Rules for storing medicines in the department. Medicines accounting

Storage rules medicines in healthcare facilities today it is regulated by the Ministry of Health of the Russian Federation.

Order 706n rules for storing medicines guide pharmacy and medical organizations in their work.

Let's consider general rules drug storage and features.

Let us pay attention to the main violations of medical institutions in this area.

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Order 706n rules for storing medicines

The rules for storing medicines determine how medicines with different properties and potential dangers should be stored.

Drugs medical purposes the rules are divided into the following groups:

• Medicines exposed to temperature (high or low). They should be stored in strict accordance with the recommended temperatures.

On the packaging of medications, the manufacturer usually indicates which regimen is recommended; as a rule, this is no more than +25 °C. Such drugs are novocaine, adrenaline and other drugs in solutions.

Samples and special selections standard procedures For nurses, which can be downloaded.

Oil and ether solutions, insulin, and ammonia react to low temperatures.

The order regulating the rules for storing medicines should be strictly followed because such medicines, after being in low temperatures, completely change and lose their beneficial qualities.

• Preparations that can lose their properties under the influence of moisture and light.



Medicines in this group include, for example, silver nitrate and proserin, which react to light, and mustard or gypsum, which lose their properties when exposed to moisture.

Storage of drugs that react to light should be given Special attention premises, if necessary, are equipped with thick blinds, stickers that reflect light and other devices that reduce the flow of light entering them.

Where to store medications with a limited shelf life

The rules establish special requirements for expired medications.

Their placement is allowed only in separately designated (quarantine) areas, so that they cannot mix with normal medications. In practice, this is a marked separate shelf or a special safe.

In this regard, the expiration dates of drugs must be constantly monitored. The order of the chief physician of the medical institution approves the residual shelf life, which is considered limited. For example, this is the last 6 months of the expiration date.

The order considers such drugs as medications with a limited shelf life.

Storage of flammable and explosive medicines in accordance with Order No. 706n

Order 706n rules for storage of medicines also establishes the specifics of placement of explosive and flammable medicines.

Such products have an increased danger due to the content of glycerin, sulfur, alcohols and ethers, turpentine, etc. In this regard, it is necessary to ensure their separate location from other medications.

In addition, explosive substances must not be placed near:

• medications containing alkalis;
• gas cylinders;
• mineral acids;
• inorganic salts, which can form a flammable mixture in combination with organic preparations;
• dressing materials.

How to store potassium permanganate

Storage conditions for potassium permanganate in accordance with the rules must meet the following requirements:

How to store ether

To preserve medicines in medicines containing ether, choose places that are away from heating elements and fire; the place should be protected from bright light. This is due to the fact that ether for anesthesia is flammable.

To ensure safe conditions for storing flammable drugs in hospitals, including ether, it is recommended to place them separately from other medical products, preferably in a specially designated room.

Storage of nitrogen and oxygen in cylinders

Several stand out important rules saving nitrous oxide and oxygen in cylinders:

1. According to GOST 26460-85, cylinders are placed under a canopy on the territory of a medical institution or in separate warehouses to ensure their protection from the sun and moisture.
2. According to PPBO 07-91 dated 08/09/1990, oxygen cylinders are placed in fireproof cabinets located outside the medical facility at a distance of at least 4 meters from window and door openings.
3. If more than 10 40-liter oxygen cylinders are stored, they are placed in a separate room. Its walls should be made without windows, from safe materials, the distance from other rooms should be at least 25 meters.
4. Warehouses intended for storing nitrogen cylinders must be equipped with ventilation, and the cylinders themselves should be placed at a safe distance from heating radiators (at a distance of at least 1 meter).
5. Explosive drugs are stored in fireproof safes outside the place where they are permanently stored in medical facilities. In addition, the premises must be equipped with fire alarms.

Rules and requirements for the storage of potent and poisonous medicines in order 706n

As follows from the rules for storing medicines in hospitals, for potent and poisonous drugs, premises that have special security equipment are required. The rules for handling them are similar to the rules for storing drugs.

Thus, potent drugs can be stored in the same room as drugs. In this case, potent and toxic substances must be stored either in different safes or on different shelves of metal cabinets.

Note that some drugs were excluded from the list of poisonous and potent drugs and moved to the list of drugs. For example, these are Midazolam, Brotizolam, Lorazepam, Estazolam, Phenobarbital, etc.

Therefore, such medicines should be stored according to the rules in force for narcotic drugs and their precursors.

How to control storage rules

Compliance with the rules is monitored by the head nurse, as well as the duty nurses of the departments.

For control purposes, they perform the following duties:

• temperature and air parameters in storage areas are recorded once per shift;
• nurses and senior nurses identify medications in storage areas using a rack card;
• records are kept of medicines that have a limited shelf life in order to control their timely use;
• When medications expire, they should be placed in a quarantine area and stored separately from other medications. They are subsequently sent for destruction.

Roszdravnadzor checklist - storage of drugs in medical institutions

Look at the checklist in the Chief Nurse System, which is used to check the storage of medications in a medical organization.

The checklist consists of 62 questions and is approved by Appendix 2 to Order No. 9438. Inspectors will evaluate the quality assurance system for storing drugs, premises, equipment and documentation.

How to decipher the storage conditions of drugs

In some cases, it is very difficult for healthcare workers to adhere to storage rules medicines in health care products, which are recommended by their manufacturer on consumer packaging.

For example, many manufacturers indicate that the drug should be stored at room temperature or in a cool place, without specifying what exact air temperature corresponds to these rules.

State Pharmacopoeia Russian Federation The recommended conditions for saving drugs were deciphered:

• 8-15°C cool or cold conditions;
• 15-25°C “room” temperature;
• 2-25°C temperature up to 25°C;
• 2-8°C temperature not exceeding 8°C.

