Ventricular arrhythmias, hypotension, nonsustained ventricular tachycardia, angina/chest pain,   sustained ventricular tachycardia, ventricular fibrillation. Headaches, hypokalemia, tremors,thrombocytopenia.

 

Hypersensitivity to the drug.

Special precautions:
Electrolytes- carefully monitor fluid and electrolyte changes and renal function. Monitor blood pressure and heart rate during therapy, and slow or stop rate of infusion if excessive decrease in blood pressure is noticed. Do not use in patients with severe obstructive arotic or pulmonary heart disease. Supraventricular and ventricular arrhythmias- closely monitor patients during
milrinone  infusion. