Anatomy-therapeutic-chemical classification(eng. Anatomical Therapeutic Chemical Classification System) - International classification system medicines. The most common and consumed in the documents of the Ministry of Health of Russia abbreviation ATX.

Along with anatomy-therapeutic-chemical classification in Russian pharmacology and medicine, classification is also widely applied. medicinal preparations According to the pharmacological pointer.

The presence of the drug in this classifier does not mean that it is currently permitted, or was resolved earlier to use in the territory Russian Federation, USA or any other country.

Sections of anato-therapeutic-chemical classification

Code A. Preparations affecting the digestive tract and metabolism

The section "Preparations affecting the digestive tract and metabolism", code A, includes the following subsections:

Code A01. Dental preparations

Subsection "Dental preparations" includes one group of drugs that coincides with the name with subsection:

A01A code. Dental preparations

A01AA Preparations for Caries Prevention

A01AA01 sodium fluoride
A01AA02 sodium monofluorophosphate
A01AA03 Olaflora
A01AA04 Tin Fluoride
A01AA30 Combined drugs
A01AA51 sodium fluoride in combinations with other drugs

A01AB Antimicrobial preparations for local treatment of oral diseases

A01AB02 hydrogen peroxide

A01AB03 chlorhexidine
A01AB04 amphotericin B.
A01AB05 Polyinoxylin
A01AB06 Domifena Bromide
A01AB07 Oxykinolin
A01AB08 neomycin
A01AB09 Mikonazole.
A01AB10 Natamicin
A01AB11 Others
A01AB12 hexetidine
A01AB13 Tetracycline
A01AB14 Benzoxonium chloride
A01AB15 Tibesonia iodide
A01AB16 MepoLornicin
A01AB17 Metronidazole

A01AB18 Clotrimazole
A01AB19 sodium perborate
A01AB21 Chlorettracycline
A01AB22.
A01AB23 Minocyclin

A01AC glucocorticosteroids for local treatment of oral diseases

A01AC01 triamcinolone
A01AC02 dexamethason
A01AC03 hydrocortisut
A01AC54 prednisone in combinations with other drugs

A01AD Other drugs for the treatment of oral diseases

A01AD01 Epinephrin
A01AD02 benzidamine * IT18) (Tablets for resorption: R02AX03)
A01AD05 Acetylsalicylic acid
A01AD06 adrenalon
A01AD07 Amlexanox
A01AD08 Bekaplermin
A01AD11 Other preparations for the treatment of oral diseases

Code A02. Preparations for the treatment of diseases associated with acidity impairment

Subsection "Preparations for the treatment of diseases associated with acidity disorder", Code A02, includes the following groups of preparations:

Code A02A.

A02AA Magnesium Preparations

A02AF Antacids in combination with wind turbines

A02AF01 Magalland and Wind Table
A02AF02 Simple combination of salts and wind turbines

A02Ag Antacids in combination with spasmolitics

A02AX antacids in combination with other drugs

Code A02B. Anti-sized drugs and preparations for the treatment of gastroesophageal reflux

A02BA Blockers H2-histamine receptors

A02BC01 omeprazole
A02BC02 Pantoprazole
A02BC03 Lansoprazole
A02BC04 RabnAzole
A02BC05 Ezomeprazole
A02bc06 dexlansoprazole
A02BC07 dexrabeprazole * 15)
A02BC08 Wanoprazan * 20)
A02BC53 Lansoprazole in combination with other drugs * 15)
A02BC54 Rabeprazole in combination with other drugs * 15)

A02BD combination of preparations for eradication Helicobacter pylori.

