Effects of changes in standing medication distribution times on PRN drug use

Effects of changes in standing distribution times of medication on "as needed", prn, medication use on an inpatient psychiatric unit were studied. It was found that significantly less prn doses were distributed when standing medications were administred at 8 A.M., 12 Noon, 4 P.M., and 9 P.M. rather than at 10 A.M., 2 P.M., 6 P.M., AND 10 P.M. Data on three categories of prn drugs were collected. Of the three groups, significant effects were found for tranquilizers and hypnotics, but not for analgesics. The results are discusses in relation to psychosocial interactions on the unit and pharmacologic effects. The current psychopharmacology literature is replete with studies of drug efficacy and pharmacologic mechanisms of action. Less clinical investigation has been conducted on the effects of drug administration. Since 1958, when Tibbits first questioned the need to give chlorpromazine in divided standing doses, many clinical investigators have evaluated the effects of medication administration frequency on clinical outcome, Clinical trials of this type have been conducted for major tranquilizers and tricyclic antidepressants. A patient's complete medication schedule includes drugs given on a regularly standing basis and those given on a pro re nata (prn), according to the circumstances, basis. The effects of varying the times throughout the day at which standing medication doses are distributed have not been investigated. This study was designed to investigate the effects of alteration in administration schedules on the prn distribution of drugs in an inpatient psychiatric hospital setting.