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REGULATION - LABOR SAFETY WHEN STORING MATERIALS PO-14000-007-98 (approved by the Ministry of Economy of the Russian Federation dated 02/25/98) (2017) Relevant in 2017

7.8. Storage of toxic and caustic chemicals

7.8.1. Depending on the physical chemical properties and degree of potential danger poisonous and corrosive chemicals must be stored in special warehouses or specially equipped areas.

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. Transportation of acids must be carried out 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 carrying out 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 on similar cases in a warehouse in a closed box.

7.8.27. Acceptance of SDYAV for storage in a warehouse must 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 employee 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 container larger size 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. Washbasins with hot and cold water, cabinets for work clothes, safety shoes and other personal protective equipment, first aid kit, 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.

Introduction………………………………………………………………………………...3
1. Indifferent agents……………………………………………………4
2. Poisonous and potent drugs……………….5
3. Rules for storing and recording toxic and potent
medicines………………………………………………………8
Conclusion……………………………………………………………………………….11
Literature………………………………………………………………………………..12

Introduction
Medicines, substances used for the treatment, diagnosis and prevention of diseases. The list of medicines approved for use and production is set out in State Register
Currently it is known that St. 5 thousand medicines produced in the form of more than 50 thousand single-component and combined dosage forms under non-proprietary (international) and patent (trade) names. Most often they are divided into pharmacotherapeutic groups according to the primary direction of their influence on the functions of individual body systems. Within each pharmacotherapeutic group, drugs are classified according to the main pharmacological effect (for example, anesthetics, anti-inflammatory, laxatives, etc.) or according to the pharmacotherapeutic principle (for example, antiarrhythmics, antidepressants, etc.).
All medicines, taking into account their possible toxic effects on the human body, if used incorrectly, are divided into three groups. The list of these drugs is presented in the State Pharmacopoeia.
List A (Venena - poisons) includes medicines, the prescription, use, dosage and storage of which, due to their high toxicity, must be carried out with extreme caution. This list includes drugs that cause addiction.
List B (heroica - potent) includes medicines, the prescription, use, dosage and storage of which must be carried out with caution due to possible complications when used without medical supervision. The third group is drugs dispensed from pharmacies without prescriptions.

1. Indifferent agents
Indifferent agents are neutral external agents that do not contain active ingredients and are prescribed mainly in the progressive stage of the disease.
With intravascular administration, the drug completely enters the bloodstream. When administered orally, intramuscularly, subcutaneously, it must pass through a number of biological membranes of cells (mucosal membrane of the stomach, liver, muscles, etc.) and only part of it enters the systemic bloodstream. The effect of the drug largely depends on how large this part is. This indicator characterizes the bioavailability of the drug. When administered intravenously, bioavailability is 100%. With other routes of administration (even intramuscular and subcutaneous), bioavailability almost never reaches 100%. The bioavailability of a drug substance is influenced by the route of administration of the drug, the individual characteristics of the patient’s body, the state of the gastrointestinal tract, cardiovascular system, liver, kidneys, as well as biopharmaceutical factors (dosage form, its composition, features of the drug production technology). The latter are especially important in the use of drugs orally (enterally) in the form of tablets and capsules. As a rule, the excipients included in the drug are indifferent and do not have any pharmacological effect, but sometimes they affect the bioavailability of the drug. For pressing tablets and filling capsules, substances are used that can adversely affect the rate of dissolution of the active compound. The dissolution of medicinal substances can be hampered by the low dispersing ability of the filler particles, and their disaggregation is facilitated by surfactants or other substances that affect the electrostatic properties of the particles.