A05AB Preparations for the treatment of diseases of biliary tract

A05AB01 hydroxymethylnicotamide

A05AX Other drugs for the treatment of biliary tract diseases

A06AX Other laxatives

A08AB Preparations for the treatment of peripheral obesity

A08AX Other means against obesity

Code A09. Drugs contributing to digestion (including enzyme preparations)

Subsection "Preparations that promote digestion (including enzyme preparations) "Includes one group of drugs that coincides with the name with subsection:

Code A09A. Drugs contributing to digestion (including enzyme preparations)

A09aa digestive enzyme preparations

A10AF insulins their analogues for inhalation

A10AF01 Insulin (Human)

Code A10B. Hypoglycemic drugs, with the exception of insulins

A10BA Biguanida

A10BA01 Fenformin
A10BA02.
A10BA03 Buofing

A10BB Sulfonylmuric derivatives

A10BB01 Glyibenclamid
A10BB02 chlorpropamide
A10BB03 Tolbulamd
A10BB04 Glibornuride
A10BB05 Tolazamide
A10BB06 Carbututamid
A10BB07 glypisid.
A10BB08 Glicvidon
A10BB09 glyclaside
A10BB10 metagixamide
A10BB11 Glizoksepid
A10BB12 Glymepirid
A10BB31 Acethexamide

A10BC heterocyclic sulfonamida

A10BC01 Glimidin

A10BD combination of hypoglycemic drugs for reception inside

A10BD01 Fenformin and Sulfonamida
A10BD02 Metformin and Sulfonamida
A10BD03 metformin and Rosiglitazone
A10BD04 Glimpiride and Rosiglitazone
A10BD05 Metformin and Pioglitazone
A10BD06 Glimpiride and Pioglitazone
A10BD07 Metformin and Sitagliptin
A10BD08 metformin and Wildagliptin
A10BD09 Pioglitazone and Aloglyptin
A10BD10 Metformin and Saxagliptin
A10BD11 metformin and linagliptin
A10BD12 Pioglitazone and Sitagliptin
A10BD13 metformin and aloglyptin
A10BD14 metformin and repaglinide * 14)
A10BD15 Metformin and Dapagliflozine * 14)

A10BD16 Metformin and Canagliflozin* 15)
A10BD17 metformin and Akarboz* 15)
A10BD18 metformin and hemigliptin* 15)
A10BD19 Linaglipin and Empagliflozin * 15)
A10BD20 Metformin and Empagilifloosin * 16)
A10BD21 Saxagliptin and Apagliflozin * 16)
A10BD22 and Evogliptin * 18)
A10BD23 Metformin and Ertugliflozin * 19)
A10BD24 Sitagliptin and Ertugliflozin * 19)
A10BD25 Metformin, Saxagliptin and Dapagliflozin * 19
A10BD26 Metformin and Lobeglitazone * P21)

A10BF alpha glucosidase inhibitors

A10BF01 AKARBOZA
A10BF02 Miglitol
A10BF03 Vogliboz

A10BG Tiazolindioni

A10BG01 Troglitazon
A10BG02 Rosiglitazon
A10BG03 Pioglitazon
A10BG04 Lobeglitazon * P21)

A10BH Dipeptidylpeptidase-4 inhibitors (DPP-4)

A10BH01 Sitaglipin
A10BH02 Wildaglipin
A10BH03 Saxaglipin
A10BH04 Aloglyptin
A10BH05 Linaglipin
A10BH06 Hemigliptin * 14)
A10BH07 Evogliptin * 18)
A10BH08 Telliglipin * P21)
A10BH51 Sitagliptin and Simvastatin
A10BH52 Hemigliptin and Rosavastatin * 19)

ATP Classification System (Anatomical Therapeutic Chemical Classification System) Along with specially developed units of drug consumption - established daily doses (DDD - Defined Daily Doses) adopted WHO as the basis of international methodology for statistical research in the field of drug consumption. Currently, the PBX / DDD system is widely used as state institutions, so I. pharmaceutical companies In many countries of the world.

Medicinal classification systems perform a "general language" function used for a unified description of their nomenclature in the country or region, as well as allow you to compare the data on the consumption of medicines at the national and international levels.

Ensuring access to standardized and validated information about the use of medicines is necessary for:

Conducting an audit of the structure of their consumption,
- identifying shortcomings when used,
- initiation of educational and other events, etc.

The main goal of creating international standards is a comparison of data from different countries.

In the field of drug consumption research, two systems are dominated by today.

