Valid Editorial from 25.02.1998
| Name of document | "REGULATIONS. OCCUPATIONAL SAFETY DURING STORAGE OF MATERIALS PO-14000-007-98" (approved by the Ministry of Economy of the Russian Federation dated 02.25.98) |
| Document type | list, position |
| Receiving authority | Ministry of Economy of the Russian Federation |
| Document number | POT RO-14000-007-98 |
| Acceptance date | 01.01.1970 |
| Revision date | 25.02.1998 |
| Date of registration with the Ministry of Justice | 01.01.1970 |
| Status | valid |
| Publication |
|
| Navigator | Notes |
"REGULATIONS. LABOR SAFETY DURING STORAGE OF MATERIALS PO-14000-007-98" (approved by the Ministry of Economy of the Russian Federation dated 02.25.98)
7.8. Storage of toxic and caustic chemicals
7.8.1. Depending on the physical and chemical properties and the degree of potential danger, toxic and caustic chemicals must be stored in special warehouses or on specially equipped sites.
7.8.2. Most chemical materials should be stored separately, since upon contact with each other they can ignite, produce explosive mixtures, emit toxic gases, etc. Data on incompatibility of storage of chemical materials are given in table. 5.
Table 5
CHEMICAL MATERIALS INCOMPATIBLE FOR COMBINED STORAGE
| Name of chemical material | Substances prohibited for joint storage with them |
| Activated carbon | Calcium hydrochloride and all oxidizing products |
| Ammonia (gas) | Mercury, chlorine, calcium hydrochloride, iodine, bromine, hydrofluoric acid (anhydrous) |
| Ammonium nitrate (ammonium nitrate) | Acids, powdered metals, flammable liquids, chlorates, nitrates, sulfur compounds, flammable fine organic products |
| Acetylene | Chlorine, bromine, copper, fluorine, silver, mercury |
| Barium peroxide | Ethyl and methyl alcohols, acetic acid, acetic anhydride, basic aldehydes, carbon disulfide, glycerin, ethylene glycol, methyl acetate, furfural |
| Bromine | Ammonia, acetylene, butane, methane, propane (or other petroleum gases), hydrogen, turpentine, benzene, fine metal powders |
| Chlorine dioxide | Ammonia, phosphates, sulfur dioxide, methane, iodine, mineral and organic acids, acetylene, ammonia, ammonia water, hydrogen |
| Potassium metal | |
| Perchloric acid | Acetic anhydride, bismuth and its alloys, alcohol, paper, wood |
| Copper | Acetylene, hydrogen peroxide |
| Sodium metal | Carbon tetrachloride, carbon dioxide, water |
| Hydrogen peroxide | Copper, chromium, iron, numerous metals and their salts, alcohol, acetone, organic products, aniline, nitromethane, all flammable liquids and combustible substances |
| Potassium permanhydrate | Glycerin, ethylene glycol, benzaldehyde, sulfuric acid |
| Mercury | Acetylene, fulminate acid, ammonia (gas) |
| Silver | Acetylene, concentrated nitric acid, ammonia compounds, oxalic acid, tartaric acid |
| Sulfuric acid | Potassium chlorate, potassium perchlorate, permanganate and other compounds with light metals similar to sodium, lithium |
| Hydrogen sulfide | Nitric acid, oxidizing gases |
| Hydrocarbons (butane, propane, benzene, highly volatile solvents, turpentine, etc.) | Fluorine, bromine, chromic acid, oxidizing agents |
| Acetic acid | Chromic acid, nitric acid, ethylene glycol, perchloric acid, peroxides, permanganates |
| Fluorine | Must be isolated from all active chemical materials |
| Hydrofluoric acid (anhydrous) | Acetic acid, aniline, chromic acid, hydrocyanic acid, hydrogen sulfide, flammable liquids and gases |
7.8.3. Toxic and caustic chemicals must be stored in closed containers. The main types of containers are given in table. 6.
Table 6
CONTAINERS FOR STORING TOXIC AND CAUSIC CHEMICALS
| N p/p | Substance | Container for its storage |
| 1 | Nitric acid: Any concentration of medium concentration | Aluminum barrels and tanks Barrels and tanks made of corrosion-resistant steel (for example, 12Х18М9Т) |
| 2 | Sulfuric acid | Barrels and tanks made of corrosion-resistant steel (for example, 12Х18М9Т) |
| 3 | Hydrochloric acid of any concentration | Steel rubberized barrels and tanks |
| 4 | Hydrofluoric acid | Ebonite cans with a capacity of up to 20 l, polyethylene cylinders with a capacity of up to 50 l |
| 5 | Sodium hydroxide | Iron drums, barrels |
Notes 1. Nitric and sulfuric acids in quantities up to 40 liters can be stored in glass bottles.
2. Containers containing caustic soda (caustic soda) must bear the inscription “Danger - caustic”.
7.8.4. Containers with chemicals must have clear inscriptions, labels with the name of the substance, GOST indication and technical specification numbers.
7.8.5. It is prohibited to store caustic substances in basements, semi-basements and upper floors of multi-storey buildings.
7.8.6. Bottles with acids must be installed in groups (no more than 100 bottles per group) in two or four rows with passages between groups at least 1 m wide.
7.8.7. It is prohibited to place acid bottles on shelves with more than two tiers in height. In this case, the shelves of the second tier should be at a height of no more than 1 m from the floor.
7.8.8. Bottles with acid are prohibited from being placed near heating appliances.
7.8.9. When pouring acid from a bottle, special devices must be used to gradually tilt the bottle and nozzle to prevent spilling and splashing of the acid.
7.8.10. When transporting and storing acids and other aggressive liquids, only cone bottles should be used, which must be tightly packed in cone baskets or wooden crates, with straw or shavings placed on the bottom and sides.
7.8.11. When storing nitric acid, straw or shavings must be soaked in a solution of calcium chloride or magnesium chloride.
7.8.12. Opening containers with acid must be done carefully, because there may be a release of vapors and gases accumulated in the upper part of the container.
7.8.13. To avoid rupture of bottles due to thermal expansion, they should be filled to no more than 0.9 of their volume.
7.8.14. Carrying filled bottles must be carried out by at least two persons using special stretchers. Raising baskets with bottles of acid by the handles is permitted only after preliminary checking the integrity and reliability of the bottom and handles of the basket.
