking action against employees who violate the Rules for Prescribing Medicines.
21. Prescriptions for medicines remain in the pharmacy and are stored for the established periods in accordance with Appendix 2.
The counterfoils of Form 3 prescription forms received from pharmacy organizations are stored in the medical institution in the manner prescribed by law.
22. Upon expiration of the storage period, prescriptions are destroyed by a commission created by order of the head of the pharmacy, which includes at least 3 people, with the drawing up of an act in one copy, which is stored for 1 year, not counting the current one. The act indicates the pharmacological group of medicines, for what period the destruction is carried out and the date of destruction.
23. Packages in which medicines containing poisonous and narcotic drugs are dispensed pharmaceutical manufacturing, are issued with an additional “Handle with Care” label, sealed by the person who tested the medicinal product, or sealed for testing. They should be stored in a separate locked cabinet until vacation.
24. The medicines listed in Appendix 3 are subject to special subject-quantitative accounting in pharmacies, pharmaceutical warehouses and healthcare institutions.
25. Payment for the cost of medicines dispensed by a pharmacy institution (enterprise) free of charge or on preferential terms according to prescriptions from doctors of state medical institutions is made at the expense of the budgetary allocations of the health care institution that issued the Form 3 prescription.
Appendix 1
to the Vacation Rules
medicines from
pharmacies and enterprises
Photos from open sources
We are all accustomed to change. We are no longer so frightened by reports of another economic crisis, because in our memory there have already been several of them. Innovations in the educational standard of schools and higher education institutions are not surprising. educational institutions. But news in the field of healthcare and access to medicines cannot but cause concern. IN modern world practically none healthy people. We all have some kind of chronic disease and are often forced to purchase certain medications. And when news feeds contain information that changes are coming in this process at some point, we experience anxiety.
From the beginning of 2017, a new order of the Ministry of Health on the rules for dispensing medicinal products from pharmacy chains comes into force. The new order will directly affect every citizen.
In particular, a ban is being introduced on the sale of a number of medicines in large quantities to one person. This restriction is introduced for alcohol-containing tinctures and syrups, mass fraction ethyl alcohol in which above 15%. Now they will be sold per person in quantities of no more than two bottles. And it is precisely with these means that many of us treat our own problems at home. colds. We advise you to make sure you have them in advance, since during the peak of the disease you will have to frequently visit the pharmacy under the new conditions of dispensing. This advice is especially relevant given long term validity of the latter.
Fans of online shopping should also listen to the innovations, since starting from the new year, any online pharmacy in Moscow will follow them.
A pleasant change is that prescriptions for patients with chronic diseases it will be possible to purchase necessary medications for future use Today this can only be done for the next two months. In this case, it is necessary to provide documentary evidence of the fact of departure or inability to get to the pharmacy in the future. From January 2017, this period has been extended to a calendar year.
If the pharmacy does not have drugs on the list of vital and necessary drugs, it will have to purchase them and make them available for sale no later than a week after the patient’s request. Today this period is written as five calendar days. But if the buyer needs to take the medicine immediately, which is indicated on the prescription by the doctor’s note “statim”, the pharmacy is obliged to provide this product on the day of application.
According to the new document, pharmacy workers are prohibited from advising the buyer of more expensive drugs when a cheaper analogue is available. Pharmacists will also have to give detailed consultation about the properties and contraindications of a particular medicine, its expiration date, storage methods and doses used. Currently, such information is provided only at the request of the pharmacy employee and is not necessarily regulated in any way. Therefore, even when purchasing medications from an online pharmacy. In 2017, you can count on the professional participation of a specialist in choosing a particular product, and on advice on its use and storage.
We can only hope that all these innovations will be implemented and will benefit the interests of pharmacy customers.
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What medications will be available by prescription starting in 2017?
In-first, according to recipes in 2017 In 2016, all the drugs that were dispensed by prescription in 2016 will be dispensed in Russia. Unfortunately for buyers of medicines, no relaxations are planned in this list.
In-secondly, Rospotrebnadzor (its head) made a rather unexpected statement-proposal that it is very desirable to sell all drugs that are in pharmacies exclusively by prescription. That is absolutely everything. Maybe with the exception of those medications that are necessary to complete all kinds of first aid kits. Read about it. The Ministry of Health proposes to soften this proposal, and we will see to what extent this softening will occur.
In a word, drug consumers can expect, if not a revolution in the dispensing system, then at least a reformation of the list of prescription drugs in the direction of a clear increase. The list will be replenished with those medications that are not needed urgently, but have a negative effect on the body when self-medicated.
All new medications that contain narcotic drugs are psychotropic. And such funds are only increasing on the pharmaceutical market every year. Alas, people do not solve problems, but accept everything for years.
Read also: When to pay personal income tax on sick leave
The third group is combined drugs: narcotic drugs, psychotropic substances and their precursors. They decided to designate this group separately: antibiotics. We are used to prescribing them for ourselves, but sometimes there is no other way, especially if we got sick on the weekend. Many people send their relatives to the pharmacy for antibiotics.
We'll see how it turns out in practice.
Definitely, new tranquilizers and antidepressants will also join the ranks of prescription drugs.
Here are some drugs that will be sold by prescription.
What is sometimes surprising is that the drug remains the same, the same active ingredient, but the packaging is different 3D, and the price is already higher and they may ask for the recipe.
Many live without medication at all! Well done!
Currently, work is underway to compile such a list. The Ministry of Health of the Russian Federation was allocated enough time for such work, up to January thirty-first, 2017.
It is already known that the list will definitely include drugs on the prescription form with the following line:
Presumably, only thirty percent of the medicines offered for sale in pharmacies will be available without a prescription.
There is also the following list of medicines
Since January 2017, the dispensing of medicines in pharmacies has become more strict. Many medications that previously could be bought without a doctor’s prescription are now simply not sold. Most of these drugs include antibiotics, but there are also regular painkillers.
The instructions for these medications previously included the clause “dispensed with a doctor’s prescription.” But pharmacies sold them without any prescriptions. Now it is planned to organize unscheduled inspections, which will entail the issuance of fines to those pharmacies where drugs are sold without a prescription.
Another question arises: how should patients receive prescriptions? Everyone knows how long the queues are at the offices of local therapists. Therefore, this issue is now being actively addressed so that the “prescription-only medicine” system will work fully.
Since the beginning of 2017, a list has been posted containing a list of medications that are prohibited from being released without a prescription.
People now really cannot live without medicines and pills, as they help us extend our lifespan when we are sick.
This year, only those medications that contain Khlopinin will be dispensed by prescription:
Also included in this list is the well-known Valocordin:
And here is a complete list of medications that will not be given to everyone, but only to those who have a special “prescription” paper from a doctor:
In 2017, changes occurred in the pharmaceutical field that are now being actively discussed.
The list of drugs that cannot be purchased without a prescription from a doctor has become longer. It contained medications with psychotropic effects and good old antibiotics. Some indignation was caused by the fact that heart remedy Valocordin. Curantil, so often prescribed to pregnant women, was also there, as well as Nimesil, a well-known painkiller.
Most likely, the list will be replenished with new titles.
Since 2017, pharmacies will not be able to sell prescription drugs if instead of an official document with a doctor’s signature and seal there is a “handwritten piece of paper”
When going to the pharmacy to buy medicine, don’t be lazy, open the Internet. Type the required medication into a search engine and look at the instructions for it. If there is a note “Only with a doctor’s prescription,” it means that without this very prescription the product you need will not be sold.
Medicines are divided into those that can be freely purchased at a pharmacy and those that are available only with a doctor's prescription. For the latter, from January 1, 2017, the rules for their leave are being tightened. The “prescription only” stamp does not include medications that are freely available on pharmacy displays. You can easily purchase antiviral medications, many cough and runny nose medications, some enzyme and painkillers.
And although the innovation has caused a lot of controversy, it is by no means news for pharmacy workers. Order No. 785 “On the procedure for dispensing medicines” has been in effect since December 14, 2005. But now the very form of the “doctor’s note” is changing.
