Appendix No. 9
Rules for dispensing codeine-containing drugs
1. Prescription form f-148-1/u-88
2. Availability of a stamp, the doctor’s personal seal and the “For prescriptions” seal
3. The prescription is valid for 10 days.
4. If the prescription is filled out correctly, tax it, sign on the back of the prescription for vacation
5. A selection of recipes and recording in the journal is carried out by the manager daily, the results are summed up monthly and annually. The use of a proofreader is not permitted in the journal. If there is an error, the incorrect number is crossed out, the correct one is written, and certified by three signatures.
Appendix No. 10
Rules for preparing prescriptions /Orders of the Ministry of Health of the Russian Federation No. 1175, 54, 785/
Number of prescribed narcotic and psychotropic drugs medicinal products of lists II and III of the List, other medicinal products drugs subject to subject-quantitative accounting, when providing palliative care to patients medical care can be increased no more than 2 times the maximum permissible quantity of drugs for prescribing per prescription established by Appendix No. 1 to Order No. 1175, or the recommended quantity of drugs for prescribing per prescription, installed by application No. 2 to order No. 1175.Appendix No. 11
Approved
Government Decree
"Pharmacy: accounting and taxation", 2012, N 7
In accordance with clause 2 of the Decree of the Government of the Russian Federation N 599<1>Order of the Ministry of Health and Social Development of Russia dated May 17, 2012 N 562n approved the Leave Procedure individuals medicinal products for medical use containing, in addition to small quantities of narcotic drugs, psychotropic substances and their precursors, other pharmacological active substances(hereinafter referred to as Order No. 562n). Let's consider the main provisions of this document.
<1>Decree of the Government of the Russian Federation dated July 20, 2011 N 599 “On control measures regarding drugs that contain small quantities of narcotic drugs, psychotropic substances and their precursors included in the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation.”
What drugs fall under the norms of Order N 562n?
Order No. 562n establishes the rules for the dispensing to individuals of medicinal products for medical use, containing, in addition to small quantities of narcotic drugs, psychotropic substances and their precursors included in Lists II, III and IV of the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation , approved by Decree of the Government of the Russian Federation of June 30, 1998 N 681 (hereinafter referred to as List N 681), other pharmacological active substances (hereinafter referred to as combination drugs).
In accordance with clause 2 of Order No. 562n, combination medicinal products containing NS, PV and their precursors in quantities not exceeding the maximum are subject to dispensing. permissible quantity NS, PV and their precursors in preparations that contain small amounts of NS, PV and their precursors included in Lists II, III and IV of List No. 681 (Maximum permissible quantities are approved by Order of the Ministry of Health and Social Development of Russia dated March 16, 2010 N 157n).
Combined medications are dispensed from pharmacies and pharmacy points according to prescriptions written out on prescription forms 107-1/u and 148-1/u-88, approved by Order of the Ministry of Health and Social Development of Russia dated February 12, 2007 N 110.
Other combination drugs are sold from pharmacies, pharmacy points and pharmacy kiosks without a prescription.
Dispensing medications according to prescriptions
According to prescription form 107-1/u. In accordance with clause 4 of Order No. 562n, combination medicinal products containing:
- ergotamine hydrotartrate in an amount of up to 5 mg (per dose of solid dosage form);
- ephedrine hydrochloride in an amount of up to 100 mg (per 100 ml or 100 g of liquid dosage form for internal use);
- pseudoephedrine hydrochloride in an amount not exceeding 30 mg (per dose of solid dosage form);
- pseudoephedrine hydrochloride in an amount not exceeding 30 mg, in combination with dextromethorphan hydrobromide in an amount exceeding 10 mg and up to 30 mg (per dose of solid dosage form);
- dextromethorphan hydrobromide in an amount exceeding 10 mg and up to 30 mg (per dose of solid dosage form).
