IV Drip Therapy – Medications Used for Drips

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Chance Reaves
MSN-Ed,RN
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Outline

Overview

Medications that are given as a drip have the following considerations:

  1. How urgently the patient needs the medication.
  2. How safe is the drug given through other methods.
  3. How the body handles the drug.

Nursing Points

General

  1. What is a drip?
    1. Medication that is given slowly over time, or
    2. Is titrated depending on a patient’s need for the medication
  2. Why is a drip chosen over other routes or methods?
    1. Consider the patient’s condition
    2. Consider the safety of the drug
    3. Consider the pharmacokinetics vs pharmacodynamics
      1. Pharmacodynamics – what the drug does to the body
      2. Pharamcokinetics – what the body does to the drug
        1. Absorption
        2. Distribution
        3. Metabolism
        4. Excretion
  3. Consider safety first
    1. Certain drugs must always be given over slow infusion or drip
      1. Electrolyte replacement
        1. Potassium
          1. IV push of this drug can result in harm to the patient
          2. This medication has to be given slowly
        2. Magnesium
      2. Drugs used to manage blood pressure
        1. Hypotension
          1. Careful titration for a goal range
          2. Includes epinephrine, neosynephrine and vasopressin
        2. Hypertension
          1. Careful titration for a goal range
          2. Includes nicardipine
      3. Drugs for sedation
        1. Propofol
        2. Dexmedetomidine
  4. Drip considerations
    1. How soon does the patient need the drug
      1. Always prioritize safety (i.e. Potassium)
    2. How safe is the drug given through other routes
      1. Ex: Potassium may be given orally, but it may not be optimal for the patient (i.e. no oral access)
  5. Safety
    1. Do safety checks
      1. Double check medication admin record
      2. Safety checks on pumps
      3. Use the correct lines
        1. Discard & change per facility policy

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Transcript

In this lesson I’m going to talk to you guys about drips in general are not going to talk about the specifics of which ones need what, but I want to cover some general overviews when you’re talking about drips and the IV patient. So anytime we’re doing drips, we need to think about three things. Number one, how urgently does a patient need the medication? Do they need it right this second? And if we don’t, what happens? The other thing we need to think about is how the medications react to the body. And we also need to think about are there any other methods that this patient could potentially get this medication? So what does a drip, when we’re talking about IV infusions, this isn’t something that’s going to be just given intermittently. You give it over a couple of hours and then sober. This is a medication that it has to be titrated based on parameters.

Maybe these are heparin parameters. Maybe these are blood pressure parameters carbapine is an example of one that you have to titrate when you want to do it, to bring down pressures and just the opposite. You can use things like Vaso Lizo or Neo to help bring pressure up. So why would we consider a drip over other things? Well, first off, we need to look at patient safety. If your patient has really high blood pressure, we need to make sure that we’re getting that addressed because we don’t want our patients having a stroke. And the way we do this as if they’re not responding to things like oral medications. If they’re not responding to even IV push medications like hydralazine or Metoprolol and they need a medication that’s going to bring their pressure down and they need to continuously get it, that’s the indication for the drip.

The other thing that you want to think about with drips is how safe the drug is and you also want to consider pharmacodynamics and pharmacokinetics. Remember, pharmacodynamics is what the drug does to the body and pharmacokinetics are what the body does to the drug and it’s based on this acronym. ADME absorption, distripution, metabolism and excretion and our pharmacology course, we go over this and Pharmco kinetics. Anytime you give a drip, always consider safety first. So let’s think about a couple of trips that you would give. The first one, maybe potassium, potassium can’t be given IV push. It’s dangerous. You can give it orally. But the thing is sometimes absorption is just not as fast, especially if your patients are starting to become a critical or a high acuity, a status. So what you want to do is you know that you have to get potassium and you know you have to get uh, give it over time.

It’s not necessarily something that needs to be titrated, but it is something that needs to be given slow over time. The next thing we want to understand is that there are drugs used in titration and in dribs to help control blood pressure. These are situations like hypertension and hypotension. Again, these drugs are titrated to a specific range, hypertension, drugs, you want to use things like a nicardipine to help bring that blood pressure down. And for patients that have hypotension as a result maybe of sepsis, what you want to use are things like Neo or epinephrin. These drugs are going to help cause vasoconstriction drive that blood pressure up. When you’re considering a drip, there are two things you need to consider, how soon they need it and how safe is it? Is there another option for Tassian as an example? Giving that drug over a short period at high volumes and high dosages can cause a lot of problems and even patient death and we don’t want that.

What we want to do is make sure that we’re being safe. The other thing is how soon do they need it, so if a patient is having really high blood pressures or really low blood pressures, they’re going to need that drip sooner rather than later. The last thing we want to consider is safety. We want to think about safety from things that we can do. So there are a couple of things that you need to look at. First one is medication administration. Record the Mar. You want to make sure that your concentration is right. You want to make sure that everything about that drug is right. You want to make sure that it’s appropriate. You want to follow all of those six patient rights, including the extra two, which has the right to refuse and is it right for the patient? That last one being is it right for the patient is really, really critical.

The great thing about new pumps is that they have safety features built in, so that makes sure that that drug is right in the doses, right, and that they’re getting it on based on the right dosage and everything matches up. These things are built in safety features to help medication errors from occurring. The last safety thing that we need to consider is the line safety. Not all of the drugs are compatible with specific lines. You need to make sure that if it’s going through an infusion pump, that you’re using the right line. Does it need a filter on it? Have they been changed frequently enough? We don’t want our patients getting infections because the lines aren’t being changed. So follow hospital policy and best practice. I hope that these tips have been helpful. Now go out and be your best selves today and as always, happy nursing.

 

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Pharm

Concepts Covered:

  • Test Taking Strategies
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  • Microbiology
  • Anxiety Disorders
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  • Nervous System
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  • Central Nervous System Disorders – Brain
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  • Dosage Calculations
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  • Concepts of Pharmacology
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  • Learning Pharmacology
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  • Prenatal Concepts
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  • Emergency Care of the Cardiac Patient
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Study Plan Lessons

12 Points to Answering Pharmacology Questions
6 Rights of Medication Administration
Anti-Infective – Antifungals
Antianxiety Meds
Antidepressants
Atenolol (Tenormin) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Barbiturates
Basics of Calculations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Catheter Selection (gauge, color)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin
Injectable Medications
IM Injections
Hydromorphone (Dilaudid) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
IV Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Benztropine (Cogentin) Nursing Considerations
Bariatric: IV Insertion
Anti-Platelet Aggregate
Anesthetic Agents
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
ACLS (Advanced cardiac life support) Drugs