7.8.15. Transportation of containers with acid is permitted only on specially equipped trolleys.
7.8.16. When transporting caustic substances in bottles, shavings for their packaging in crates must be impregnated with a fire-resistant compound. Bottles should be filled to no more than 0.9 volumes and carefully sealed.
7.8.17. Acids must be transported in special tanks with internal acid-resistant lining.
7.8.18. Acids and other caustic liquids in small (up to 1 kg) packaging must be transported in appropriate packaging that protects the container from breaking and falling out. Glass containers containing caustic substances must be tightly sealed and packed in wooden or plywood boxes using lightweight packaging material. The weight of such boxes should not exceed 50 kg.
7.8.19. Storage warehouses and places where acids are used must have reserve tanks for emergency drainage of acids.
7.8.20. In areas where chemicals and solutions are stored, instructions for their safe handling must be posted in visible and accessible places.
7.8.21. It is prohibited to place containers with highly toxic substances (STS) on top of each other or in bulk. SDYAV, packed in iron drums, can be installed in two tiers in height.
7.8.22. Joint storage of poisons with other materials, as well as poisons of different categories, is not permitted.
7.8.24. An order must be issued for the transportation of SDYV within the organization - permission as for the performance of work of special danger.
7.8.25. Transportation of toxic chemicals is allowed only in serviceable, closed containers indicating the name of the pesticide and the inscription “POISON”.
7.8.26. Delivery of SDYAV during rain or snowfall should be carried out by covering them with a tarpaulin, which should be stored in a warehouse in a closed box for such cases.
7.8.27. Reception of SDYAV for storage in a warehouse should be carried out only by the employee responsible for their storage, and in the presence of the employee responsible for their transportation.
7.8.28. Reception of SDYAV at the warehouse must be carried out on the day the cargo arrives at the organization.
If the cargo arrives at night, it is accepted into the warehouse in the morning.
Before being accepted into the warehouse, cargo with SDYAV in a sealed form must be under guard.
7.8.29. Before accepting cargo with SDYV at the warehouse, the employee responsible for storing SDYV must carefully check the correctness and integrity of the packaging and labeling of each individual piece of cargo.
7.8.30. When unloading poisons, the worker responsible for storing SDYV must ensure that precautions are taken to ensure that the container with SDYV is not damaged, not subject to impacts, thrown, dragged, etc.
7.8.31. If there are no stencils of the established sample on the container, the warehouse manager (storekeeper) must restore them and note this in the acceptance certificate.
7.8.32. If container malfunctions are detected, poisons in the faulty container (without refilling) must be transferred to a new, clean, larger container and hermetically sealed with a lid. All work must be carried out wearing a gas mask.
7.8.33. During non-working hours, the premises where poisons are stored must be closed, sealed (sealed) and placed under guard.
7.8.34. Entry into the poison storage room after a break in work for more than one hour is permitted only after turning on the ventilation and its continuous operation for at least 30 minutes.
7.8.35. When storing cyanide salts, you should be guided by the sanitary rules for the design and maintenance of warehouses for storing highly toxic substances.
7.8.36. Cyanide salts should be stored in isolated, fireproof, heated rooms, access to which is permitted only to specially designated personnel.
7.8.37. Premises for storing cyanide salts must be dry and equipped with effective ventilation. In a room separate from the storage room there should be washbasins with hot and cold water, cabinets for work clothes, safety shoes and other personal protective equipment, a first aid kit, and a telephone.
7.8.38. In the pantry for storing cyanide salts there must always be scales, a weight, a tool for opening containers, a scoop, a brush, containers for collecting waste, which are prohibited from being used or taken to other premises; they must be neutralized immediately.
7.8.39. A small tightly closing hole must be installed in the door of the pantry for storing cyanide salts to determine the presence of hydrogen cyanide (hydrocyanic acid) in the air of the room, the presence of which is determined by a litmus test introduced into the room through the specified hole before opening the door.
7.8.40. If the presence of hydrogen cyanide is detected in the air of the pantry, the room must be ventilated and the air sample repeated.
Entry into the storage room where cyanide salts are stored is permitted only if there is no reaction to hydrogen cyanide in the samples produced.
7.8.41. In emergency situations, entry into the cyanide salt storage room is permitted only with a gas mask.
7.8.42. Opening containers, packaging or hanging cyanide salts must be carried out by specially trained workers - storekeepers.
In this case, strict records of the consumption and receipt of cyanide salts must be kept and recorded in a special journal.
7.8.43. Work with cyanide salts must be carried out using personal protective equipment - rubber gloves, gas masks.
7.8.44. Opening containers containing cyanide salt should be done with a non-impact tool in a fume hood.
7.8.45. Spills of cyanide salts must be carefully collected and placed in a special metal sealable container for waste, and the place where the spill occurred must be rendered harmless.
7.8.46. Dust collected from equipment must be neutralized in specially designated areas.
7.8.47. To store saltpeter, only metal containers with a tight-fitting lid should be used. Storing saltpeter in bags or wooden containers is prohibited.
7.8.48. Boron-containing substances must be stored in dry and heated rooms, since these substances are highly hygroscopic.
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Question:
Please tell me whether the order dated 07/03/1968 N 523 (as amended on 02/04/1977, as amended on 12/30/1982) “On the procedure for storing, recording, prescribing, dispensing and using poisonous, narcotic and potent medicines” is valid, regarding the storage of toxic and potent substances, since today it has not been abolished?
Indeed, “Rules for the storage and accounting of poisonous, narcotic and potent drugs” in medical institutions, self-supporting pharmacies and pharmaceutical warehouses” (Appendices No. 4 – 6), approved by Order of the USSR Ministry of Health dated July 3, 1968 No. 523 “On procedure for storage, accounting, prescribing, dispensing and use of poisonous, narcotic and potent medicines" (as amended on 02/04/77), have not been canceled by anyone and therefore, as a general rule, can be considered valid to the extent that does not contradict the legislation of Russia .
However, it should be noted that the rules for storing and recording narcotic substances are established by Decrees of the Government of the Russian Federation dated December 31, 2009 N 1148 “On the procedure for storing narcotic drugs and psychotropic substances” (as amended on June 9, 2010) and dated November 4, 2006 . N 644 “On the procedure for submitting information on activities related to the trafficking of narcotic drugs and psychotropic substances, and registration of transactions related to the trafficking of narcotic drugs and psychotropic substances” (as amended on June 09, 2010).