When to issue a rack card

The procedure for storing medications in the health care department requires that rack cards be kept on them when storing medications. These are special cards that provide basic information about the medicine and the conditions for saving it.

The rack card is updated with newly received medicine. If the medical institution received a drug of the same dosage, release form and the same series, you can leave old map. If medicines with different characteristics, for example, a different form of release, are received, a new card must be issued. Example of filling out a rack card see in the Chief Nurse System.

Order 706n establishes in paragraph 10 a specific list of information that is permissible to reflect on such a card; health workers do not have the right to abbreviate it.

Violations of the rules

Roszdravnadzor analyzed the main violations of the rules according to the order that occur in health care facilities:

• the requirements of the drug manufacturer, which are indicated on its packaging, are violated;
• Regular medications and expired medications are placed together;
• the medical institution does not record the expiration dates of medications;
• In the medicine storage rooms there are no devices for measuring temperature and humidity indicators, or these devices have not been verified.

REMINDER approved by Order of the Ministry

1. Procedure for obtaining medications from pharmacies

1.1. Medicines intended for the treatment of patients in inpatient conditions are dispensed by pharmacies to the paramedic on duty or nurse only in original factory or pharmacy packaging.

1.2. A representative of the department, receiving a medicine, is obliged to check its compliance with the prescription in the requirement.

2. Rules for storing medicines in departments

2.1. The head of the department (office) is responsible for the storage and consumption of medicines, as well as for the order in storage areas, compliance with the rules for issuing and prescribing medicines. The direct executor of organizing the storage and consumption of medicines is the senior nurse.

2.2. Storage of medications in departments (offices) must be organized in locked cabinets. It is necessary to divide into groups “External”, “Internal”, “Injection”, “ Eye drops". In addition, in each compartment of the cabinet, for example, "Internal", there should be a division into powders, mixtures, ampoules, which are placed separately, and powders are stored, as a rule, on the top shelf, and solutions on the bottom.

2.3. Odorous and coloring substances should be kept in a separate cabinet.

2.4. Storage of medications in the operating room, dressing room, and treatment room is organized in instrumental glass cabinets or on surgical tables. Each bottle, jar, and rod containing medications must have an appropriate label.

2.5. Poisonous medicines should be stored in a separate cabinet under lock and key.

Narcotic drugs should be stored in safes or iron cabinets. On inside The doors of the cabinet (safe) must have the inscription “A” and a list of toxic agents indicating the highest single and daily doses.

Stockpiles of poisonous and narcotic drugs should not exceed the 5-day requirement for them.

2.6. Potent drugs (list B) should be stored in a separate (wooden) cabinet under lock and key.

Stocks of potent drugs should not exceed 10-day requirements.

2.7. The keys to cabinets “A” and “B” are kept only by persons appointed by order of the medical institution, responsible for the storage and distribution of poisonous and potent drugs, and at night these keys are handed over to the doctor on duty, about which a corresponding entry is made in a special journal and placed signatures of the person who handed over and accepted the keys and the indicated medications.

2.8. In storage areas and at the posts of doctors and nurses on duty there should be tables of the highest single and daily doses of poisonous, narcotic and potent drugs, as well as tables of antidotes for poisoning.

2.9. In departments (offices) of institutions, the following material assets are subject to subject-quantitative accounting:

a) poisonous medicines in accordance with the rules approved by Order of the USSR Ministry of Health dated 07/03/68 N 523;

b) narcotic drugs in accordance with the rules approved by Order of the USSR Ministry of Health dated December 30, 1982 N 1311;

c) ethyl alcohol (Order of the USSR Ministry of Health dated August 30, 1991 N 245);

d) new drugs for clinical trials and research in accordance with the current instructions of the Ministry of Health;

e) scarce and expensive medicines and dressings in accordance with the list approved by order of the head of the healthcare facility.

Subject-quantitative accounting of the above material assets is carried out in the form approved by Order of the USSR Ministry of Health dated 07/03/68 N 523, with the exception of narcotic drugs, which are recorded in the book of narcotic drugs in departments and offices in the form 60-AP, approved by the Order of the USSR Ministry of Health dated 12/30/82 N 1311. Book pages must be laced, numbered, books must be signed head of the institution.

Form for recording material assets listed in subparagraphs a, c, d, e.

Name of the product_________________________________________

Narcotic Medicines Accounting Book funds in departments and offices

Name of the product_______________________________________________

Unit of measurement______________________________________________

Date of receiving	Where did it come from and document number					Case history no.

2.10. Temperature and light conditions must be observed in places where medications are stored. Infusions, decoctions, emulsions, penicillin, serums, vaccines, organopreparations, solutions containing glucose, etc. should be stored only in refrigerators (temperature 2 - 10 degrees C).

3.1. Disinfectants, solutions for technical purposes (hand treatment, tools, furniture, linen, etc.) should be stored together with medications intended for the treatment of patients.

3.2. In departments and at posts, package, hang, pour, transfer medications from one package to another, replace labels.

3.3. Dispensing medications without a doctor’s prescription, replacing one medication with another.

3.4. Prescribe, register and store medicines under conventional, abbreviated names not approved by the Pharmacopoeial Committee (for example, cough syrup, hand disinfection solution, “triple solution”, etc.).

4. Medicines containing poisonous and narcotic drugs should be given to patients only separately from other medicines.

5. To avoid mistakes, before opening the ampoule or packaging, you should read the name of the drug, dosage out loud, check it with the prescription and then release it to the patient.

