Group 1 drugs. Groups of drugs. Classification by chemical structure

Medicines are the main products sold by pharmacies. When selling, they are guided by the rules of retail trade approved by the government of the Russian Federation. However, these rules take into account the specifics of the sale of medicines, since an important feature of medicines as a product is the lack of clear criteria for assessing the effectiveness/safety ratio of use.

There are several classifications of drugs.

Anatomical-therapeutic-chemical classification -- international system of classification of medicines.

This classification divides drugs into groups with 5 different levels:

· anatomical organ or system;

· basic therapeutic/pharmacological;

· therapeutic/pharmacological;

· therapeutic/pharmacological/basic chemical;

· by chemical structure.

Each group, depending on the level, has an alphabetic or numeric code.

Code A: Drugs affecting the digestive tract and metabolism (Dental drugs; Drugs for the treatment of diseases associated with acidity disorders; Drugs for the treatment of functional gastrointestinal disorders; Antiemetic drugs; Drugs for the treatment of diseases of the liver and biliary tract; Laxatives; Antidiarrheal drugs; Drugs for the treatment of obesity (excluding dietary products); Digestive drugs (including enzyme preparations); Drugs for the treatment of diabetes mellitus; Vitamins; Mineral supplements; General tonics; Anabolic drugs for systemic use; Appetite stimulants; Other drugs for the treatment of gastrointestinal diseases and metabolic disorders) .

Code B: Drugs affecting hematopoiesis and blood (Anticoagulants; Hemostatics; Hematopoiesis stimulants (antianemic drugs); Lipid-lowering drugs; Plasma replacement and perfusion solutions; Other hematological drugs).

Code C: Drugs for the treatment of diseases of the cardiovascular system (Drugs for the treatment of heart disease; Antihypertensive drugs; Diuretics; Peripheral vasodilators; Angioprotectors; Beta-blockers; Blockers of “slow” calcium channels; Drugs affecting the renin-angiotensin system; Lipid-lowering drugs).

Code D: Drugs for the treatment of skin diseases (Antifungal drugs for the treatment of skin diseases; Dermatoprotectors; Drugs for the treatment of wounds and ulcers; Drugs for the treatment of itchy skin (including antihistamines and anesthetics); Drugs for the treatment of psoriasis; Antibacterial drugs and antimicrobial drugs for the treatment of skin diseases; Glucocorticosteroids for local treatment of skin diseases; Antiseptics and disinfectants; Dressing material; Preparations for the treatment of acne; Other drugs for the treatment of skin diseases).

Code G: Drugs for the treatment of diseases of the urogenital organs and sex hormones (Antiseptics and antimicrobial drugs for the treatment of gynecological diseases; Other drugs for the treatment of gynecological diseases; Sex hormones; Drugs for the treatment of urological diseases).

Code H: Hormonal preparations for systemic use (excluding sex hormones)

Code J: Antimicrobials for systemic use

(Antibacterial drugs for systemic use; Antifungal drugs for systemic use; Antituberculosis drugs; Antiviral drugs for systemic use; Immune serum and immunoglobulins; Vaccines).

Code L: Antitumor drugs and immunomodulators (Antitumor drugs; Antitumor hormonal drugs; Immunomodulators; Immunosuppressants).

Code M: Drugs for the treatment of diseases of the musculoskeletal system (Anti-inflammatory and antirheumatic drugs; Drugs for the local treatment of diseases of the musculoskeletal system; Muscle relaxants; Antigout drugs; Drugs for the treatment of bone diseases; Drugs for the treatment of other diseases of the musculoskeletal system).

Code N: Drugs for the treatment of diseases of the nervous system (Anesthetics; Analgesics; Antiepileptic drugs; Psychoanaleptics; Other drugs for the treatment of diseases of the nervous system).

Q Code: Veterinary drugs

R code: Drugs for the treatment of diseases of the respiratory system

(Nasal drugs; Drugs for the treatment of throat diseases; Drugs for the treatment of obstructive respiratory diseases; Drugs used for coughs and colds; Systemic antihistamines; Other drugs for the treatment of respiratory diseases).

Code S: Drugs for the treatment of diseases of the sensory organs (Drugs for the treatment of eye diseases; Drugs for the treatment of otological diseases; Drugs for the treatment of ophthalmological and otological diseases).

Code V: Other medicinal products (Allergens; Other therapeutic products; Diagnostic drugs; Nutritional products; Other non-therapeutic products; Contrast agents; Diagnostic radiopharmaceuticals; Radiotherapeutic agents; Surgical desmurgy agents).

Pharmacological classification

In Russia, it is more common to divide medicines into pharmacological groups:

1. Vegetotropic agents

1.1. Adrenolytic agents (Alpha and beta blockers, Alpha blockers, Beta blockers, Sympatholytics)

1.2. Adrenomimetic agents (Adreno- and sympathomimetics (alpha-, beta-), Alpha-adrenomimetics, Beta-adrenomimetics)

1.3. Anticholinergics (m-cholinolytics, n-cholinolytics (ganglioblockers), n-cholinolytics (muscle relaxants))

1.4. Cholinomimetic agents (m-, n-cholinomimetics, including anticholinesterase agents, m-cholinomimetics, n-cholinomimetics)

2. Hematotropic agents (Antiplatelet agents, Anticoagulants, Plasma and other blood components substitutes, Fibrinolysis inhibitors, Coagulants (including blood clotting factors), hemostatic agents, Hematopoiesis stimulators, Fibrinolytics)

3. Homeopathic remedies

4. Hormones and their antagonists

4.1. Androgens, antiandrogens

4.2. Glucagon and its analogues

4.3. Hormones of the hypothalamus, pituitary gland, gonadotropins and their antagonists

4.4. Thyroid hormones, their analogs and antagonists (including antithyroid drugs)

4.5. Insulins

4.6. Corticosteroids (Glucocorticoids, Mineralocorticoids)

4.7. Estrogens, gestagens; their homologues and antagonists

4.8. Other hormones and their analogues

5. Diagnostic tools

5.1. Immunobiological diagnostic tools

5.2. Contrast agents (X-ray contrast agents, Magnetic resonance contrast agents)

5.3. Other diagnostic tools

6. Immunotropic agents (Vaccines, serums, phages, Immunoglobulins, Immunosuppressants, Immunomodulators)

7. Intermediates

7.1. I1-imidazoline receptor agonists

7.2. Adenosinergic drugs

7.3. Angiotensin II receptor antagonists (AT1 subtype)

7.4. Histaminergic agents

7.4.1. Histaminolytics (H1-antihistamines, H2-antihistamines, Mast cell membrane stabilizers, Other _immunomodulator)

7.4.2. Histaminomimetics

7.5. Dopaminomimetics

7.6. Prostaglandins, thromboxanes, leukotrienes and their antagonists

7.7. Serotonergic agents

7.8. Other _immunomodulators

8. Metabolics

8.1. Anabolic steroids

8.2. Antihypoxants and antioxidants

8.3. Proteins and amino acids Vitamins and vitamin-like products

8.4. Hypoglycemic synthetic and other drugs

8.5. Lipid-lowering drugs (Nicotinates, Statins, Fibrates, Other immunomodulators)

8.6. Detoxifying agents, including antidotes

8.7. Correctors of bone and cartilage tissue metabolism

8.8. Macro- and microelements

8.9. Rehydrants

8.10. Regulators of water-electrolyte balance and acid-base balance

8.11. Agents affecting uric acid metabolism

8.12. Products for enteral and parenteral nutrition

8.13. Means that prevent the formation and promote the dissolution of stones

8.14. Enzymes and antienzymes

8.15. Others _mmunomodu

9. Neurotropic agents

9.1. Anxiolytics

9.2. Antidepressants

9.3. Local irritants

9.4. Local anesthetics

9.5. Anesthetics

9.6. Neuroleptics

9.7. Nootropics (neurometabolic stimulants)

9.8. Normotimics

9.9. General tonics and adaptogens

9.10. Opioids, their analogs and antagonists

9.11. Antiparkinsonian drugs

9.12. Antiepileptic drugs

9.13. Psychostimulants

9.14. Sedatives

9.15. Sleeping pills

9.16. Drugs affecting neuromuscular transmission

9.17. Other neurotropic drugs

10. Non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs

11. Organotropic agents

11.1. Dermatotropic agents

11.2. Gastrointestinal drugs (Antacids and adsorbents, Carminatives, Hepatoprotectors, Choleretic drugs and bile preparations, H2-antihistamines, Proton pump inhibitors, Antidiarrheals, Antiemetics, Appetite regulators, Laxatives, Drugs that normalize intestinal microflora, Gastrointestinal motility stimulants , including emetics, Dental agents, Other gastrointestinal agents)

11.3. Respiratory agents (Anticongestants, Antitussives, Secretolytics and stimulants of motor function of the respiratory tract, Respiratory stimulants, Surfactants, Other respiratory agents)

11.3.1. Cardiovascular drugs (I1-imidazoline receptor agonists, Angioprotectors and microcirculation correctors, Angiotensin II receptor antagonists (AT1 subtype), Antiarrhythmic drugs, Beta-blockers, Calcium channel blockers, Vasodilators, Hypertensive drugs, ACE inhibitors, Correctors of cerebrovascular accidents, Nitrates and nitrate-like drugs, Cardiac glycosides and non-glycoside cardiotonic drugs, Other cardiovascular drugs)

11.4. Myotropic antispasmodics

11.5. Drugs that regulate the function of the genitourinary system and reproduction (Diuretics, Non-hormonal contraceptives, Potency regulators, Drugs that affect metabolism in the prostate gland and urodynamic correctors. Tocolytics, Uterotonics, Other drugs that regulate the function of the genitourinary system and reproduction)

12.1. Antibiotics (Aminoglycosides, Amphenicols, Ansamycins, Glycopeptides, Carbapenems, Lincosamides, Macrolides and azalides, Penicillins, Tetracyclines, Cephalosporins, Other antibiotics)

12.2. Antiseptics and disinfectants

12.3. Antiviral drugs (Medicines for the treatment of HIV infection)

12.4. Antihelminthics

12.5. Antifungal agents

12.7. Synthetic antibacterial agents (Sulfonamides, Quinolones/fluoroquinolones, Other synthetic antibacterial agents)

13. Antitumor agents

13.1. Alkylating agents

13.2. Antimetabolites

13.3. Antitumor antibiotics

13.4. Antitumor hormonal agents and hormone antagonists

13.5. Antitumor agents of plant origin

13.6. Antitumor agents - monoclonal antibodies

13.7. Other antineoplastic agents

14. Regenerants and reparants

15. Dietary supplements

16. Various means

16.1. Excipients, reagents and intermediates

16.2. Baby food (including formula)

16.3. Radioprophylactic and radiotherapeutic agents

16.4. Sclerosants

16.5. Means for the correction of disorders in alcoholism, toxic and drug addiction

16.6. Other miscellaneous means

All medications are also divided into prescription and over-the-counter medications. There is also a group of drugs included in the minimum range of drugs necessary to provide medical care (Appendix 2).

To optimize the workflow and better serve visitors, the pharmacist must understand the entire range of the pharmacy. Knowledge of drug groups will help the pharmacist create a certain order, which is necessary not only for the convenience of the employee, but is also prescribed in legislative acts.

To monitor the quality of products, various types and types of classification of drug groups and rules for their placement have been created. Compliance with these rules will help the pharmacist avoid problems when working with products.

Types of classifications

At the moment, there are several different types of drug classification.

The first type is trading, which serves for the proper management of a pharmacy, analysis of its profitability, and the use of various techniques to increase sales. This type distinguishes medications according to financial and economic parameters, such as place of production, type of supply, price of the product.

The second type is legal classification, the purpose of which is the legal protection of the organization. When receiving a product, the pharmacist classifies it according to parameters such as registration number and date, and separate groups of drugs.

The next type is pharmacological classification, aimed at identifying the storage conditions of drugs, determining side effects, contraindications, features of use and incompatibility.

Pharmacological classification

Medicines are divided into fourteen groups:

Each of the listed categories is allowed for sale only if the pharmacy receives the appropriate license. Knowledge of this classification will help the pharmacist systematize the location of products to speed up the work process. Certain categories are popular with different groups of customers, which every pharmacist should know.

Today, there are already special programs that help pharmacists in their activities: compiling reports, arranging drugs into groups, monitoring product balances and their expiration dates.

In addition, there are drugs that are dispensed to the client only with a prescription from a specialized doctor; accordingly, pharmacy products are divided into prescription and over-the-counter. This rule is enshrined in law, so its violation leads not only to a bad reputation for the pharmacy, but also to criminal liability. Prescription drugs are not displayed on display, so it is very important to monitor changes in their list.

The listed types of classifications were created to organize a convenient and comfortable space for all participants in the process of selling pharmaceuticals.

H1 - antihistamines- drugs that block H1 receptors. They are used to treat and prevent allergic diseases (reduce the toxic effect of histamine), have a sedative (calming) and anti-inflammatory effect.

H2-antihistamines- drugs that block H2-histamine receptors; one of the main antiulcer drugs, since they inhibit excess gastric secretion.

Adenosinergic drugs- stimulate the exchange of ATP, the activity of which determines the level of oxygen saturation of tissues.

Adrenergic agonists- stimulate adrenergic receptors, causing effects similar to adrenaline. These include alpha and beta adrenergic agonists.

Adsorbents- absorb toxic (harmful) substances, reduce their absorption by the gastrointestinal tract.

Alpha blockers- 6 alpha-adrenergic receptor locators; prevent the passage of vasoconstrictor impulses through adrenergic synapses and thereby cause dilation of arterioles and precapillaries, improve urodynamics in benign prostatic hyperplasia.

Alpha adrenergic agonists- alpha-adrenergic receptor stimulants. Causes contraction of smooth muscles, vasoconstriction and increased blood pressure; reduce secretion in the nasal cavity and facilitate nasal breathing.

Anabolics (or anabolic steroids)- synthetic drugs with maximum anabolic (“accumulative”) and minimal androgenic (masculinizing) activity; stimulate protein synthesis in the body: cause a decrease in the excretion of urea by the kidneys, retain nitrogen in the body and excrete sulfur, potassium and phosphorus compounds necessary for protein synthesis; promote calcium fixation in bones. The clinical effect of anabolic steroids is manifested in increased appetite, increased body weight, improved general condition, and increased bone density. Prescribed in combination with adequate dietary therapy.

Angioprotectors and microcirculation correctors- improve both the condition of the vascular wall and blood circulation in the area of ​​the vascular bed of the smallest caliber.

Androgens, antiandrogens. Androgens are preparations of male sex hormones; cause the appearance of male secondary sexual characteristics, stimulate the formation of sperm, and have anabolic effects. They are used for delayed sexual development, decreased sexual function and enlarged prostate gland in males, for chronic diseases that occur with exhaustion, for oncological pathology of the genital area in females under 60 years of age simultaneously with radiation therapy, in the early stages of hypertension, for angioneurotic forms of angina pectoris, vascular and nervous disorders in the menopause. Antiandrogens are substances of steroidal and non-steroidal structure that suppress the physiological activity of the body’s own androgens. They are used in the treatment of prostate cancer, for hyperandrogenic conditions in women (baldness, hirsutism, etc.) and children with premature puberty, and for functional diagnostics of endocrine diseases.

Anxiolytics, sedatives and hypnotics, Anxiolytics (or tranquilizers, or ataractics)- psychotropic drugs that reduce the severity or suppress anxiety, fear, restlessness, emotional stress, relieve anxiety. Sedatives - sedatives; regulate the functions of the central nervous system, enhancing inhibition processes or reducing excitation processes; enhance the effect of hypnotics, analgesics and other drugs that depress the central nervous system. Sleeping pills that make it easier to fall asleep and deepen natural sleep; cause the development of inhibition processes in the cerebral cortex, calm, and induce sleep.

Angiotensin II receptor antagonists (AT1 - subtype)- one of the new groups of antihypertensive drugs. The main mechanism of action: blockade of AT1 receptors, which allows for a pronounced antihypertensive and organoprotective effect; against the background of blockade of AT1 receptors, the adverse effect of angiotensin II on the cardiovascular system is inhibited. Angiotensin II is a peptide that has a strong vasoconstrictor effect, causes a rapid increase in blood pressure, stimulates the secretion of aldosterone, and in high concentrations increases the secretion of hypertension and causes sympathetic activation. All these effects contribute to the development of hypertension.

Antacids- reduce the acidity of gastric juice.

Antiplatelet agents- agents that prevent platelet aggregation and blood clot formation.

Antiarrhythmic drugs- means that restore the normal rhythm of heart contractions.

Antibiotics-- antimicrobial substances effective against pathogens and protozoa, except viruses.

Antihypoxants and antioxidants- substances that restore adequate oxygen supply to tissues and reduce tissue hypoxia.

Antidepressants- help eliminate depression.

Anticoagulants- substances that prevent blood clotting and the formation of blood clots.

Anticongestants(from the English congestion - accumulation, thickening, rush of blood) - drugs that help thin the blood.

Antimetabolites- substances that are close in chemical structure to natural metabolic products (metabolites) and slow down their transformations and physiological activity. They are used as antitumor agents (slowing tumor growth when using these substances is caused by a disruption in the synthesis of DNA and RNA nucleic acids).

Antiseptics and disinfectants- broad-spectrum drugs that promote the death of banal (ordinary) and pathogenic (disease-causing) flora (various microorganisms).

Proteins and amino acids- complex organic substances, which are the main “building material” for tissues and organs; provide many enzymatic processes.

Beta blockers- drugs that have a specific blocking effect on the effects associated with the stimulation of beta-adrenoreactive systems, preventing the effect of norepinephrine (one of the adrenal hormones) on them. They help normalize heart rate (slow heart rate), reduce tissue oxygen demand (reduce oxygen starvation), reduce elevated blood pressure and IOP, reduce ischemic disorders in tissues, have an antispastic and analgesic effect, can stimulate the contractile function of the uterus, and reduce concentration.

Beta-agonists- increase the sensitivity of beta-adrenergic receptors and cause relaxation of the respiratory muscles without vasoconstriction, increased frequency and strengthening of heart contractions, improvement of the functional state of the conduction system of the heart in case of conduction disorders (AV blockades), increased cardiac output against the background of a decrease in blood supply to the ventricles of the heart, increased need myocardium in oxygen; contribute to a decrease in renal blood flow, a decrease in uterine tone, and inhibition of the release of biologically active substances from mast cells that contribute to the development of bronchospasm with symptoms of inflammation.

Beta-agonists- the same as beta-agonists.

Biogenic stimulants- drugs that enhance (stimulate) metabolism in the body, in particular, the rate of cell division and restoration (reparation) of damaged tissues, the activity of the immune system (the body’s defenses), blood pressure, the activity of the central and autonomic nervous systems, etc.

Biologically active food additives. According to the Federal Law “On the Quality and Safety of Food Products” (No. 29-FZ of January 2, 2000): “natural (identical to natural) biologically active substances intended for consumption simultaneously with food or included in food products.”

H1-histamine receptor blockers- drugs used to treat and prevent allergic diseases; reduce the body's response to histamine, relieve spasms of the respiratory muscles caused by histamine, reduce capillary permeability, prevent the development of tissue edema caused by histamine, reduce its hypotensive effect, prevent the development and alleviate the course of allergic reactions (especially acute manifestations), reducing the toxicity of histamine. Some of these drugs have ganglioblocking, sedative and hypnotic effects of varying degrees of severity.

Calcium channel blockers (or slow channel blockers, or calcium ion antagonists)- drugs that inhibit the passage of calcium ions through the cell membrane and thereby reduce the possible negative impact of calcium ions in pathological conditions. Used to dilate blood vessels of the heart; how antiarrhythmic drugs reduce heart rate and blood pressure; how antispastic agents for spasms of the digestive and urinary system help slow down thrombus formation, inhibit the secretion of pituitary hormones and the production of adrenaline and norepinephrine by the adrenal glands.

Vasodilators- vasodilators. These include the following groups: alpha-adrenergic agonists; alpha blockers; angiotensin II receptor antagonists (AT1 subtype); ACE inhibitors; prostaglandins, thromboxanes, leukotrienes and their antagonists, etc.

Vaccines, serums, phages. Vaccines- biological products to create immunity in people to infectious diseases. Corpuscular vaccines contain attenuated or killed microbes (virions), non-corpuscular vaccines contain products of chemical breakdown of microbes (chemical vaccines), neutralized bacterial exotoxins or poisons (toxoids). Based on the number of antigens included in the vaccine, a distinction is made between monovaccines and polyvaccines (associated). Depending on the species composition, vaccines can be bacterial, viral, or rickettsial. Immune serums- preparations from animal and human blood containing antibodies against pathogens of infectious diseases or their metabolic products. They are used for serodiagnosis, seroprophylaxis and serotherapy. Phages are viruses that can penetrate a bacterial cell, reproduce and cause its lysis. Bacteriophages are used for phage prevention and phage therapy of infectious diseases. Bacteriophages are prescribed for various intestinal infections, dysbacteriosis, purulent infections, etc.

Carminatives- moderately stimulate intestinal motility and have a slight antispasmodic effect on the sphincter muscles. Used for flatulence (especially in elderly and senile people).

Vitamins and vitamin-like products. Vitamins- substances not synthesized by the body and obtained from the environment, necessary in certain (very small) quantities to maintain optimal functional activity in general. Vitamin-like- substances similar to vitamins in structure and therapeutic effect, but not replacing the vitamins themselves.

Hepatoprotectors- drugs that support adequate functional activity of the liver.

Hypoglycemic synthetic and other drugs- artificially produced drugs that lower blood sugar.

Lipid-lowering drugs- reducing the content of lipids in the blood, preventing the development of atherosclerosis.

GCS (glucocorticosteroids or glucocorticoids)- adrenal hormones; affect carbohydrate and protein metabolism, but are less active in relation to water and salt metabolism; promote the accumulation of glycogen in the liver, increase blood glucose levels, increase the excretion of nitrogen in the urine; have anti-inflammatory, desensitizing and antiallergic effects; They also have antishock and antitoxic properties.

Homeopathic remedies- means that do not have a material principle or contain single molecules of it. The main effect of homeopathic medicines is aimed at stimulating the protective and adaptive functions of the body, restoring adaptive mechanisms through the least irritation of certain receptors that respond to this effect. The effect is realized through the mental, neuro-vegetative, endocrine, metabolic and immune systems.

Gorgons of the hypothalamus, pituitary gland, gonadotropins and their antagonists. Hormones of the hypothalamus, pituitary gland-- hormones that have a regulatory effect on the function of the endocrine system as a whole. Gonadotropins- hormones of the anterior pituitary gland that regulate the functional activity of the gonads. They are used for absolute or relative deficiency of the corresponding hormones in the body. Gonadotropin antagonists (antigonadotropins)- drugs that suppress the functional activity of the gonads.

Hormones and their analogues. Hormones- biologically active substances produced by the endocrine glands of the body in negligible quantities and necessary to maintain an adequate level of vital activity of the body. Their analogues are drugs of a similar structure and direction of therapeutic action, obtained artificially. They are used for absolute or relative deficiency of the corresponding hormones in the body.

Thyroid hormones, their analogs and antagonists (including antithyroid drugs). Thyroid hormones (or thyroid hormones - thyroxine, triiodothyronine) are a secretion product of the thyroid gland, their analogues are drugs obtained artificially. They increase the need of tissues for oxygen, enhance energy processes, stimulate growth and differentiation of tissues, affect the functional state of the nervous and cardiovascular systems, liver, kidneys and other organs, enhance the absorption of glucose and its utilization. Antagonists (including antithyroid drugs)- drugs that inhibit the overactivity of the thyroid gland.

Detoxifying agents, including antidotes, - blocking the effect of various toxins (harmful substances) on the body.

Diuretics- diuretics; increase the excretion of urine from the body and reduce the fluid content in the tissues and serous cavities of the body.

Dopaminomimetics Dopamine- a neurotransmitter that plays an important role in the activity of the central nervous system in structure - a biogenic mineral formed from L-tyrosine (a precursor of norepinephrine). Dopaminomimetics are drugs that stimulate dopamine receptors, as well as, in large doses, alpha and beta adrenergic receptors. They cause a decrease in renal vascular resistance, an increase in renal blood flow and filtration, an increase in the amount of urine excreted, and an increase in blood flow in the vessels of the abdominal organs. Used in anti-shock therapy, treatment of acute cardiac and vascular failure.

Other lipid-lowering drugs- see Lipid-lowering drugs.

Other hormones and their analogues- see Hormones and their analogues.

Other gastrointestinal drugs- see Gastrointestinal drugs.

Other metabolisms. Metabolite - means that regulate carbohydrate, fat, protein, water-electrolyte and other types of metabolism.

Other respiratory products- see Respiratory agents.

Other synthetic antibacterial agents- are characterized by high antibacterial activity, the mechanism of which has not yet been fully studied. The effect is partly due to the blockade of polymerization, and therefore the suppression of DNA synthesis in sensitive bacterial cells. Used mainly for infectious diseases of the urinary tract, gastrointestinal tract, etc.

Other drugs regulating the function of the genitourinary system and reproduction, - see Drugs regulating the function of the genitourinary system and reproduction.

Gastrointestinal drugs- means for the treatment of the gastrointestinal tract; include drugs of various groups: replacing, stimulating or weakening the secretory function of the digestive glands (bitters, antacids, choleretic drugs, blockers of histamine H1 receptors, individual enzymes or their complexes, etc.), drugs stimulating or weakening the motor activity of the smooth muscles of the digestive tube, bile and pancreatic ducts (cholinomimetics, anticholinergics, direct antispasmodics), emetics (for poisoning) and antiemetics, antiulcer drugs (for ulcerations of the stomach, intestines), antibiotics and other antibacterial drugs (for infectious lesions), hepatoprotectors, etc.

Choleretic and bile preparations- agents that stimulate the outflow of bile and its adequate activity. They are divided into two groups: those that enhance the formation of bile and bile acids (choleretics) and those that promote its release from the gallbladder into the intestines (cholekinetics). Choleretics increase the amount of segregated bile and the content of cholates in it, increase the osmotic gradient between bile and blood, which enhances the filtration of water and electrolytes into the bile capillaries, accelerate the flow of bile through the bile ducts, reduce the possibility of cholesterol precipitation, that is, prevent the formation of gallstones, enhance the digestive and motor activity of the small intestine. Cholekinetics stimulate contractions of the gallbladder, reduce its tone, and also relax the muscles of the biliary tract and sphincter of Oddi. Most choleretic drugs simultaneously enhance the secretion of bile and facilitate its entry into the intestines.

Substitutes for plasma and other blood components- synthetic (obtained artificially) drugs administered intravenously, used to restore bcc, preserve its aggregate state, replace certain blood functions, maintain water-electrolyte balance, blood oncotic pressure, and correct acid-base balance.

Immunomodulators-- preparations of animal, microbial, yeast and synthetic origin that change the activity of the immune system (the body's defenses); have the specific ability to stimulate immune processes and activate immunocompetent cells and additional immune factors; strengthen the overall resistance (resistance) of the body, accelerate regeneration processes. They are used in complex therapy of sluggish regeneration processes, infectious, infectious-inflammatory and other diseases.

ACE inhibitors- chemical compounds that can block the transition of angiotensin I to biologically active angiotensin II. They reduce peripheral vascular resistance, post- and preload on the myocardium, reduce SBP and DBP, reduce left ventricular filling pressure and the incidence of ventricular and reperfusion arrhythmias, improve regional (coronary, cerebral, renal, muscular) blood circulation. As a result of therapy with ACE inhibitors, the sensitivity of peripheral tissues to the action of insulin increases, glucose metabolism improves, diuresis and natriuresis increases, potassium levels increase, and water metabolism is normalized.

Gastric proton pump inhibitors- reduce the acidity of gastric juice: suppress the secretion of hydrochloric acid, both basal (nighttime and daytime) and stimulated (regardless of the type of stimulus), prevent increased secretion after eating.

Fibrinolysis inhibitors- means that prevent the dissolution of a blood clot formed in the lumen of a blood vessel after damage; have a hemostatic effect in various pathological conditions in which the fibrinolytic activity of blood and tissues is increased, as well as during surgical operations.

Insulins. Insulin is a hormone produced by beta cells of the pancreas, is a specific sugar-lowering agent, regulates carbohydrate metabolism, enhances the absorption of glucose by tissues, facilitates its penetration into tissue cells, promotes its conversion into glycogen (increases glycogen reserves in the liver and muscles), that is has a hypoglycemic effect; stimulates protein synthesis and reduces its consumption by tissues, reduces lipids in the blood.

Coagulants (including blood clotting factors), hemostatics. Coagulants are substances that stimulate blood clotting, hemostatics are hemostatic agents. They are used to prevent and stop bleeding and to normalize blood clotting.