2. Poisonous and potent drugs
Among the vast number of drugs used in modern medicine, there is a group of drugs whose physiological effect on the body is manifested even at small and very small single doses. Such drugs are called poisonous and potent.
The difference between poisonous and with potent drugs for the most part, only quantitative: the former 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.
A number of experts consider poisonous and potent drugs to be potentially dangerous compounds that have a psychoactive effect on the human body, which, when abused, cause symptoms of addiction and ultimately irreversible processes in the human body, including death
When classifying substances into the category - potent and poisonous agents, also take into account the degree of public danger and harm to health when they are abused; data received from experts from medical, judicial and law enforcement agencies about the facts of their non-medical use; toxicological and pharmacological assessment of the effect of a specific potent substance.
Which drugs are poisonous and which should be considered potent are indicated in the pharmacopoeia. All poisonous drugs are collected in a special list called List A, potent drugs are in List B, placed in the “Introductory Part” of the pharmacopoeia. The belonging of a medicinal product to a particular list is also stated in pharmacopoeial monographs under the heading “Storage”.
Potent substances include not only the substances listed in these Lists, but also dosed dosage forms provided that the drug does not contain other pharmacologically active substances that determine the specific activity of the drug. If a specific composition of a combined product contains, in addition to the main controlled substance, other pharmacologically active substances and is not listed in the Lists, then the issue is resolved by expert means. This provision also applies to dosage forms in the form of suppositories (suppositories) and prolonged forms (long, retard). Accordingly, if these dosage forms are not indicated in the List for a specific substance, then they also do not fall under the control of these Lists.
After the expert opinion of the PKKN that a given specific composition of the drug or the corresponding dosage form (suppositories, retard, long) is recognized as potent, from that time on from a legal standpoint it is potent, and with the next edition of the revised Lists, the prescription composition of the specific combined drug is accordingly included in them drug.
To decide whether a particular substance should be classified as a controlled substance, the proposal must contain chemical characteristics substance, and if this substance is plant, then its botanical characteristics.
To resolve the issue of classifying a specific substance as a narcotic drug or psychotropic substance, it is necessary to have answers to the following questions:
1. Does this substance have the ability to:
- cause a state of dependence;
- have a stimulating or depressive effect on the central nervous system causing hallucinations or disturbances in motor function, or thinking, or behavior, or perception, or mood;
- lead to abuse and harmful effects similar to any substance included in Schedules I, II, III or IV of the Single Convention on narcotic drugs 1961
2. Is there sufficient evidence that the substance is being abused or is likely to be abused in such a way that it poses or may pose a public health problem and social problem, which provide the basis for the application of control measures to this substance.
As the nomenclature of medicines changes, the contents of lists A and B also change. In the State Pharmacopoeia, list A includes 116 names of poisonous medicines. Of the 116 items, 26 are placed on the list with the sign P. This sign marks narcotic and other substances that are subject to dispensing from pharmacies in accordance with special instructions of the Ministry of Health. List B includes 326 items. Poisonous and potent medicines require especially careful handling compared to others.
In order to prevent accidents, as well as abuse, the Russian Ministry of Health has established special “Rules for the storage, accounting and dispensing of poisonous, narcotic and potent medicines.” The rules provide, first of all, for the isolation of poisonous and potent medicines from all others.

3. Rules for storage and accounting of poisonous and potent medicines
The records of medications are kept by the senior nurse, who has a notebook with a seal signed by the chief physician. The older sister records the number of medications dispensed, notes the patient's name, and the medical history number. The keys to cabinet “A” and “B” are kept only by persons responsible for storing poisonous and potent medicines. At night, the keys are handed over to the doctor on duty or the duty officer nurse, about which a corresponding entry is made in a special journal; indicating the reserves of medicinal substances, the person who accepted the key signs in this journal.
Medicines containing toxic and narcotic substances in departments and offices are subject to subject-quantitative accounting in a special book, numbered, laced and signed by the chief physician (in accordance with the form). Books for recording narcotic and acutely scarce medicines must always be kept in in perfect order and presented at the request of the inspection officers.
Medicines containing poisonous and potent drugs obtained from a pharmacy must have an accurate and clear designation on the label: “Internal”, “External”, “For injection”, “Eye drops”, etc., as well as the name the name of the department (office), the number of the pharmacy that manufactured the medicine, the composition of the medicine corresponding to the prescription specified in the requirement, the date of manufacture and the signature of the person who manufactured the medicine, checked it and dispensed it. Labels of drugs containing toxic drugs must be stamped with black ink “A”, and labels of drugs containing potent drugs must be stamped with red ink “B”.
Poisonous medicines are stored in a separate metal or wooden cabinet under lock and key, narcotic drugs - in safes or iron cabinets. On inside The cabinet doors must have the inscription “A” and a list of toxic medicinal substances indicating the highest single and daily doses.
Potent medications are stored in a separate cabinet under lock and key. Stocks of poisonous and narcotic medicines in departments and offices should not exceed the 5-day requirement for them, and for highly active ones - the 10-day requirement. The head of the department (office) and the senior nurse are responsible for storing and dispensing poisonous, narcotic and potent drugs to patients. Medicines containing toxic and narcotic substances should be given to patients separately from other medicines.
In addition to the main therapeutic effect, medications can cause negative side reactions. Medical worker must know which combinations of medicinal substances are unacceptable for use. Negative reactions of the body to some medications are often easily eliminated by reducing the dose or after the first days of treatment. These reactions should be distinguished from intolerance, which is an expression of the body’s inability to perceive a particular medicinal substance and can lead to serious complications. The healthcare professional must know the dosage of medications.
The dose of the drug is prescribed depending on body weight and age (child, adult).
There is a single dose - for one dose,
the highest single dose - the limit for one dose,
daily dose - the limit for taking a medicinal substance during the day,
toxic dose - a limit, exceeding which leads to poisoning; and deadly.
Higher therapeutic doses (single and daily) for poisonous and potent drugs are given in State Pharmacopoeia in articles devoted to individual drugs, as well as in two summary tables in which the highest therapeutic doses for adults and children are presented separately. For children, they are given according to age (for children up to 6 months, from 6 months to 1 year, 2 years, 3-4 years, 5-6 years, 7-9 and 10-14 years). Therapeutic dose range, i.e. the interval between the threshold and highest therapeutic doses is designated by the term “therapeutic latitude”. Since threshold doses are rarely used in practice, the therapeutic breadth of drugs is usually judged by the interval between the average and highest therapeutic doses. The greater the therapeutic breadth of the drug, the safer its use (the lower the risk of overdose).
Doses are usually indicated in grams or fractions of a gram. When the therapeutic range of drugs is low, they are sometimes dosed per 1 kg of body weight (for example, 1 mg/kg) or per unit of body surface (for example, 1 mg/m2). Doses of medicinal substances exceeding the highest therapeutic levels are designated as toxic. At these doses, medications can cause toxic effects that are dangerous to the body. In addition, lethal doses are released.