The procedure for storing potent and toxic medicines is determined by clauses 66 – 69 approved by Order of the Ministry of Health and Social Development of the Russian Federation dated August 23, 2010 N 706n “Rules for the storage of medicines” (as amended on December 28, 2010) and clauses 3.11 – 3.13, 3.19 approved by the Order Ministry of Health of the Russian Federation dated March 4, 2003 N 80 Industry Standard “Rules for the dispensing (sale) of medicines in pharmacies. Basic provisions" OST 91500.05.0007-2003 (as amended on April 18, 2007).
Thus, the current Russian legislation fully regulates the procedure for storing narcotic, potent and poisonous medicines and has not established the procedure for recording poisonous and potent medicines. Consequently, Order of the USSR Ministry of Health No. 523 can be considered valid only in terms of the requirements for recording potent and toxic substances. However, it should be noted that this order is defined exclusively for self-supporting pharmacies and pharmacy points of the 1st group and pharmacy warehouses, i.e. for organizations that are currently not identified by law. Thus, for currently existing pharmacy organizations and drug wholesale trade organizations, purely formally, the norms of Order of the USSR Ministry of Health No. 523 cannot be considered valid.
ABOUT THE PROCEDURE FOR STORING, RECORDING, PRESCRIPTION, DISCHARGE AND USE OF TOXIC, NARCOTIC AND POTENT MEDICINES
RULES
STORAGE AND ACCOUNTING OF TOXIC, DRUG AND
POTENT AGENTS IN CONTROL AND ANALYTICAL TECHNIQUES
PHARMACY MANAGEMENT LABORATORIES
1. Toxic drugs of list “A”, as well as toxic substances used as reagents in pure form, must be stored in separate metal or wooden cabinets under lock and key, and sealed or sealed at night.
Reagent solutions containing toxic substances should be stored in separate locked cabinets after completion of work, with the exception of titrated solutions, which can be stored in the usual manner.
Finished dosage forms containing toxic drugs supplied to the laboratory for analysis must be stored separately from other drugs in locked cabinets.
2. Narcotic drugs, regardless of the dosage form, must be stored in safes, and especially poisonous drugs: arsenous anhydride, crystalline sodium arsenate, mercury dichloride (sublimate), strychnine nitrate, brucine, nicotine, phosphorus, hydrocyanic acid and its salts, chloropicrin and carbon disulfide must be stored in a specially designated internal compartment of the safe.
3. The head of the laboratory or a person authorized by him by order of the laboratory is responsible for the storage of poisonous and narcotic drugs.
4. The keys to the safe(s) where poisonous and narcotic drugs are stored must be kept by the head of the laboratory or a person authorized to do so.
5. Poisonous and narcotic drugs or medicines containing them, issued to an analytical chemist for analysis, are stored in isolation under lock and key with the analytical chemist.
6. Poisonous and narcotic medicines received for analysis at the pharmacy warehouse are stored for three months upon completion of the analysis, after which their remains are transferred to the poisons department of the pharmacy warehouse or used with the permission of the pharmacy administration for the needs of the laboratory and written off as an expense with the relevant acts; Rejected toxic drugs after expiration of the shelf life are destroyed in accordance with current rules.
Remains of dosage forms containing poisonous and narcotic drugs are stored:
a) received from city pharmacies - within 10 days;
b) those received from rural pharmacies - within 20 days, after which they are destroyed with the participation of a representative of a higher organization, which is documented in a laboratory report.
7. Toxic substances used as reagents must have labels on each package: the name of the drug “Poison”, with the image of crossed bones and a skull, as well as “Handle with care”.
8. All toxic substances used as reagents in analyses, as well as toxic drugs in their pure form and narcotic drugs, regardless of dosage form, entering the laboratory for analysis are subject to subject-to-quantitative accounting in separate numbered and laced books, sealed and signed head of a higher organization in the form:
I. Form of the book of registration of poisonous medicines,
arriving for analysis
Name of the product ________________________________________
______________________________________________________________
+————————+—————————————————+
| Parish | Consumption |
|Date|N |From |N |Co-|Quantity |Quantity |Date you-|Result-|Remaining|Mark about|
|pos-|pp, |whom |se- |li-|and date of |expense-|completion|tat | from |transmission |
|tup-|i.e.|semi-|rii |che-|issuing |dovanno-|analysis |analysis|analysis|to the warehouse,|
|le- |N |cheno |(or|st-|analyze- |th environment-|and | | |use-|
|niya |ana-|and N |pro-|in |tiku on|stva on |receipt| | |vania or|
| |lisa|doc- |would) | |analysis |analysis |analysis-| | |destroy-|
| | |ta | | |and dis- | | ka | | |remain |
| | | | | |squeak | | | | |tka from |
| | | | | |analy- | | | | | analysis |
| | | | | |tika | | | | | |
+—-+—-+——+—-+—+——-+———+———+——-+——-+———+
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
+—-+—-+——+—-+—+——-+———+———+——-+——-+———+
Note: Column 11 indicates the number and date of the document that documents the consumption of the remaining toxic agent.
II. Form of a book of registration of toxic substances,
used as a reagent
Name of substance _____________________________________________
9. Documents for poisonous and narcotic drugs must be kept by the person responsible for their storage for three years.
10. Potent medicines, as well as dosage forms containing them, can be stored together with other non-potent medicines.
11. Reagents belonging to list “B”, necessary for the current work, can be stored in the usual manner, and their stocks should be stored in a locked cabinet.
Storage of poisonous and potent drugs
The rules for storing poisonous, narcotic and potent medicines in pharmaceutical warehouses, medical institutions, control and analytical laboratories and other healthcare institutions are regulated by special instructions approved by orders of the Ministry of Health.
Group A drugs are divided into subgroups. Of the total number of drugs classified as list A according to the State Pharmacopoeia, a certain part of the drugs is subject to subject-quantitative accounting in pharmacies. Salvarsan preparations are subject to special batch accounting.
All narcotic and especially toxic drugs: arsenic anhydride, crystalline sodium arsenate, strychnine nitrate, mercury dichloride (sublimate) and mercury oxycyanide - should be stored in pharmacies only in safes, and especially toxic drugs - in the internal, locked compartment of the safe.