According to prescription form 148-1/u-88. In accordance with clause 5 of Order No. 562n, combination medicinal products containing:
- codeine or its salts (in terms of pure substance) in an amount of up to 20 mg (per dose of a solid dosage form) or in an amount of up to 200 mg (per 100 ml or 100 g of a liquid dosage form for internal use);
- pseudoephedrine hydrochloride in an amount exceeding 30 mg and up to 60 mg (per dose of solid dosage form);
- pseudoephedrine hydrochloride in an amount from 30 mg to 60 mg in combination with dextromethorphan hydrobromide in an amount exceeding 10 mg and up to 30 mg (per dose of solid dosage form);
- dextromethorphan hydrobromide in an amount of up to 200 mg (per 100 ml or 100 g of liquid dosage form for internal use);
- ephedrine hydrochloride in an amount exceeding 100 mg and up to 300 mg (per 100 ml or 100 g of liquid dosage form for internal use);
- ephedrine hydrochloride in an amount of up to 50 mg (per dose of solid dosage form);
- phenylpropanolamine in amounts up to 75 mg (per dose of solid dosage form) or up to 300 mg (per 100 ml or 100 g of liquid dosage form for internal use).
If the amount of the combination prescribed in the prescription medicinal product exceeds its maximum permissible quantity for prescribing per prescription specified in Appendix 1 to the Instructions<2>, the pharmaceutical worker at the pharmacy (pharmacy point) dispenses the combined drug in the quantity established by Appendix 1 to the Instructions (clause 6 of Order No. 562n).
<2>Instructions on the procedure for prescribing medications and filling out prescriptions and invoice requirements, approved. By Order of the Ministry of Health and Social Development of Russia dated February 12, 2007 N 110.
By virtue of clause 8 of Order No. 562n, when dispensing combined medicinal products according to prescriptions written out on prescription forms form 107-1/u, for which, in accordance with the Instructions, the period is set to one year, the prescription is signed by a pharmaceutical worker at the pharmacy (pharmacy point) and returned to the patient, indicating on the back the name of the pharmacy (pharmacy point), the quantity of the combined drug dispensed and the date of its dispensing.
The combination medicinal product is dispensed by a pharmaceutical worker at a pharmacy (pharmacy point) in accordance with the frequency of dispensing specified in the prescription.
The next time a patient visits a pharmacy (pharmacy point), the pharmacist takes into account the notes on the previous dispensing of the combined drug.
Upon expiration of the validity period, the prescription is canceled with the stamp “The drug is dispensed” and returned to the patient.
Prescriptions written out on prescription forms form 148-1/u-88, after dispensing the combined medicinal product, must be stored in a pharmacy (pharmacy point) for three years (clause 9 of Order No. 562n).
For your information. In Letter dated 06.06.2012 N 975/25-1, officials of the Ministry of Health and Social Development of Russia explained that codeine-containing drugs prescription The following drugs, previously classified as over-the-counter drugs, are subject to:
- containing codeine or its salts (in terms of pure substance) in an amount of up to 20 mg (per dose of solid dosage form);
- containing codeine or its salts (in terms of pure substance) in an amount of up to 200 mg (per 100 ml or 100 g of liquid dosage form for internal use). In addition, attention is drawn to the fact that in accordance with Order of the Ministry of Health and Social Development of Russia N 562n, codeine-containing drugs are not subject to subject-quantitative accounting and the norms providing for an increase in the validity of a prescription to one month or one year for chronic patients do not apply to codeine-containing drugs.
Destruction of prescription forms according to form 148-1/у-88
By virtue of clause 10 of Order No. 562n, upon expiration of the shelf life, prescriptions written out on prescription forms in form 148-1/u-88 are subject to destruction in the manner prescribed by clause 2.16 of the Procedure for dispensing medicines, approved by the Order of the Ministry of Health and Social Development of Russia dated December 14, 2005 N 785 (hereinafter - Order N 785). The procedure for destroying prescriptions left in a pharmacy institution (organization) after the established storage periods, and the composition of the commission for their destruction may be determined by health authorities or pharmaceutical activities subject of the Russian Federation. The forms of acts for the destruction of recipes are given in Appendices 2 and 3 to this Order.
