Pharmacology: Titration of Medication

What does "titration "mean?

It means that the HCP has not ordered a set flow rate for IV medications. The nurse calculates and adjusts the flow rate (usually hourly) based on a formula the HCP prescribes that includes critical parameters.

What are some parameters used to titrate a medication?

Blood pressure, pulse, respiratory rate, oxygen saturation, urine output. Laboratory values. weight, hemodynamic pressures, reflex irritability.

LOC.

When a patient is having a medication titrated, must they have a IV pump?

YES

What is the most common frequency at which IV flow rates are changed in titration?

Hourly

Can IV rates be increased during titration?

YES

Can IV rates be decreased during titration?

YES

Is the nurse ethically and legally responsible to accurately and timely administer drug titrations?

YES

What is a common name for titrations?

Drips

If the HCP orders an Insulin drip does the nurse have to start another IV site/line or can it be “piggybacked"?

An insulin drip cannot be piggybacked, and a new IV site/line must be established (unless the patient has a multiple lumen IV catheter.)

What do you use to titrate an insulin drip?

Watch the blood glucose.

Dopamine is titrated and treats what disorder?

HYPOtension

What do you monitor to titrate Dopamine?

The BP and urine output.

What organ system is Dopamine harmful to?

The kidneys... do not use with CKD (chronic kidney disease).

Dobutamine is titrated and used for what disorders?

It strengthens the heart in heart failure, and it raises blood pressure.

Does Dobutamine harm the kidneys?

NO. Pay attention, one drug starts with "Dop" and the other with "dobut".

Remember the one with a U is good for the Urine.

What do you monitor to titrate Dobutrex?

BP and urine output.

Labetalol can be titrated and is used for what

problem?

HYPERtension

What do you monitor to titrate Labetalol?

Heart rate (watch for bradycardia) and BP

Midazolam (Versed) can be titrated and is used in what situation?

To induce anesthesia and treatment of severe seizure.

What do you monitor to titrate Midazolam?

The LOC

Propofol is titrated and is used in what situation?

Used for sedation.

What do you monitor to titrate Propofol?

The BP and LOC.

What do you have to monitor for adverse effects of Propofol (Diprivan)

Triglycerides and body enzymes ...think any blood test that measures anything that ends in -ASE!!!

Nitroglycerin can be titrated and is used for what problems?

Used for CHF after an MI, and for Hypertension.