In pharmacies of categories V and VI, storing narcotic and especially poisonous drugs is permitted only in a material room in safes or metal boxes screwed to the floor. It is not permitted to store these medications in assistant rooms. In large pharmacies (I-IV categories) in assistant rooms, it is necessary to store a supply of narcotic and poisonous drugs in quantities not exceeding 5-day requirements, and storage should also be carried out in special safes.
The total stocks of poisonous and narcotic drugs in city pharmacies should not exceed the monthly requirement. In other pharmacies, the stock of these drugs is determined by regional or regional pharmacy departments.
In on-duty pharmacies, poisonous and narcotic medicines are left overnight in a separate locked cabinet in quantities and assortment necessary to provide emergency medical care. After duty, this closet is sealed.
All poisonous medicines included in list A, but not related to narcotic and especially poisonous drugs, are stored separately, in metal cabinets specially designated for this purpose, under lock and key. In small pharmacies, all List A drugs (including narcotic and especially poisonous ones) can be stored in one safe.
Cabinets and safes containing poisonous and narcotic drugs are designed as follows:
1) on the inside of the safe and cabinet doors there is the inscription “A - Venena” (poison);
2) below this inscription, on the same side of the doors, there is a list of poisonous and narcotic drugs stored in a safe or cabinet, indicating the highest single and daily doses;
3) inscriptions on the containers in which poisonous and narcotic drugs are stored are written in Latin in white font on a black background (black label). The highest single and daily dose is indicated on each bar.
To make medicines with poisonous components, the safes and cabinets where they are stored must have hand scales, weights, mortars, cylinders and funnels. On utensils used for making medicines, it is advisable to be marked: “For mercuric chloride”, “For silver nitrate”, etc. These utensils are washed separately from others under the supervision of a pharmacist.
The key to the cabinet with List A supplies, located in the assistant's room, must be held by the pharmacist - pharmacy technologist during working hours. After the end of the working day, the cabinet is sealed and the key, along with a seal or seal, is handed over to the head of the pharmacy or another responsible pharmacy employee authorized to do so by order of the pharmacy.
Material rooms, as well as safes in which narcotic and especially toxic drugs are stored, must have light and sound alarms. The windows of material rooms in which poisonous and narcotic drugs are stored should be equipped with metal bars. At night these rooms are locked and sealed. Only the head of the pharmacy or a person authorized by him can dispense narcotic and especially poisonous drugs from the material to the assistant's room for current work.
Storage of poisonous and narcotic drugs in pharmaceutical warehouses, control and analytical laboratories, pharmaceutical enterprises, research and educational institutions is also carried out in safes or metal cabinets under lock and key, in rooms whose windows must have iron bars.
In cases where this is provided for by the instructions, the doors of rooms in which poisonous and narcotic drugs are stored are lined with iron, and the room itself is equipped with light and sound alarms. Rooms where narcotic and poisonous drugs are stored should be locked and sealed or sealed after work is completed. The keys, seal or seal must be kept by the person responsible for storing poisonous and narcotic drugs. In rooms, cabinets, and safes where poisonous medicines are stored, it is necessary to have scales, weights, funnels, cylinders, mortars and other utensils for work.
In all cases, employees responsible for the storage and dispensing of poisonous and narcotic drugs must strictly follow the relevant instructions and regulations approved by the Ministry of Health.
Subject-quantitative accounting of poisonous and narcotic drugs is carried out in a special book, numbered, laced and signed by the head of a higher organization with a round seal attached.
In this book, for each name of the drug taken into account, one page is allocated, on which the monthly balances and receipts of this drug, as well as its daily consumption, are reflected.
The consumption of the drug is indicated for each day separately: dispensing for outpatient prescriptions and dispensing to medical institutions, pharmacy departments and pharmacy points of group I. This is done so that at the end of the month, when checking the actual presence of toxic and potent substances and checking them with the book balance, the established norms of natural loss can be applied. These standards are applied separately: for outpatient dispensing of toxic and potent substances and for dispensing to medical and other organizations.
Storage and accounting of salvarsan preparations. Group A drugs also include salvarsan drugs - miarsenol and novarsenol. They are under special control of the State Control Commission for testing such drugs under the Ministry of Health. This commission regulates the production of salvarsan preparations, establishes expiration dates, the procedure for their storage and accounting. The drugs are produced in sealed ampoules in special packaging, which indicates the quantity, batch number and production time. In addition, the supplier indicates on each package that the batch has passed chemical, biological and clinical testing, and the date of inspection.
To record the movement of salvarsan drugs in pharmacies, a special log is kept. It contains information about the receipt and dispensing of drugs in medical institutions. The receipt portion indicates the date the drug was received at the pharmacy, the batch number, dosage and the institution from which the drug was received. When dispensing the drug, the journal indicates the name and address of the medical institution, date of issue, batch number, quantity and dosage.
Storage of potent drugs. A fairly large group of medicines belongs to potent drugs or, as they are commonly called, to list B drugs. These medicines should be stored in separate cabinets on the doors of which there is the inscription “B - Heroica” (potent) and a list of those included in list B
Drugs indicating the highest single and daily doses.
The inscriptions on the containers in which potent drugs are stored are written in red on a white background. The highest single and daily doses are also indicated on the bars. After finishing work, cabinets B are locked. They are open during business hours and can be used by pharmacy workers involved in the preparation of medicines.
Drugs not included in lists A and B are stored in regular cabinets or on assistant turntables. The inscriptions on the bars with these medicines are written in black on a white background.
In all cabinets where medicines are stored (list B or regular list), a certain system for arranging the bars should be followed:
1) store liquid medicines separately from bulk ones;
2) do not place medicines that are similar in name next to each other, so as not to confuse them when making the medicine. Therefore, you cannot arrange drugs on cabinet shelves in alphabetical order;
3) medicines for internal use belonging to list B should be placed in cabinets so that drugs with similar higher doses are placed on the shelves (for example, drugs with doses of 0.1 g are stored on one shelf, and from 0.1 g on the other up to 0.5 grams), and place them on cabinet shelves taking into account the pharmacological grouping.
As the experience of many pharmacies has shown, uniform numbering of medicines brings significant benefits. For example, if rods and material cans with norsulfazole have No. 363, then under this number they are decorated in the assistant and material room. Thus, pharmacy workers clearly know that any glass with this number contains norsulfazole.
Rules for storing toxic medicinal substances (List A).
Toxic medicinal substances (list A) are stored under lock and key in iron cabinets or in metal boxes (safe), which must bear the inscription “ Venena"(Poisonous).