If previously a prescription was considered a banal piece of paper on which the doctor’s hand had scribbled the prescribed medicine, this “gag” will no longer pass in the new year. A prescription form is required (form No. 107/u). With the doctor's personal seal, seal medical institution, dosage and frequency of application.
Remember, recipes also have an expiration date. Now it is 60 days. For chronic patients, the validity period of the prescription may be longer.
There is no official list of all drugs that must be sold strictly according to a prescription. The Ministry of Health will compile a list during January medical supplies, which will only be available with a prescription. In the meantime, they will focus on the instructions for the medications.
State Duma deputies plan to tighten control over pharmacies. For selling drugs without a doctor’s prescription, you can still “run into” a fine, but people’s representatives propose to increase administrative punishment up to 10 thousand rubles. And as the most extreme measure, it is proposed to close the pharmacy for three months.
Starting from 2017, control over the sale of drugs will be strengthened. Is it worth purchasing drugs? (TV and radio company "Seim")
they have recent years mania prohibit everything limit punish etc. all laws are aimed at the negative there is not a single law to give provide provide increase in favor of the people even with authoritarianism you rarely see this, well, well, let's see where this curve will lead
Here you go. I've read a lot of nonsense) The comments are about nothing. Why stand in line with a blood pressure of 180, when there is an ambulance for such a situation. Although, in general, it is necessary to stock up on medications as soon as they come to an end, and not on the day of the crisis (. Someone wrote about an antibiotic, which should always be in the first aid kit . Are you sure? And what (read, for what) should be at home? Do you think one antibiotic cures everything? harmful antibiotic 2.5 days...and thereby cause bacteria resistance (addiction to the drug), the next time it no longer affects the microbe. Thus, we returned tuberculosis to society, for which it became difficult to select drugs and the mortality rate increased. If you are afraid of the drug, don’t start drinking it... it will be really bad, then the doctor will write a prescription, and in a difficult situation, you yourself will finish it. And Valocordin is not a harmless drug at all, because it contains Phenobarbital (read on Wiki), but it does not save you from death at all. rather out of fear)) So, an ambulance and an ambulance again, if you really feel bad. PS. I ALWAYS get a coupon through the Internet, I’ve never sat at the office for 3 hours. strictly on time and almost always on time. Doctors are not interested in accepting 35 people instead of 15. Why is it “impossible to get in”?!
Read also: Application for extraordinary leave
Give me a piece of paper. Starting in the new year, the sale of drugs without a prescription will be tightened
IN recent months Kursk residents, while shopping at the pharmacy, hear a warning from pharmacists that from January 1, 2017, most medications will be dispensed strictly according to prescriptions. But is this so and what barriers will now be put in front of patients?
Whose order?
On June 21, 2016, the State Duma adopted in the first reading government bill No. 1093620-6 “On Amendments to the Code Russian Federation about administrative offenses in terms of improving administrative responsibility in the healthcare sector.” And in September, at a meeting with Roszdravnadzor of the Russian Federation, it was announced that from January 1, 2017, drugs prescription will be under special control of the department.
“Actually, the order of the Ministry of Health and social development RF No. 785 “On the procedure for dispensing medicines” is valid from December 14, 2005. It is he who regulates the procedure for dispensing medicines from pharmacies, regardless of the form of ownership. That’s why we still fine pharmacies for selling medicines without a prescription,” explained the deputy head of the department of licensing, supervision and control in the field of medical and social activities Regional Office of Roszdravnadzor Lyudmila Ilyukhina.
Lethal injection. Kursk children are dying from a “harmless” drug
Let us remind you that 70% of drugs registered in the Russian Federation are sold strictly according to prescriptions, and only 30% are sold without it. But what then will change in the new year? Nothing but tougher legislation regarding control and supervision of pharmacies. Currently, Roszdravnadzor is constrained by current legislation and cannot effectively influence pharmacies for violations of the quality and safety of medical and pharmaceutical activities. It’s just that pharmacists did not always pay attention to these requirements, and the population did not see the problem and did not understand it.
How will they be punished?
The current version of the Code of Administrative Offenses does not establish administrative liability for a number of violations in the field of laboratory and clinical practice rules when conducting clinical and preclinical studies of medicines for medical use, procedures for providing medical care regarding non-compliance with the established by them mandatory requirements, procedures for conducting medical examinations, examinations and examinations, as well as the procedure for prescribing and prescribing medications. Therefore, changes have been made to the Code of Administrative Offenses of the Russian Federation (CAO).
The price of health. Do beneficiaries have enough medicine?
The new law proposes completely different fines and other types of punishment for violating drug trade regulations, including dispensing prescription drugs without a prescription.
So, from January 1, 2017, if it is discovered that a medicine is being sold without a prescription, Roszdravnadzor may fine the pharmacist who violated the law in the amount of 5 to 10 thousand rubles (now - from 1,500 to 3 thousand rubles); official you will have to pay from 20 to 30 thousand rubles (now - from 5 to 10 thousand rubles); legal - from 100 to 150 thousand rubles (now - from 20 to 30 thousand rubles). The apogee may be the closure of the pharmacy for 3 months (90 days).
Therefore, you understand, most pharmacies, if not all, will not want to take risks and will work strictly according to the letter of the law.
Self-medication is to blame
The impetus for the changes was the level of self-medication of the population, which has recently gone through the roof, and sometimes turns into very tragic consequences. Here it is already worth dealing with another problem - the shortage of doctors and queues in hospitals, which force people to go to the pharmacy and consult with a pharmacist about what medications should be taken for a particular disease.
“But the pharmacy must follow the doctor’s recommendation, draw the buyer’s attention to storage conditions and frequency of administration, nothing more. And the prescription itself is the doctor’s request to the pharmacist about what exactly he should give to the patient,” notes Ilyukhina. “And now it also happens that a person actually visited a doctor, but came to the pharmacy not with a prescription written on an official form, but with a piece of paper on which the doctor indicated the name of the drug. And pharmacists dispense medications based on these scraps. This whole situation must change."
The level of self-medication may be off the charts, but there is a logical explanation for this trend - how long will a person have to wait in line at a hospital for a prescription? Especially considering that the majority prefer not to go on sick leave with every cold, but to endure it on their feet, since the authorities do not favor sick leave, and many of us do not consider a sluggish ARVI to be a real disease, supporting our immunity with medications (not even antibiotics) from the nearest pharmacy. But now, before going to the pharmacy, you will have to go on a “crusade” to the hospital and sit in line there, most likely not for an hour or two.
Shortages and queues
It is impossible to say right now which medications will be dispensed only by prescription: in fact, there is no clear list; it was abolished in 2011 because it was too long and cumbersome. So you will have to focus on the packaging of the drug, which should indicate the name, dose, release form, manufacturers, expiration date, storage conditions and dispensing rules - with or without a prescription.
Plan
Introduction
1. Organization of a workplace for receiving prescriptions and dispensing medications
2. The main responsibilities of a pharmacist for taking prescriptions
2.1 Procedure for taking prescriptions
2.2 Forms of prescription forms
3. Organization of work on dispensing medicines
3.2 Features of dispensing medicines to cancer patients and chronically ill patients
4. Norms for one-time dispensing of certain medicines
Conclusion
Main goal pharmacy organization- providing the population with medicines, which means the production function of any pharmacy is:
Monitoring the correct prescription of medications;
Taking prescriptions;
Manufacturing of medicines according to doctors' prescriptions;
In-pharmacy quality control;
Correct dispensing of medications from pharmacies.
To perform the functions of accepting prescriptions, manufacturing drugs according to doctors’ prescriptions and the requirements of health care facilities, monitoring their quality, as well as dispensing manufactured drugs in pharmacies, a prescription production department (RPO) can be created. To accept prescriptions and dispense finished medicinal products (FPP), a department of ready-made forms (FDF) is created in pharmacies. Some pharmacies combine these two functions.