6. The duration of storage of medicines prepared in a pharmacy is limited to certain periods. To determine the expiration date, you need to know the release date. Factory-produced medicines have a digital designation of series, where two last digits indicate the year, and the two preceding them indicate the month of issue. In accordance with the Order of the USSR Ministry of Health dated October 29, 1968 N 768, the following storage periods are established for medications manufactured in a pharmacy:

6.1. For aqueous solutions containing benzylpenicillin, glucose - 1 day.

6.2. For injection solutions- 2 days, for solutions of sodium chloride 0.9%, novocaine 0.25%, 0.5% in bottles sealed without running in - 7 days. Once opened, use immediately.

6.3. For eye drops- 2 days.

6.4. For infusions, decoctions, mucus - 2 days.

6.5. For emulsions, suspensions - 3 days.

6.6. For other medications - 10 days.

7. The head of the department (office) is obliged at least once a month to personally check the storage, accounting and consumption of medicines, expiration dates, paying special attention to medicines on list “A”.

8. The pharmacy is responsible for the quality of the medicine manufactured and dispensed to the department and its exact compliance with the prescription (requirements), provided that the integrity of the packaging (unopened) is maintained and the medicine is kept under the conditions specified by the storage rules. After opening the package and the first use of the medicine in the department, further responsibility for its quality rests with the department staff, headed by the head.

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

Published on October 13, 2010. Enters into force on October 24, 2010. Registered with the Ministry of Justice of the Russian Federation on October 4, 2010. Registration No. 18608

Rules for storing medicines

I. General provisions

1. These Rules establish requirements for premises for storing medicines for medical use(hereinafter referred to as medicines), regulate the storage conditions of these medicines and apply to

• drug manufacturers,
• organization of wholesale trade in medicines,
• pharmacy organizations,
• medical and other organizations operating in the circulation of medicines,
• individual entrepreneurs with a license for pharmaceutical activities or license for medical activities(hereinafter referred to as organizations and individual entrepreneurs).

II. General requirements for the design and operation of drug storage premises

2. The design, composition, size of areas (for organizations of wholesale trade in medicines), operation and equipment of premises for storing medicines must ensure them safety.
3. In the premises for storing medicines, certain temperature And air humidity, allowing for the storage of medicines in accordance with the requirements of the manufacturers of medicines specified on the primary and secondary (consumer) packaging.
4. Premises for storing medicines must be equipped air conditioners and other equipment that allows for the storage of medicines in accordance with the requirements of the manufacturers of medicines specified on the primary and secondary (consumer) packaging, or it is recommended to equip the premises with windows, transoms, and second lattice doors.
5. Premises for storing medicines must be provided racks, cabinets, pallets, stockpiles.
6. The finishing of premises for storing medicines (internal surfaces of walls, ceilings) must be smooth and allow for the possibility of wet cleaning.

III. General requirements for premises for storing medicines and organizing their storage

7. Premises for storing medicines must be equipped with devices for registration of air parameters(thermometers, hygrometers (electronic hygrometers) or psychrometers). The measuring parts of these devices must be located at a distance of at least 3 m from doors, windows and heating devices. Devices and (or) parts of devices from which readings are visually read must be located in a place accessible to personnel at a height of 1.5-1.7 m from the floor.
The readings of these instruments must be recorded daily in a special magazine (map) registration on paper or electronically with archiving (for electronic hygrometers), which is maintained by the responsible person. The registration log (card) is stored for one year, not counting the current one. Control devices must be certified, calibrated and verified in accordance with the established procedure.
8. Medicines are placed in storage rooms in accordance with the requirements of the regulatory documentation indicated on the packaging of the medicinal product, taking into account:

• physicochemical properties of medicines;
• pharmacological groups(for pharmacies and medical organizations);
• method of application (internal, external);
• state of aggregation of pharmaceutical substances (liquid, bulk, gaseous).

When placing medicines, the use of computer technologies is allowed (alphabetically, by code).
9. Separately, in technically fortified premises that meet the requirements Federal Law dated January 8, 1998 N 3-FZ "On narcotic drugs and psychotropic substances"(Collected Legislation of the Russian Federation, 1998, No. 2, Art. 219; 2002, No. 30, Art. 3033, 2003, No. 2, Art. 167, No. 27 (Part I), Art. 2700; 2005, No. 19, Article 1752; 2006, No. 43, Article 4412; 2007, No. 30, Article 3748, No. 31, Article 4011; 2008, No. 52 (part 1), Article 6233; 2009, No. 29, Art. 3614; 2010, No. 21, Article 2525, No. 31, Article 4192) are stored:

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

10. Shelving (cabinets) for storing medicines in medicine storage rooms must be installed in such a way as to ensure access to medicines, free passage of personnel and, if necessary, loading devices, as well as accessibility of shelving, walls, and floors for cleaning.
Racks, cabinets, shelves intended for storing medicines must be numbered.
Stored medicinal products must also be identified using rack card, containing information about the stored medicinal product (name, release form and dosage, batch number, expiration date, manufacturer of the medicinal product). When using computer technology, identification using codes and electronic devices is allowed.
11. In organizations and individual entrepreneurs it is necessary to maintain accounting for medicines with a limited shelf life on paper or electronically with archiving. Control over the timely sale of medicines with a limited shelf life should be carried out using computer technology, rack cards indicating the name of the medicine, series, expiration date or expiration date logs. The procedure for maintaining records of these medicines is established by the head of the organization or individual entrepreneur.
12. When identifying drugs with expired they must be kept separately from other groups of medicines in a specially designated and designated (quarantine) area.

