correct dosage times for various meds

Trauma Columnist · Dec 5, 2014

Good morning!

Although I can't answer your specific question, we are the largest peer to peer nursing site and someone else will be along to help you!

Loo17 · Dec 5, 2014

Ok is there a ROT (Rule Of Thumb) for the time in which.certain meds are to be given?..like obvious if.a order indicted a med to be given qid we know thats 4x a day within 24 hr so every 6hrs ...but some times to divide it equally is not a reasonable time for pt to take I.e. 0000....so is it ok to cut a few hrs here and there for when they are more likely awake?..and also I've learned that with ABTs its best bid time is like 8am and 8 pm but what about tiD and qid ABT orders....

Daily 0900

BID 0900 2100

TID 0600 1400 2200

QID 0000 0600 1200 1800

These are the times I have seen most often in facilities that have shift times that start at 7am, 3pm, 7pm, and 11pm.

The midnight med pass is usually done with the nightshift vitals/assessment. When patients are going home with antibiotics I usually tell them to do their best at keeping the times as close as possible and that taking the night dose at 11pm and the morning dose at 7am is better than missing a dose.

Not sure if this answers your question.

As far as a rule of thumb, there are certain meds like Levothyroxine that is commonly given at 6am and Coumadin which is commonly given at 5 or 6pm in the hospital.

THELIVINGWORST, ASN, RN · Dec 5, 2014

At my hospital usually it goes like this:

Daily 1000

BID 1000 and 2200

TID 0600, 1400, and 2200

QID 0000, 0600, 1200, and 1800

If it's with meals then it's 0800, 1200, and 1800 usually.

psu_213, BSN, RN · Dec 5, 2014

One place I worked had "standard" med times as decried about, so that a QID med was given every 6 hours, BID med every 12, etc. One exception--they had "BID diuretic dose," which was 0800 and 1700. That way you did not have to give someone lasix as they were getting into bed.

caliotter3 · Dec 5, 2014

As you can see there is some variation at different facilities. Best to have an established policy, whatever that may be, and stick to it.

nurseprnRN, BSN, RN · Dec 5, 2014

Antibiotics and antiseizure meds should be given close to the most regular schedule, to maintain serum levels. But if you're giving furosemide at 08 and 17, give the BID K+ at the same time, for what should be obvious reasons. Some daily meds are better given at bedtime than wakey-wakey time. Kids on ADHD meds usually take them at 08, 14, and 20, not q8hrs, so the max effectiveness is in hours when they need to have their best ability to concentrate (school, after school activities, homework). Some QID meds should be taken with food-- breakfast, lunch, dinner, and bedtime snack; you're not going to wake somebody up with a pudding cup and a pill at midnight and 06.

You can and should use nursing discretion based on your knowledge of the purpose and action of the meds. That's the responsibility of the RN, to use critical thinking when planning patient care.

ixchel · Dec 5, 2014

At my hospital usually it goes like this:
Daily 1000
BID 1000 and 2200
TID 0600, 1400, and 2200
QID 0000, 0600, 1200, and 1800
If it's with meals then it's 0800, 1200, and 1800 usually.

This is what we do as well, except the with meals times. AC or ACHS for us is 0730, 1130, 1630, and 2200.

Loo17 · Dec 5, 2014

Antibiotics and antiseizure meds should be given close to the most regular schedule, to maintain serum levels. But if you're giving furosemide at 08 and 17, give the BID K+ at the same time, for what should be obvious reasons. Some daily meds are better given at bedtime than wakey-wakey time. Kids on ADHD meds usually take them at 08, 14, and 20, not q8hrs, so the max effectiveness is in hours when they need to have their best ability to concentrate (school, after school activities, homework). Some QID meds should be taken with food-- breakfast, lunch, dinner, and bedtime snack; you're not going to wake somebody up with a pudding cup and a pill at midnight and 06.

You can and should use nursing discretion based on your knowledge of the purpose and action of the meds. That's the responsibility of the RN, to use critical thinking when planning patient care.

Short acting ADHD meds (Ritalin, Adderall) would never be given at 2000. The kid would never sleep! For those that are short acting, the latest I have ever seen it given would be 5pm to help with homework but even that is rare.

nurseprnRN, BSN, RN · Dec 8, 2014

Thank you, Loo17. Of course you're right. I must have slipped a cognitive cog on that one. :)

dudette10, MSN, RN · Dec 10, 2014

Take a look at the timing associated with EMAR orders. Q8 is not the same as 3x/day. In my experience in a teaching hospital, the interns often need to be coached for the correct timing, so it's important that the nurse knows appropriate timing for meds. Good question!

KelRN215, BSN, RN · Dec 12, 2014

Ok is there a ROT (Rule Of Thumb) for the time in which.certain meds are to be given?..like obvious if.a order indicted a med to be given qid we know thats 4x a day within 24 hr so every 6hrs ...but some times to divide it equally is not a reasonable time for pt to take I.e. 0000....so is it ok to cut a few hrs here and there for when they are more likely awake?..and also I've learned that with ABTs its best bid time is like 8am and 8 pm but what about tiD and qid ABT orders....

When I worked in the hospital, QID was 08, 12, 16 and 20. Q6hrs was q6hrs. When I was on QID dosing of antibiotics last year, I took it when I ate breakfast lunch, late afternoon snack and dinner. Staying up late or waking up early to take a med that needs to be taken with food doesn't make sense. BID is BID-whenever, whatever the patient does at home. I take my BID meds roughly at 7:30 AM and 9 PM, not q 12hr. Who says the best BID timing is 8A-8P for BID antibiotics? Perhaps the patient wakes up at the crack of dawn and is in bed by 8P and the best schedule for him is 6A-6P. It's not like the bacteria in the body says "I'm not going to die from this dose because it's not 8AM." TID doesn't mean q 8hr. I have patients on TID meds who take them at 6A-12P-6P or 8A-2P-8P (which was the standard TID schedule when I worked in the hospital).