Departments are managed by department heads and their deputies. The RPO staff includes positions of pharmacists and pharmacists. Pharmacists are allocated to accept prescriptions for individually manufactured drugs and over-the-counter drugs, carry out quality control of prepared drugs, dispense drugs, and control drugs manufactured in pharmacies. Positions of pharmacists may also be allocated to conduct information work, monitor the work of pharmacists, etc. In addition to pharmaceutical personnel, RPOs should have auxiliary personnel positions: packers and nurse-washers. The presence of a production function in a pharmacy is an indicator of quality drug provision population, medical and preventive institutions, availability of medicinal care, breadth of the range of pharmaceutical services provided by pharmacies.
The workplace is organized in the sales area of the pharmacy. The department's area, available equipment and facilities comply with current building codes (SNiP), technical and economic equipment standards.
The equipment and equipment of workplaces in a pharmacy depends on the volume of work of the pharmacy. The prescription and dispensing workstation is usually isolated from visitors, although modern equipment does not always provide for such isolation. At this workplace, standard equipment is installed, which includes a sectional table, cabinets for storing medications, and turntables for storing manufactured dosage forms.
Besides this, workplace for receiving and dispensing prescriptions, it is equipped with a refrigerator for storing heat-labile drugs, a cabinet for storing poisonous and potent drugs, as well as a computer. Currently, many pharmacies are equipped with automated workstations - prescription workstations. It is quite well suited to speed up the sales process using barcoding.
Workplaces are equipped in accordance with the nature of the work performed. The following rules are observed:
There should be no items at the workplace that are not required during the work process;
Each item must have permanent place; - all objects frequently used in work should be on the floor by hand;
Pharmacist-technologist during use various items should not make unnecessary movements.
The workplace for receiving and dispensing medications must be equipped with the necessary reference literature, in particular - the latest edition of the State Pharmacopoeia, tables of highest single and daily doses, literature on compatibility and interactions of drugs, orders of the Ministry of Health regulating the acceptance and dispensing of prescriptions and drugs according to them .
There are also reference books of medicines, including Vidal and Mashkovsky, State Register Medicines, price tables, tariffs for the manufacture of medicines, accounting documents, in particular a prescription journal or receipt journal and a log of incorrectly written prescriptions. In addition, there must be labels and signatures at the workplace for taking and dispensing medicines.
When taking and dispensing medications, a pharmacist must be guided by a number of documents:
Laws of the Russian Federation “On Medicines”, “On Narcotic Drugs and Psychotropic Substances”, “On Protection of Consumer Rights”, etc.;
List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation;
Lists of the Standing Committee on Narcotics Control (PCNC);
List of medicines of lists A and B;
Current orders, regulatory documents of the Ministry of Health of the Russian Federation and other departments;
Pharmacist's Code of Ethics.
In addition, this list also includes Decrees of the Government of regions and territories on issues of pharmaceutical activity.
Recipe– this is a written request from the specialist who prescribed it to the pharmacist (pharmacist) about the manufacture and dispensing of medicines. A prescription is at once a medical, legal and financial document.
When accepting prescriptions and dispensing medications, pharmacists must be guided by Order of the Ministry of Health of the Russian Federation No. 328 dated August 23, 1999. “On the rational prescribing of medicines, the rules for writing prescriptions for them and the procedure for their dispensing by pharmacies (organizations”).
All medicines, with the exception of those named in the List of Medicines Dispensed Without a Prescription, approved by the Ministry of Health of Russia, must be dispensed only with prescriptions in established forms. Medicines are prescribed if there are appropriate indications for citizens who have sought medical help and, if necessary, treatment after discharge from the hospital. It is prohibited to write prescriptions for drugs:
Not approved for medical use by the Russian Ministry of Health and not registered in the Russian Federation;
Used only in health care facilities (anesthetic ether, chloroethyl, sombrevin, etc.);
In the absence of medical indications.
The pharmacist-technologist for taking prescriptions and dispensing medicines is assigned the following responsibilities:
Receiving prescriptions and requirements, checking their correctness, compatibility of ingredients and compliance of prescribed doses with the patient’s age, determining the cost of the drug and preparing the relevant documentation;
Accounting for incoming prescriptions and transferring them for the manufacture of prescribed medications;
Monitoring the accuracy of prescriptions prescribed by doctors and informing your immediate supervisor about all cases of violation by doctors of the rules for prescribing prescriptions;
Registration of medicines that are unavailable and refused to the population, daily information about this to the heads of the department or pharmacy;
Prescription dispensing of finished medicines.
2.1 Procedure for taking prescriptions
When taking prescriptions and dispensing medications, it is advisable to follow the following algorithm of actions:
1.Checking the compliance of the form of the prescription form with the medicinal prescription. Any prescription, regardless of the procedure for paying for the medicine and the nature of the action of the medications included in it, must contain the following mandatory and additional details.
Required details include:
Stamp of the healthcare facility, indicating the name of the healthcare facility, its address and telephone number;
Prescription date;
Full name the patient and his age;
Full name doctor;
Name and quantity of drugs;
Detailed method of drug use;
Doctor's signature and stamp.
Additional prescription details depend on the composition of the drug and the form of the prescription form. Prescriptions are written out on printed forms according to the forms established by the Russian Ministry of Health.
2. Verification of the eligibility of the person who wrote the prescription. Medicines are prescribed by the doctor directly caring for the patient. When providing emergency and emergency medical care, medications are prescribed by a doctor visiting team emergency medical services or department doctor emergency care outpatient clinic. In some cases, medications can be prescribed by a specialist with secondary medical education (dentist, paramedic, midwife).
3.Checking the correctness of the prescription and the method of application of the drug. The composition of the medicinal product, the designation of the dosage form and the doctor’s request to the pharmacist about the manufacture and dispensing of the medicinal product are written out on Latin. The names of narcotic drugs, psychotropic and toxic substances, as well as list A drugs are written at the beginning of the prescription. The method of administration of the drug is written in Russian, indicating the dose, frequency, time of use in relation to food intake. If emergency dispensing of a drug is necessary, the designations cito or statum are placed at the top of the prescription form. Only abbreviations accepted by the rules are allowed.
4.Checking the compatibility of ingredients in the recipe. In a prescription that requires individual preparation, the compatibility of the ingredients included in the medicinal product is checked. If it is necessary to change the composition or quantity active ingredients, replacing one dosage form with another, etc. This issue must be discussed with the doctor who wrote the prescription.
5. Checking the highest single and daily doses of drugs, taking into account the patient’s age. When assessing a drug prescription, a pharmacist must check the highest single and daily doses (VRD and VSD) of the drug, taking into account the patient’s age. When dispensing narcotic, psychotropic and toxic substances, he must be guided by paragraph 3.9 of Order No. 785 of December 14, 2005 of the Ministry of Health and “Requirements for the dispensing of narcotic drugs and psychotropic substances; medicines subject to subject-quantitative accounting; anabolic steroids».
6. Checking the compliance of the quantity of prescribed drugs with those established by orders of the Ministry of Health of the Russian Federation dated February 12, 2007 No. 110. When an extemporaneous prescription is received at a pharmacy, the pharmacist is obliged to dispense the drug on the PCU in half the highest single dose, in the event that the doctor did not comply with the established rules for filling out the prescription or exceeded the highest single dose. In some cases, it is possible to exceed the established standards, which is possible if there is a doctor’s instructions on the prescription “For special purposes”, certified by the doctor’s signature and seal, as well as the seal “For prescriptions”. For incurable oncological and hematological patients, the amount of narcotic drugs prescribed in one prescription can also be increased by 2 times against the established norms.
7. Checking the validity of the prescription. Based on Order No. 110 of February 12, 2007, the Ministry of Health and Social Development of the Russian Federation establishes following dates actions of recipes.
Prescriptions written out on a special prescription form for narcotic drugs and psychotropic substances are valid for 5 days from the date of issue, on prescription form No. 148-1/u-88 - 10 days.
A prescription written on prescription form No. 148-1/у-88 is valid for 10 days, 1 month. The validity period is indicated by a strikethrough.