And particularly toxic medicinal substances (morphine, atropine sulfate, etc.) are stored in internal, locked compartments of safes and cabinets.
In the same cabinet (safe) there is everything necessary for weighing, measuring and mixing these substances (scales, weighing scales, funnels, cylinders, measuring fingers, etc.). Design of the bars: black background, white letters.
In rooms where toxic medicinal substances are stored, the windows are reinforced with iron bars, and the doors are lined with iron. With the permission of higher organizations, it is possible to store these substances in the same room with other medicinal substances. Cabinets and safes must be locked with keys that are kept by the head of the pharmacy (responsible for the pharmacy) or by the pharmacist-technologist.
Working with toxic medicinal substances (List A).
Toxic substances are weighed out to the pharmacist by a pharmacist-technologist. To receive substances for work, you must fill out the appropriate documentation.
On the reverse side the pharmacist indicates:
- name of a poisonous drug substance,
- the amount of a given substance.
The signatures of the person who dispensed the substance (pharmacist-technologist) and the person who accepted it for work (pharmacist) are affixed. The date is indicated.
Safes are sealed or sealed after working hours.
The amount of toxic medicinal substances in assistant rooms should be such that the supply of 15-day requirements is not exceeded; the remaining amount of substances is stored in a material room equipped with light and sound alarms.
Preparation of dosage forms containing toxic medicinal substances.
The dosage form is sealed, the patient is given a signature and an additional label “Handle with care.” In the same way, a dosage form containing the potent substances codeine and codeine phosphate is prepared. Read more about storing potent substances (List B).
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RULES FOR STORAGE, ACCOUNTING AND DISPENSING OF MEDICINES
Poisonous medicinal substances (list A) stored under lock and key in an iron cabinet or in a metal box (safe), which should bear the inscription Venena, or Poisonous. Particularly poisonous drugs (atropine sulfate, inorganic arsenic compounds, morphine, etc.) are stored in internal, locked compartments of safes or cabinets. In the same cabinet (safe) they keep everything necessary for weighing, measuring and mixing these products. A list of toxic agents contained in the safe is attached to the inside of the doors, indicating the highest single doses. Toxic substances in their pure form are allowed to be stored only in pharmacies of district veterinary stations, city clinics, veterinary laboratories and institutes. Other veterinary institutions are allowed to have group A drugs in finished dosage forms in limited quantities.
Potent substances (list B) also stored separately from other products. The boxes (cabinets) in which they are contained must bear the inscription Heroica, or Potent. List B substances can be stored in all medical institutions and pharmacies of collective and state farms. All other substances (Varia) are stored without restrictions, taking into account the general rules.
On bottles with medicinal substances (shtanglas), their names are written on the labels: with toxic substances - in white on a black background, with potent substances - in red on a white background, and with all others - in black on a white background.
In rooms intended for storing toxic substances, the windows are reinforced with iron bars and the doors are lined with iron. With the permission of higher organizations, it is allowed to store these drugs in the same room with other medicinal substances. The keys to cabinets (safes) and doors of rooms where toxic and potent substances are stored must be kept by the pharmacy manager (or the person in charge of the pharmacy). The room is locked, sealed or sealed.
Instead of prescriptions, when dispensing manufactured medicines containing poisonous, narcotic and some potent substances, they issue a signature with a yellow stripe at the top and the inscription Signature on it in black font, and when dispensing finished medicines, if necessary, they give a label. The signature reproduces a summary of the prescription, i.e., indicates the name of the pharmacy, the prescription number in the book, the type and age of the animal, the composition of the medicine, the method of administration, and the names of the persons who made the form. The inscription is written on the labels
enter the prescription number, type of animal and method of administration of the medicine. There are also warning labels that read:
- Mix before use, etc.
Products for internal use are provided with white labels, for external use - yellow or red, for parenteral - blue.
A prescription received by a pharmacy is checked regarding dosage, combination of medications, it is taxed, if the drug is paid, it is numbered, and the next receipt number is given.
The income and consumption of therapeutic and prophylactic drugs, with the exception of poisonous and some narcotic substances, are taken into account by item in quantitative terms in books according to the approved form. Toxic medicinal substances are subject to subject-quantitative recording in special journals.
Veterinary institutions purchase and spend therapeutic and preventive agents free of charge (according to the state budget) in cases of providing assistance in an outpatient clinic (clinic), providing medical care in emergency cases outside a veterinary institution, during preventive treatments, diagnostic tests and forced disinfections (disinsections), in case of infectious diseases. For payment (at the expense of the farm, organization and citizens), medicines and dressings for the treatment of animals on farms, funds used for castration of animals and cosmetic operations, disinfectants (disinfectants and deratization) for carrying out planned activities on farms, means of accelerating growth and fattening of animals.
The rules for storing poisonous, narcotic and potent medicines in pharmaceutical warehouses, medical institutions, control and analytical laboratories and other healthcare institutions are regulated by special instructions approved by orders of the Ministry of Health.
Group A drugs are divided into subgroups. Of the total number of drugs classified as list A according to the State Pharmacopoeia, a certain part of the drugs is subject to subject-quantitative accounting in pharmacies. Salvarsan preparations are subject to special batch accounting.
All narcotic and especially toxic drugs: arsenic anhydride, crystalline sodium arsenate, strychnine nitrate, mercury dichloride (sublimate) and mercury oxycyanide - should be stored in pharmacies only in safes, and especially toxic drugs - in the internal, locked compartment of the safe.
In pharmacies of categories V and VI, storing narcotic and especially poisonous drugs is permitted only in a material room in safes or metal boxes screwed to the floor. It is not permitted to store these medications in assistant rooms. In large pharmacies (I-IV categories) in assistant rooms, it is necessary to store a supply of narcotic and poisonous drugs in quantities not exceeding 5-day requirements, and storage should also be carried out in special safes.
The total stocks of poisonous and narcotic drugs in city pharmacies should not exceed the monthly requirement. In other pharmacies, the stock of these drugs is determined by regional or regional pharmacy departments.
In on-duty pharmacies, poisonous and narcotic medicines are left overnight in a separate locked cabinet in quantities and assortment necessary to provide emergency medical care. After duty, this closet is sealed.
All poisonous medicines included in list A, but not related to narcotic and especially poisonous drugs, are stored separately, in metal cabinets specially designated for this purpose, under lock and key. In small pharmacies, all List A drugs (including narcotic and especially poisonous ones) can be stored in one safe.
