Milrinone

Mechanism :

Milrinone is a positive inotrope and vasodilator, with little chronotropic activity different in structure and mode of action from either the digitalis glycosides or catecholamines.

Indication :

• Congestive cardiac failure
• Cardiac surgery (post-operative, low output failure)

Contraindications :

Contraindicated in hypersensitivity to milrinone or other ingredients of the preparation, immediately following acute myocardial infarction, severe obstructive aortic or pulmonary valvular disease or hypertrophic subaortic stenosis. Careful monitoring should be maintained during milrinone injection therapy, including blood pressure, heart rate, electrocardiogram, fluid balance, electrolytes, and renal function. Supraventricular and ventricular arrhythmias have been observed in the high-risk population. Patients should be closely monitored for arrhythmias during infusion and the infusion stopped if arrhythmias develop. Use with caution in patients who are hypotensive prior to treatment.

Dosing :

Adverse Effect :

Ventricular tachycardia, arrhythmias and fibrillations, angina, hypotension, headache, hypokalemia, tremor, thrombocytopenia, bronchospasm and anaphylactic shock.

Interaction :

Beta-blockers: Combination with beta-blockers may potentiate hypotension or cardiac arrhythmias.
Calcium-Channels Antagonists: Theoretically, calcium antagonists could impair the response to milrinone, but a clinically important interaction has not been established.
Furosemide: Should not be administered in the same intravenous lines.

Hepatic Dose :