Conclusion
Medicines are substances used in certain doses to treat a disease or to prevent it. The source of the medicinal substance is medicinal raw materials. The most common and long-known medicinal raw materials include many plants, both wild and cultivated by specialized farms. The second source of medicinal raw materials is the organs and tissues of various animals, waste products of fungi and bacteria, from which hormones, enzymes, antibiotics and other biologically active substances are obtained. The third source is some natural and synthetic derivatives. After appropriate processing of the medicinal raw material, the active substance is obtained. A medicinal substance is one or a mixture of substances, natural or synthetic, used for the prevention and treatment of diseases. Medicine- This is a medicine in a ready-to-use form.
Belonging to lists A and B of all medicines produced under various brand or trade names and their various dosage forms is determined by their active ingredient. Accounting, storage, prescription, dispensing and use of drugs included in list A must be carried out with extreme caution.
Accounting, storage, prescription, dispensing and use of drugs included in list B must be carried out with caution due to possible complications when used without medical supervision.

Literature

1. Gaevy M.D. Pharmacotherapy with basics of clinical pharmacology. Volgograd. 1996 – 22 p.
2. Mashkovsky M.D. Medicines, vol. 1-2. M., 1988;
3. Mikhailov I.B. Clinical pharmacology and therapy S.-Pb.: 1998 - 6 p.
4. Toxicological chemistry. / Ed. N.I. Kaletina. - M.: Geotar-media, 2008. - 116 p.

in regular storage rooms 2. in isolated storage rooms 3. in technically fortified rooms similar to storage rooms for narcotic and psychotropic drugs 4. on a rack under normal conditions5. in metal cabinets, sealed or sealed at the end of the working day

010. For medical immunobiological preparations the following is issued:

MIBP production certificate 2. certificate of conformity 3. sanitary-epidemiological conclusion 4. declaration of conformity 5. certificate of state registration

011. Ketamine is prescribed:

1. on prescription form form No. 107-1/u 2. on the prescription form, form No. 148-1/u-88 3. on a special prescription form for narcotic drugs and psychotropic substances4. in the requirement-invoice 5. on the prescription form, form No. 148-1/u-04 (l) or form No. 148-1/u-06 (l)

012. Norm for prescribing and dispensing phenobarbital for the treatment of patients with protracted and chronic diseases:

1. 10 -12 tablets 2. 20 tablets3. for a course of treatment up to 1 month 4. 50 tablets 5. 1 package

013. On separate forms of invoice requirements for each group of drugs, invoice requirements are written out for the following drugs, except:

1. narcotic drugs 2. psychotropic substances 3. precursors 4. potent and toxic substances5. anabolic steroids

014. Admission of persons to work with narcotic drugs and psychotropic substances is carried out:

heads of organizations or their substitutes 2. pharmaceutical service management body 3. authorities for control over the circulation of narcotic drugs and psychotropic substances 4. internal affairs body 5. licensing authority