A prescription written on prescription form No. 107-1/u is valid for 10 days, 2 months, 1 year. The validity period is indicated by a strikethrough.
Prescriptions for all other medications are valid for 2 months from the date of discharge.
Prescriptions written out on prescription forms No. 148-1/u-04 (l) and No. 148-1/u-06 (l) are valid for 1 month from the date of issue, with the exception of medicines that are subject to quantitative registration .
Prescriptions for barbituric acid derivatives, ephedrine in its pure form, pseudoephedrine in its pure form, ephedrine and pseudoephedrine mixed with other substances, anabolic steroids, clozapine, tianeptine for the treatment of patients with protracted and chronic diseases can be prescribed for a course of treatment of up to 1 month.
In this case, the prescription must contain the inscription “For special purposes”, which is sealed with the doctor’s signature and the seal of the healthcare facility “For prescriptions”. Prescriptions that do not meet the above requirements remain in the pharmacy, are canceled with the “Prescription Invalid” stamp and are registered in a special journal.
8. Taxation of the prescription. The prescription, written correctly, is then taxed. In pharmacies with equipped workstations, this process occurs using various software. If a prescription is filled out incorrectly, it is registered in the “Register of Incorrectly Filled Out Prescriptions”, previously canceled with the “Recipe Invalid” stamp.
9.Registration of a recipe.
10. Registration of a signature if necessary.
11.Issuing a receipt.
12.Payment for the prescription.
All these stages go together, since registration, payment and issuance of a receipt occur as components of one process.
2.2 Forms of prescription forms
Currently, by order of the Ministry of Health and Social Development No. 110 dated February 12, 2007 “On the procedure for prescribing and prescribing medicines and products medical purposes and specialized products therapeutic nutrition» approved following forms prescription forms:
1) Form “Special prescription form for narcotic drugs and psychotropic substances”;
2) Form No. 148 -1/ u-88 “Prescription form”;
3) Form No. 107 -1 /у “Prescription form”;
4) Form No. 148 -1/у - 04 (l) “Recipe”;
5) Form No. 148 –1/у - 06 (l) “Recipe”.
1. Form “Special prescription form for narcotic drugs and psychotropic substances” according to the instructions to order No. 110, “it is produced on pink paper with watermarks and has serial number. On the prescription form of this sample they write out narcotic drugs and psychotropic substances included in List II of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation (according to Decree of the Government of the Russian Federation No. 681 of June 30, 1998).
The prescription contains the full last and first name of the patient. “Medical history No.” or “No. medical card» of the patient, or the history of the child’s development, medical history. In addition, the full last name, first name and patronymic of the doctor are indicated. The prescription is signed by the doctor who wrote the prescription, and then certified with the doctor’s personal seal. Additionally, it is certified with the round seal of the health care facility and signed by the chief physician or his deputy.
Only one name of a medicinal product is allowed to be prescribed on one prescription form, and corrections are not allowed. The prescription remains in the pharmacy organization for subject-quantitative accounting.
2. Form No. 148 -1/ u-88 “Prescription form” has a series and number. In addition, it must contain the following details: address or medical card number of the patient, seal of the health care facility “For prescriptions”, full name. the patient and the doctor completely. For free and preferential holidays, the prescription is written out in duplicate. Psychotropic substances of List III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation are prescribed on this prescription form (according to Decree of the Government of the Russian Federation No. 681 of June 30, 1998), as well as other medicines that are subject to quantitative registration and anabolic steroids.
It is allowed to prescribe only one name of a medicinal product on one prescription form, and with reverse side The prescription contains a note about who prepared, checked and dispensed the medicine. The prescription remains in the pharmacy organization for subject-quantitative accounting
3. Form No. 107 -1/у “Prescription form”. All medications are prescribed on this prescription form, with the exception of those prescribed on the prescription form form No. 148 -1/u - 88 and a special prescription form for narcotic drugs and psychotropic substances. The prescription is signed by the doctor and certified with his personal seal.
No more than 3 types of medicines are prescribed on one prescription form, and corrections are also not allowed. Ethyl alcohol is prescribed on a separate form and is additionally certified with the seal of the healthcare facility “For prescriptions”.
4. Form No. 148 -1/у-04 “Recipe” and 5. and Form No. 148 -1/у-06 “Recipe” are intended for prescribing medicines on preferential terms (free or at a discount), and form No. 148 -1/-06 is drawn up using computer technology. Medicines, medical products and specialized medical nutrition products for disabled children are prescribed on the prescription form listed above.
The prescription form is written out in 3 copies, each with a single series and number, and the prescription is signed by a doctor (paramedic) and certified with his personal seal. When dispensing a medicinal product in a pharmacy, information about the actual medicinal products dispensed is indicated on the prescription form, and the date of dispensing is indicated. This prescription form has a tear line separating the form and the spine that is given to the patient. In this case, a note is made on the spine about the name of the drug, dosage, quantity, and method of use.
3.1 Dispensing prescription drugs
When dispensing medications according to doctors' prescriptions, the pharmacist must follow certain rules:
When dispensing narcotic drugs, psychotropic, potent and toxic substances, ethyl alcohol and other medicines that have special conditions implementation, compliance with the order of the Ministry of Health and Social Development of the Russian Federation dated February 12, 2007 No. 110 and the Rules for the Dispensing of Medicines in Pharmacy Organizations, Standard OST 91500.05.0007-2003 is required. At the same time, the dispensing of narcotic drugs and psychotropic substances according to doctors’ prescriptions is carried out in accordance with List II and List III of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation;
Based on the requirements of Order No. 785, paragraph 3.2 of this order, the right to work with narcotic drugs and psychotropic substances is given only to those pharmacy organizations and institutions that have a license for this type of activity;
Only those pharmacists who are given the right to carry out such activities in accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated May 13, 2005 can dispense narcotic drugs and psychotropic substances. No. 330;
When dispensing narcotic drugs and psychotropic substances, as well as extemporaneous drugs containing medicinal substances located at the PCU, instead of a prescription, patients are given a signature with a yellow stripe and the inscription “Signature” in black font;
If the patient has a prescription long acting, then it is returned indicating on the back the amount of the drug dispensed and the date of dispensing;
Dispensing of narcotic drugs and psychotropic substances is permitted only with prescriptions from health care facilities located in the same locality;
The release of narcotic drugs and psychotropic substances prescribed by a doctor is carried out to the patient or the person representing him only upon presentation of a document proving his identity;
Narcotic drugs and psychotropic substances dispensed with a doctor's prescription, as well as those dispensed free of charge or at a discount, are dispensed upon presentation of a prescription written out on a special prescription form, form No. 148 -1/ y-04 (l). Also, psychotropic substances in the PKU and anabolic steroids are dispensed according to prescriptions from a doctor or paramedic, as well as on preferential terms upon presentation of 2 prescriptions - prescription form No. 148-1/ y-88 and form No. 148-1/ y-04 (l);
It is prohibited to dispense narcotic drugs and psychotropic substances, medicines in the PCU, as well as anabolic steroids according to prescriptions prescribed by veterinary medical organizations for the treatment of animals;
It is also prohibited to separate the dispensing of medicines located on the PCU and the dispensing of medicines included in the combination drug according to extemporaneous prescriptions;
Replacement of a medicinal product prescribed in a prescription with its synonym is carried out only in agreement with the buyer or with the doctor, while the trade name of the dispensed medicinal product, as well as the signature and date of dispensing of this drug are indicated on the back of the prescription;
When dispensing a medicinal product, the pharmacist must explain to the buyer the rules for taking the medicinal product, methods of taking it, single and daily doses, dosage regimen and storage rules for this medicinal product.