Anatomical Therapeutic - AT) Classification developed by the European Association of Pharmaceutical Market Research Association (European Pharmaceutical Market Research Association - Ephmra);

Anatomical Therapeutic Chemical (Anatomical Therapeutic Chemical - ATC) Classification developed by Norwegian scientists.

Within the system developed by EPHMRA, drugs are broken into groups of three or four levels. The ATS classification modified and expanded the EPHMRA classification, including therapeutic / pharmacological / chemical subgroups in the fourth level and chemical substances at the fifth level.

The EPHMRA classification uses IMS to provide statistical results of market research for the needs of the pharmaceutical industry. It must be emphasized that due to a number of technical differences between the EPHMRA and PBX classification systems, it is impossible to conduct a direct comparison of data collected using both systems.

ANATOMICAL THERAPEUTIC CHEMICAL CLASSIFICATION SYSTEM) Along with specially designed drug consumption units - established daily doses (DDD. - Defined Daily Doses) adopted WHO as the basis of an international methodology for statistical research in the field of drug consumption.

Currently, the PBX / DDD system is widely used both government agencies and pharmaceutical companies in many countries of the world.

It should be noted that any international standards are born in search of a compromise, and the system of classification of medicines is no exception to the general rule. Drugs can be used on two or more equally important indications, at the same time, the main indications for their use in different countries may differ. This often leads to the emergence of various alternatives for their classification, but the decision should be made regarding the main indication. Countries in which drugs are used otherwise than determined by the PBX system may seek to develop national classification systems. However, it is first to weigh the importance of national traditions, on the one hand, and the ability to introduce a methodology that will allow reliable comparisons of drug consumption at the international level. Currently, a variety of examples can be brought that the active implementation of the ATC / DDD methodology turned out to be a powerful impetus for national research in the consumption of medicines and creating capable drug control systems.

Development of the ATC system

The prerequisites for the creation of a PBX classification was the emergence of a large number of new drugs in the 50s and 19th of the 20th century, which led to an increase in the costs of drug treatment. In this regard, in the 1960s, the first international research was conducted in the field of drug consumption. Comparison of the consumption of medicines in 6 European countries in 1966-1967. Recovered significant national differences in their use. In 1969, the WHO European Bureau organized and held in Oslo Symposium "Medicinal Consumption", where it was decided to develop an international classification system to study the features of drug consumption.

In the early 70s, the Norwegian Medicinal Control Agency (NORSK MedisinalDepot, NMD) used an anatomy-therapeutic classification for this purpose developed by the European Association of Pharmaceutical Market Research (EPHMRA). The agency has modified significantly and expanded it by creating a system currently known as a PBX classification system. In addition, since strict methodological standards should be applied to obtain reliable information on drug consumption, there was a need not only to include a generally accepted international classification system, but also in a universal unit for measuring drug consumption. This unit was named "Installed daily dose (DDD)".

In 1981, the WHO Regional Office for Europe recommended the use of the PBX / DDD methodology in other countries of the world.

In 1982, the WHO Center was established to cooperate in statistical research methodology (The Who Collaborating Center for Drug Statistics Methodology), which operates on the basis of NMD in Oslo, is a coordinating body and contributes to the widespread international dissemination of the PBX / DDD methodology. In 1996, WHO pointed out the need to use the PBX / DDD system as an international standard for research on drug consumption, in connection with which the center has passed into the immediate subordination of WHO headquarters in Geneva.

Responsibilities of the Center are:
- classification of new drugs,
- DDD definition,
- Periodic revision of the classification of PBX and DDD.

In 1996, an international working group WHO for the methodology of statistical studies of medicines. Its experts appointed by WHO are engaged in the further development of the ATS / DDD system, the development of guidelines for awarding and changing the PBX codes established by daily doses and so on.

Structure and nomenclature of the classification system PBX

Classification system PBX - a system of separation of drugs into groups depending on their action to a certain anatomical organ or the system, as well as on their chemical, pharmacological and therapeutic properties.

Medicinal preparations are classified by groups of 5 different levels.