015.B pharmacy organizations narcotic and psychotropic medicines are stored separately, taking into account:

highest single doses 2. highest daily doses 3. series numbers 4. physicochemical properties5. Method of administration (parenteral, internal, external)

016. Logs of registration of transactions in which the amount of precursors of narcotic drugs and psychotropic substances changes are stored in:

metal cabinet (safe) 2. a metal cabinet in a technically fortified room 3. a safe in a technically fortified room 4. the desk of the head of the organization 5. the accounting department

017. Economic relations between the supplier and the buyer (pharmacy organization) are formalized:

obligation 2. agreement3. agreement (contract) 4. specification 5. letter of credit

018. To record the movement of cash in the cash register, each organization must maintain:

cashier's journal2. cash book 3. book of records accepted and issued by the cashier cash 4. journal of cash flows on the current account 5. journal of registration of incoming and outgoing cash documents

019. Removal of medicines from a pharmacy for analysis applies to:

shortages 2. wholesale sales 3. retail sales 4. small wholesale sales5. other documented consumption of goods

020. Monthly goods spent in a pharmacy to provide first aid are written off according to:

act 2. inventory 3. certificate 4. register 5. statement

021. An economic indicator that determines the level of income from the sale of goods for each ruble of trade turnover is:

profitability from sales2. level gross income trade ( trade overlays) 3. visibility coefficient 4. level of distribution costs 5. turnover

022. Salaries of pharmacy employees are attributed to:

losses 2. profit 3. sales4. distribution costs 5. shortage of inventory items

023. In accordance with the established Sales Rules…. information on prices for goods sold in pharmacies is provided to the buyer by:

designing uniform and clearly defined price tags for goods sold 2. display of goods in display cases with prices indicated on them 3. posting in the sales area a list of goods sold and a price list 4. in any way established by the pharmacy independently 5. in a way accepted on the territory by executive authorities of the constituent entities of the Russian Federation

024. Type of financial liability, depending on the amount of compensation for damage caused, to which employees are held for damage caused by failure to perform or improper performance of their job duties, resulting in the theft or shortage of narcotic drugs, psychotropic substances or precursors:

1. individual 2. limited 3. collective 4. complete5. multiple

025. Workplaces are subject to certification for working conditions:

1. all jobs available in the organization 2. workplaces with harmful and dangerous working conditions 3. . workplaces equipped with various devices and mechanisms 4. 50% of all workplaces available in the organization 5. 75% of all workplaces available in the organization

026. The ester group contains a medicinal product:

1. benzonal2. sulfocamphoric acid 3. ethylmorphine hydrochloride 4. isoniazid 5. validol

027. A medicinal product contains a tertiary amino group:

1. benzonal 2. benzylpenicillin sodium salt 3. streptocide 4. aminalon5 . caffeine

028. According to its chemical structure, an azo dye is:

1. phenazepam2. salazopyridazine 3. aminazine 4. phthalazole 5. furosemide

029. The main properties of a medicinal product containing a functional group in its structure:

1. ketone 2. aldehyde 3. ether4. amino group 5.alcohol hydroxyl

030. The phenomenon of fluorescence is used to identify:

1. furatsilin 2. quinozole 3. ftivazide4. riboflavin 5. Acetylsalicylic acid

031. Medicine soluble in acids and alkalis:

1 . zinc oxide 2. magnesium oxide 3. lithium carbonate 4. bismuth nitrate basic

5. barium sulfate

032. The complexing property of drugs is confirmed by reagents:

1. FeCl 3 , CuSO 4 , Fehling's reagent2. A gNO 3 , CoCl 2 , Dragendorff reagent

3. AgNO 3 , FeCl 3, NaNO 2 4. Marquis reagent, Dragendorff reagent,KMnO 4

5. picric acid,KMnO 4 , Ca(OH) 2

033. Group reagent for 5-nitrofuran derivatives:

1. iodine solution 2. concentrated sulfuric acid 3. ammonia solution

4. concentrated nitric acid5. sodium hydroxide solution

034. General reaction of the authenticity of resorcinol and phthalazole:

1. from iron (III) chloride2. formation of fluorescein 3. bromination

4. with copper (II) sulfate 5. azo coupling with diazonium salt

035. Caffeine forms a precipitate with an iodine solution in the presence of:

1 . hydrochloric acid 2. alcohol 3. sodium hydroxide 4. ammonia

5. sodium acetate

036. General reagent for determining the identity of sulfadimethoxine and

butadione:

1. copper ( II ) sulfate 2. potassium iodide 3. iodine solution 4. concentrated sulfuric acid 5. ammonia solution

037. The admixture of iodides in potassium bromide and sodium bromide is determined by

reactions with:

1. silver nitrate 2. chloramine 3. concentrated sulfuric acid

4. iron ( III ) chloride 5. potassium permanganate

038. Admixture of ammonium salts and paraform in hexamethylenetetramine according to

GF is detected by reaction with:

iodine solution 2. alkali 3. Fehling's reagent4.Nessler reagent

5. hydrochloric acid

039. Acid hydrolysis reaction is used for quantitative

definitions:

butadione2. hexamethylenetetramine 3. glucose 4. streptocide 5. sodium salicylate

040. Adsorption indicators are used in the quantitative method

definitions:

1. acidimetric 2. alkalimetric 3. bromatometric

4. argentometric 5. complexometric

041. Bromatometric method (electrophilic substitution option)

used for quantitative determination:

1. benzoic acid2. salicylic acid 3. ascorbic acid 4. hexenal 5. potassium iodide

042. For the quantitative determination of dibazole, the following method is used:

1. iodometry 2. argentometry 3. acidimetry in a non-aqueous medium

4. alkalimetry5. all listed

043. The equivalence factor of sodium tetraborate when determining it by the acidimetric method is equal to:

1 2. ½ 3. ¼ 4. 2 5. 4

044. Chromatographic methods in quality control of medicines are used for:

1. authentication 2. determination of foreign impurities 3. quantitative determination 4. determination of residual amounts of solvents5. all of the above

045. Ascorbic acid is stored in a well-closed container, protected from light, since during storage it undergoes the process:

recovery 2. hydrolysis 3. polymerization4. oxidation 5. condensation

046. Polyethylene glycol (PEG) added to the protoplast suspension:

1 . promotes their fusion 2. prevents their fusion 3. increases the stability of the suspension 4. prevents microbial contamination 5. reduces the possibility of microbial contamination

047. Combining the genomes of cells of different species and genera is possible through somatic hybridization:

1. only in natural conditions2. only in artificial conditions 3. in natural and artificial conditions 4. during the development of a pathological process 5. under stress

048. Penicillin acylase is used for:

1. testing factory batches of penicillin for sterility 2. assessing the effectiveness of penicillin structures against resistant bacteria 3.obtaining semisynthetic penicillins 4. relieving allergic reactions to penicillin 5. relieving pyrogenic reactions

049. The constant presence of destructor strains in aeration tanks is ineffective; periodic application of their commercial preparations is caused by:

1. low rate of their reproduction 2. their displacement by representatives of activated sludge microflora3. loss of plasmids where genes are localized oxidative enzymes 4. safety problems 5. environmental problems

050. Immobilization of individual enzymes is limited

1. high lability of the enzyme2. the presence of a coenzyme in the enzyme 3. the presence of subunits in the enzyme 4. whether the enzyme belongs to hydrolases 5. whether the enzyme belongs to ligases

051. The bioavailability of drugs is determined by the method:

1 . pharmacokinetic 2. photometric 3. volumetric 4. titrimetric 5. pharmacopoeial

052. The accuracy of dosing powders depends on the following technological property:

1 . flowability 2. bulk mass 3. compressibility 4. density 5. appearance

053. By direct compression tableting we mean the process:

1. with pre-granulation2. without preliminary granulation 3. with mass molding 4. after homogenization 5. using a hydraulic press

054. Thinners (fillers) are used for the purpose of:

1. improving the fluidity of the tablet mass 2. granulating powders 3. increasing the mechanical strength of tablets4. providing the necessary mass of tablets 5. improving the dissolution of tablets in the gastrointestinal tract

055. Microencapsulation of drugs is carried out for the purpose of:

1. regulation of release parameters 2. stabilization of the drug substance 3. increasing dosage uniformity 4. better compressibility during further tableting 5. creation of intraocular dosage forms

056. Static methods of extraction of plant materials include:

1. maceration 2. maceration with circulation of extractant 3. continuous countercurrent extraction 4. percolation 5. repercolation

057. The technological scheme for the production of tinctures using the maceration method consists of the stages:

1. infusion, draining the finished extract, filtering, packaging 2. infusion, draining the finished extract, filtering, evaporation 3.infusion, draining the finished extract, settling, filtering , standardization, packaging 4. infusion, draining the finished extract, standardization 5. infusion, evaporation, standardization, packaging