For the treatment of incurable oncological and hematological patients, the rate of prescribing and dispensing of medicines subject to subject-quantitative recording, as well as Schedule II narcotic drugs and barbituric acid derivatives, is allowed to be increased by 2 times compared to the amount specified in Appendix No. 1 of the Instructions, approved by order of the Ministry of Health and Social Development No. 110 dated 02/12/07
Chronically ill patients are allowed to establish a prescription validity period of up to 1 year for finished medicines and individually manufactured medicines, with the exception of:
Medicines subject to subject-quantitative accounting;
Anabolic agents;
Medicines dispensed from a pharmacy on preferential terms (free or at a discount);
In this case, the doctor makes a note on the prescription “Chronic patient” and indicates the validity period of the prescription, the frequency of dispensing drugs from the pharmacy (monthly or weekly), certifies this indication with his signature and personal seal, as well as the seal of the health care facility “For prescriptions”.
3.3 Procedure for dispensing medicines provided free of charge or at a discount
One of the main tasks public policy in the field of healthcare - this is the provision of medicines to the category of citizens who enjoy benefits in the field of provision of medicines.
Currently, 30 million people enjoy benefits. financing is provided from the federal budget, budgets of constituent entities of the Russian Federation, local budgets and funds from the compulsory health insurance fund.
The following have the right to receive free medications:
Children under 3 years old;
Disabled people, WWII participants and persons equivalent to them;
Citizens exposed to radiation at nuclear facilities;
Heroes of the Soviet Union, Heroes of the Russian Federation, holders of the Order of Glory;
Heroes of Socialist Labor, full holders of the Order of Labor Glory;
Cancer patients, sick mental illness, diabetes, leprosy, etc.
All of these categories of patients receive free of charge all medicines and medical products, which are annually approved by the authorities of the constituent entities of the Russian Federation. The government has also defined categories of diseases for which certain medicines are provided free of charge. These diseases include tuberculosis, syphilis, bronchial asthma, Parkinson's disease, myocardial infarction and others.
Some groups of the population receive medicines at a 50% discount. These include:
Pensioners receiving a minimum pension;
Working disabled people of the 2nd group and unemployed disabled people of the 3rd group;
Persons who took part in the liquidation of the consequences of the accident at the Chernobyl nuclear power plant;
Citizens, awarded with medals for selfless work during the Second World War;
Honorary donors of the Russian Federation and others.
To provide preferential treatment, a system for the distribution of medicines and control over the prescription of medicines is being created. Medicines are dispensed on preferential and free prescriptions from pharmacies that have an agreement with the territorial health authority.
To streamline the drug supply to the population and exercise control, other models of providing decreed groups are being introduced in some regions. The need for medicines is determined by the district health departments together with authorized pharmaceutical companies, between which tariff agreements are concluded.
The period for providing preferential prescriptions from pharmacies is:
Within 1 day for preferential prescriptions designated cito;
No more than 3 days for medicines included in the List;
Within 5 days for preferential prescriptions issued based on the conclusion of the CEC.
Prescriptions for medications to be obtained in pharmacies free of charge or with a 50% discount are written out only for outpatient treatment by the attending physician of the clinic. Preferential prescriptions for medicines are issued in accordance with the standards and within the framework of the territorial formulary, with the exception of cases of prescription:
When five or more medications are prescribed to one patient at a time, or more than ten medications are prescribed within one month;
Narcotic drugs, psychotropic, potent and toxic substances, anabolic hormones;
Medicines according to analogue replacement formularies in cases of an atypical course of the disease, in the presence of complications of the underlying disease or concomitant diseases, when dangerous combinations of medicines are prescribed, as well as in case of intolerance or unavailability of medicines included in the territorial formulary in the pharmacy;
Special medications: immunomodulators, antitumor, antituberculosis, antidiabetic and other medications that affect the activity of the endocrine system.
Doctors working part-time in a clinic, doctors of departmental clinics of federal subordination, dentists, private practitioners (working under an agreement with a territorial health care authority) have the right to independently write prescriptions for receipt at a pharmacy on preferential terms, and in special cases preferential prescriptions can be issued paramedic or midwife.
Prescription of preferential prescriptions for psychotropic, potent and toxic substances, anabolic hormones, immunomodulators, antidiabetic, antituberculosis, narcotic drugs for patients who do not suffer from cancer/hematological diseases, are carried out by the attending physician only by decision of the medical commission of the clinic or on the recommendation of a specialist doctor.
It is not allowed for hospital doctors, as well as clinic doctors, to write preferential prescriptions while patients are in hospital.
On one prescription form, form 148-1/u-88, it is allowed to prescribe one name of medicines that are subject to subject-quantitative registration, to be received on preferential terms. When filling out the form, you must highlight the form of payment (free or with a 50 percent discount from the cost). The prescription must indicate a telephone number by which the pharmacist can coordinate with the attending physician a replacement of the drug, the cost of which is more than 30% higher than the cost of the prescribed drug. If the difference is more than 30%, the pharmacist has the right to independently replace the drug.
A patient who has received a medicinal product on preferential terms is given a mark on the preferential dispensing record card.
Narcotic drugs and psychotropic substances of list II must be prescribed to privileged categories of citizens on special prescription forms for narcotic drugs, bearing the stamp of the medical institution, serial number and degree of protection, and in addition to the special prescription form of the established sample, a prescription is issued on the form accounting form N 148-1/у-04 (l) (Appendix 2).
Validity period preferential prescription- up to 1 month, with the exception of prescriptions for narcotic drugs and psychotropic substances of list II - 5 days, for those containing psychotropic substances of list III, potent, toxic substances, medicines: apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dicaine, silver nitrate, pachycarpine hydroiodide, other drugs subject to subject-quantitative accounting, anabolic hormones - 10 days.
To attach a patient to a pharmacy at the place of residence to provide him with narcotic drugs, a written order from the head of the medical institution, registered in the prescribed manner, is issued. Lists of cancer patients assigned to the pharmacy to provide narcotic drugs are updated monthly.
The maximum permissible quantity of medicines for prescribing per prescription is given in Appendix No. 1 to the Instructions on the procedure for prescribing medicines and issuing prescriptions and invoices, approved by order of the Ministry of Health and Social Development of the Russian Federation dated February 12, 2007. No. 110:
According to the same appendix of order No. 110, “when prescribing narcotic medicines not provided for in this appendix, their maximum permissible quantity for prescribing in one prescription may be five times higher than the dose specified in the instructions for medical use of the prescribed medicine.”
The rules for taxation of prescriptions and requirements of health care facilities are as follows:
After the pharmaceutical examination, the prescription is taxed, that is, the retail price of the prescription and the requirements are determined;
The retail price for extemporaneous dosage forms and intrapharmacy preparations consists of the following components:
From the cost of the original ingredients;
From the cost of pharmaceutical glassware;
From the tariff for the manufacture of medicine.
The pharmacy, as a legal entity, independently develops tariffs for the manufacture and packaging of medicines, after which they are approved by the order of the pharmacy.
Tariffs are based on:
Standards for time spent on individual operations for the production, control, packaging and dispensing of extemporaneous forms and intrapharmaceutical preparations, which were previously developed by VNIIF;
The cost of 1 minute of working time, calculated taking into account the average salary.
Examples of taxation of extemporaneous recipes.
Rp. Sol. Sodium bromidi
MDS. 1 table each. spoon 3 times a day after meals.