IV. Requirements for premises for storing flammable and explosive medicines and organizing their storage

13. Storage facilities flammable and explosive drugs must fully comply with current regulations.
14. In order to ensure the storage of flammable and explosive medicines on the principle of homogeneity in accordance with their physico-chemical, fire hazardous properties and the nature of the packaging, storage premises for wholesale trade organizations of medicines and manufacturers of medicines (hereinafter referred to as warehouse premises) are divided into separate premises (compartments) with fire resistance limit building structures for at least 1 hour.
15. Necessary for packaging and manufacturing of medicinal products for medical use in one work shift quantities of flammable medicines may be kept in production and other premises. The remaining amount of flammable drugs at the end of the shift is transferred to the next shift or returned to the main storage location.
16. The floors of warehouses and unloading areas must have hard, even coating. It is prohibited to use boards and iron sheets to level floors. Floors must ensure comfortable and safe movement of people, cargo and Vehicle, have sufficient strength and withstand the loads of stored materials, ensure simplicity and ease of cleaning the warehouse.
17. Warehouses for storing flammable and explosive medicines must be equipped fireproof and resistant racks and pallets designed for the appropriate load. The racks are installed at a distance of 0.25 m from the floor and walls, the width of the racks should not exceed 1 m and, in the case of storing pharmaceutical substances, have flanges of at least 0.25 m. Longitudinal passages between the racks should be at least 1.35 m.
18. For storing flammable and explosive drugs in pharmacy organizations and for individual entrepreneurs there are isolated premises, equipped with automatic fire protection and alarm systems (hereinafter referred to as premises for storing flammable and explosive medicines).
19. Pharmacy organizations and individual entrepreneurs are allowed to store pharmaceutical substances that have flammable and combustible properties, in a volume of up to 10 kg outdoors for storing flammable and explosive medicines in built-in fireproof cabinets. Cabinets must be located away from heat-dissipating surfaces and passages, with doors at least 0.7 m wide and at least 1.2 m high. Free access to them must be provided.
It is allowed to store explosive drugs for medical use (in secondary (consumer) packaging) for use on one work shift in metal cabinets outdoors for storing flammable and explosive medicines.
20. The amount of flammable medicines allowed for storage in premises for storing flammable and explosive medicines located in buildings for other purposes should not exceed 100 kg in bulk.
Premises for storing flammable and explosive drugs used for storing flammable pharmaceutical substances in quantities over 100 kg must be in separate building, and the storage itself should be carried out in glass or metal containers isolated from premises for storing flammable drugs of other groups.
21. It is prohibited to enter premises for storing flammable and explosive medicines with open fire sources.

V. Features of organizing the storage of medicines in warehouses

22. Medicines stored in warehouses must be placed on racks or at podtovarniki(pallets). It is not allowed to place medicines on the floor without a tray.
Pallets can be placed on the floor in one row or on racks in several tiers, depending on the height of the rack. It is not allowed to place pallets with medicines in several rows in height without the use of racks.
23. When unloading and loading operations are carried out manually, the height of stacking of medicines should not exceed 1.5 m.
When using mechanized devices for unloading and loading operations, medicines should be stored in several tiers. At the same time, the total height of placement of medicines on the racks should not exceed the capabilities of mechanized loading and unloading equipment (lifts, trucks, hoists).

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

Storing medications that require protection from light

24. Medicines that require protection from light are stored in rooms or specially equipped places that provide protection from light. natural and artificial lighting.
25. Pharmaceutical substances that require protection from light should be stored in containers made of light-protective materials(orange glass containers, metal containers, packaging made of aluminum foil or polymer materials painted black, brown or orange), in a dark room or cabinets.
To store pharmaceutical substances that are particularly sensitive to light (silver nitrate, proserin), glass containers are covered with black opaque paper.
26. Medicines for medical use that require protection from light, packaged in primary and secondary (consumer) packaging, should be stored in cabinets or on racks, provided that measures are taken to prevent entry for these medications direct sunlight or other bright directional light(use of reflective film, blinds, visors, etc.).

Storing medications that require protection from moisture

27. Pharmaceutical substances requiring protection from exposure to moisture, should be stored in a cool place at temperatures up to + 15 degrees WITH(hereinafter referred to as a cool place), in a tightly closed container made of materials impervious to water vapor (glass, metal, aluminum foil, thick-walled plastic containers) or in the manufacturer’s primary and secondary (consumer) packaging.
28. Pharmaceutical substances with pronounced hygroscopic properties should be stored in glass containers with a hermetically sealed seal filled with paraffin on top.
29. To avoid spoilage and loss of quality, storage of medicines should be organized in accordance with the requirements printed in the form of warning notices on the secondary (consumer) packaging of the medicine.

Storage of medicines that require protection from volatilization and drying out

30. Pharmaceutical substances that require protection from volatilization and drying:

• actual volatile drugs;
• medicines containing a volatile solvent

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

• solutions and mixtures of volatile substances

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

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

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

• medicinal products with a certain lower limit of moisture content

1. magnesium sulfate,
2. sodium para-aminosalicylate,
3. sodium sulfate,

should be stored in cool place, in materials impervious to volatile substances (glass, metal, aluminum foil) or in primary and secondary (consumer) packaging of the manufacturer. The use of polymer containers, packaging and closures is permitted in accordance with the requirements of the state pharmacopoeia and regulatory documentation.
31. Pharmaceutical substances - crystalline hydrates should be stored in hermetically sealed glass, metal and thick-walled plastic containers or in the manufacturer’s primary and secondary (consumer) packaging under conditions that meet the requirements of regulatory documentation for these medicinal products.

Storage of medicines requiring protection from exposure to elevated temperatures

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

Storage of medicines requiring protection from exposure to low temperatures

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

Storage of medicines requiring protection from gases contained in the environment

35. Pharmaceutical substances requiring protection from exposure to gases

• substances that react with oxygen in the air:

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

• substances that react with carbon dioxide in the air:

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

should be stored in hermetically sealed container made of materials impermeable to gases, filled to the top if possible.