Non-hormonal contraceptives- non-hormonal drugs that prevent pregnancy; most often contain cytocidal substances that inhibit sperm motility and prevent fertilization of the egg.

Correctors of bone and cartilage tissue metabolism- substances that restore metabolic processes of bone and cartilage tissue: accumulate in bone tissue and inhibit the activity of osteoclasts, reduce bone pain, repair foci of osteolysis, stop (reduce) bone resorption (inhibit osteoclasts) and stimulate bone formation (activate osteoblasts).

Correctors for cerebrovascular accidents- substances that prevent the development of cerebral circulatory disorders and restore metabolic processes in the central nervous system; have a positive effect on blood supply to the brain, microcirculation, and oxygen supply.

Macro- and microelements- inorganic (mineral) substances involved in all types of metabolism: ensure the normal course of human life processes, are necessary to maintain the constancy of the internal environment of the body, acid-base balance and water-salt metabolism.

Local irritants- increasing the sensitivity of nerve endings on a limited surface area of ​​the skin or mucous membranes; help improve blood supply and tissue trophism, relieve pain.

Local anesthetics- local painkillers; reduce or completely suppress the excitability of sensitive nerve endings in mucous membranes, skin and other tissues.

Mineralocorticoids- hormones of the adrenal medulla; affect the exchange of electrolytes and water and relatively little - on carbohydrate and protein metabolism. Used for adrenal dysfunction (hypocorticism), myasthenia gravis, general muscle weakness, adynamia, hypochloremia and other diseases associated with mineral metabolism disorders.

M-Anticholinergics- substances that block m-cholinergic receptors in the area of ​​the endings of parasympathetic nerve fibers, resulting in dilated pupils, paralysis of accommodation, tachycardia, improved AV conduction, decreased tone of the bronchi and bladder, weakened intestinal motility, decreased secretion of glands (bronchial and digestive). They are used (as antispasmodics and analgesics) for stomach diseases, cholelithiasis, smooth muscle spasms (various types of colic), bradycardia, neuralgia, myositis, rheumatoid arthritis and bronchial asthma.

M-cholinomimetics- substances that cause the effects of acetylcholine when acting on cholinergic receptors: slowing heart contractions, dilating peripheral blood vessels, lowering blood pressure, increasing gastrointestinal motility, contracting the smooth muscles of internal organs, increasing the secretion of glands of the mucous internal organs, sweat and lacrimal glands, changing the speed of synaptic transmission in different parts of the brain, miosis (constriction of the pupils), etc. The positive effect of m-cholinomimetics on IOP (they improve the outflow of intraocular fluid and, thereby, lower IOP) allows them to be used in the treatment of intraocular hypertension and glaucoma.

Anesthetics- inhaled and/or non-inhaled drugs, narcotic and non-narcotic analgesics in combination with sedatives, cardiac and other drugs used for general anesthesia (pain relief accompanied by a reversible loss of consciousness).

Neuroleptics-- drugs for the treatment of severe diseases of the central nervous system (psychosis), which have a peculiar calming effect, accompanied by a decrease in reactions to external stimuli, weakening of mental and motor arousal and affective tension, suppression of feelings of fear, and weakening of aggressiveness. Some of the antipsychotics have antiemetic, some have antidepressant effects.

Non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs, - non-narcotic painkillers; reduce or completely relieve pain, reduce muscle tone. This group includes a number of drugs that, in addition to analgesic properties, have particularly pronounced anti-inflammatory properties. Due to the fact that the anti-inflammatory effect is predominant in these compounds and is close in potency to that of steroid hormones, they are called NSAIDs. They are most widely used in the treatment of rheumatoid arthritis, ankylosing spondylitis and other inflammatory diseases.

Nicotinates- nicotinic acid preparations (vitamin PP, or vitamin B3). They are used for the prevention and treatment of pellagra, hypoacid (low acidity of gastric juice) gastritis, acute and chronic hepatitis, liver cirrhosis, vascular spasms, atherosclerosis, neuritis, trophic disorders, and infectious diseases.

Nitrates and nitrate-like agents- organic compounds used for the treatment of coronary artery disease, heart failure, angina attacks as pain relievers and improve metabolic processes in the myocardium.

Normotimics- means that normalize the emotional background; relieve acute manic states, prevent affective attacks in mentally ill people and chronic alcoholics, and are able to smooth out mood swings and prevent the development of depressive symptoms. Preparations with normothimic action include, for example, lithium salts and “minor” anticonvulsants.

General tonics and adaptogens- increasing the overall tone of the body, its defenses, are used to eliminate chronic fatigue, as prophylactic agents to stimulate the immune system.

Opioids, their analogs and antagonists. Opioids are narcotic analgesics, including morphine and alkaloids similar in structure and synthetic compounds that have opiate-like properties. Opoids are characterized by strong analgesic (pain-relieving) activity, a special effect on the central nervous system, expressed in the development of euphoria and, with repeated use, the appearance of mental and physical dependence, the development of a withdrawal state when the drug is discontinued. Antagonists - block all types of opioid receptors; are used for acute intoxication with narcotic analgesics, in alcoholic coma, various types of shock, to identify drug addiction (since when administered they cause a state of withdrawal).

Penicillins- antimicrobial drugs produced by various types of penicillium mold. A number of semi-synthetic penicillins, which are more stable and effective against microorganisms resistant to the action of benzylpenicillin, have been obtained chemically. Effective against infectious diseases caused by gram-positive bacteria (streptococci, staphylococci, pneumococci, etc.), spirochetes, etc. Ineffective against viruses, mycobacterium tuberculosis, amoebiasis, rickettsia, fungi, gram-negative microorganisms.

Prostaglandins, thromboxanes, leukotrienes and their antagonists- biologically active substances formed in cells from arachidonic and some other unsaturated fatty acids contained in membrane phospholipids; have multifaceted physiological activity; are considered hormone-like substances (“local” hormones) that regulate cellular metabolism. Prostaglandins are regulators of local metabolic processes with varying effects on adrenergic systems. Thromboxanes have a strong vasoconstrictor effect and promote platelet aggregation. Leukotrienes play an important role in the development of inflammation and bronchospasm. Antagonists are substances with the opposite direction of action.

Antiviral agents- suppress the reproduction of viruses; differ in immunomodulatory, antitumor, antiviral activity. Among the antiviral agents are: interferons, synthetic compounds and substances of plant origin, nucleoside derivatives.

Antifungals (or antimycotics)- have a detrimental effect on pathogenic fungi - causative agents of mycoses.

Antidiarrheals- drugs for diarrhea, fixatives, Depending on the etiology of diarrhea, drugs from various pharmacological groups are used: infectious is treated with antibiotics or other antibacterial drugs, associated with functional disorders of the gastrointestinal tract - drugs that improve digestive processes, adsorbents and astringents, accompanied by a spastic component - antispasmodics and anticholinergics.

Antitussives- reducing and alleviating non-productive cough.

Antitumor hormonal agents and hormone antagonists- agonists and antagonists of androgens, estrogens, gestagens and other hormones. Used primarily for hormone-dependent tumors. Estrogens are prescribed when suppression of the action of androgens in the body or increased activity of estrogens (for prostate cancer) is indicated. Androgens are used when an increase in androgen activity or a decrease in estrogen activity is indicated (for breast cancer, etc.). Progestins are also used for breast and uterine cancer. When a decrease in glucocorticoid secretion is indicated (in Itsenko-Cushing's disease, etc.), adrenal function blockers are used. Glucocorticoids, due to their lympholytic effect and ability to inhibit lymphocyte mitosis, are used primarily for acute leukemia (mainly in children) and malignant lymphomas. Antiestrogens are prescribed for breast cancer in women (in postmenopausal women) and endometrial cancer. Antiandrogens - for prostate cancer. Inhibitors of the biosynthesis of adrenal hormones - for corticosteromas, tumors of the adrenal cortex, breast cancer.

Antiparkinsonian drugs- drugs that affect the cholinergic and dopaminergic systems of the brain, “leveling” the interaction of various neurotransmitters in the central nervous system. These drugs include: anticholinergic and dopaminergic synthetic drugs.

Antiemetics- have an effect at the level of different parts of the nervous regulation of vomiting. In case of vomiting due to local irritation of the gastric mucosa, irritating substances are removed and then coating and astringent agents are used, and local anesthetics may also be prescribed. To relieve excitation of the vomiting center, anticholinergic and antihistamine drugs, neuroleptics of the phenothiazine and butyrophenone group, acting on dopaminergic systems, are used.

Antiepileptic drugs- having the ability to prevent the development of seizures in patients with epilepsy. These drugs include: anticonvulsants and sedatives (tranquilizers) drugs, neuroleptics, diuretics, nootropics.

Psychostimulants and nootropics. Psychostimulants - increase mental and physical performance, improve the perception of external stimuli (sharpen vision, hearing, etc., speed up responses), improve mood, relieve fatigue, invigorate and temporarily reduce the need for sleep. Nootropics (neurometabolic stimulants) are drugs that stimulate metabolic processes in the central nervous system (brain): improve mental activity, stimulate cognitive functions, learning and memory, increase the brain’s resistance to various damaging factors, including extreme stress and hypoxia.

Rehydrants- drugs that replenish fluid loss in the body. These also include regulators of water-electrolyte balance and acid-base balance and substitutes for plasma and other blood components.

Appetite regulators- reducing or increasing appetite.

Regulators of water-electrolyte balance and acid-base balance- drugs whose action is aimed at correcting the content of water, electrolytes (water-electrolyte balance) and the concentration of hydrogen ions in the body. Regulators include: alkalis, antiacidotic (to reduce high levels of gastric juice acidity) agents and acids.

Potency regulators- reducing or increasing potency.

