Support needs of supply nurses in rural and remote Queensland.

OBJECTIVE: The aim of this report is to discuss a needs analysis conducted with rural and remote nurses in Queensland undertaking supply of medications in public hospitals without a pharmacist. DESIGN: Survey questionnaire. METHODS: A questionnaire was faxed to 65 Queensland Health rural and remote hospitals using supply nurses. It contained six closed questions regarding previously identified medication 'supply' issues, and three open questions to determine additional information. RESULTS: Of the surveys, 42 (65%) were returned. Major areas of interest included a safety checklist for medication supply (90%, 38/42), more information on medication labelling requirements (83%, 35/42) and timing of medications with regard to food (86%, 36/42). Requirements for patient counselling, increased access to consumer medication information (CMI) (76%, 32/42), and resources regarding doses, indications, interactions and adverse effects also rated highly (73%, 31/42). Thirty-three supply nurses highlighted at least one issue in the open questions: more information on the legal requirements of repackaging medications (39%, 13/42), increased access to CMI and counselling tools (36%, 12/42) and an efficient stock control system (30%, 10/42). CONCLUSIONS: This report highlights the need to broaden current support services available to nurses undertaking the supply of medications. It is vital that support programs, and the laws and guidelines related to supplying medications in rural and remote hospitals, support health care professionals providing quality use of medicines (QUM) and reflect the realities of rural and remote health care.

Potentiation of 5-hydroxytryptamine (5-HT) responses by a 5-HT uptake inhibitor in pulmonary and systemic vessels: effects of exposing rats to hypoxia.

The aim was to determine whether uptake of 5-hydroxytryptamine (5-HT) by the 5-HT transporter (SERT) modulates contractile responses to 5-HT in rat pulmonary arteries and whether this modulation is altered by exposure of rats to chronic hypoxia (10% oxygen; 8 h/day; 5 days). The effects of the SERT inhibitor, citalopram (100 nM), on contractions to 5-HT were determined in isolated ring preparations of pulmonary artery (intralobar and main) and compared with data obtained in systemic arteries. In intralobar pulmonary arteries citalopram produced a potentiation (viz. an increase in potency, pEC(50)) of 5-HT. The potentiation was endothelium-dependent in preparations from normoxic rats but endothelium-independent in preparations from hypoxic rats. In main pulmonary artery endothelium-independent potentiation was seen in preparations from hypoxic rats but no potentiation occurred in preparations from normoxic rats. In systemic arteries, citalopram caused endothelium-independent potentiation in aorta but no potentiation in mesenteric arteries; there were no differences between hypoxic and normoxic rats. It is concluded that SERT can influence the concentration of 5-HT in the vicinity of the vasoconstrictor receptors in pulmonary arteries. The data suggest that in pulmonary arteries from hypoxic rats, unlike normoxic rats, the SERT responsible for this effect is not in the endothelium and, hence, is probably in the smooth muscle. The data are compatible with reports that, in the pulmonary circulation, hypoxia induces/up-regulates SERT, and hence increases 5-HT uptake, in vascular smooth muscle. The findings may have implications in relation to the suggested use of SERT inhibitors in the treatment of pulmonary hypertension.