Storage of odorous and coloring medicines

36. Smelly medicines (pharmaceutical substances, both volatile and practically non-volatile, but having strong odor) should be stored in a hermetically sealed, odor-proof container.
37. Coloring medicines (pharmaceutical substances that leave a colored mark that is not washed off by normal sanitary and hygienic treatment on containers, closures, equipment and inventory:

• brilliant green,
• methylene blue,
• indigo carmine

should be stored in a special cabinet in a tightly closed container.
38. To work with coloring medicinal products, it is necessary to highlight for each name special scales, mortar, spatula and other necessary equipment.

Storage of disinfectant medicines

39. Disinfectants Medicines should be stored in hermetically sealed containers in an isolated room away from storage areas for plastic, rubber and metal products and premises for obtaining distilled water.

Storage of drugs for medical use

40. Storage of medicinal products for medical use is carried out in accordance with the requirements state pharmacopoeia And regulatory documentation, and also taking into account properties substances included in their composition.
41. When stored in cabinets, on racks or shelves, medicinal products for medical use in secondary (consumer) packaging must be placed label(marked) outward.
42. Organizations and individual entrepreneurs must store medicines for medical use in accordance with requirements for their storage indicated on the secondary (consumer) packaging of the specified medicinal product.

Storage of medicinal plant materials

43. Bulk medicinal plant materials should be stored in dry(no more than 50% humidity), in a well-ventilated area in a tightly closed container.
44. Bulk medicinal plant materials containing essential oils, stored separately in a well-closed container.
45. Bulk medicinal plant materials must be subject to periodic monitoring in accordance with the requirements of the state pharmacopoeia. Grass, roots, rhizomes, seeds, fruits that have lost their normal color, smell and required quantity active ingredients, as well as those affected by mold, barn pests, reject.
46. ​​Storage of medicinal plant materials containing cardiac glycosides, is carried out in compliance with the requirements of the state pharmacopoeia, in particular, the requirement for repeated testing for biological activity.
47. Bulk medicinal plant materials included in the lists potent And poisonous substances approved by Decree of the Government of the Russian Federation of December 29, 2007 N 964 "On approval of lists of potent and toxic substances for the purposes of Article 234 and other articles of the Criminal Code of the Russian Federation, as well as large amounts of potent substances for the purposes of Article 234 of the Criminal Code of the Russian Federation" (Collected Legislation of the Russian Federation, 2008, No. 2, Art. 89; 2010, No. 28, Art. 3703), stored in a separate room or in a separate cabinet under lock and key.
48. Prepackaged medicinal plant materials are stored on shelves or in cabinets.

Storage of medicinal leeches

49. Storage of medicinal leeches is carried out in a bright room without the smell of medicines, for which a constant temperature regime.
50. The maintenance of leeches is carried out in accordance with the established procedure.

Storage of flammable drugs

51. Storage of flammable drugs

• medicines that have flammable properties

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

• medicines that have flammable properties

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

should be carried out separately from other medicines.
52. Flammable medications are stored in tightly closed, strong glass or metal containers to prevent evaporation liquids from vessels.
53. Bottles, cylinders and other large containers with flammable and flammable medicines should be stored on shelves in one row in height. It is prohibited to store them in several rows in height using different cushioning materials.
It is not allowed to store these medicines in heating devices. The distance from the rack or stack to the heating element must be at least 1 m.
54. Storage of bottles containing flammable and flammable materials pharmaceutical substances should be carried out in containers that protect against impacts, or in cylinder tippers in one row.
55. At workplaces of production premises allocated in pharmacy organizations and individual entrepreneurs, flammable and combustible medicines can be stored in quantities not exceeding replacement need. In this case, the containers in which they are stored must be tightly closed.
56. It is not allowed to store flammable and highly combustible medicines in completely filled containers. The filling level should be no more than 90% volume. Alcohols in large quantities are stored in metal containers filled to no more than 75% of the volume.
57. It is not allowed to store flammable medicines together with

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

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

58. Medical ether and ether for anesthesia Store in industrial packaging, in a cool place, protected from light, away from fire and heating devices.

Storage of explosive drugs

59. During storage explosive medicines (medicines with explosive properties (nitroglycerin); medicines with explosive properties (potassium permanganate, silver nitrate) measures should be taken against contamination with dust.
60. Containers with explosive drugs (barbells, tin drums, bottles, etc.) must close tightly to prevent vapors from these products from entering the air.
61. Storage of bulk potassium permanganate allowed in a special compartment of warehouses (where it is stored in tin drums), in rods with ground stoppers separately from others organic matter- in pharmacy organizations and individual entrepreneurs.
62. Bulk solution nitro glycerin stored in small well-closed bottles or metal vessels in a cool place, protected from light, taking precautions against fire. Move the container with nitroglycerin and weigh out this drug under conditions that prevent spillage and evaporation of nitroglycerin, as well as contact with the skin.
63. When working with diethyl ether Shaking, impacts, and friction are not allowed.
64. It is prohibited to store explosive medicines with acids and alkalis.