058. Solvents for injection solutions should not have:

1. high dissolving ability 2. chemical purity 3. storage stability 4. pharmacological indifference 5.low boiling point

059. Quality control of solutions in ampoules is not carried out according to the following indicator:

1. pyrogenicity 2. sterility 3. absence of mechanical inclusions 4. qualitative and quantitative analysis of active ingredients 5.isohydricity

060. Methods for obtaining tinctures

1. countercurrent extraction and percolation2. percolation and accelerated fractional maceration 3. extraction with liquefied gases 4. repercolation 5. circulation extraction

061. Propellant does not include:

1. freons 2. propane 3. vinyl chloride 4. carbon dioxide5. acetone

062. Method suitable for drying heat-labile substances:

1. sublimation 2. fluidization 3. UHF field 4. infrared 5. spray drying

063. Emulsion in industry using an RPA apparatus is obtained by the following method:

1. mechanical dispersion 2. ultrasonic dispersion 3. solubilization 4. coacervation 5. bubbling

064. For superficial ointments:

1. resorptive 2. penetrating3. protective 4. pastes 5. rectal

065. Newtonian fluids include:

1. gel 2. ointments 3. pastes4. water 5. liniments

066. Essential oils are called:

1. complex volatile natural compounds of a basic nature, containing nitrogen in their composition 2. natural high-molecular nitrogen-free compounds with surface and hemolytic activity 3.mixtures of volatile fragrant natural compounds, primarily related to terpenoids and distilled with water vapor4. high molecular weight natural compounds that form thick colloidal solutions 5. complex natural compounds that form insoluble complexes with proteins and have tanning properties

Functional purpose: treatment

Conditions of implementation: outpatient, inpatient

Storage of narcotic and psychotropic medicinal substances is carried out in accordance with standard requirements for technical strength, approved by Order of the Ministry of Health of the Russian Federation No. 330 dated November 12, 1997. The same requirements apply to the storage of toxic and potent substances.

Storage must be carried out in technically fortified premises in safes. Safes (metal cabinets) must be kept closed. The keys to the safe are kept by financially responsible persons authorized to do so by order of the head of the health care facility, and at night these keys are transferred to the doctor on duty, about which a corresponding entry is made in a special journal, where the signatures of the person who handed over and accepted the keys, and the quantity of the indicated medications are placed. List A includes toxic and narcotic substances. To list B - potent.

Stocks of narcotic and psychotropic medicines in the departments should not exceed a 3-day requirement (Rule of the Ministry of Health of the Russian Federation No. 330 of November 12, 1997), poisonous medicines - a 5-day requirement, potent medicines - a 10-day requirement.

To provide emergency assistance in the evening and at night for life-saving reasons, it is allowed to create a 5-day reserve of narcotic drugs in hospital emergency departments. The specified reserve can be used in all departments of the hospital.

On the inside of the safe doors there must be a list of narcotic, psychotropic, poisonous and potent medicinal substances, indicating the highest single and daily doses. At nursing stations there should also be tables of the highest single and daily doses of poisonous, potent, narcotic and psychotropic drugs, as well as tables of antidotes for poisoning.

In departments and offices, health care facilities are subject to the following: quantitative accounting:

1. Narcotic drugs and psychotropic substances of lists II and III, approved by Decree of the Government of the Russian Federation No. 681 of June 30, 1998.

2. Medicines included in the list of PKKN No. 1 “Potent substances”

3. Medicines included in the list of PKKN No. 2 “Poisonous substances”

4. Medicines of list A, list B, ethyl alcohol.

The records of the above medicines are kept in a special book, numbered, laced, signed by the head and sealed by the health care facility. The form of the book is approved by Appendix 5 of Order No. 330 of the Ministry of Health of the Russian Federation - 1997.

Medical personnel who, due to their official duties, gain access to narcotic drugs and psychotropic substances, must have permission to work with the above-mentioned drugs in accordance with Decree of the Government of the Russian Federation No. 892 of 06.08.98 “On approval of the Rules for the admission of persons to work with narcotic drugs drugs and psychotropic substances.

Nursing staff have the right to open the ampoule and administer a narcotic analgesic to the patient only after the doctor has recorded this prescription in the medical record and in his presence. A corresponding entry is made in the “Medical Record” about the injection given, certified by the signatures of the attending physician and medical officer, indicating the name, dose and time of administration of the drug. After administering a narcotic drug from a syringe tube, its capsule is cut off.