Cabinets and safes containing poisonous and narcotic drugs are designed as follows:
1) on the inside of the safe and cabinet doors there is the inscription “A - Venena” (poison);
2) below this inscription, on the same side of the doors, there is a list of poisonous and narcotic drugs stored in a safe or cabinet, indicating the highest single and daily doses;
3) inscriptions on the containers in which poisonous and narcotic drugs are stored are written in Latin in white font on a black background (black label). The highest single and daily dose is indicated on each bar.
To make medicines with poisonous components, the safes and cabinets where they are stored must have hand scales, weights, mortars, cylinders and funnels. On utensils used for making medicines, it is advisable to be marked: “For mercuric chloride”, “For silver nitrate”, etc. These utensils are washed separately from others under the supervision of a pharmacist.
The key to the cabinet with List A supplies, located in the assistant's room, must be held by the pharmacist - pharmacy technologist during working hours. After the end of the working day, the cabinet is sealed and the key, along with a seal or seal, is handed over to the head of the pharmacy or another responsible pharmacy employee authorized to do so by order of the pharmacy.
Material rooms, as well as safes in which narcotic and especially toxic drugs are stored, must have light and sound alarms. The windows of material rooms in which poisonous and narcotic drugs are stored should be equipped with metal bars. At night these rooms are locked and sealed. Only the head of the pharmacy or a person authorized by him can dispense narcotic and especially poisonous drugs from the material to the assistant's room for current work.
Storage of poisonous and narcotic drugs in pharmaceutical warehouses, control and analytical laboratories, pharmaceutical enterprises, research and educational institutions is also carried out in safes or metal cabinets under lock and key, in rooms whose windows must have iron bars.
In cases where this is provided for by the instructions, the doors of rooms in which poisonous and narcotic drugs are stored are lined with iron, and the room itself is equipped with light and sound alarms. Rooms where narcotic and poisonous drugs are stored should be locked and sealed or sealed after work is completed. The keys, seal or seal must be kept by the person responsible for storing poisonous and narcotic drugs. In rooms, cabinets, and safes where poisonous medicines are stored, it is necessary to have scales, weights, funnels, cylinders, mortars and other utensils for work.
In all cases, employees responsible for the storage and dispensing of poisonous and narcotic drugs must strictly follow the relevant instructions and regulations approved by the Ministry of Health.
Subject-quantitative accounting of poisonous and narcotic drugs is carried out in a special book, numbered, laced and signed by the head of a higher organization with a round seal attached.
In this book, for each name of the drug taken into account, one page is allocated, on which the monthly balances and receipts of this drug, as well as its daily consumption, are reflected.
The consumption of the drug is indicated for each day separately: dispensing for outpatient prescriptions and dispensing to medical institutions, pharmacy departments and pharmacy points of group I. This is done so that at the end of the month, when checking the actual presence of toxic and potent substances and checking them with the book balance, the established norms of natural loss can be applied. These standards are applied separately: for outpatient dispensing of toxic and potent substances and for dispensing to medical and other organizations.
Storage and accounting of salvarsan preparations. Group A drugs also include salvarsan drugs - miarsenol and novarsenol. They are under special control of the State Control Commission for testing such drugs under the Ministry of Health. This commission regulates the production of salvarsan preparations, establishes expiration dates, the procedure for their storage and accounting. The drugs are produced in sealed ampoules in special packaging, which indicates the quantity, batch number and production time. In addition, the supplier indicates on each package that the batch has passed chemical, biological and clinical testing, and the date of inspection.
To record the movement of salvarsan drugs in pharmacies, a special log is kept. It contains information about the receipt and dispensing of drugs in medical institutions. The receipt portion indicates the date the drug was received at the pharmacy, the batch number, dosage and the institution from which the drug was received. When dispensing the drug, the journal indicates the name and address of the medical institution, date of issue, batch number, quantity and dosage.
Storage of potent drugs. A fairly large group of medicines belongs to potent drugs or, as they are commonly called, to list B drugs. These medicines should be stored in separate cabinets on the doors of which there is the inscription “B - Heroica” (potent) and a list of those included in list B
Drugs indicating the highest single and daily doses.
The inscriptions on the containers in which potent drugs are stored are written in red on a white background. The highest single and daily doses are also indicated on the bars. After finishing work, cabinets B are locked. They are open during business hours and can be used by pharmacy workers involved in the preparation of medicines.
Drugs not included in lists A and B are stored in regular cabinets or on assistant turntables. The inscriptions on the bars with these medicines are written in black on a white background.
In all cabinets where medicines are stored (list B or regular list), a certain system for arranging the bars should be followed:
1) store liquid medicines separately from bulk ones;
2) do not place medicines that are similar in name next to each other, so as not to confuse them when making the medicine. Therefore, you cannot arrange drugs on cabinet shelves in alphabetical order;
3) medicines for internal use belonging to list B should be placed in cabinets so that drugs with similar higher doses are placed on the shelves (for example, drugs with doses of 0.1 g are stored on one shelf, and from 0.1 g on the other up to 0.5 grams), and place them on cabinet shelves taking into account the pharmacological grouping.
As the experience of many pharmacies has shown, uniform numbering of medicines brings significant benefits. For example, if rods and material cans with norsulfazole have No. 363, then under this number they are decorated in the assistant and material room. Thus, pharmacy workers clearly know that any glass with this number contains norsulfazole.
Combustible and flammable liquids (kerosene, gasoline, etc.) and lubricants should be stored in rooms with fireproof structures or one-story buildings buried in the ground. Storage of these liquids in the basements of industrial and service buildings is prohibited.
Flammable liquids must be stored in specially equipped containers or closed containers; storing them in open containers and together with other materials is prohibited.
Draining and dispensing flammable liquids is permitted only into hermetically sealed metal containers using pumps, through a copper mesh, or by gravity from taps. Dispensing and draining of these materials in buckets, as well as using siphons, is prohibited.
The receipt, storage and distribution of leaded gasoline should be carried out in accordance with the current Sanitary Rules for the storage, transportation and use of leaded gasoline in vehicles, approved by the Main State Sanitary Inspectorate.
Storage and transportation of leaded gasoline in open containers is prohibited. The container in which leaded gasoline is stored and transported must bear the inscription “Leaded gasoline. Poisonous."