Storage of narcotic and psychotropic drugs

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

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

66. In accordance with Decree of the Government of the Russian Federation of December 29, 2007 N 964 “On approval of lists of potent and toxic substances for the purposes of Article 234 and other articles of the Criminal Code of the Russian Federation, as well as large amounts of potent substances for the purposes of Article 234 of the Criminal Code of the Russian Federation Federation" potent and toxic drugs include drugs containing potent and toxic substances included in the lists of potent substances and toxic substances.
67. Storage of potent and poisonous medicines under control in accordance with international legal standards (hereinafter referred to as potent and poisonous medicines under international control) is carried out in premises equipped with engineering and technical security means similar to those provided for the storage of narcotic and psychotropic drugs.
68. It is allowed to store potent and poisonous medicines under international control, and narcotic and psychotropic medicines in one technically fortified room.
In this case, the storage of potent and poisonous medicines should be carried out (depending on the volume of supplies) on different shelves of a safe (metal cabinet) or in different safes (metal cabinets).
69. Storage of potent and poisonous medicines that are not under international control is carried out in metal cabinets, sealed or sealed at the end of the working day.
70. Medicines subject to subject-quantitative accounting in accordance with the order of the Ministry of Health and social development of the Russian Federation of December 14, 2005 N 785 “On the procedure for dispensing medicines” (registered with the Ministry of Justice of the Russian Federation on January 16, 2006 N 7353), with the exception of narcotic, psychotropic, potent and poisonous medicines, are stored in metal or wooden cabinets that are sealed or sealed at the end of the working day.
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2.1. Responsible for storage and rational use medicines, as well as the head of the department (office) and the head nurse for the order in storage areas, compliance with the rules for issuing medicines to the patient. The direct executor of organizing the storage and consumption of medicines is the senior nurse.

2.2. Responsibility for the complete set, availability, and expiration dates of kits for emergency assistance V treatment rooms(etc. in the X-ray room, endoscopic room in hospitals, antenatal clinic and teenage room) are borne by the heads of the department and senior nurses.

2.3. Storage of medications in departments (offices) must be organized in locked cabinets. It is necessary to divide into groups “External,” “Internal,” “Injection,” “Eye drops.” In addition, in each compartment of the cabinet, for example, “Internal”, there should be a division into powders, mixtures, ampoules, which are placed separately, with powders stored, as a rule, on the top shelf, and solutions on the bottom.

2.4. Storage of medications in the operating room, dressing room, and treatment room is organized in instrumental glass cabinets (darkened) or on surgical tables. Each bottle, jar, and container containing medications must have an appropriate label.

2.5. Narcotic drugs, psychotropic, poisonous, potent substances must be stored in safes or metal cabinets attached to the wall or floor. On the inside of the cabinet (safe) doors there is a list of medications indicating the highest single and daily doses.

2.6. Medicines (not subject to subject-quantitative accounting) must be stored in a separate (wooden) cabinet under lock and key in compliance with the temperature and light conditions,

2.7. In storage areas and at the posts of doctors and nurses on duty there should be tables of the highest single and daily doses of narcotic, psychotropic, poisonous and potent substances, as well as tables of antidotes for poisoning.

2.8. In places where medications are stored, the following must be observed: temperature and light conditions specified by the manufacturer on the packaging.

Storage rooms must maintain a certain air temperature and humidity, which must be checked at least twice a day. To monitor these parameters, the premises must be equipped with hygrometers, which are fixed on the internal walls of the storage facility away from heating devices at a height of 1.5 -1.7 m from the floor and at a distance of at least 3 m from the doors.

In each room where medicines are stored, there must be a temperature and humidity recorder.

2.9. Medicines that require protection from exposure to elevated temperatures should be stored at room (+15-+25 degrees C), cool (or cold - +8-+15 degrees C) temperature. In some cases, a lower storage temperature is required (for example, for ATP - 3-5 degrees C), which should be indicated on the label or in the instructions for use of the drug. Thermometers in refrigerators must be certified and verified in accordance with the established procedure. Thermometers must have passports. For each refrigerator, the temperature regime is recorded in a special log.

2.10. Antibiotics should be stored in industrial packaging at room temperature unless otherwise indicated on the label.

2.11. Organic preparations should be stored in a cool, dry place, protected from light, at a temperature of 0+15 degrees C, unless otherwise indicated on the labels or in the instructions for use.

2.12. Pills and tablets are stored separately from other medicines in their original packaging, which protects them from external influences and is designed for dispensing to individual patients. Tablets and dragees should be stored in a dry place and, if necessary, protected from light.

2.13. Dosage forms for injections should be stored in a cool (+8-+15 degrees), protected from light place, which should be indicated on the label, in a separate cabinet and taking into account the nature of the container (fragility), unless otherwise indicated on the packaging.

2.14. Liquid dosage forms (syrups, tinctures) should be stored in a hermetically sealed, filled to the top container in a cool (+8-+15 degrees), protected from light place.

2.15. Plasma replacement (and detoxification) solutions stored in isolation at a temperature ranging from 0 degrees C to 40 degrees C (which should be indicated on the label) in a place protected from light. In some cases, freezing of the solution is allowed if this does not affect the quality of the drug.

2.16. Ointments, liniments Store in a cool (+8-+15 degrees), protected from light place in a tightly closed container. If necessary, storage conditions are combined depending on the properties of the incoming ingredients. For example, drugs containing volatile and thermolabile substances are stored at a temperature not exceeding 10 degrees C.

2.17. Storage suppositories should be carried out in a dry, cool (+8-+15 degrees), protected from light place.

2.18. Storing Most Medicines in aerosol packages should be carried out at a temperature of +3 to +20 degrees C in a dry place, protected from light, away from fire and heating devices. Aerosol packages should be protected from impacts and mechanical damage.

2.19. Medicines requiring protection from volatilization and drying out, (alcohol tinctures, ammonia solutions, ethyl alcohol of various concentrations, hydrogen peroxide) should be stored in a cool place, in hermetically sealed containers made of materials impenetrable to volatile substances (glass, metal, aluminum foil).

2.20. Storage flammable and combustible liquids must be carried out separately from other materials. Flammable liquids (alcohol and alcohol solutions, alcohol and ether tinctures, alcohol and ether extracts, ether) are stored in tightly closed, durable glass containers, in a cool place protected from light.

It is not allowed to store flammable substances together with flammable substances ( vegetable oil, dressing material).

2.21. Rubber products

Protection from light, especially direct light sun rays, high (more than 20 degrees C) and low (below 0 degrees C) air temperatures; flowing air (drafts, mechanical ventilation); mechanical damage (squeezing, bending, twisting, pulling, etc.);

To prevent drying, deformation and loss of elasticity, the relative humidity is at least 65%;

Isolation from exposure to aggressive substances (iodine, chloroform, ammonium chloride, Lysol, formaldehyde, acids, organic solvents, lubricating oils and alkalis, chloramine B, naphthalene);

Storage conditions away from heating devices (at least 1 m).

Rubber products cannot be laid in several layers, since objects located in the lower layers are compressed and caked.

Cabinets must have tightly closing doors. The inside of the cabinets must have a completely smooth surface.

Storing rubber products in a supine position (bougies, catheters, ice packs, gloves, etc.), avoiding bending, flattening, twisting, etc.;

Storage of products in a suspended state (tourniquets, probes, irrigation tubes) is equipped with hangers located under the cabinet lid.

It is recommended to store backing circles, rubber heating pads, ice bubbles slightly inflated, rubber tubes are stored with plugs inserted at the ends;

Removable rubber parts of appliances should be stored separately from parts made of other materials;

2.22. Dressings stored in a dry, ventilated area in cabinets, drawers, racks and pallets, which should be painted light inside oil paint and kept clean.

Sterile dressings (bandages, gauze pads, cotton wool) are stored in the original packaging. It is prohibited to store them in the original opened packaging.

Non-sterile dressing material (cotton wool, gauze) is stored packed in thick paper or in bales (bags) on racks or pallets.

Disinfectants, solutions for technical purposes (hand treatment, tools, furniture, linen, etc.) should be stored together with medications intended for the treatment of patients.

In departments and at posts, package, hang, pour, transfer medications from one package to another, replace labels.

2.24. The shelf life of medications prepared in a pharmacy is limited to certain periods indicated on the bottle labels. The shelf life of medicines prepared in a pharmacy must be posted in the treatment room.

2.25. Provide cabinets for storing documents (registration logs, requirements-invoices, acceptance certificates, etc.) for medicines that are subject to subject-quantitative accounting.

Appendix 2

to the order of the MUZ ""

INSTRUCTIONS

for medication registration, dressings and medical products in departments (offices)

1. In pharmacies, departments (offices) the following are subject to subject-quantitative accounting:

Narcotic drugs, psychotropic substances and precursors of narcotic drugs and psychotropic substances, and other drugs subject to subject-quantitative accounting,

Ethanol,

Expensive medicines (by decision of the head of the institution),

Dressings.

2. Subject-quantitative records are kept in appropriately designed journals:

Narcotic drugs, psychotropic substances and precursors of narcotic drugs and psychotropic substances in accordance with the Decree of the Government of the Russian Federation of November 4, 2007. No. 644,

The pages of the journals must be numbered, the journals must be laced and certified by the signature of the head of the institution.

3. For each name, packaging, dosage form, dosage of medicines subject to subject-quantitative recording, a separate page opens.

4. The basis for daily recording in the journals of received and issued medicines are the requirements - invoices (from the head and senior nurses, at the post), acceptance certificates or other documents.

5. Medicines are dispensed to departments (offices) in the amount of the current need for them: narcotic and psychotropic medicines - daily, 3-day (5-day), all others - 10-day.

6. It is prohibited to receive and store medicines in departments (offices) in excess of the current need, as well as to prescribe medicines from the pharmacy (head nurse) according to general requirements– waybills for several departments (cabinets) and carry out subsequent packaging, moving from one dish to another, replacing labels, etc.

7. Medicines containing narcotic, psychotropic, poisonous and potent substances must be given to patients separately from other medicines. Patients take medications in the presence of medical worker. An exception may be drugs that are not narcotic, psychotropic, poisonous, or potent, prescribed for diseases that require continuous maintenance treatment ( ischemic disease hearts with angina pectoris of exertion and rest, hypertonic disease with a steady increase blood pressure, diabetes, epilepsy and other similar diseases).

Give out medications without a doctor's prescription, replace one medicine with another.

Prescribe, register and store medicines under conventional, abbreviated names not approved by the pharmacopoeial committee (for example, cough syrup, hand disinfection solution, “triple solution”, etc.).

7.2. To avoid mistakes, before opening the ampoule or packaging, you should read the name of the drug, dosage out loud, check it with the prescription and then release it to the patient.

8. The head of the department (office) is obliged to constantly monitor:

Justification for prescribing medications,

Strict implementation of assignments in accordance with medical history,

The amount of actual availability of medicines in the department (office),

Take decisive measures to prevent the creation of their reserves in excess of current needs.

9. The pharmacy is responsible for the quality of the medicine manufactured and dispensed to the departments and its exact compliance with its requirements, provided that the integrity of the packaging is maintained (unopened) and the medicine is kept under the conditions specified by the storage rules. After opening the package and the first use of the medicine in the department, further responsibility for its quality lies with the department staff, headed by the manager.

10. A pharmacy representative checks the state of storage, accounting and consumption of medicines in hospital departments at least once a quarter; narcotic, psychotropic and potent drugs - monthly.

11. Senior nurses of all departments keep journals of medicines according to expiration dates. If there are drugs with an expired shelf life, store them (until they are sent for destruction) separately from other goods in the “quarantine zone”. Expired drugs should be sent for destruction to an organization that has the appropriate license (except for narcotic drugs and psychotropic substances).

12. Continue personalized accounting of medicines in departments.

Currently medical institutions and pharmacies that deal with a variety of medications, in the matter of their proper storage, are guided by Order of the Ministry of Health of the Russian Federation No. 706n “On approval of rules for the storage of medicines.” The article lists the main points regarding storage conditions for medications. In addition, the issue of monitoring the implementation of storage procedures, as well as types of violations, is touched upon.