1. Oral and external administration of a narcotic drug is also carried out in the presence of a doctor and medical officer and is noted in the “Medical Card” according to the same scheme.

2. The m/s does not throw away empty ampoules and syringe tubes from narcotic drugs, but stores them in a safe and hands them over daily to the person responsible for accounting and storage

3. When transferring duty, the correspondence of the entries in the accounting log (the number of ampoules and syringe tubes used and the remainder) is checked with the actual number of ampoules and syringe tubes.

4. Empty ampoules and syringe tubes are destroyed only by a special commission approved by the head of the medical institution.

Log of transfer of keys and contents of the safe.

Department_______________________________________

Form of a book for recording narcotic drugs in departments and offices.

_____________________________________________________

Name of the medical institution

BOOK

Accounting for narcotic drugs

In departments and offices

Name of the product_____________________________________________

Unit of measurement_________________________________________________

For violation Federal Law RF “On Narcotic Drugs and Psychotropic Substances”, officials and citizens of the Russian Federation bear responsibility in accordance with the legislation of the Russian Federation.

Ticket No. 19

Task 1

Task 2

Task 3

Care for vomiting.

Examiner's package No. 19

Task 1

A patient with right-sided hemiplegia is discharged home. The patient lives in an apartment with his 30-year-old daughter. The daughter loves her father very much and is confident that she can cope with leaving him. She had never cared for seriously ill people before.

Needs violated: the need for security.

Patient's problem: lack of knowledge about caring for a seriously ill patient among the patient's relatives.

Goal: The daughter will demonstrate sufficient knowledge of organizing home care in 4 days and will be able to provide full care for her father at home.

Nursing intervention plan

1. Conduct an analysis of the patient’s ability to care for himself together with his daughter.

2. Show your daughter the necessary care items.

3. Explain the rules for using care products.

4. Familiarize your daughter with the relevant literature on organizing home care.

5. Organize training by day:

Day 1 – feeding a seriously ill patient, performing morning toilet

Day 2 – supply of a bedpan, urinal, care of the external genitalia

authorities

Day 3 – change of bed linen and underwear for a seriously ill patient

Day 4 – various positions of the patient in bed, prevention

bedsores

6. Confirm the information received the day before every day.

Assessing the effectiveness of care

The patient's daughter demonstrated knowledge of caring for a seriously ill patient at home. The goal has been achieved.

Task 2

The mechanism of action of siphon enema, indications, contraindications and possible complications.

Task 3

Care for vomiting.

Help with vomiting

Functional purpose: medicinal

Execution conditions: outpatient, inpatient

Vomiting is a complex reflex act of involuntary ejection of stomach contents.

There are vomiting of central and peripheral origin.

Central vomiting occurs when the vomiting center in the cerebral cortex is irritated. It occurs without any warning signs (salivation, vomiting) and does not bring relief.

Peripheral vomiting occurs with gastrointestinal disease, occurs with precursors and brings relief to the patient.

EQUIPMENT: 2 aprons, oilcloth, gloves, basin, glass of water, tray, napkin (individual towel).

Algorithm of the procedure.

1. Reassure the patient

2. Sit the patient down (if condition allows) and put an oilcloth apron on him, put on an apron and gloves.

3. Place the basin at your feet.

4. Hold the patient’s head while vomiting by placing your palm on his forehead and holding his shoulder with the other hand

5. After vomiting, have the patient rinse their mouth with water and spit into a tray.

6. Help the patient lie down

7. Take the basin with its contents out of the room, but leave the vomit in the basin to show it to the doctor.

8. Carry out disinfection measures.

Ticket No. 20

Task 1

Ø Identify the violated needs.

Ø Identify the patient's problems.

Ø Formulate goals and plan nursing interventions.

Task 2

Task 3

Examiner Pack 20

Task 1

Ksenia U, 18 years old, entered the clinic accompanied by her mother and a medical team. brothers carrying the patient on a stretcher. The reason for admission was deterioration in health, inability to walk. The patient had surgery on her head several years ago. femur. Medical diagnosis: Ewing's sarcoma stage 4. As a result of a nursing examination, the nurse found out that the patient could not walk due to general weakness and immobility in the right hip joint. The mother is inseparably next to her daughter.

1. Identify the violated needs.

2. Identify the patient's problems.

3. Formulate goals and plan nursing interventions.

Patient problem solving standard

The needs to move, excrete, eat, dress, undress, be clean, work and study are violated.