To prepare the solution, 6g is required. sodium bromide and 200 ml of water. First, the cost of the ingredients is determined:
The cost of 1g of sodium bromide is 0.21x 6 = 1.26
Purified water 0.00 x 0.2 l = 2.00
To the cost of ingredients we add the cost of the bottle and the tariff
Bottle 0.25 l 4-00
tariff 10-00
total 17-26
Rp. Acidi ascorbinici 0.1
Sachari albi 0.2
M., ut fiat pulvis
S. 1 time each. 3 times a day for 30 minutes. before meals.
The cost of ingredients is determined:
Ascorbic acid 2 g x 0.72 = 1.44
White sugar 4 g x 0.05 = 0.2
2. Tariff for 10 times. =14.50
3. Tariff for each subsequent 10 times.
0.5 x 10 = 5.00
Box price 1.00
Total - 22.14
workplace pharmacist prescription medicine
In order for any pharmacy organization to fulfill its main task - providing medicines to the population, it is necessary:
Organize a pharmacist’s workplace for receiving prescriptions and dispensing medications, for which it is necessary to equip workplaces in the prescription and production department;
A pharmacist who accepts prescriptions and dispenses medicines according to them must be guided by the laws of the Russian Federation, current orders, regulatory documents, ethical code pharmacist;
When accepting prescriptions, a pharmacy employee must follow the rules and procedure for accepting prescriptions, ensure that the prescriptions comply with the forms established by the Russian Ministry of Health;
When accepting prescriptions, the pharmacist-technologist is obliged to check the correctness of their execution, the presence, in addition to the name of the medicinal product, of mandatory and additional details;
The pharmacist must check the prescription for compatibility of ingredients, higher single and daily doses of the drug, check the compliance of the quantity of the prescribed drug with the requirements established by orders of the Ministry of Health of the Russian Federation dated February 12, 2007 No. 110;
When dispensing medicines, the pharmacist is guided by the order of the Ministry of Health and Social Development of the Russian Federation dated February 12, 2007 No. 110, “Rules for the dispensing of medicines in pharmacies,” Standards OST 91500.05.0007-2003.
1. Burtsev V. Use of internal control of a commercial organization in state and management audit. / V. Burtsev. // Audit and taxation. - 2002. - N 2. - P.22-26.
2. Versan V. Top management of enterprises and the effectiveness of quality management systems / V. Versan // Standards and quality - 2005. - N 11. - P.28-31.
3. State standards of the Russian Federation (ISO) series 9000-2001.
4. Drugova Z.K. Development of an internal control system to improve the quality of management of the activities of a pharmacy organization: Methodical recommendations/ Z.K. Drugova, A.M. Biteryakova, M.V. Malakhovskaya // Tomsk: TPU Publishing House, 2006. - 34 p.
5. Endovitsky D.A. Justification of the place of internal audit in the internal control system. /YES. Endovitsky; A.A. Aronova // Auditor N 12 2003. - 37-45. //
6. I.V. Kosova "Organization and Economics of Pharmacy". Textbook / I.V. Kosova, E.E. Loskutova, E.A. Maksimkina and others. Ed. I.V. Kosova. – M.: Publishing Center “Academy”; Mastery, 2002. – 400 p.
7. IPS "Consultant Plus".
8. Kaverina O.D. Management accounting. /O.D. Kaverina. M.: finance and statistics, 2003. - 351 p.
9. Kononova S.V. Pharmaceutical services, market formation. /S.V. Kononova, G.A. Oleinik. // New pharmacy. - 2003. - N 6. - P.25-31.
10. Ryzhkova M.V. Development of an anti-crisis management strategy for a pharmaceutical organization: abstract. for the academic degree of Doctor of Pharmacy. Sciences: /Ryzhkova M.V.: State. chemical-pharmaceutical acad. - St. Petersburg, 2004. - 45 p.
11. Website: http://www.knews.ru/allnews/803315.
12. Website: http://www.medbrak.ru/atical. htm
13. Website: http://www.medicine-lib.ru/ml01/pages/10006667. php.
14. Khasanov B.A. Internal audit in the management control system /B.A. Khasanov // Auditor - N 2 2003, pp. 42-44.
15. Khorokhordin D.N. Current issues formation of a system for assessing the quality of internal audit. / D.N. Khorokhordin // Auditor. - 2002. - N 7. - P.40-42.
(from 14 days to 23 days) Storage of finished medicinal products by pharmaceutical groups:
Diagram of storage cabinets for storing finished medicinal products indicating the pharmacological group (Appendix No. 5)
Compliance of the form with the prescribed prescription
Prescription registration
Expiration date of the prescription
Make a conclusion on the issuance of a medicinal product according to this prescription, indicate the reason for refusal
*copies of recipes (if possible, the original) should be attached to the diary (Appendix No. 6)
Storage of finished drugs by pharmaceutical group. By pharmacological action Medicines are divided into the following drugs:
Antispasmodics - relieve spasms of smooth muscles internal organs and eliminate vascular spasms;
Analgesics are medicinal substances of natural, semi-synthetic and synthetic origin intended to relieve pain;
Antiallergic - medicinal substances that reduce the symptoms of allergies;
Anti-colds - used for coughs and colds;
Antifungal - intended for the treatment of fungal diseases;
Cardiovascular - used to treat heart failure and disorders of vascular tone;
Antihypertensives - cause a decrease in arterial blood pressure, used in the treatment of hypertension.
Compliance of the form with the prescribed prescription. When taking prescriptions and dispensing drugs according to them, you must follow a certain algorithm of actions. At the first stage, the compliance of the form of the prescription form with the medicinal prescription, mandatory and additional details is checked. The following forms of prescription forms are available:
1) Form “Special prescription form for narcotic drugs and psychotropic substances”;
2) Form No. 148 -1/ u-88 “Prescription form”;
3) Form No. 107 -1 /у “Prescription form”;
4) Form No. 148 -1/у - 04 (l) “Recipe”;
5) Form No. 148 -1/у - 06 (l) “Recipe”.
The form “Special prescription form for narcotic drugs and psychotropic substances” is produced on pink paper with watermarks and has a serial number.
Narcotic drugs and psychotropic substances are prescribed on this form. The prescription contains the full surname, first name and patronymic of the patient, the medical history No., or the patient’s medical card No., or the history of the child’s development, medical history. The full last name, first name and patronymic of the doctor are indicated. The prescription is signed by the doctor who wrote the prescription, and then certified with the doctor’s personal seal. Additionally, it is certified with the round seal of the health care facility and signed by the chief physician or his deputy.
Only one name of the drug is allowed to be written on one form, and corrections are not allowed. The prescription remains in the pharmacy organization for subject-quantitative accounting. The prescription is valid for 5 days from the date of issue.
Form No. 148 -1/ y-88 “Prescription form” has a series and number. Psychotropic substances are prescribed on this form, as well as other drugs that are subject to quantitative registration and anabolic steroids. The prescription is signed by the doctor and certified by his personal seal and additionally certified by the seal of the healthcare facility “For prescriptions”.
Only one name of drug can be written on one form, and on the back of the prescription a note is made about who prepared, tested and dispensed the drug. The prescription remains in the pharmacy organization for subject-quantitative accounting. Validity period - 10 days.
Form No. 107 -1/у “Prescription form”. All drugs are prescribed on this form, with the exception of those prescribed on form No. 148 -1/u - 88 and a special prescription form for narcotic drugs and psychotropic substances. The prescription is signed by the doctor and certified with his personal seal. No more than 3 names of drugs are written on one form, and corrections are not allowed. Validity period - 10 days, 2 months, 1 year. The validity period is indicated by a strikethrough. Prescriptions for all other medications are valid for 2 months from the date of discharge.
Form No. 148 -1/у-04 “Prescription” and Form No. 148 -1/у-06 “Prescription” are intended for prescribing drugs on preferential terms (free or at a discount). Form No. 148 -1/-06 is drawn up using computer technology. These forms are used to prescribe medications, medical products and specialized medical nutrition products for disabled children. The prescription form is written out in 3 copies, each with a single series and number, and the prescription is signed by a doctor (paramedic) and certified with his personal seal. Validity period is 1 month from the date of discharge, with the exception of medicines that are subject to quantitative registration.
When dispensing a drug In a pharmacy, information about the drugs actually dispensed is indicated on the prescription form, and the date of dispensing is indicated. This prescription form has a tear line separating the form and the spine that is given to the patient. In this case, a note is made on the spine about the name of the drug, dosage, quantity, and method of use.
When dispensing prescription drugs, the pharmacist must follow the following rules.