Pumping, receiving and dispensing leaded gasoline must be mechanized. Fuel warehouses must have separate containers and gasoline pipelines for leaded and unleaded gasoline.
Empty containers must be stored in special fenced areas, remote from production workshops and warehouses, in accordance with current fire safety rules.
Storage areas for flammable and combustible liquids are not heated.
Lighting of warehouse premises is permitted only by electric lighting; fittings, lamps and wiring must be explosion-proof.
Acids and caustic alkalis should be stored in special ventilated rooms in glass braided bottles in one row. Each bottle must be labeled with the name of the acid or alkali. Storing acid and alkali in the same room is prohibited.
Paint and varnish materials must be stored in special rooms equipped with ventilation, in durable sealed containers with attached tags or stickers indicating the name of the materials. It is prohibited to stack cans and barrels on top of each other. It is not allowed to store paints and varnishes together with acids, alkalis and other chemicals.
Methyl, wood and synthetic alcohols must be stored in accordance with current sanitary regulations.
Reservoirs, tanks, and containers for storing flammable and explosive liquids must be located on the territory of the enterprise in accordance with the rules for their storage.
Cylinders with compressed and liquefied gases must be stored in special closed, ventilated rooms in a vertical position, in cages with barriers (subsection 6.5) that protect the cylinders from falling. Special purpose cylinders that do not have shoes should be stored horizontally on wooden frames or racks. The cylinder valves must be directed in one direction.
Storing cylinders filled with different gases in the same room is prohibited. Empty cylinders must be stored separately from filled ones. If the number of filled and empty cylinders does not exceed 80, they can be placed in one room. In this case, storage areas for empty and filled cylinders must be separated by a solid barrier with a height of at least 1.5 m. All cylinders are accepted, stored and released only with safety caps screwed on. To protect the cylinders from direct sunlight, window glass should be painted over with white paint.
The passages between the rows of cages must be at least 1.5 m wide for the free passage of carts with cylinders. Cylinder storage facilities must have areas for dispensing filled and receiving empty cylinders.
It is prohibited to store flammable materials at a distance of 10 m around the warehouse with cylinders and to carry out work with open fire.
Stocks of calcium carbide should be stored in dry, well-ventilated areas with a roof that is impermeable to precipitation. It is prohibited to store calcium carbide in basements or heated rooms. The flooring in these rooms should rise 0.5 m above the level of the area adjacent to the warehouse.
Drums with calcium carbide can be stored in a stack in a horizontal or vertical position, in no more than two tiers with boards laid between them. The first tier is also installed on the boards. The width of the passage between stacks must be at least 1 m.
In calcium carbide storage rooms, only explosion-proof electric lighting is allowed. Calcium carbide should be stored in hermetically sealed drums labeled “Carbide”.
Opening drums with calcium carbide, hanging it, sifting out fines and dust, and also selecting ferrosilicon should be done in a separate room, protected from precipitation.
It is prohibited to open calcium carbide drums using blowtorches or tools that may cause a spark.
The drum containing calcium carbide is uncorked using a brass chisel or hammer. Tightly sealed drums are opened with a special knife; the cut area on the lid is pre-lubricated with a thick layer of grease.
Workers are allowed to sift and sort calcium carbide only wearing dust masks or wearing several layers of gauze bandages.
Carbide dust must be systematically collected and extinguished. Accumulation of carbide dust in warehouses is not permitted.
Opened or damaged drums are not allowed to be stored in carbide warehouses. If immediate use is not possible, calcium carbide should be poured into a hermetically sealed container.
In calcium carbide storage warehouses it is prohibited: smoking and working with open fire; arrange heating and plumbing; use water when extinguishing a fire.
When storing imported polymeric materials, adhesives, and mastics, it is necessary to pay strict attention to compliance with company instructions and instructions, as well as the risk of explosion of vapors emitted by adhesive solvents.
The glue must be stored in a hermetically sealed container, in a dark room equipped with ventilation and adapted for storage, at a distance of at least 2 m from water heating devices. The temperature in the premises should not exceed 20 °C.
Potent toxic substances should be stored in accordance with the Sanitary Rules for the design, equipment and maintenance of warehouses for storing potent toxic substances.
When working with aggressive and toxic substances, smoking and eating are prohibited. After finishing work, you should thoroughly wash your hands, rinse your mouth and perform other mandatory personal hygiene requirements, according to the instructions of medical personnel.
Hazardous substances must have good quality, durable and clean packaging and containers that meet the requirements of current GOSTs or specifications, guaranteeing the safety of the substance from damage, etc., as well as safety during their storage and transportation. Bottles and other glass or ceramic containers containing liquid hazardous substances must be packed in wooden boxes, racks or baskets with loose packing material between the spaces.
Potently toxic substances must be stored in separate, closed, well-ventilated rooms at a distance of at least 300 m from residential, public buildings and bodies of water. At the entrance to these warehouses, warning signs in accordance with GOST 12.4.026-76 must be posted. In the absence of a special room, it is allowed to store highly toxic substances in isolated sections or extensions to separate warehouse buildings on the territory of the enterprise.
Flammable and flammable substances (gasoline, kerosene, alcohol, varnishes, paints, oils, etc.) are prohibited from being stored or left at work places. All operations involving the spilling of solvents, as well as dispensing and working with dry pigments (red lead, etc.), varnishes, and paints must be organized in such a way that the possibility of spilling or scattering on the floor is excluded. To clean up spilled paint, it is prohibited to use a tool that could cause sparks.
It is not permitted to carry hazardous substances on the back or shoulders, or to tilt or drag them. In some cases, liquid hazardous substances in bottles or other appropriate containers placed in wooden boxes, lattices or baskets can be carefully carried by two people at a height of 15-20 cm from the surface, or on a stretcher with special sockets.
All drugs, depending on their pharmacological activity, are divided into three groups: poisonous, potent and non-potent. This separation is important for preventing the danger of overdose during the preparation of drugs and their use. In general, the concept of drug toxicity is relative. Many mild medications can be poisonous in overdose.
Poisonous drugs (Venena) - these are products, the prescription, use, dosing and storage of which, due to their high toxicity, must be carried out with extreme caution. These include drugs that cause drug addiction - narcotic drugs, which are approved by special bodies.
Potent drugs (Heroica) - these are products whose prescription, use, dosing and storage must be carried out with caution.