For reference. In accordance with clause 2.16 of Order No. 785, the storage periods for prescriptions in a pharmacy institution (organization) are:
- on medicines, included in the List of medicines dispensed by prescription from a doctor (paramedic), as well as other medicines dispensed free of charge or at a discount<3>, - five years;
- for narcotic drugs and psychotropic substances included in List II of List No. 681, and psychotropic substances included in List III of List No. 681 - ten years;
- for other medicines subject to subject-quantitative registration, with the exception of NS and PV included in List II of List No. 681, and PV included in List III of List No. 681; anabolic steroid- three years.
M.R. Zaripova
Journal expert
"Pharmacy: accounting
and taxation"
Question:
According to order No. 1175n dated December 20, 2012, the dispensing rate for phenobarbital is 30 tablets, and if the prescription states “special purpose”, how many can we dispense? And if there are 12 tablets in a package, what quantity do we have the right to dispense if there is 1 tablet in the package?
Answer:
Attention, you are using open access to outdated consultations. Current consultations for the last 5 years are available only to registered clients who have paid for access to the site.
The drug phenobarbital is a derivative of barbituric acid and is included in List III of psychotropic substances approved by Decree of the Government of the Russian Federation of June 30, 1998 N 681 “List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation” (as amended on 07.11. 2013).In accordance with paragraph 15 of the Order of the Ministry of Health of the Russian Federation of December 20, 2012 N 1175n “Procedure for prescribing and prescribing drugs” approved, the number of prescribed psychotropic drugs of List III of the List when providing palliative care to patients can be increased by no more than 2 times compared to with the recommended number of drugs to be prescribed per prescription, installed by the Application No. 2 to the specified Order.
Moreover, according to paragraph 23 of the Procedure, prescriptions for barbituric acid derivatives for the treatment of patients with chronic diseases may be discharged for a course of treatment of up to two months. In these cases, the inscription “By special purpose", separately signed medical worker and seal medical organization"For recipes."
According to Appendix No. 2 to the above “Procedure for Prescribing and Prescribing Medicines,” the recommended amount of phenobarbital for prescribing per prescription is 30 tablets.
Therefore, when providing palliative care A doctor can prescribe up to 60 tablets of phenobarbital to a patient in one prescription without any special notes on it.
In addition, for the treatment of patients with chronic diseases, the doctor can prescribe in one prescription the number of phenobarbital tablets required for a course of treatment for 2 months. In this case, the prescription must bear the inscription “For special purposes”, sealed with the additional signature of a medical worker and the seal of the medical organization “For prescriptions”.
In both of the above cases, it is not the responsibility of the pharmacist to check the quantity of the prescribed drug. Responsibility for the correct prescription of the drug lies with the doctor who wrote the prescription, as well as the medical organization.
26.12.13
Narcotic drugs: Buprenorphine, Codeine, Codeine phosphate, Cocaine, Cocaine hydrochloride (hydrochloride), Morphine, Morphine hydrochloride, Morphine sulfate, Morphilong, Omnopon, Prosidol, Promedol, Fentanyl, Estocin, Estocina hydrochloride, Ethylmorphine hydrochloride, etc. .
Psychotropic substances: Amobarbital (Barbamil), Amfepramone (Fepranone), Ketamine, Ketamine hydrochloride (Calipsol, Ketalar), Etaminal sodium, etc.
Rules for prescribing narcotic drugs and psychotropic substances:
The drug is prescribed on a special pink prescription form.
The amount of narcotic drugs and psychotropic substances prescribed in a prescription is indicated in words.
In the column “Medical history No...” the medical No. is indicated. outpatient cards.
The prescription is signed by the doctor and certified with his personal seal. Additionally, the prescription is signed by the head physician for treatment - preventive institution or deputy and certified with the round seal of the health care facility.
Narcotic drugs and psychotropic substances included in list 2 of the list of “Narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation” are prescribed on the prescription form.
Only one name of the drug is written on one prescription form.
answer21. Rules for writing prescriptions: list of drugs and substances prescribed on form No. 148, design of the form.
