Milrinone
From IDWiki
Classification
- Bipyridine phosphodiesterase III inhibitor that causes inotropy and peripheral vasodilation
Indication
- Heart failure and cardiogenic shock, generally indicated by renal failure despite aggressive diuresis
- Especially useful in right heart failure or biventricular failure, as it dilates the pulmonary veins.
Starting
- Bolus: 50 mcg/kg bolus over 10 to 30 min
- Infusion: 0.375 to 0.75 mcg/kg/min (dose adjustment necessary for renal impairment)
Stopping
- Titrate off by first replacing with hydralazine/ramipril and digoxin, which replace it's two main effects
Half-life
- 2-4 hours
Adverse effects
- Hypotension
- Ventricular arrhythmias