If the prescription contains narcotic drugs, psychotropic, potent, toxic substances, apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dicaine, silver nitrate, pachycarpine hydroiodide, anabolic hormones - in a mixture with other ingredients, then it is prohibited to dispense them not as part of the manufactured medicinal product funds;
If a doctor prescribes the drugs listed above in a dose exceeding the highest single dose, the pharmacy worker is obliged to dispense this drug in half the dose that is established as the highest single dose;
Pharmacies are prohibited from dispensing the above listed drugs on veterinary prescriptions. medical organizations for the treatment of animals;
When dispensing extemporaneously manufactured drugs containing narcotic drugs, psychotropic, potent, toxic substances, as well as apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dicaine, silver nitart, pachycarpine hydroiodide, ethyl alcohol, instead of a prescription, patients are given a signature with a yellow stripe at the top and the inscription in black font on it “Signature”;
When dispensing finished drugs from pharmaceutical manufacturers, the method of use is indicated on the label;
When producing extemporaneous medicinal products containing narcotic drugs, psychotropic, potent and toxic substances, according to doctor’s prescriptions and the requirements of medical institutions, the pharmacy pharmacist is obliged to sign on the back of the prescription or request for dispensing, and the pharmacy pharmacist is obliged to sign for the receipt of the required amount of narcotic drugs, psychotropic, potent and toxic substances;
When dispensing drugs according to long-acting prescriptions, the prescription is returned to the patient indicating on the back the amount of the drug dispensed and the date of dispensing. The next time the patient visits pharmacy establishment notes on the previous receipt of the medicine are taken into account. Upon expiration of the validity period, the prescription is canceled with the stamp “Prescription is invalid” and left at the pharmacy;
Prescriptions for drugs with anabolic activity, including steroid hormones, tranquilizers, antidepressants, antipsychotics, drugs containing 8-hydroxyquinoline derivatives, antihistamines are canceled with the stamp: “The medicine has been dispensed”;
When prescribing prescriptions for finished drugs to chronically ill patients, it is allowed to set the validity period of the prescription within up to one year. The doctor must make a note “Chronic patient”, indicate the validity period of the prescription and the frequency of dispensing medicines from the pharmacy (weekly, monthly, etc.), certify this indication with his signature and personal seal, as well as the seal of the medical institution “For recipes."
A prescription that does not meet at least one of the listed requirements or contains incompatible medicinal substances is considered invalid, and the pharmacist has the right to refuse to issue the drug.
Preparation of documentation for subject-quantitative accounting:
A copy of one sample sheet of medicinal products subject to PCU (Appendix No. 7)
Subject-quantitative accounting- documented operational accounting of the movement of goods according to individual assortment positions in natural meters. Narcotic and psychotropic drugs are subject to subject-quantitative accounting; precursors; Medicines included in the list of potent substances; Medicines included in the list of toxic substances; substances of apomorphine hydrochloride, atropine sulfate, dicaine, homatropine hydrobromyl, sodium silver, pachycarpine hydroidide; ethanol. PKU of medicines are kept in the Book of registration of narcotic and other medicines, numbered, laced, sealed and certified by the signature and seal of the head of the territorial management body of pharmaceutical organizations.
The book is started for one year. The first page indicates the medicines subject to PCU. A separate sheet is provided for each dosage form, dosage, and packaging of the drug. It indicates accounting units, receipts (for each receipt document separately, indicating the number and date), expenses (daily entries) for each type of document. Corrections are crossed out and certified by the signature of the financially responsible person. On the first day of each month, the availability of medicines subject to PCU is checked with the balance in the Accounting Book. Before the inventory is taken, the book balance will be the opening balance. For finished medicines, these balances must match. In case of discrepancies, those responsible are identified. If there is a discrepancy between the book balance and the actual availability of drugs and ethyl alcohol, natural loss is calculated.
When carrying out any operation, as a result of which the quantity and condition of drugs subject to PCU changes, these drugs are registered in the Accounting Book by financially responsible persons. The said Book is stored after the last entry is made in it in accordance with the established rules of state archival affairs.
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Recipe No. 1 |
Rp: Sol. Omnoponi 2% 1.0 D.t.d. 6 in amp. S. 0.5-1 ml under the skin | |
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Recipe No. 2 |
Rp: Cyclodoli 0.002 D.t.d. N. 50 in tabul. S. S-1 tablet 1-2 times a day | |
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Recipe No. 3 |
Rp: Suprastini 0.025 D.t.d. N 20 in tabul. S. 1 tablet 2-3 times a day | |
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Recipe No. 4 |
Rp: Sol.Pilocarpini hydrochloride 1% 10.0 D.S. Eye drops. 1-2 drops 1-2 times a day | |
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Recipe No. 5 |
Rp: Tabul. Bepassi 0.5 S. 6 tablets 3 times a day (half an hour after barely) | |
In accordance with the requirements of the legislation on licensing of pharmaceutical activities, employees of pharmacy organizations engaged in retail trade medicines and their dispensing, are responsible for compliance with the rules for the circulation of medicines. Pharmacy employees need to know the modern procedure for prescribing medications and the rules for preparing prescription forms, and know the algorithms for conducting a pharmaceutical examination of a prescription in order to avoid errors when dispensing medications.
He talks about the legal requirements for preparing prescription forms for medicines. Natalia Zolotareva, Ph.D., Associate Professor, Department of Management and Economics of Pharmacy, St. Petersburg State Chemical-Pharmaceutical Academy.
Decree of the Government of the Russian Federation dated December 22, 2011 No. 1081 “Regulations on licensing of pharmaceutical activities” is a key document defining the list of licensing requirements and conditions that the state currently imposes on licensees engaged in retail trade in medicinal products for medical use, namely for pharmacy organizations , individual entrepreneurs with a license for pharmaceutical activities.
Specified licensees in mandatory must comply with the rules for dispensing drugs for medical use. The same document defines the concept of “gross violation of licensing requirements and conditions,” which includes issues related to the dispensing of medicines. If the established vacation rules are violated, the control authorities have the right to regard the identified violations as gross, with all the ensuing consequences, ranging from quite serious penalties and including suspension of the licensee’s activities.
WHAT ARE THE HOLIDAY RULES DETERMINED TODAY?
Let's start with legal regulation to figure out how to take prescriptions correctly, namely Federal Law 04/12/10 No. 61-FZ “On the Circulation of Medicines” (Chapter 10 “Pharmaceutical Activities”, Article 55), which reads: “The rules for the dispensing of medicines (medicines) for medical use by pharmacies and individual entrepreneurs are approved by the authorized federal body executive power." Which legislative acts approved regulating the procedure for drug dispensing?
- Federal Law No. 323-FZ "On the fundamentals of protecting the health of citizens in the Russian Federation";
- Federal Law of 02/07/92 No. 2300-I “On the Protection of Consumer Rights”;
- Decree of the Government of the Russian Federation dated January 19, 1998 No. 55 “On approval of the rules of sale individual species goods...";
- Order of the Ministry of Health of the Russian Federation dated August 31, 2016 No. 647n “On approval of the Rules for proper pharmacy practice medicinal products for medical use" (came into force on March 1, 2017);
and departmental regulations- orders of the Russian Ministry of Health:
- No. 1175n from 2012.12 (came into force on July 1, 2013), which determines the procedure for prescribing and prescribing medications, as well as prescription forms;
- No. 54n dated 01.08.12 (came into force on July 1, 2013), dedicated to a special prescription form for narcotic drugs and psychotropic substances;
- No. 785 of December 14, 2005 “On the procedure for dispensing medicines”;
- No. 157n dated March 16, 2010 “On approval of the maximum permissible amount of narcotic drugs, psychotropic substances and their precursors contained in drugs.”
The process of dispensing drugs according to a prescription involves close interaction between a medical and pharmaceutical worker. The responsibility of the first one includes prescribing the drug if the necessary requirements are met, and the second one must, before dispensing the drug according to a prescription, carry out its pharmaceutical examination, if necessary, transfer it for manufacturing, and then dispense the drug. The requirement for feedback between pharmaceutical and medical organizations remains important. Literally, the regulatory requirement involves regularly sending information about all incorrectly written prescriptions to the medical organization. Such feedback, regular and properly established, eliminates a number of questions regarding identified violations from the point of view of prescription drug dispensing.
