Decentralized pharmacist concept solves unit dose problems

In order to solve problems associated with the unit dose drug distribution system at LDS Hospital, the decentralized pharmacist concept was tried. The pharmacist uses a master medication cart to fill new drug orders at the nursing station and a computer video terminal at the nursing station to check patient profiles. The reactions of nurses and members of the medical staff to the decentralized pharmacist are described.

Cortical projections of the thalamic mediodorsal nucleus in the rabbit

The cortical projection of the thalamic mediodorsal nuclear complex (MD) in the rabbit was mapped retrograde horseradish peroxidase and anterograde tritiated proline techniques. The projection field occupied the entire medial wall rostral to a mid corpus callosal level, wrapped around the frontal pole onto the lateral convexity and tailed off caudally on the dorsal bank of the rhinal sulcus. The projection of the lateral approximately one-half of MD, the half which does not receive olfactory input, was confined to medial cortex supply all but the most rostral region. This projection field of lateral MD was precisely organized in two dimensions with the most lateral part projecting most caudally and the most dorsal part projecting most ventrally. A representation for the third, anterior-posterior (A-P), dimension was not evident since any cortical point within the field was supplied by a cylinder of cells extending the entire A-P extent of lateral MD. The medial half of MD, which does receive olfactory input, projected to the remaining rostral medical cortex, the lateral convexity and rhinal sulcal region. The inverse dorsoventral relationship was partially preserved and on overlapping A-P gradient was present with sulcal projections originating more caudally in medial MD and the rostral medial projection originating more rostrally.

The distribution of olfactory input in the opossum mediodorsal nucleus

Discharges of single cells in the thalamic mediodorsal nucleus (MD) of the opossum were recorded during electrical stimulation of the lateral olfactory tract. Responsive sites were histologically localized throughout the entire mediolateral extent of MD. In both rabbit and squirrel monkey responses are confined to the medial half of MD. Thus the lateral non-olfactory nuclear subdivision, common to both rabbit and squirrel monkey, was not found in the opossum. Firing patterns of cells were similar to those observed in rabbit and squirrel monkey. They commonly consisted of an early spike or burst of spikes, followed by a period of inactivity and then, in many cells, by a later period of response or of resumed spontaneous activity. The results indicate that olfactory input is characteristic of MD in a diverse sample of mammals but that topographic organization of the input is distinctly different in the opossum.

Computerized medication monitoring system

A computerized medication monitoring system for alerting and warning of potential adverse drug reactions is described. The system integrates computerized data on each hospital patient (medications, clinical laboratory, blood gas, ECG, ALLERGIES, DIAGNOSIs, etc.) and returns to the pharmacist warning messages and suggestions regarding patient drug therapy. The broad data base allows for nearly complete drug therapy monitoring. When a warning message is received, the pharmacist contacts the physician or nursing staff and explains the potential problem. The system also generates prescription labels and patient drug profiles which are used in a unit dose dispensing system. Five percent of 13,727 patients monitored have had drug alerts. Of these alterts, 44.9% were drug-laboratory contraindications and only 28.9% were drug-drug interactions. Of the 690 alerts received, 77% resulted in the physician changing the patient's therapy.