natrecor drips

[shannonRN]

i am hoping everyone will come to my aid again. you guys are great resources!! last night i had a patient who was to be started on a natrecor drip. i work med-surg and haven't heard of one of these drips before. i called the coordinator/supervisor and she said she didn't know much, pharmacy couldn't find the policy and procedure, and the doc thought we were perfectly capable of monitoring her on our floor but gave me the okay for transfer. we were finally able to convince the coordinator to give us an imcu bed for this patient.

so i guess my question would be, what is everyone else's policy and procedure. and any info you would be willing to share on this drug would be appreciated. :)

[jentenrn]

When using the natrecor it is a weight based protocol. Our emergency department has started to use ti more frequently and we are now able to order it from the pharmacy by simply writing "Natrecor gtt and bolus per protocol" and then the pt's weight. You give the bolus and then start the drip and there is no titration neccessary as with a nitro drip. The literature states that there should be a nearly immediate response in patients respiratory status but I have yet to see it happen inside of an hour or two and generally by that time they are in the ICU. I am unable to speak for the long term use of the product since I work in the ER. I can say that in the time it takes for the ER MD and PMD to decide to use the drug, the time it takes for pharmacy to prepare it and then to administer it, the short term effects are no different from that Lasix and nitro gtt combination.

[lsyorke, RN]

We use Natrecor ALOT!! This is on a telemetry floor with nurses carrying a normal patient load of 6 patients. It's also given in our outpatient area. There is a slide card from the manufacturer that calculates the loading dose and drip rate based on weight. The major thing to watch for is hypotension. I'll be honest, I haven't had anyone severely drop their pressure and I've hung Natrecor alot!