FIVE RECIPES FORMS
Two key regulatory documents are directly related to the procedure for prescribing drugs and the forms of the prescription form - these are order No. 1175n and order No. 54n (both came into force on July 1, 2013).
Traditionally operating regulatory documents determined the forms of prescription forms. Today there are 5 forms of prescription forms: No. 107-1/u, 148-1/u-88, 148-1/u-04 (l), No. 148-1/u-06 (l), special prescription form . From January 1, 2016, by order No. 385n, separate changes were made to the forms of prescription forms 148-1/u-88, 107-1/u. But in order for stocks of previously purchased prescription forms to be used for their intended purpose, it was allowed to use old-style forms before the entry into force of the order of the Ministry of Health of Russia dated June 30, 2015 No. 385n "On amendments to the order of the Ministry of Health of the Russian Federation dated August 1, 2012 No. 54n" On approval of the form of prescription forms containing the prescription of narcotic drugs or psychotropic substances, the procedure for their production, distribution, registration, accounting and storage, as well as registration rules", i.e. until July 1, 2016. After this, pharmacy workers must require those forms prescription forms, the structure of which has been changed in accordance with current regulatory documents.
Order No. 1175n introduced a lot of new things into the procedure for prescribing and prescribing medications. The first place in importance of innovation can be given to the paradigm of drug prescription itself. If previously a health worker could use any drug name: INN, grouping or trade name, as it was convenient for him, then in connection with the entry into force of this regulatory document, the priority is clearly established in prescribing drugs according to the INN. If it is missing, then the group name should be used, and if both names are missing, then according to trade name.
The list of those who have the right to prescribe and write prescriptions now includes specialists with secondary medical education: paramedics and midwives. Only if such powers are assigned to them by the relevant order of the head of the medical organization. Individual entrepreneurs traditionally also have the right to prescribe medications and write prescriptions, but there are certain restrictions, for example, related to the fact that medical specialists who carry out private medical activities, do not have the right to prescribe narcotic and psychotropic drugs from Lists 2 and 3.
If a recipe comes under a trade name, what should you do with it? Can it be rejected, or is it written out correctly? The answer to this question is in the order of the Ministry of Health No. 1175n - a health worker has the right to use a trade name when prescribing in case of individual intolerance and/or for health reasons, but this decision must be confirmed by a medical commission, as evidenced by the corresponding stamp on the back of the prescription.
DIFFERENCES IN RECIPES FORMS
What is the difference between these forms of prescription forms and how can health workers fill them out correctly in order to prevent incorrect pharmaceutical examination in the pharmacy?
√ Special prescription form(the most difficult one is in terms of the details and structure, although from the point of view of its use there is only one case when a health worker can and should use this form). This strict accounting form has several degrees of protection and is intended for prescribing narcotic and psychotropic drugs from List 2 of the List, approved by Decree of the Government of the Russian Federation dated March 21, 2011 No. 181 “On the procedure for importing into and exporting from the Russian Federation narcotic drugs, psychotropic substances and their precursors" (for example, morphine, promedol, prosedol, etc.). List 2 is updated regularly. Working with narcotic drugs from Lists 2 and 3 requires a separate license, unlike work with potent toxic drugs.
All prescription forms differ in purpose of use, structure, composition of details, validity period and shelf life.
Current regulations require that if a narcotic drug or psychotropic substance is prescribed for preferential categories citizens, in addition to the special prescription form, it is necessary to provide forms 148-1/u-04 (l), No. 148-1/u-06 (l). The special prescription form has undergone changes - it has become larger, and from June 30, 2015, the validity period of this prescription form has been significantly increased - from 5 to 15 days from the date of prescription. The stamp of the medical organization must be clearly legible (its name, address and telephone number). The form has a series, number, date of prescription, indication “child” or “adult” (underlined); The patient's full name, age (number of completed years (children under one year - number of months), series and number of the compulsory medical insurance policy, number of the outpatient medical card. In Latin, according to the INN, indicating the dosage, packaging and quantity, the corresponding medicinal product is indicated. Only in In this form of the prescription form, the number of prescribed psychotropic and narcotic drugs from List 2 must be indicated not only in numbers, but also in words.
All this is certified by the personal signature of the doctor, as well as the personal seal of the health worker. This form must indicate the full name of the authorized person, who can be the head or deputy head of a medical organization, structural unit, or an appointed authorized person, which certifies these forms (full name, signature). It is additionally certified by the seal of the medical organization or the seal for prescriptions. Next on the prescription form is a note from the pharmacy organization about the dispensing of the drug. If the pharmacy worker is satisfied with everything in the design of the prescription form, he indicates what is dispensed, dosage, and packaging. Certified by full name (full name), date of issue and seal of the pharmacy organization.
√ Prescription form 148-1/у-88- the form of which is simpler in terms of the composition of the details, but if we talk about the purposes of the form, there are 5 options for use.
- Narcotic and psychotropic drugs from Schedule 2, but in the form of transdermal therapeutic systems, i.e. any other dosage form of a narcotic drug or psychotropic substance classified as Schedule 2, must be written out on a special prescription form. Traditionally, this form is used to prescribe and prescribe psychotropic drugs from List 3.
- Other medications are subject to subject-quantitative accounting, but there is an addition - with the exception of drugs sold without a doctor's prescription.
- To prescribe drugs with anabolic activity (anabolic steroids).
- Also, since 2012, the procedure for dispensing combined drugs containing small amounts of narcotic and psychotropic substances and their precursors, other pharmacological active substances. It's about about the combinations that are indicated in clause 5 of the order of the Ministry of Health of Russia dated May 17, 2012 No. 562 “On approval of the Procedure for dispensing to individuals medicinal products for medical use, containing, in addition to small quantities of narcotic drugs, psychotropic substances and their precursors, other pharmacological active substances.”
- When prescribing individually manufactured medicinal products that contain narcotic drugs and psychotropic substances from List 2 of the List of Resolution No. 681, provided that the content of narcotic and psychotropic substances in these combination drugs does not exceed the highest single dose, and the drug itself is not included in Schedule 2.
This form is valid for 15 days. Since August 2016, either the patient’s full address with a zip code, or the patient’s medical card number, has been indicated on the prescription form.
√ Prescription form 107-1/у- the most simple form prescription form. At the same time, regulatory documents indicate the following: this form must be used for prescribing and prescribing combination drugs containing small doses of narcotic, psychotropic substances, their precursors and other pharmacologically active substances, but those combinations that are indicated in clause 4 of Order No. 562 of the Ministry of Health of Russia .
The form must contain a stamp of the medical organization, name (in full), address, telephone number, date, indication of “adult” or “children”, full name of the patient (in full), his age, full name of the doctor (in full), name of the medicinal product in Latin according to INN with indicating dosage, packaging and dosage.
Up to three names of drugs can be written out on this prescription form (unlike other forms, where only one name can be indicated). Personal signature and stamp of the doctor on the form. Valid up to 60 days. For chronic patients extension possible up to 1 year.
MAJOR VIOLATIONS WHEN COMPLETING RECIPES
The St. Petersburg State Chemical-Pharmaceutical Academy conducted a study in which recipes placed in the journal of incorrectly written prescriptions were analyzed. Sometimes health workers do not indicate the validity period of the prescription, incorrectly fill out the “full address” details, do not fully indicate the full name of the doctor and the patient, the stamps are not clearly readable, incorrectly fill out the details regarding the patient’s age, there are no notes from the medical commission when the prescription is written out under a trade name, there are extra seals and inscriptions exceed the drug supply norm.
The last one is a frequently occurring error. Current regulatory regulations establish maximum permissible dispensing rates and recommended quantities per prescription. But any rule allows for an exception; it is marked by order No. 1175n (clause 15, clause 22, clause 23), which makes it possible to legally exceed established standards drug release.
Based on materials from an online seminar organized by the St. Petersburg Union of Doctors