The difference between toxic and potent drugs is mostly only quantitative: toxic substances are usually used in doses of the order of thousandths and ten-thousandths of a gram, and potent ones - in hundredths and tenths of a gram.
Whether a medicinal product belongs to the list of potent or toxic substances is determined by the State Pharmacological Center for Medicines. The content of these lists changes depending on changes in the nomenclature of medicines. For example, in the State Fund of X in the “Introductory Part” there are lists of toxic (list A) and potent (list B) substances. List B includes 326 names of medicines, list A - 116. Order of the Ministry of Health of Ukraine No. 233 dated July 25, 1997 approved six Lists of medicines registered in Ukraine, including Lists of potent, poisonous, narcotic and psychotropic medicines. parathas 1.
1 The textbook provides the designation of potent and toxic substances adopted according to the Global Fund X: list B and list A.
Storage, accounting and dispensing of poisonous, narcotic and potent medicines in pharmacies is carried out in compliance with the rules established by orders of the Ministry of Health of Ukraine.Rules for storing toxic and potent substances.
Poisonous medicines must be stored separately, in metal cabinets specially designated for this purpose under lock and key. There should be an inscription on the inside of the safe and cabinet doors Venena indicating a list of stored substances, their single and daily doses.
Particularly toxic drugs - arsenic anhydride, crystalline sodium arsenate, strychnine nitrate, mercury dichloride (sublimate), mercury cyanide and oxycyanide - should be stored only in the internal, locked compartment of the safe.
The cabinet for toxic substances should have hand scales, weights, weights, mortars, cylinders, funnels, which are needed for the preparation of medicines. Such utensils are marked: “for atropine”, “for sublimate”, etc. These items are washed and processed separately from the rest of the utensils under the supervision of a pharmacist.
Potent medicines, as well as lapis pencils, should be stored in separate cabinets. There should be a sign on the inside of the door « Heroica» and a list of potent substances indicating the highest single and daily doses.
The inscriptions on the bars in which toxic medicinal substances are stored must be white on a black background, and on the bars containing potent drugs - red on a white background, in both cases the highest single and daily doses must be indicated on the bars . On dispensers with conventional medicines, the inscriptions are made in black on a white background.
During working hours, the pharmacist-technologist must have the key to the cabinet “for toxic substances” located in the assistant’s room. Safes and cabinets are sealed or sealed after the end of the working day, and the keys to them, a seal or a seal must be kept by the head of the pharmacy or by persons authorized by the order of the pharmacy. Cabinets “for potent substances” must be locked after the end of the working day. Material rooms in which narcotic and especially toxic drugs are stored must have light and sound alarms. There should be bars on the windows. After finishing work, these rooms are locked and sealed.
Rules for prescribing toxic and potent substances. For prescribing narcotic drugs in pure form or in a mixture with indifferent substances (according to the list approved by the Ministry of Health of Ukraine), form F-3 is provided. Toxic and potent substances, including ethyl alcohol, are prescribed on prescription form F-1.
Narcotic and intoxicating drugs in pure form or with indifferent substances are allowed to be prescribed only to doctors who work in public health care institutions.
The names of poisonous (the list of which is approved by the Ministry of Health of Ukraine) and narcotic drugs are written at the beginning of the prescription, followed by all other drugs.
The prescription of form No. 3 is additionally signed by the head of the healthcare institution or his deputy for medical affairs and certified by the seal of the healthcare institution (stamp). Prescriptions for dosage forms containing toxic substances and ethyl alcohol must be sealed with the seal of the medical institution “For prescriptions” and the personal seal of the doctor.
When prescribing poisonous or potent drugs in doses exceeding the highest single dose, the doctor must write the dose of this drug in words and put an exclamation mark.
Rules for the dispensing of medicinal products containing toxic medicinal substances. When accepting a prescription for a medicinal product containing a toxic substance, the pharmacist must show special care and accuracy: it is necessary to clarify the patient’s age, check the correct dosage, the compatibility of the prescribed ingredients and underline the name of the toxic drug with a red pencil. When preparing medications, a toxic substance is weighed out by a pharmacist-technologist in the presence of a pharmacist. The poisonous drug obtained by the pharmacist is immediately used to prepare the drug. It is prohibited to dispense poisonous, narcotic and potent drugs prescribed in a prescription other than in the prepared dosage form.
If a doctor prescribes a poisonous, narcotic or potent drug in a dose exceeding the highest single dose without an appropriate prescription, the pharmacist must dispense the prescribed drug in an amount of 50% of the dose established as the highest single dose.
Narcotic drugs prescribed on special prescription forms F-3 are dispensed only from pharmacies attached for these purposes to territorial treatment and preventive institutions.
Ethylmorphine hydrochloride, codeine, codeine phosphate, sodium etaminal, barbamyl mixed with other drugs are dispensed by pharmacies within a city or rural administrative region according to prescriptions from medical institutions located on their territory.
When dispensing extemporaneously prepared medications containing toxic, narcotic substances and ethyl alcohol, patients are given a signature instead of a prescription (Fig. 5).
Prescriptions for dispensed drugs are stored in pharmacies, not taking into account the current year, for:
For five years - for narcotic drugs prescribed on special prescription forms f-3;
Last name, initials of the doctor
Prepared
Checked
Let go
Date Price
A new doctor's prescription is required to re-dispense medications.
Rice. 5. Sample signature
Three years - for medicines dispensed free of charge or on preferential terms;
One year - for drugs subject to subject-quantitative accounting (with the exception of narcotic drugs), anabolic steroids;
One month - for the rest of the drugs.
At the end of the shelf life, all recipes must be destroyed in accordance with the established procedure.
Prepared medicines containing toxic agents are sealed by the person who checked the medicine (or sealed “for running-in”).
Bottles in which solutions of mercury dichloride (sublimate), cyanide and oxycyanide are dispensed are labeled “Poison” with the image of crossbones and a skull, “Handle with care”, and the name of the poisonous drug must be indicated in Russian (or local) language and solution concentration.
A solution of mercury dichloride (sublimate), intended for disinfection, is stained with eosin or fuchsin; the signature or label must indicate what the solution is tinted with.
The packaging of other pharmaceutical preparations containing toxic agents, as well as phenol in pure form, or solutions with a concentration above 5%, strong acids, perhydrol and other similar products, must bear the “Handle with Care” label.
All prepared medications containing toxic substances are stored in a separate locked cabinet until release.
