Titrate
Formal Definition
To adjust the dose of a medication incrementally based on patient response or a target parameter — achieved by progressively increasing or decreasing the dose until the desired clinical effect is reached.
How It's Used on the Ward
"Titrate the drip" or "titrate to effect" — nurses and residents adjust infusion rates in real time based on vital signs or symptom response.
Example
""Vasopressin running at 0.03 units/min: titrate norepinephrine to MAP >65. If MAP not achieved by 0.5 mcg/kg/min norepi, notify me — next step is vasopressin uptitration.""
Clinical Context
Titration orders require a clear target parameter and a clear range. "Titrate morphine for pain" is too vague — "titrate morphine 1–4mg IV q1h PRN for pain >7/10, notify if >10mg in 4h" is actionable. Titratable drips (vasopressors, insulin, heparin, sedation) require intensive monitoring — understand the pharmacokinetics. The most common ICU drips are titratable: never start one without knowing the target.