Drug administration in relation to meals in the institutional setting

To investigate adherence to literature recommendations for administration of five cardiovascular drugs in relation to mealtimes, data from records of 183 adult patients in two short-term and two long-term care settings were tabulated. Ninety-three percent of patients taking quinidine sulfate and 85% of patients taking the other four study drugs received one or more doses incorrectly. Findings show that timing recommendations for dosing in relation to meals are not considered in these institutions when drug administration schedules are established. The practice of arbitrary schedule selection could have serious consequences, including adverse physiologic and financial impact on the patient from loss of therapeutic effectiveness or development of drug toxicosis. Medication schedules need to be designed to achieve the greatest drug bioavailability.