List of funds subject to PCU:
1. Narcotic drugs and psychotropic substances of Schedule 2 (see question No. 20), psychotropic substances Schedule 3: Aprofen, Halothane (Ftorotan), Sodium hydroxybutyrate and other salts of hydroxybutyric acid, Taren, Pentobarbital, Ethylamphetamine, etc.
2. Schedule 4 precursors: Acetone, Potassium permanganate, Pseudoephidrine, Sulfuric acid, Hydrochloric acid, Ephedrine, Ergometrine, Ergotamine, Ethyl ether, etc.
3. Potent substances on List No. 1 of the PCCN (Permanent Committee on Narcotics Control): Barbital, Clonidine, Diazepam, Spasmoveralgin, Ether for anesthesia, etc.
4. Poisonous substances Sp. No. 2 PKKN: Arsenic anhydride, Mercury dichloride, Strychnine nitrate, etc.
5. Substances: appomorphine h/x, homatropine hydrobromide, atropine sulfate, dicaine, silver nitrate, pachycarpine hydroiodide.
6. Ethyl alcohol.
7. Medical antiseptic solution.
8. Clozapine (Leponex, Azaleptin).
9. Butorphanol (Stadol, Moradol).
Form No. 148-1/u-88.
The prescription is signed by the doctor and certified with his personal seal. Additionally, it is certified by the seal of the health care facility “For prescriptions.”
List 3 psychotropic substances are prescribed on the prescription form; other medicines subject to PCU; anabolic steroids.
Only one name of the drug is allowed to be written on one form.
22. Rules for writing prescriptions: filling out form No. 107.
23. Rules for writing prescriptions: standards for dispensing narcotic and other substances, conditions for overestimation.
1. Codeine, codeine phosphate 0.2
2. Morphine hydrochloride. Solution for injection, ampoules 1% 1 ml, 20 ampoules.
3. Omnopon. Solution for injection, ampoules 1%, 1 ml, 10 ampoules, 2%, 1 ml, 5 ampoules.
4. Promedol. Tablets for oral administration, 25 mg, 50 tablets.
5. Promedol. Solution for injection, ampoules 1-2%, 1 ml, 10 ampoules. Syringe tube 1-2% 1 ml 10 syringe tubes.
6. Ethylmorphine hydrochloride and other ephedrine salts (powder) 0.6 g.
7. Ethylmorphine hydrochloride (dionine) powder 0.2 g.
8. Combined drugs containing Ephedrine hydrochloride, included in list No. 1 of potent substances of PKKN:
1) Teofedrine, Teofedrin-N, Neo-theofedrine 30 tablets
2) Solutan 1 bottle
3) Spasmoveralgin, Spasmoveralgin-Neo 50 tablets
9. Clonidine 0.075 mg 0.15 mg 1 package, 50 tablets
10. Pachycarpine hydroiodide (powder) 1.2g
11. Anabolic hormones: neurobolil 1 pack, methandrostenolol 5 mg No. 10, oxandrolone 25 mg No. 100, retabolil 50 mg 1 ml No. 1, Nandrolone 1 ml No. 6 and No. 12, Silabolin 2.5% 1 ml No. 10
12. Derivatives of barbituric acid: phenobarbital 50 mg 10 tabs, phenobarbital 100 mg 12 tabs,
13. Fepranon 25 mg 50 tab
14. Ethyl alcohol: in pure form 50.0 and in the mixture 50.0
1. Ethylmorphine hydrochloride (dionine). Possible in eye drops and ointments up to 1.0, and for overestimation you need a doctor’s order “for a special purpose”, which is certified by the signature and personal seal of the doctor and the seal of the health care facility “for prescriptions”
2. Narcotic drugs, barbituric acid derivatives and potent drugs can be increased 2 times compared to what is indicated in the table for incurable cancer patients. There must be a written order from the head of the health care facility to assign the patient to the pharmacy to provide him with narcotic drugs.
