Posted on: June 24th, 2020
Titration = adjustment of drug until the desired clinical effect is achieved.
Some drugs we administer to effect: i.e. Oxygen for target Sp02, IV Naloxone for target RR, Dopamine for target SBP. An initial starting dose is administered and further dosing altered based upon response.
However, some medications are “titrated” with repeated set dosages. For example, under the Hypoglycemia Medical Directive, D10W is given 0.2g/kg (2mL/kg), every 10minutes (to a maximum of 2 dosages), to correct symptomatic hypoglycemia. The dose given each time (2mL/kg) is not altered and the entire dosage should be completed in its entirety, not stopped early (i.e. after 1mL/kg) if the patient regains normal LOA. This is to ensure adequate glucose replacement to overcome the threshold of hypoglycemia which varies from patient to patient.