Patient's problem: limited mobility due to hip disease and lack of self-care. Risk of bedsores.

Goal: the patient will not have bedsores and will be provided with full care in the clinic.

Nursing intervention plan

1. Teach the patient’s mother the basics of hygiene procedures and the elements of preventing bedsores.

2. Place the sore leg on the anti-decubitus circle.

3. Maintain a comfortable and safe environment.

4. Calm the patient.

5. Create complete peace to reduce worries about illness and immobility.

6. Educate the patient exercise therapy complex and self-massage of the limb.

7. Encourage the patient to get out of bed with assistance.

Assessing the effectiveness of care

The patient's mother performs the necessary personal hygiene procedures every day. The patient has become more active, is doing exercise therapy, and is trying to get up with outside help.

Task 2

The mechanism of action of a cleansing enema, indications, contraindications and possible complications.

Task 3

Preparing the patient and performing an oil enema (on a phantom).

Performing an oil enema

OIL ENEMA – the oil introduced into the intestines envelops the stool. After an oil enema, bowel movement occurs within 6-10 hours. After performing an oil enema, the patient must lie down for several hours, otherwise the oil injected into the intestines will leak out. Therefore, it is more convenient to give an enema at night.

EQUIPMENT: pear-shaped balloon or Janet syringe, gas outlet tube (packaged), spatula, petroleum jelly, oil (vaseline, vegetable) 50-100 ml (as prescribed by a doctor), gloves, toilet paper, napkins, oilcloth, diaper, screen, tray, water thermometer.

Procedure algorithm

I.Preparation for the procedure:

1. Clarify the patient’s understanding of the purpose and progress of the upcoming procedure and obtain his consent to carry out the procedure. If the patient is uninformed, check with the doctor for further tactics.

2. Heat the oil in a water bath to 38 0 C.

3. Check the temperature of the oil (not the water!) with a thermometer.

4. Lower the head of the bed to a horizontal level and help the patient turn on his left side, his legs bent at the knees and hip joints, place an oilcloth with a diaper under the patient.

5. Take 50 (100) ml of warm oil into a pear-shaped balloon (as prescribed by your doctor). Lubricate with Vaseline gas outlet pipe. Place the balloon and tube in the tray.

II. Execution of the procedure.

6. Wear gloves. Insert the gas outlet tube 20-30 cm. (If it is impossible to position the patient on the left side, administer the enema with the patient “lying on his back”)

7. Attach a pear-shaped balloon to the tube and slowly introduce oil. Without opening the pear-shaped cylinder, disconnect it from the gas outlet tube.

8. Remove the gas outlet tube and place it together with the pear-shaped cylinder in the tray.

9. Wipe toilet paper(with a napkin) the anal area (in women in the front-to-back direction) if the patient is helpless.

III. Completion of the procedure.

10. Remove the oilcloth and diaper and throw them into a waterproof bag.

11. Remove gloves and place them in the tray.

12. Cover the patient with a blanket and help him find a comfortable position.

13. Wash your hands.

14. Make an entry in the “Medical Record” about the procedure performed and the patient’s reaction to it.

15. Carry out disinfection measures.

16. Assess the effectiveness of the procedure after 6-10 hours and make a note about this in the “Medical record”.

Ticket No. 21

Task 1

Ø Identify the violated needs.

Ø Identify the patient's problems.

Ø Formulate goals and plan nursing interventions.

Task 2

Enemas. Types of enemas.

Task 3

Examiner's package No. 21

Task 1

Kalashnikova E.D. was admitted to the surgical department due to amputation of the lower limb. After a successful operation, the patient complains of phantom pain in the area of ​​the amputated limb.

1. Identify the violated needs.

2. Identify the patient's problems.

3. Formulate goals and plan nursing interventions.

Patient problem solving standard

Needs violated: maintain environmental safety.

Patient's problem: experiencing phantom pain in the area of ​​the amputated limb.

Goal: The patient will know how to overcome phantom sensations.

Nursing intervention plan

1. Conduct a conversation with the patient, establish a trusting relationship.

2. Give the patient advice: the sensations will decrease if you look at the amputation site.

3. Provide literature on suggestive pain relief techniques.

Assessing the effectiveness of care

The patient knows how to overcome phantom sensations and successfully uses the acquired skills when phantom pain occurs. The goal has been achieved.

Task 2

Enemas. Types of enemas.

Task 3

Preparing the patient and performing a cleansing enema (on a phantom).