3. Derivatives of barbituric acid, ephedrine, pseudoephedrine can be prescribed for a course of treatment of up to 1 month. The prescription must contain: a doctor’s instruction “for a special purpose,” which is certified by the doctor’s signature and the seal of the health care facility “for prescriptions.”
4. Ethyl alcohol for patients chronic course diseases up to 100.0 in a mixture and in pure form. On the prescription: a doctor’s instruction “for a special purpose,” certified by the doctor’s signature and stamp “for prescriptions.”
answer22. Rules for writing prescriptions: filling out form No. 107 .
1. To be filled out by the doctor in legible handwriting. 2. The name and age of the patient are indicated. 3. In column Rp: dosage and name of the drug. 4. The doctor’s personal signature and stamp is affixed. 5. All drugs are prescribed except for narcotic, psychotropic, sp.2, potent and poisonous ones. 6.No more than 3 drugs are written on one form. 7. On the back there are 3 columns: prepared, checked, released. 8. A health care facility stamp is affixed to the top of the prescription. 9. Corrections are not allowed. 10. Valid for 1 month, stored in the pharmacy for 1 year.
answer23. Rules for writing prescriptions: standards for dispensing narcotic and other substances, conditions for overestimation .
Norms for dispensing narcotic and other substances:
15. Codeine, codeine phosphate 0.2
16. Morphine hydrochloride. Solution for injection, ampoules 1% 1 ml, 20 ampoules.
17. Omnopon. Solution for injection, ampoules 1%, 1 ml, 10 ampoules, 2%, 1 ml, 5 ampoules.
18. Promedol. Tablets for oral administration, 25 mg, 50 tablets.
19. Promedol. Solution for injection, ampoules 1-2%, 1 ml, 10 ampoules. Syringe tube 1-2% 1 ml 10 syringe tubes.
20. Ethylmorphine hydrochloride and other ephedrine salts (powder) 0.6 g.
21. Ethylmorphine hydrochloride (dionine) powder 0.2 g.
22. Combined drugs containing Ephedrine hydrochloride, included in list No. 1 of potent substances of PKKN:
4) Teofedrine, Teofedrin-N, Neo-theofedrine 30 tablets
5) Solutan 1 bottle
6) Spasmoveralgin, Spasmoveralgin-Neo 50 tablets
23. Clonidine 0.075 mg 0.15 mg 1 package, 50 tablets
24. Pachycarpine hydroiodide (powder) 1.2g
25. Anabolic hormones: neurobolil 1 pack, methandrostenolol 5 mg No. 10, oxandrolone 25 mg No. 100, retabolil 50 mg 1 ml No. 1, Nandrolone 1 ml No. 6 and No. 12, Silabolin 2.5% 1 ml No. 10
26. Derivatives of barbituric acid: phenobarbital 50 mg 10 tabs, phenobarbital 100 mg 12 tabs,
27. Fepranon 25 mg 50 tab
28. Ethyl alcohol: pure 50.0 and mixed 50.0
Conditions for overestimating vacation standards (Project No. 110)
5. Ethylmorphine hydrochloride (dionine). It is possible in eye drops and ointments up to 1.0, but for overestimation you need a doctor’s order “for a special purpose”, which is certified by the signature and personal seal of the doctor and the seal of the health care facility “for prescriptions”
6. Narcotic drugs, barbituric acid derivatives and potent drugs can be increased 2 times compared to what is indicated in the table for incurable cancer patients. There must be a written order from the head of the health care facility to assign the patient to the pharmacy to provide him with narcotic drugs.
7. Derivatives of barbituric acid, ephedrine, pseudoephedrine can be prescribed for a course of treatment of up to 1 month. The prescription must contain: a doctor’s instruction “for a special purpose,” which is certified by the doctor’s signature and the seal of the health care facility “for prescriptions.”
8. Ethyl alcohol for patients with chronic illness up to 100.0 in a mixture and in pure form. On the prescription: a doctor’s instruction “for a special purpose,” certified by the doctor’s signature and stamp “for prescriptions.”