X-ray contrast agents- used for diagnostic purposes in X-ray contrast examination of vessels, hollow organs, biliary and urinary tracts, subarachnoid space, for myelography and lymphography; administered in various ways prior to the study.

Respiratory aids- these include: anticongestants; antitussives; secretolytics and stimulants of motor function of the respiratory tract.

Sedatives

Secretolytics and stimulants of motor function of the respiratory tract. Secretolytics (or mucolytics) - thinning mucus (sputum). Stimulants of motor function of the respiratory tract - stimulate coughing, which facilitates the removal of sputum. They are used for diseases of the respiratory system, conditions accompanied by the formation of viscous, difficult to separate sputum of a mucous or mucopurulent nature.

Cardiac glycosides and non-glycoside cardiotonic drugs. Cardiac glycosides change all the main functions of the heart: they strengthen and accelerate heart contractions, increase the duration of diastole (due to which blood flow to the ventricles of the heart improves, resulting in an increase in the stroke volume of the heart), and reduce the excitability of the conduction system of the heart. They are used for heart failure, atrial fibrillation, atrial flutter, paroxysmal atrial and nodal AV tachycardia. Non-glycoside cardiotonic drugs are distinguished by greater therapeutic activity and breadth of clinical effects compared to cardiac glycosides; in particular, they provide a vasodilator effect that improves the contractile function of the myocardium and facilitates its activity.

Serotonergic agents- the effects are similar to serotonin: they cause a constriction of peripheral blood vessels, contraction of the smooth muscles of internal organs, have a sedative effect, enhance the effect of hypnotics and analgesics. Used as an antihemorrhagic agent.

Laxatives- drugs that promote defecation: stimulate intestinal motility, cause the urge to stool and defecation. Mechanism of action: either chemical or mechanical (due to stretching) irritation of the receptors of the intestinal mucosa, or softening of feces, facilitating their movement through the intestines.

Sleeping pills- see Anxiolytics, sedatives and hypnotics.

Myotropic antispasmodics- substances that reduce smooth muscle tone; have antispasmodic and vasodilating activity. They are used as antihypertensive agents and reduce peripheral vascular resistance.

Agents affecting uric acid metabolism, - reduce the level of uric acid in the blood (cause hypouricemia). Mechanism of action: either inhibit xanthine oxidase and reduce the urate content in the body, or block tubular reabsorption of uric acid in the kidneys and intensify its excretion.

Means for correcting disorders of alcoholism, substance abuse and drug addiction-- used primarily for the treatment of alcoholism and to facilitate smoking cessation. To develop a negative conditioned reflex reaction to alcohol, emetics and drugs that change the metabolism of alcohol in the body are prescribed using a special technique. Relief and relief of withdrawal symptoms is achieved with the help of tranquilizers, sedatives and alpha-blockers; neuroleptics, tranquilizers, antidepressants, nootropics, cardiovascular drugs, vitamins, herbal medicines (thyme decoction) are also widely used.

Enteral and parenteral nutrition products for nutrition through the gastrointestinal tract and beyond it- if it is impossible for patients to perform normal facial expressions; drugs can be administered through special tubes (etheral feeding) or in the form of solutions (parenteral). Along with the delivery of essential nutrients, they increase the volume of circulating plasma, regulate water-electrolyte balance and acid-base balance.

Sulfonamides- drugs that have chemotherapeutic activity against infections caused by gram-positive and gram-negative bacteria, some protozoa (causative agents of malaria and toxoplasmosis), chlamydia (trachoma, paratrachoma); have a bacteriostatic effect.

Tocolytics- drugs that improve uteroplacental blood flow, reduce the tone of the uterus and improve the condition of the fetus inside the womb.

Uterotonics- drugs that increase the tone of the uterus.

Enzymes and antienzymes. Enzymes influence the enzymatic processes of the body: proteolytic drugs break down protein molecules into amino acids, special fibrinolytic drugs help dissolve blood clots, depolymerizing drugs break down DNA and RNA nucleic acids, reduce the viscosity of hyaluronic acid - have a resolving effect on scar tissue, etc. Antienzymes (inhibitors) enzymes) - drugs that inactivate enzymes.

Quinolones, fluoroquinolones- antibacterial drugs active against aerobic gram-negative bacteria and most strains of staphylococci (less effective against streptococci, ineffective against anaerobic bacteria). They are used for urinary tract infections, complicated respiratory tract infections (with gram-negative flora), infections caused by Pseudomonas, Salmonella and Shigella, osteomyelitis, prostatitis.

Cephalosporins- antibiotics with high chemotherapeutic activity, highly effective against penicillin-resistant staphylococci, streptococci, Escherichia, Klebsiella, Proteus, gram-negative bacteria, etc., have a bactericidal effect.

Estrogens, gestagens; their homologues and antagonists. Estrogens are female sex hormones produced by the ovaries in greater quantities in the first phase of the menstrual cycle; promote the growth of the endometrium (inner lining of the uterus). Gestagens - produced by the ovaries in the second phase of the menstrual cycle; promote secretory transformations in the endometrium and the preservation of pregnancy when it occurs. Homologues are substances similar to estrogens and gestagens in structure and function. Antagonists are substances with opposite effects.

The concept of infectious diseases refers to the body’s reaction to the presence of pathogenic microorganisms or their invasion of organs and tissues, manifested by an inflammatory response. For treatment, antimicrobial drugs are used that selectively act on these microbes in order to eradicate them.

Microorganisms leading to infectious and inflammatory diseases in the human body are divided into:

• bacteria (true bacteria, rickettsia and chlamydia, mycoplasma);
• mushrooms;
• viruses;
• protozoa.

Therefore, antimicrobial agents are divided into:

• antibacterial;
• antiviral;
• antifungal;
• antiprotozoal.

It is important to remember that one drug can have several types of activity.

For example, Nitroxoline ®, Rev. with a pronounced antibacterial and moderate antifungal effect - called an antibiotic. The difference between such a remedy and a “pure” antifungal agent is that Nitroxoline ® has limited activity against some species of Candida, but has a pronounced effect against bacteria on which the antifungal agent has no effect at all.

In the 50s of the twentieth century, Fleming, Chain and Florey received the Nobel Prize in Medicine and Physiology for the discovery of penicillin. This event became a real revolution in pharmacology, completely revolutionizing the basic approaches to the treatment of infections and significantly increasing the patient’s chances of a complete and rapid recovery.

With the advent of antibacterial drugs, many diseases that caused epidemics that previously devastated entire countries (plague, typhus, cholera) turned from a “death sentence” into a “disease that can be effectively treated” and are now practically non-existent.

Antibiotics are substances of biological or artificial origin that can selectively inhibit the vital activity of microorganisms.

That is, a distinctive feature of their action is that they affect only the prokaryotic cell, without damaging the cells of the body. This is due to the fact that there is no target receptor for their action in human tissues.

Antibacterial agents are prescribed for infectious and inflammatory diseases caused by the bacterial etiology of the pathogen or for severe viral infections, in order to suppress the secondary flora.

When choosing adequate antimicrobial therapy, it is necessary to take into account not only the underlying disease and the sensitivity of pathogenic microorganisms, but also the patient’s age, pregnancy, individual intolerance to the components of the drug, concomitant pathologies and taking medications that are not combined with the recommended medication.

Also, it is important to remember that if there is no clinical effect from therapy within 72 hours, the drug is changed, taking into account possible cross-resistance.

For severe infections or for the purpose of empirical therapy with an unspecified pathogen, a combination of different types of antibiotics is recommended, taking into account their compatibility.

Based on their effect on pathogenic microorganisms, they are divided into:

• bacteriostatic - inhibiting the vital activity, growth and reproduction of bacteria;
• Bactericidal antibiotics are substances that completely destroy the pathogen due to irreversible binding to the cellular target.

However, such a division is quite arbitrary, since many antib. may exhibit different activity, depending on the prescribed dosage and duration of use.

If the patient has recently used an antimicrobial agent, re-use should be avoided for at least six months to prevent the emergence of antibiotic-resistant flora.

How does drug resistance develop?

Most often, resistance is observed due to mutation of the microorganism, accompanied by a modification of the target inside the cells, which is affected by types of antibiotics.

The active substance of the prescribed solution penetrates the bacterial cell, but cannot contact the required target, since the “key-lock” binding principle is violated. Consequently, the mechanism for suppressing the activity or destroying the pathological agent is not activated.

Another effective method of protection against drugs is the synthesis by bacteria of enzymes that destroy the main structures of the antibacterial agent. This type of resistance most often occurs to beta-lactams, due to the production of beta-lactamases by the flora.

Much less common is an increase in resistance due to a decrease in the permeability of the cell membrane, that is, the drug penetrates inside in too small doses to provide a clinically significant effect.

To prevent the development of drug-resistant flora, it is also necessary to take into account the minimum concentration of suppression, which expresses a quantitative assessment of the degree and spectrum of action, as well as the dependence on time and concentration. in blood.

For dose-dependent drugs (aminoglycosides, metronidazole), the effectiveness of action depends on the concentration. in the blood and the focus of the infectious-inflammatory process.

Time-sensitive medications require repeated administrations throughout the day to maintain an effective therapeutic concentration. in the body (all beta-lactams, macrolides).

Classification of antibiotics by mechanism of action

• drugs that inhibit the synthesis of bacterial cell walls (penicillin antibiotics, all generations of cephalosporins, Vancomycin ®);
• destroying the normal organization of the cell at the molecular level and interfering with the normal functioning of the tank membrane. cells (Polymyxin ®);
• agents that help suppress protein synthesis, inhibit the formation of nucleic acids and inhibit protein synthesis at the ribosomal level (Chloramphenicol preparations, a number of tetracyclines, macrolides, Lincomycin ®, aminoglycosides);
• inhibit. ribonucleic acids - polymerases, etc. (Rifampicin ®, quinols, nitroimidazoles);
• inhibitory processes of folate synthesis (sulfonamides, diaminopyrides).