Rules for storing medicines

Rules for storing medicines require standardization of premises, which must meet certain requirements:

• to maintain a certain temperature and constant air exchange, it is necessary to have an air conditioner, refrigeration units, vents, ventilation, as well as certified devices that record temperature and humidity (such devices are recommended to be placed at a distance of three meters from doors, windows and heating systems)
• In the room where medications are stored, it is necessary to regularly carry out wet cleaning, so the walls and ceilings must be smooth.

Medicines differ in their properties and potential threat to others, therefore Order No. 706n has developed its own storage rules for each group of medicines. According to the Order, the following groups are distinguished:

Medicines exposed to temperature

Changes in temperature can affect the nature of the properties of medicinal products, therefore it is necessary to strictly follow the recommendations indicated on the packaging of the drug regarding its compliance with the rules for storing medicinal products. Thus, positive indicators are usually limited to 25 degrees; medications in solutions (adrenaline, novocaine) can be stored at this temperature.

At low temperatures, some medications - essential and oil solutions, insulin - lose their medicinal properties. Storage temperature conditions were discussed in detail in the State Pharmacopoeia of the Russian Federation.

Preparations sensitive to light and moisture

You can prevent the effects of daylight or artificial lighting on medications if, in accordance with the rules for storing medicines, you keep them in containers made of light-protective materials in dark places. In addition, for drugs that are especially sensitive to light (prozerin, silver nitrate), the use of additional means of protection is provided - black opaque paper, which is used to cover the container, and thick blinds or stickers are hung in the room itself that block or reflect light.

To prevent exposure to moisture from affecting the quality of medications, you need to strictly monitor the humidity level in the room (within 65%). Storing drugs in a cool room in a hermetically sealed container creates conditions for preserving their medicinal qualities.

Preparations susceptible to the action of gases from environment

The list of medications that react with gases from the environment is quite extensive (sodium barbital, hexenal, magnesium peroxide, morphine, aminophylline and many other compounds). Such preparations should be stored at temperatures from +15 to +25°C in hermetically sealed containers.

Preparations subject to drying and evaporation

This group includes medicines with volatile properties: alcohols, essential oils, ammonia solutions, formaldehydes, crystalline hydrates, etc. They must be stored in glass, metal or aluminum containers that are impenetrable to volatile substances. Proper storage conditions for such medications, including temperature, can always be found on the manufacturer's packaging.

Storage conditions for other medicines

• with a limited shelf life. In medical institutions, it is necessary to record the availability of drugs with a limited expiration date and carefully monitor the timing of their sale; for this purpose, a log of the expiration dates of medications is kept. When implementing medical services You should choose, first of all, those medications whose expiration date expires earlier. According to the storage conditions for expired medicines, they are kept separately from other medicines in a specially designated area (marked shelf or safe).
• requiring subject-quantitative accounting. For medicines containing narcotic, poisonous and potent components, the law provides for more stringent storage conditions, which must be strictly observed. They can be kept in one isolated room, equipped with engineering and technical security equipment. These funds are stored in metal cabinets that have appropriate inscriptions, are locked with a key and are sealed at the end of the day every day. Such medical supplies are necessarily subject to subject-quantitative recording, which implies maintaining documentation that records the intake of medications and their further movement.
• flammable and explosive drugs. The contents of such medications should be monitored especially carefully, since irresponsible storage of them can cause a fire and harm the health of health workers and patients. These include preparations containing alcohol, turpentine, glycerin and other flammable substances. Storage conditions for such medicines require places that are isolated and equipped with an automatic fire alarm system. Contain such medications in glass or metal containers away from heat sources. They cannot be combined with dressing materials due to their flammable properties, mineral acids, compressed gases, inorganic salts and alkalis. Preparations containing ether also belong to the group of flammable substances; they should be stored in cool, dark places, away from open flames. Potassium permanganate, which in combination with certain substances (ethers, alcohol, sulfur) acquires explosive properties, must be stored at room temperature and protected from moisture and bright light. The solution of the substance must be kept in tightly sealed containers for five years. The shelf life of the powder is unlimited.

How to properly ensure the storage of medicines in a medical facility

Compliance with the rules for storing medicines in medical institutions The head nurse or charge nurse should monitor the following actions:

• fixation temperature indicators and air humidity in storage facilities (once per shift);
• checking the compliance of the names of the funds with the specified groups;
• checking the release date of drugs in order to prevent the use of expired products. Elder sister controls the movement of unusable products into the quarantine zone and their subsequent disposal.

Pharmaceutical packaging does not always contain information about the specific storage temperature of medicines in medical institutions - manufacturers often limit themselves to the words “in a cool place” or “at room temperature”. To avoid difficulties with correct reading and subsequent violations, the State Pharmacopoeia of the Russian Federation established temperature limits that correspond to these recommendations. According to them, cold conditions are a temperature of 2 - 8°C, cool conditions are a temperature of 8 - 15°C, and "room" means a temperature of 15 - 25°C (sometimes up to 30°C).

Failure to comply with the procedure for storing medicines

Violations in the storage of medications identified during control activities may result in various administrative penalties. Institutions conducting medical activities should not ignore the well-known rule: the procedure for storing medicines requires keeping them in different places - this requirement is not observed quite often. The most common violations also include those associated with the absence or malfunction of thermometers and hygrometers and non-compliance with expiration dates: expired drugs are not transferred to a special area or the organization forgets to record the expiration dates of drugs.

In order to avoid claims from regulatory authorities, it is necessary to take into account the information on the storage procedure for medicines indicated on the packaging of the drugs and ensure the appropriate climatic conditions. In summer, for example, temperatures can exceed 30°C, so you should pay attention even to those medications that do not require storage in refrigerators.