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Introduction. Recently, the country has been implementing a large-scale set of measures aimed at improving the quality of life of children, preserving and strengthening their health. Within the framework of the state program of the Russian Federation "Development of Healthcare", measures have been planned to modernize the children's healthcare system, including improving the quality and accessibility of medical care for children, including their medical care. The accumulated experience of using various medicines in pediatric practice indicates that their pharmacological and pharmaceutical characteristics do not always correspond to the real needs of children's healthcare. Thus, the organization of pharmacy manufacturing of personalized extemporeal medicines for children is a promising and relevant direction in the domestic pharmacy. Purpose of the study was to analyze the use of extemporeal drugs in pediatric practice and to provide scientific and practical justification for the development of their manufacture in pharmacies of medical organizations based on the doctrine of personalized medicine. Material and methods. The theoretical and methodological basis of the research was made up of legislative and regulatory legal acts in the field of drug circulation, drug supply and pharmaceutical activities; scientific papers on technology and quality control of extemporeal medicinal products, as well as other scientific, methodological and reference literature on the subject under consideration. Latent-semantic and structural-logical methods, the method of expert assessments and content analysis were used in the research. Results. As a result of the analysis of the experience of leading medical organizations in St. Petersburg that provide assistance to children with various pathologies, it has been established that, based on the doctrinal provisions of personalized medicine, the use of extemporeal drugs for children makes it possible to individualize the dosage of active substances and select the optimal composition of excipients, to increase the effectiveness of pharmacotherapy. However, the implementation of this approach faces a number of obstacles, despite which significant prospects for the development of pharmaceutical drug manufacturing in the context of advanced technologies and innovations in regulatory regulation are opening up in modern conditions. Thus, individual dosing of the active (active) substances in medicines, the selection of specialized physical therapy makes it possible to minimize side effects, reduce the number of hospitalizations, which in turn reduces the overall cost of medical care and treatment. Conclusion. The establishment of the manufacture of extemporeal drugs used in pediatric practice is an important aspect of personalized medicine. The individual manufacture of children's dosage forms requires high professional competence, strict adherence to drug manufacturing technology and consideration of individual patient characteristics. Such an integrated approach will ensure the effectiveness of the implemented pharmacotherapy, reduce the risk of side effects and increase the safety of treatment. At the same time, it is necessary to pay attention not only to the social and medical aspects of patient-oriented therapy, but also to the economic performance of medical organizations