Classification of antibiotics by chemical structure and origin

1. Natural - waste products of bacteria, fungi, actinomycetes:

• Gramicidins ® ;
• Polymyxins;
• Erythromycin ® ;
• Tetracycline ® ;
• Benzylpenicillins;
• Cephalosporins, etc.

2. Semi-synthetic - derivatives of natural antibacterials:

• Oxacillin ®;
• Ampicillin ® ;
• Gentamicin ® ;
• Rifampicin ®, etc.

3. Synthetic, that is, obtained as a result of chemical synthesis:

• Levomycetin ®;
• Amikacin ®, etc.

Classification of antibiotics by spectrum of action and purposes of use

Modern classification of antibiotics by groups: table

Having no subclasses:

• Lincosamides (lincomycin ®, clindamycin ®);
• Nitrofurans;
• Hydroxyquinolines;
• Chloramphenicol (this group of antibiotics is represented by Levomycetin ®);
• Streptogramins;
• Rifamycins (Rimactan ®);
• Spectinomycin (Trobitsin ®);
• Nitroimidazoles;
• Antifolates;
• Cyclic peptides;
• Glycopeptides (vancomycin ® and teicoplanin ®);
• Ketolides;
• Dioxidine;
• Fosfomycin (Monural ®);
• Fusidane;
• Mupirocin (Bactoban ®);
• Oxazolidinones;
• Evernomycins;
• Glycylcyclines.

Groups of antibiotics and drugs in the table

Penicillins

Like all beta-lactam drugs, penicillins have a bactericidal effect. They influence the final stage of the synthesis of biopolymers that form the cell wall. As a result of blocking the synthesis of peptidoglycans, due to their effect on penicillin-binding enzymes, they cause the death of the pathological microbial cell.

The low level of toxicity to humans is due to the absence of target cells for antibacterial agents.

The mechanisms of bacterial resistance to these drugs have been overcome by the creation of protected agents enhanced with clavulanic acid, sulbactam, etc. These substances suppress the action of the tank. enzymes and protect the drug from destruction.

Natural BenzylpenicillinBenzylpenicillin Na and K salts.

Cephalosporins

Due to low toxicity, good tolerability, the ability to be used by pregnant women, as well as a wide spectrum of action, cephalosporins are the most commonly used antibacterial agents in therapeutic practice.

The mechanism of action on the microbial cell is similar to penicillins, but is more resistant to the effects of the drug. enzymes.

Rev. cephalosporins have high bioavailability and good absorption by any route of administration (parenteral, oral). They are well distributed in internal organs (with the exception of the prostate gland), blood and tissues.

Only Ceftriaxone ® and Cefoperazone ® are capable of creating clinically effective concentrations in bile.

A high level of permeability through the blood-brain barrier and effectiveness in inflammation of the meninges is noted in the third generation.

The only cephalosporin protected by sulbactam is Cefoperazone/sulbactam ® . It has an expanded spectrum of effects on flora, due to its high resistance to the influence of beta-lactamases.

The table shows groups of antibiotics and the names of the main drugs.

* They have an oral release form.

Carbapenems

They are reserve drugs and are used to treat severe nosocomial infections.

Highly resistant to beta-lactamases, effective for the treatment of drug-resistant flora. In case of life-threatening infectious processes, they are the first-priority means for an empirical regimen.

The teachers are distinguished:

• Doripenema ® (Doriprex ®);
• Imipenema ® (Tienam ®);
• Meropenem ® (Meronem ®);
• Ertapenem ® (Invanz ®).

Monobactams

• Aztreonam ® .

Rev. has a limited range of applications and is prescribed to eliminate inflammatory and infectious processes associated with Grambacteria. Effective in treating infections. processes of the urinary tract, inflammatory diseases of the pelvic organs, skin, septic conditions.

Aminoglycosides

The bactericidal effect on microbes depends on the concentration level of the agent in biological fluids and is due to the fact that aminoglycosides disrupt the processes of protein synthesis on bacterial ribosomes. They have a fairly high level of toxicity and many side effects, however, they rarely cause allergic reactions. Practically ineffective when taken orally due to poor absorption in the gastrointestinal tract.

Compared to beta-lactams, the rate of penetration through tissue barriers is much poorer. They do not have therapeutically significant concentrations in bones, cerebrospinal fluid and bronchial secretions.

Macrolides

They provide inhibition of the process of growth and reproduction of pathogenic flora, due to the suppression of protein synthesis on cell ribosomes. bacterial walls. With increasing dosage, they can have a bactericidal effect.

Also, there are combined teachers:

1. Pilobact ® is a complex solution for the treatment of Helicobacter pylori. Contains clarithromycin ® , omeprazole ® and tinidazole ® .
2. Zinerit ® is a product for external use to treat acne. The active ingredients are erythromycin and zinc acetate.

Sulfonamides

They inhibit the growth and reproduction of pathogenic microorganisms due to their structural similarity to para-aminobenzoic acid, which is involved in the life of bacteria.

They have a high rate of resistance to their action in many representatives of Gram-, Gram+. They are used as part of complex therapy for rheumatoid arthritis, retain good antimalarial activity, and are effective against toxoplasma.

Classification:

For topical use, silver sulfathiazole (Dermazin ®) is used.

Quinolones

Due to the inhibition of DNA hydrases they have a bactericidal effect and are concentration-dependent agents.

• The first generation includes non-fluorinated quinolones (nalidixic, oxolinic and pipemidic acids);
• Second pok. represented by Gram-drugs (Ciprofloxacin ®, Levofloxacin ®, etc.);
• The third is the so-called respiratory means. (Levo- and Sparfloxacin ®);
  Fourth - Rev. with antianaerobic activity (Moxifloxacin ®).

Tetracyclines

Tetracycline ®, whose name was assigned to a separate group of antibacterial agents, was first obtained chemically in 1952.

Active ingredients of the group: metacycline ®, minocycline ®, tetracycline ®, doxycycline ®, oxytetracycline ®.

On our website you can get acquainted with most groups of antibiotics, complete lists of drugs included in them, classifications, history and other important information. For this purpose, a section “” has been created in the top menu of the site.

CHAPTER 7. CLASSIFICATION OF DRUGS (PHARMACEUTICAL SUBSTANCES). DOSES

The active ingredients are varied in strength of pharmacological activity and composition. In terms of composition, pharmaceutical substances can be in the form of individual medicinal substances, medicinal plant or animal raw materials, or a sum of active substances. Among medicines, depending on their pharmacological activity, 3 groups are distinguished: substances of list A (poisonous), substances of list B (potent) and non-potent.

This separation is important for preventing the danger of overdose in the process of manufacturing drugs and their use.

7.1. CLASSIFICATION OF MEDICINES (PHARMACEUTICALS)

SUBSTANCES) BY NATURE OF ORIGIN

By nature of origin Medicines are classified into mineral and organic (obtained by chemical or biological synthesis, including from animal or plant materials).

7.2. CLASSIFICATION OF MEDICINES DEPENDING ON

FROM PHARMACEUTICAL ACTIVITY

Active ingredients and pharmaceutical preparations are divided into 3 types:

1) medicines (list A);

2) medicines (list B);

3) non-potent.

List A funds - medicines, the dosage and use of which require special caution due to their high toxicity. These lists also include drugs that can cause addiction.

List B funds - medicines for which therapeutic, higher single and daily doses are established and which are stored with precautions to avoid possible complications.

Mild drugs - a wide group of drugs, relatively safe, used in various therapeutic doses.

To the poisonous (venena) and potent (heroica) include those medicines that are included in lists A and B, established by the order of December 31, 1999? 472 “On the list of medicines of lists A and B.”

7.3. CLASSIFICATION OF MEDICINES FROM THE POSITION OF ORDERS OF THE MINISTRY OF HEALTH OF THE RF REGARDING

PRESCRIBING

From the standpoint of orders of the Ministry of Health of the Russian Federation regarding the writing of prescriptions medicines divided into 3 types:

Included in the list of medicines dispensed according to prescriptions from a doctor (paramedic) when providing additional free medical care to certain categories of citizens entitled to receive state social assistance, approved by order of the Ministry of Health and Social Development of the Russian Federation dated

September 28, 2005? 601;

Included in the list of medicines dispensed without a doctor's prescription, approved by order of the Ministry of Health of the Russian Federation dated

September 13, 2005? 578;

Included in the list of medicines subject to subject-quantitative registration, approved by order of the Ministry of Health of the Russian Federation dated December 14, 2005? 785 “On the procedure for vacation...”.

7.4. CLASSIFICATION FROM THE POSITION OF THE ORDER OF THE MINISTRY OF HEALTH OF THE RF REGARDING

STORAGE ORGANIZATIONS

From the standpoint of the order of the Ministry of Health? 377 November 13, 1996 “On approval of requirements for storage organization...” All medicines, depending on their physical and physicochemical properties and the impact of various environmental factors on them, are divided into 8 types:

Requiring protection from light;

Requiring protection from moisture;

Requiring protection from volatilization and drying out;

Requiring protection from exposure to elevated temperatures;

Requiring protection from exposure to low temperatures;

Requiring protection from exposure to gases contained in the environment;

Odorous, coloring;

Disinfectants.

