Drug administration in relation to meals in an institutional setting
Pharmaceutical companies provide explicit instructions about drug dosage, when the drugs should be administered, whether or not to take them with food, and which foods to avoid. In institutional settings, the instructions regarding timing and meals are often ignored, leading to potentially serious consequences due to variations in bioavailability, the amount of the drug that is absorbed. Too much can lead to toxicity, while too little may delay or prevent the drug from having an effect. Seventy-five patients in each of two long-term care settings, and a total of 33 patients in two short-term care settings were studied to find out if manufacturers' instructions were followed when drugs were administered. Five cardiovascular drugs with specific recommendations about timing were included. In spite of a good deal of information regarding the timing of these five drugs relative to meals, this was not incorporated in the drug schedules. The physician order for frequency was used to select times of administration from the standard hospital policy. Only one physician order specified the relationship to meals, and this patient received the medication correctly. Only 15 percent of the patients received all their doses in a manner that ensured greatest bioavailability. Another 15 percent received their medication in doses that would lead to the lowest bioavailability. The rest, 70 percent, received drug doses in an inconsistent pattern. Health care personnel are not following the recommendations in the literature regarding timing relative to meals, and this may have serious consequences for the patient in terms of complications and resulting increased cost of medical care. Either the patient's usual drug-meal schedule should be maintained, or if timing is manipulated, the patient's response should be carefully monitored. Hospital personnel must be educated so that they understand the importance of the drug-meal relationship and the maintenance of an appropriate schedule. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Heart and Lung
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Publication Name: Nursing Times
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