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How to titrate a Cardizem drip


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Nurses deal with tons of different procedures, problems, illnesses and symptoms at work every day. And while you learn how to handle most situations while in school, you may be rusty in certain areas that you don’t deal with often. We’re checking off one item that may be on your “what the heck is that?” list with this breakdown on how to titrate a Cardizem drip, courtesy of The Nerdy Nurse.

First, an important message: “Patients who require Cardizem are usually facing life threatening conditions like A-fib and this can be very stressful to a nurse who doesn’t typically deal with this sort of condition. Depending on your floor there may actually be policies that states that you should transfer patients to critical care or intensive care units if they require titration on a Cardizem gtt. You should make sure that you are familiar with your facilities policy on the subject of Cardizem drips before you take responsibility for this nursing skill.”

What is Cardizem used for and how does it work?

Cardizem is a medication administered for cardiac conditions. According to

A calcium channel blocker used to slow the ventricular rate of rapid atrial fibrillation and atrial flutter. Calcium contributes to the contraction of the heart and constriction of the arteries. Blocking the movement of calcium relaxes vascular smooth muscle (decreasing peripheral resistance) lowering the blood pressure and slowing conduction through the AV node which slows the heart rate which will reduce the work load of the heart.

When the patient sustains a rapid heart rate it could lead to an increased risk of myocardial damage (cardiomyopathy) and deterioration into ventricular fibrillation. The varying stroke volume (amount of blood pumped out of the ventricle with each contraction) decreases and causes the cardiac output to decrease. Patients will need intervention when the heart rate is over 100 and they are symptomatic.

Goal of therapy:

  • Rate control – can be accomplished in the field with medication
  • Maintenance of sinus rhythm – done in hospital
  • Prevention of thromboembolism – initiated in hospital with medication

Rapid atrial fibrillation is a life-threatening condition and should be handled as an emergency issue once identified.

Monitoring the patient:

“Patients with Cardizem drips are facing cardiac issues which require close surveillance and monitoring by a nurse. This often means 2 on 1 or perhaps even 1 on 1. At the very least the patient needs to be on a cardiac telemetry monitor so that a telemetry nurse can monitor their rhythm and help you stay aware of any changes they see. This is not a substitute for eyeing the patient, but is an extra safeguard and is usually required by the hospital. If it’s not required, it’s still a good idea to ask the doctor for an order for cardiac monitoring. No nurse I know can tell a patient’s heart rhythm just by looking at them. If you can, you need to contact me and tell me when you developed superpowers.”

Learn more about the process at The Nerdy Nurse and let us know your experience with the procedure in the comments!

The Nerdy Nurse
Brittney Wilson, RN, BSN, also known as The Nerdy Nurse, is a Clinical Informatics Specialist practicing in Georgia. In her day job she gets to do what she loves every day: Combine technology and healthcare to improve patient outcomes. She can best be described as a patient, nurse and technology advocate, and has a passion for using technology to innovate, improve and simplify lives, especially in healthcare. Brittney blogs about nursing issues, technology, healthcare, parenting and various lifestyle topics at

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