7.5. CLASSIFICATION FROM THE POSITION OF THE FEDERAL CONTROL SERVICE

BEHIND DRUG TRAFFICKING

From the standpoint of the Federal Drug Control Service, medicinal funds are divided into 3 classes:

1. Narcotic drugs(NS) - substances of synthetic or natural origin, drugs, plants included in the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, in accordance with the legislation of the Russian Federation, international treaties of the Russian Federation, including the United Convention on Narcotic Drugs of 1961

2. Psychotropic substances(PS) - substances of synthetic or natural origin, drugs, natural materials included in the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, in accordance with the legislation of the Russian Federation, international treaties of the Russian Federation, including the Convention on psychotropic substances 1971

3. Precursors of narcotic drugs and psychotropic substances

(hereinafter - precursors) - substances often used in the production, manufacture, processing of narcotic drugs and psychotropic substances, included in the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, in accordance with the legislation of the Russian Federation, international treaties of the Russian Federation Federation, including the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988.

7.6. CLASSIFICATION UNDER THE DRUGS ACT

In accordance with Federal law? 3-FZ “On narcotic drugs and psychotropic substances” All narcotic substances, depending on the control measures applied by the state, are included in the following lists:

2. List of narcotic drugs and psychotropic substances, the circulation of which is limited in the Russian Federation and in respect of which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List II).

4. List of precursors, the circulation of which is limited in the Russian Federation and in respect of which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (list IV).

Trafficking in substances whose names are included in the “List of Narcotic Drugs, Psychotropic Substances and Their Precursors Subject to Control in the Russian Federation”, approved

Decree of the Government of the Russian Federation dated June 30, 1998? 681 is considered from the standpoint of Art. 234 of the Criminal Code of the Russian Federation.

7.7. DOSES OF MEDICINES

Dose- a certain amount of a drug (active substance) introduced into the body.

Toxic (dosis toxica);

Lethal (dosis letalis);

Therapeutic or medicinal (dosis curativa).Therapeutic or medicinal doses are divided into 3 types (dosis cu-

rativa):

1) threshold (cause the initial effect of the substance);

2) maximum - highest (cause the greatest or maximum action);

3) moderate (determine a moderate pharmacological effect). The average dose is approximately 1/3 or 1/2 of the maximum (highest) dose. It is usually contained in a unit dosage form (tablet, ampoule, capsule).

For substances included in lists A and B, government bodies (Pharmacological, Pharmacopoeial committees) establish the highest (maximum) and therapeutic doses:

Single dose ( pro dosi) for children, adults and animals;

Daily intake (pro die) for children and adults (hereinafter in the text

VRD and VSD).

7.8. RULES FOR CALCULATING DOSES ACCORDING TO AGE

Rule 1

Therapeutic doses are based on the intake of drugs by an adult of middle age and weight

70 kg.

Rule 2

For patients over 60 years of age, the dose of medicinal substances is reduced by 1/2-1/3 of the adult dose.

Rule 3

Children are prescribed a dose:

According to the table of GF doses by age;

Recalculated per 1 kg of body weight according to the formula:

7.9. RULES FOR DOSING

IN CAPITAL IN THE RECIPE

A pharmacy employee is obliged to give the patient a medicinal product in the quantity and dose prescribed by the doctor.

By order of the Ministry of Health and Social Security? 110 of 02/12/2007 established: single, daily and course doses when prescribing medications are determined by the attending physician based on the patient’s age, severity and nature of the disease in accordance with the standards of medical care. When prescribing a narcotic drug or psychotropic substance of lists II and III, other drugs subject to subject-quantitative recording, the dose of which exceeds the highest single dose, the doctor must write the dose of this drug or substance in words and put an exclamation point. A recipe that does not meet this requirement is considered invalid.

If it is possible to clarify the dosage and compatibility with the doctor who wrote the prescription, the pharmacy employee can dispense the drug to the patient.

Rule 4

Changes in the composition of dosage forms (if necessary) must be made only with the consent of the doctor, except for cases established by the current State Pharmacopoeia, orders and instructions of the Ministry of Health of Russia, and must be noted on the request, prescription (copy of the prescription, label).

In the absence of the specified mark on the request, prescription (copy of the prescription, label), the quality of production of the dosage form is assessed as “Unsatisfactory”. Changes in the quantity of the drug dispensed or the dispensing of tablets instead of powders must also be noted on the request, prescription (copy of the prescription, label).

Rule 5

When issuing medicines of lists NS, PV, A and B, in the written control passport and on the back of the prescription, the persons who issued and received the substance put a signature, date, indicate the name, weight or volume of what was received in words.

Issued: Atropini sulfatis 0.9 (nine decigrams) Date... Signature... Received: Atropini sulfatis 0.9 (nine decigrams) Date... Signature...

Rule 6

If the prescription exceeds the dispensing norm, the pharmacy must reduce the number of doses of the dosed drug or the volume (weight) of the non-dosed drug in order to maintain the dispensing norm.

The norms for the dispensing of medicines are presented in the order

MZ? 110.

Rule 7

Pharmaceutical substances are dosed in units of mass (gram, milligram, microgram), volume units (milliliter, drops) and in the form of activity units (IU - international or IE - international units).

The definition of units of action for various medicinal substances is indicated in the relevant articles of the pharmacopoeia. When dosing by mass, doses of medicinal substances are indicated in the decimal system of measurement (the unit of mass is 1 g). When dosing substances weighing less than 1 g (1.0), the following designations are used:

0.1 - 1 decigram;

0.01 - 1 centigram;

0.001 - 1 milligram;

0.0001 - 1 decimilligram;

0.00001- 1 centigram;

0.000001 - 1 microgram.

7.10. CHECKING PRESCRIBED DOSES

7.10.1. The amounts of substances in the prescription are prescribed by distribution method

Verification algorithm:

1. Find according to the GF the highest single dose (HSD) and the highest daily dose (HDD), respectively. The highest single and daily doses for adults, children and animals are established in the State Fund X, p. 1021, 1037, 1045 respectively.

2. Compare the found VRD with the single dose (SD) prescribed in the prescription.

3. Compare the found IRR with the daily dose (DD) prescribed in the prescription.

4. In the event that the RD and SD are exceeded without the corresponding registration of a prescription in comparison with the VDV and VSD, the pharmacy employee contacts the doctor and clarifies the dose and conditions of administration; correct RD and SD. In this case, it is recommended to adopt a RD equal to half of the GFD according to the Global Fund.

Rule 8

By order M3 and SR RF? 110 of 02/12/2007 established: “If it is possible to clarify with the doctor or other medical professional who wrote the prescription the name of the drug, its dosage, compatibility, etc., the employee of the pharmacy institution (organization) may dispense the drug to the patient.” .

Example 1

Rp.: Atropini sulphatis 0.002 Sacchari 0.25

M. ut f. pulv. D.t.d. ? 10

1. The maximum permissible dose of atropine sulfate subcutaneously and orally is 0.001.

2. IRR of atropine sulfate is 0.003.

3. The RD of atropine sulfate is 0.002.

4. The SD of atropine sulfate is 0.002. 3 = 0.006.

5. Single and daily doses are overestimated (without the appropriate prescription from a doctor).

As a result of consultation between the pharmacist and the doctor, it was decided to give the patient atropine sulfate in a dose equal to half the highest single dose.

6. The corrected RD is equal to: VRD:2 = 0.00:2 = 0.0005.

7. Corrected SD is equal to: 0.0005. 3 = 0.0015.

Rp.: Atropini sulphatis 0.0005 Sacchari 0.25 M. ut f. pulv. D.t.d. ? 10

S. 1 powder 3 times a day.

7.10.2. The masses of substances in the prescription are written out using a separating method

A. Dosage per dosage form

Solution algorithm:

1. Find according to the GF the highest single dose (HSD) and the highest daily dose (HDD), respectively.

2. Determine the RD for one appointment. To do this, divide the prescribed amount of the medicinal substance by the number of prescribed doses (powders, suppositories, pills, etc.).

3. Determine diabetes. To do this, the RD is multiplied by the number of doses per day.

4. Compare RD and SD with VRD and VSD.

5. If the RD and SD exceed the VDV and VSD, agree on the dose with the doctor; correct the RD and SD and calculate the mass of the medicinal substance that must be taken to prepare the dosage form. To do this, multiply the corrected RD by the number of prescribed doses (powders, suppositories, pills, etc.).

Example 2

Rp.: Novocain 6.0

Ol. cocoa 60.0

M. ut f. supp.

Div. in p. aeq. ? 20

1. The VRD of novocaine is 0.2.

2. IRR of novocaine is 0.6.

3. RD is equal to 6.0:20 = 0 3.

4. SD is 0.3. 2 = 0.6.

5. RD is overestimated compared to the pharmacopoeia, SD is not overestimated.

6. The RD corrected in agreement with the doctor is equal to half

WFD: 0.2:2 = 0.1.

To prepare candles you need to take 0.1 novocaine. 20 = 2.0.

Recipe view after correction:

Rp.: Novocaini 2.0

Ol. cocoa 60.0

M. ut f. supp.

Div. in p. aeq. ? 20

D.S. 1 candle in the morning and evening.

B. Checking doses in liquid non-dose dosage forms taken by spoon

Solution algorithm:

1. Find the VRD and VSD according to the GF.

2. Determine the RD of the medicinal substance for 1 dose. To do this, establish the number of doses of the drug (NPS) by dividing the volume of the dosage form by the volume of the spoon (volume of a tablespoon - 15 ml, volume of a dessert spoon - 10 ml, volume of a teaspoon - 5 ml); find the RD of a medicinal substance by dividing its mass (volume) by the number of doses.

3. Determine the SD of the drug substance. To do this, the RD is multiplied by the number of doses per day.

4. Compare the found RD and SD with the table values

VRD and VSD.

5. If the RD and SD exceed the VDV and VSD, agree on the dose with the doctor. RD and SD are corrected accordingly. Calculate the amount of medicinal substance (pharmaceuticals)

tic substance), which must be taken to prepare the dosage form. To do this, multiply the RD of the drug by the number of doses of the drug.