The 1st level indicates an anatomical organ or system of organs and has an alphabone code:

Code A: Preparations affecting the digestive tract and metabolism

Code B: Preparations affecting blood formation and blood

Code C: Preparations for treating diseases of cardio-vascular system

Code D: Preparations for the treatment of skin diseases

Code G: Preparations for the treatment of diseases of urogenital organs and sex hormones

Code H: Hormonal drugs For system use (excluding sex hormones)

Code J: Antimicrobial preparations for system use

Code L: Anticancer preparations and immunomodulators

Code M: Preparations for treating diseases bone-muscular system

Code n: Preparations for treating diseases nervous system

Code R: Preparations for treating diseases respiratory system

Code S: Preparations for the treatment of diseases of the senses

Code V: Other medicinal drugs

Each first level group has subordinate second-level groups.

Level 2 groups have a three-digit alphanumeric code.
An example of second-level subgroups for group A:

• A01 Dental preparations;
• A02 Preparations for the treatment of diseases associated with acidity impairment;
• A03 Preparations for treatment functional disorders GTS;
• A04 Antiwheat preparations;
• A05 Preparations for the treatment of liver disease and biliary tract;
  etc.

3rd level groups have a four-digit code, a level of the 4th level - five-digit code.

Below is an example of subgroups 3 and 4 levels for the group A02:

• A02A Antacids
  • A02AA Magnesium Preparations
  • A02ab Aluminum preparations
  • A02ac calcium preparations
  • A02AD combination of aluminum, calcium and magnesium preparations
  • A02AF Antacids in combination with wind turbines
  • A02Ag Antacids in combination with spasmolitics
  • A02AH Antacids in combination with sodium bicarbonate
  • A02AX antacids in combination with other drugs
• A02B Anti-Outbred Preparations and Preparations for the Treatment of Gastroesophageal Reflux
  • A02BA Histamine H2 receptor blockers
  • A02BB Prostaglandins
  • A02BC proton pump inhibitors
  • A02BD combination of preparations for eradication Helicobacter pylori.
  • A02BX Other anti-sized preparations and preparations for the treatment of gastroesophageal reflux

The fifth level of ATC classification indicates a certain substance. Example of the fifth level groups for the A02BA group:

• A02BA. Histamine H2 receptor blockers
• A02Ba01 Cimetidin
• A02Ba02 Ranitidin
• A02Ba03 Famotidin

One substance may have 1 and more ATC codes depending on the method of administration, dose and therapeutic application.

Consider the example of codes assigned to tetracycline:

		The code is assigned to the monoprets of tetracycline for local application For diseases of the oral cavity
		The code is assigned tetracycline monoprets for outdoor use in dermatology
		The code is assigned to tetracycline monoprets for systemic use
		The code is assigned to combined tetracycline preparations for systemic use.
		The code is assigned to tetracycline monoprets used for local applications in ophthalmology.
		The code is assigned to tetracycline monoprets used for the local treatment of ear diseases.
		The code is assigned tetracycline monoprets used for local treatment as eye and ears

And one more example: Bromocriptine preparations can be produced in various dosages. Low dose tablets of the active substance are used as inhibitors of prolactin synthesis, they are assigned code G02CB01:

Bromocriptine tablets with greater action are used for the treatment of Parkinsonism and the Code of N04BC01 is used to treat PBXs:

Nomenclature system PBX

In the PBX system use international unpatient names (MNN, or Inn) WHO for pharmaceutical substances. If the active substance is not yet assigned to the MNN, then other generally accepted unpatient namesPreferably taken to use in the United States (United States ADOPTED NAMES, USAN) or UK (British Approved Names, Ban).

Criteria for the inclusion of medicines in PBX

The WHO Center includes new articles in the classification of ATS only on the application of manufacturers, agencies for drug control and research institutions. WHO has developed a special procedure for consideration of applications for the introduction of new articles in the classification of ATS, which is largely similar to the PNN assignment procedure.

PBX codes are usually not assigned:

New substances before applying for licensing;

Auxiliary drugs.

