Analysis of experience in the use of individually manufactured drugs in psychiatric practice
Issue:
5
Year:
2024
Introduction. The article provides an analysis of the problematic issues that medical organizations and pharmacies face when using drugs manufactured according to extemporaneous prescriptions in clinical practice in psychiatric medical organizations.
Objective. The purpose of this study is to analyze the experience of using extemporaneous formulations in psychiatric practice in order to determine the frequency of its prescription in the treatment of mental disorders.
Material and methods. The study used: content analysis, observation method, documentary, systemic, statistical and other methods for studying drug prescriptions for psychiatric patients. The basis of the research was the specialized departments and hospitals of the Sverdlovsk Regional Psychiatric Hospital, namely, prescription sheets and requirements-invoices for medications prepared according to extemporaneous prescriptions for adult patients from 18 to 60 years old with a psychiatric history
Results and discussion. During the study, a decrease in interest in extemporaneously manufactured dosage forms included in the pharmaceutical manual in the section for psychiatrists was noted. 11 prescriptions with analgesic and sedative effects were selected from the Pallas's cat. A study of the frequency of prescription of individually prepared dosage forms showed that the prescription of the studied prescriptions to patients is uneven. More often, extemporaneously manufactured drugs are prescribed in hospitals, with priority given to infusions of sedative preparations, Pavlov’s mixture, sodium bromide powder with valerian root powder and Dobronravy drops are less commonly prescribed. In the narcological department, painkillers are more often prescribed: painkiller lotion and chloroform oil. In the women's outpatient department No.43 and the men's outpatient department No.44, extemporaneous medications are prescribed extremely rarely and mainly valerian-based drugs.
Rarely in doctors' prescriptions were drugs with outdated formulations observed, such as Bekhterev's mixture, suppositories with chloral hydrate, and Professor Sirotin's pills. The decrease in interest in extemporaneously manufactured drugs can be explained by the lack of necessary substances in pharmacies; in addition, clinical recommendations contain only registered drugs; the prescription of extemporaneous dosage forms requires consideration by a medical commission, which complicates the work of doctors.
Conclusion. Drugs of extemporaneous manufacture can be used more widely as an addition to the main therapy in the prevention and treatment of psychiatric nosologies, subject to the adoption of regulatory documents and introduction into circulation as part of clinical recommendations, as well as updating the manual formulation.
Keywords:
extemporaneous formulation
individual therapy
mental illness.
References:
- Федеральный закон от 05.12.2022 №502-ФЗ О внесении изменений в статью 56 ФЗ «Об обращении лекарственных средств». http://publication.pravo.gov.ru/Document/View/0001202212050043 [Federal Law of December 5, 2022 No. 502-FLD On amendments to Article 56 of the Federal Law “On the Circulation of Medicines” http://publication.pravo.gov.ru/Document/View/0001202212050043 (in Russian)]
- Международная классификация болезней МКБ №11 [Электронный ресурс]. URL: https://mkb11.online/ (Дата обращения: 08.11.2023). [International classification of diseases ICD No. 11 [Electronic resource]. URL: https://mkb11.online/ (Access date: 11/08/2023) (in Russian)]
- Справочник лекарственных препаратов Видаль [Электронный ресурс]. URL: https://www.vidal.ru/ (Дата обращения: 01.11.2023). [Vidal Directory of Medicines [Electronic resource]. URL: https://www.vidal.ru/ (Access date: 11/01/2023) (in Russian)]
- Фармацевтический мануал. Чл.-кор. Акад. мед. наук СССР проф. М.П. Николаев, С.Е. Марголин, провизор Г.Д. Коренблат и др. Сост. бригадой авт. под общ. ред. чл.-кор. Акад. мед. наук проф. М.П. Николаева. М-во здравоохранения СССР. Глав. аптечное упр. Москва: Медгиз, 1949 (16-я тип. Полиграфиздата); 244. [Pharmaceutical manual. Corr. Member. Academician honey. Sciences USSR prof. M.P. Nikolaev, S.E. Margolin, pharmacist G.D. Korenblat et all. Comp. brigade under general ed. member-corr. Academician honey. science prof. M.P. Nikolaeva. Ministry of Health of the USSR. Head. pharmacy management. Moscow: Medgiz, 1949 (16th type. Polygraphizdat); 244 (in Russian)]
- Pharmacodynamics of antipsychotic drugs in women and men. Internet (frontiersin.com), 09.04.21. Полный текст оригинала см.: https://www.frontiersin.org/articles/10.3389/fpsyt.2021.650904/full
- . Петров А.Ю., Айро И.Н., Бережная Е.С., Кинев М.Ю., Гончарова Ю.М. Проблемы экстемпорального изготовления лекарственных форм в аптечных организациях как формы персонифицированной фармации в Российской Федерации и за рубежом. Медицина. Прикладные исследования и методы. 2022; 6: 78–86. [Petrov A.Yu., Airo I.N., Berezhnaya E.S., Kinyev M.Yu., Goncharova Yu.M. Problems of extemporaneous production of dosage forms in pharmaceutical organizations as a form of personalized pharmacy in the Russian Federation and abroad. Medicine. Applied research and methods. 2022; 6: 78–86 (in Russian)]