Example 3

Rp.: Apomorphini hydrochloridi 2.5 Aq. pur. 100 ml

Solution algorithm:

1. The VFD of apomorphine hydrochloride is 0.01.

2. IRR - 0.03.

3. The number of doses of the drug (NPS) is 100 ml / 10 ml = 10 dessert spoons (1 spoon of water - 10 ml).

4. The RD of apomorphine hydrochloride is 2.5:10 = 0.25>0.01 (VRD).

5. The SD of apomorphine hydrochloride is 0.25. 3 = 0.25>0.03 (VSD).

6. RD and SD are overestimated without the corresponding registration of the prescription.

In agreement with the doctor, take a single dose equal to half the highest single dose; correct RD and SD.

7. Corrected RD (corrected) of apomorphine hydrochloride is 0.01/2 = 0.005.

8. The corrected SD is 0.005. 3 = 0.015.

9. Calculation of the corrected mass of the drug:

To prepare the dosage form, you need to take apomorphine hydrochloride:

RD (correction) x number of drug doses: 0.005. 10 = 0.05.

Recipe view after correction: Rp.: Apomorphini hydrochloridi 0.05 Aq. pur. 100 ml

M.D.S. 1 dessert spoon 3 times a day.

B. Checking the doses of liquid potent or toxic substances prescribed in a mixture with other liquids and taken in drops

Solution algorithm:

1. Find the VRD and VSD according to the GF.

2. Determine the number of drops in 1 ml of the drug according to the table of drops (see Table 6.3).

3. Determine the total number of drops in the dosage form.

4. Determine the number of doses of the drug (NPDS) by dividing the number of drops in the entire dosage form by the number of drops of 1 dose.

5. Find the RD of a drug by dividing its amount in drops by the number of doses of the drug.

6. Determine the SD of the drug substance. To do this, the RD is multiplied by the number of doses per day.

7. Compare the found RD and SD with the VRD and VSD.

8. If the RD and SD are exceeded in comparison with the VDP, the RD and SD are corrected in consultation with the doctor.

9. Calculate the amount of medicinal substance that must be taken to prepare the dosage form.

Rule 9

The number of drops in the entire dosage form is equal to the sum of the drops of each ingredient.

Example 4

Rp.: Tinct. Conv. Tinct.

Val. ana 10 ml Tinct.

Belladonnae 40 ml Mentholi 0.2 M.D.S.

40 drops 3 times a day.

1. The VRD of belladonna tincture is 23 drops, the VVD is 70 drops.

2. Using the table of drops (see Table 6.3), determine: 1 ml of lily of the valley tincture - 50 drops; 10 ml tincture of lily of the valley - 500 drops; 1 ml of valerian tincture - 51 drops; 10 ml of valerian tincture - 510 drops; 1 ml of belladonna tincture - 44 drops; 40 ml belladonna tincture - 1760 drops. The total number of drops is: 500+510+ +1760 = 2770 drops.

3. The number of drug doses is: 2770:40 = 69.

4. The RD of belladonna tincture is (40.44): 69 = 1760:69 = 25 drops.

5. The SD of belladonna tincture is 25. 3 = 75 drops.

6. SD and RD are overestimated compared to VRD and VSD.

7. A modified dose (S from the highest single dose) has been agreed with the doctor. The corrected RD is 23:2 = 11.5 drops.

8. The corrected SD is 13. 3 = 39 drops.

9. Then you need to change the total amount of belladonna tincture so that there are 11.5 drops per dose, i.e. 11.5. 69/44 = 18 ml.

A single dose of the dosage form contains:

Belladonna tincture - 12 drops (see above);

Lily of the valley tincture - 500/69 = 7.3 drops;

Valerian tincture - 510/69 = 7.4 drops.

Thus, a mixture of tinctures of belladonna, valerian and lily of the valley for 1 dose should be prescribed: 11.5 + 7.3 + 7.4 = 26.2 drops.

Recipe view after correction: Rp.: Tinct. Conv. Tinct. Val. ana 10 ml Tinct. Belladonnae 20 ml Mentholi 0.2

M.D.S. 26 drops 3 times a day.

7.11. REQUIREMENTS FOR THE DESIGN OF INSTRUCTIONS ON THE GLASSES

In pharmacy, it is customary to store medicines in glass, tightly closed containers (shtanglas). An inscription indicating the contents is glued or engraved on the side of the rod.

Rule 10

Bars containing toxic medicinal substances (list A) must have white inscriptions on a black background. The highest single and daily doses must be indicated.

On bars with potent substances (list B), the inscriptions are made in red on a white background. Indicate the single and daily dose of the substance.

Rule 11

In the storage premises of the pharmacy, all containers with medicines must indicate: the batch number of the manufacturer, the analysis number of the control and analytical laboratory (medicine quality control center), expiration date, date of filling and the signature of the person who filled the container. Bars containing medicinal products containing cardiac glycosides must indicate the number of units of action in 1 g of medicinal plant material or in 1 ml of the medicinal product.

In the assistant's rooms, all containers with medicinal substances must indicate: the date of filling, the signature of the person who filled the container and the person who verified the authenticity of the medicinal substance. The highest single and daily doses must be indicated on the bars with medicinal substances of lists A&B, and on the bars with medicinal substances intended for the manufacture of sterile dosage forms there must be a warning inscription “For sterile dosage forms”.

Barbells with solutions, tinctures and liquid semi-finished products should be provided with normal drop meters or empirical pipettes. The number of drops in a certain volume must be determined by weighing 20 drops 5 times and indicated on the label.

Control questions

1. What is the need for classification of medicines?

2. For what purpose is the classification of medicines used from the standpoint of accounting and storage?

3. What is the significance of the classification of drugs from the standpoint of PCCN?

4. What groups are medicines divided into depending on their strength?

5. How are medicines stored and what inscriptions should be on the shelves?

Tests

1. According to the nature of origin, medicines are classified into:

1. Mineral.

2. Synthetic.

3. Organic (obtained by chemical or biological synthesis, including from animal or plant materials).

2. List A funds are:

1. Medicines, the dosage and use of which require special caution due to their high toxicity.

2. These lists also include medications that can cause drug addiction.

3. List B drugs are drugs:

1. For which therapeutic doses have been established.

2. For which the highest single doses are established.

3. For which daily doses have been established.

4. Stored with precaution to avoid possible complications.

5. Included in the list of potent substances.

4. Depending on the physical and physico-chemical properties, the impact of various environmental factors on them, medicines are classified into:

1. Requiring protection from light.

2. Requiring protection from moisture.

3. Requiring protection from volatilization and drying out.

4. Requiring protection from exposure to elevated temperatures.

5. Requiring protection from low temperatures.

6. Requiring protection from gases contained in the environment.

7. Smelling, coloring.

8. Disinfectants.

5. In accordance with Federal Law? 3-FZ “On Narcotic Drugs and Psychotropic Substances”, all narcotic substances, depending on the control measures applied by the state, are included in the following lists:

1. List of narcotic drugs and psychotropic substances, the circulation of which is prohibited in the Russian Federation in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (list I).

2. List of narcotic drugs and psychotropic substances, the circulation of which is limited in the Russian Federation and in respect of which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List II).

3. List of psychotropic substances, the circulation of which is limited in the Russian Federation and in respect of which certain control measures may be excluded in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List III).

4. List of psychotropic substances, the circulation of which is permitted in the Russian Federation and in respect of which certain control measures may be excluded in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List III).

5. List of precursors, the circulation of which is limited in the Russian Federation and in respect of which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (list IV).

6. Dose - a certain amount of a drug:

1. Injected into the body.

2. Causing a positive effect on the course of the disease.

7. Depending on the strength of the pharmacological action, doses are distinguished:

1. Toxic (dosis toxica).

2. Lethal (dosis letalis).

3. Therapeutic or curative (dosis curativa).

4. For children and adults.

8. Therapeutic or therapeutic doses are divided into 3 types:

1. Threshold (causes the initial effect of the substance).

2. Maximum - highest (cause the greatest or ultimate action).

3. Medium (determine a moderate pharmacological effect).

9. Changes in the composition of dosage forms should be made only with the consent of:

1. Pharmacist-technologist.

2. Doctor.

10. All changes in the composition of the medicinal product must be noted on:

1. Requirements.

2. Recipe.

3. Copies of the prescription.

4. Label.

5. Passport of written control.

11. When issuing medicines with lists NS, PV, A and B in the written control passport and on the back of the prescription l And those who issued and received the substance put:

1. Signature.

2. Date.

3. Indicate the name.

4. The mass or volume of the product received in words.

12. 0.00001 is:

1. 1 milligram.

2. 1 decimilligram.

3. 1 centi-milligram.

13. If the dosage of a medicinal product is exceeded without appropriate registration, the pharmacy employee:

1. May dispense medication to the patient.

2. Cannot dispense medication.

3. Can dispense a drug in a dose equal to 1/2 of the highest single dose.

14. The number of drops in the entire dosage form is:

1. The amount of drops of each ingredient.

2. The sum of the volumes of medicines divided by the sum of drops of each ingredient.

15. In the assistant's rooms, all medicinal products must be marked with the following:

1. Date of completion.

2. Signature of the person who filled out the bar.

3. Signature of the person who verified the authenticity of the medicinal substance.

4. Analysis number according to the packing work log.

16. Bars containing medicinal substances of lists A and B must indicate:

1. Higher single and daily doses.

2. Name of the manufacturer and date of manufacture.

17. Bars containing medicinal substances intended for the manufacture of sterile dosage forms must bear the following warning notice:

1. Sterile.

2. Non-pyrogenic.

3. For sterile dosage forms.

18. Barbells containing toxic medicinal substances (list A) must bear the following inscriptions:

19. Barbells containing potent substances (list B) must bear the following inscriptions:

1. Black on a white background.

2. Red on a white background.

3. White on a black background.

4. Be sure to indicate the highest single and daily doses.