Combined drugs.

An exception Fixed-applied fixed combinations of active substances used in a number of countries, for example:

A02BD combination of preparations for Eradication Helicobacter Pylori

Principles of drug classification

The fundamental principle is that all drugs that have similar ingredients, the strength of action and dosage form are assigned only one PBX code.

If the drug is produced in different dosage forms With different strength of action, composition or therapeutic testimony for use, it can have more than one code.

WHO indicates that the substances assigned to one 4th level cannot be considered pharmacotherapeutically equivalent, since they may differ by the mechanism of action, therapeutic effect, drug interactions and developing side reactions.

New medicinal substanceswhich do not belong to the well-known groups of similar substances of the 4th PBX level, usually include in the "X" group ("Other") of the 4th level. And only if several such substances refer to one group of 4 levels, for them, with the next revision of the classification, a new group will be created. Therefore, innovative preparations are often included in the group with the X index.

In the system, outdated or seized drugs are preserved, so it is not a guide when making decisions on issues such as pricing, generic or therapeutic replacement of drugs, reimbursement of medical treatment costs. Assigning a PBX Code to the drug is also not a recommendation for its use or evaluation of its effectiveness, including compared with other drugs.

WHO is committed to ensuring the stability of PBX codes and daily doses, which is necessary for research.

DDD -Defined Daily Doses

The classification system PBX is closely related to the use of a specially developed unit for measuring drug consumption - DDD.

By definition of WHO, DDD is a "calculated mean supportive daily dose of the drug used according to the main indication in adults." DDD is not similar to the recommended daily dose, which can significantly depend on the severity and nature of the course of the disease, body weight of the patient, its ethnic origin, the recommendations of national guidelines for drug therapy and other factors.

For example, in the WHO Guide it is indicated that the recommended daily doses in different countries may differ 4-5 times. DDD is a fixed unit of measurement of real drug consumption and can be applied to carry out comparative studies on drug consumption by different groups of the population. DDD is defined only for those drugs that are assigned by the PBX code and which are presented in the pharmaceutical market at least in one country.

Typically, drug consumption data represents in the formula of DDD / 1000 inhabitants / day, and when assessing consumption in hospitals - DDD / 100 beds-days.

In the PBX published indices, in a separate column next to the chemical substance, it is indicated (in most cases) the method of its introduction and DDD.

Applications Application PBX / DDD Methodology

1. Collection and analysis of statistical data on drug consumption.

2. Consumption learning research medicines of various scale (in separate medical institutions, in the region, in the country, internationally).

3. Using the system for educational purposes, in the creation of information bases on medicines.

4. Evaluation of the safety of drugs.

5. Analysis of cases of incorrect assignment or drug leave.
FROM The help of the PBX 5-level codes analyze the data of the prescriptions or drug leave to prevent cases of "duplicated" (simultaneous reception of the patient of two drugs with different trade names, but containing the same active substance) and "pseudo-processed" (receiving a patient of two drugs with different active substances, but having similar pharmacodynamic properties, such as diazepams and oxazepams) of prescriptions of drugs.

6. Creating drug registries.

Amendments to the PBX system

The availability of medicines on the market is constantly changing and their uses increase that dictates the need to regularly revise the PBX system. Here great importance It has a principle: to reduce the number of changes to the minimum. Before you make a change, you need to consider and weigh all the difficulties that it will cause the PBX system for the user, and compare them with the advantages that will be achieved thanks to this change. Changes in the PBX system make cases when the main indication of the drug is undoubtedly changed, and when it is necessary to create new groups corresponding to the new acting substances, or deepening the differentiation of drug grouping.

The ATC / DDD methodology is a dynamic system and changes in it can be continuously (every year it publishes a list of changes entered into the classification system).

Finally, in almost every country there are monopreparations and combined drugs that do not have a PBX code or DDD. In such cases, consultation on the WHO collaborating center on the methodology of drug statistics in Oslo and apply for a new PBX-code assignment and setting DDD. Since PBX codes and DDD are tied to national drugs, these lists should be regularly updated in accordance with the annual update of the ATC / DDD system.

The full classification index of the PBX codes, like DDD, is usually reprinted annually by the WHO Center for Cooperation in the Methodology of Statistical Medicine Studies.

The last option of the PBX classification and detailed information about the PBX system of classification can be found at http://www.whocc.no/atcddd/

List of used information:

The task of each doctor is not only to assess the patient's condition and on the basis of symptoms to establish the correct diagnosis, but also correctly define a medicine that will help to cope with the disease that occurred. For the rapid search for the desired drug, an international standard of methodology of all known medicines - ATC (ATC) was created. The classification of medicines at the international level sounds like "Anatomical Therapeutic Chemical Classification System". The system is based

Purpose of the system

The main purpose of the system is to improve the quality of drug treatment and its availability in different countries. For this purpose, statistics on the features of drug consumption are carried out worldwide, and all research data is accumulated in the ATX system. The classification of medicines is based on the separation of medicines by their active component. All preparations with one active substance and similar therapeutic effect are assigned one accessory code.

Medication can have several codes if different forms Release with different concentrations of the active ingredient. All medicines are divided into groups that are defined in the code by lettering notation and Arabic figures. This allows the code to identify the identity and therapeutic effect of any medication registered in the system. The classification of medicines (ATC) provides for one code for one drug, even if there is equally important testimony. The decision on which indication should be considered the main one, accepts the WHO Working Group.

Enclusion Criteria

Manufacturers, Research Institutions and Medicinal Control Agencies are applying for making data on the preparation. The following article follows the procedure for introducing a new article into the system. Not all drugs are included in ATX. Classification of medicines does not contain data on combined drugs, with the exception of substances with a fixed combination active ingredients, such as B-adrenoreceptor blockers and diuretics. Also, the system does not fall into the system folk Medicine and drugs that have not been licensed.

Cautions

The classification of medicines (ATC) cannot be considered as a recommendation for use or evaluation of the effectiveness of a drug. Medicia treatment Must prescribe a specialist.

Introduction

Currently, a huge amount of medicines is presented at the pharmaceutical market. To systematize and simplify work with the diversity of medicines, they must be classified and encoded. Classification and coding are used to describe the drug number of the country or region and help assemble and summarize data on drug consumption. Classification helps to establish the necessary nomenclature for each drug group, develop general methods Testing and quality control, rationally organize the reception and storage of drugs. Coding allows you to rationally plan the purchase of medicines and simplify their inventory.

The purpose of this work was to determine the tasks and requirements for drug classification systems, determine the most common approaches to the classification and coding of medicines.

Medicinal Classifications Systems

Anatomy-therapeutic-chemical classification

Anatomy-therapeutic-chemical classification ( Anatomical Therapeutic Chemical Classification System) WHO is adopted as an international standard of methodology intended for statistical research in the field of drug consumption in different countries.

In ATC system, drugs are classified in accordance with their basic therapeutic use (that is, according to the main active substance). The fundamental principle is that only one ATX code is defined for each prepared dosage form. The drug may have more than one code if it contains different doses of the active substance or is represented in several dosage forms, therapeutic readings for which are different. If the drug has two or more important testimony or its main therapeutic application is different in different countries, the question of which indication should be considered as the main, the WHO technical working group decides and only one code is usually assigned to this. When incorporating new drugs in the official index of the ATC codes, the WHO Center is very considering simple drugs (contain one active substance), but the fixed combinations of active substances widely used in different countries are also assigned ATX codes.

Separate ATH codes are not assigned:

b combined drugs (exception - widely used combinations of active substances);

b new substances before submitting an application for licensing;

b with auxiliary drugs or means of traditional medicine.

Advantages of the ATX system:

• 1. Allows you to identify the drug, including an active substance, determine the method of its introduction, as well as in appropriate cases daily dose Its consumption.
• 2. Unlike most other ATX classifications, it takes into account both therapeutic properties of drugs and their chemical characteristics.
• 3. It has a hierarchical structure, which facilitates the logical division of medicines into certain groups.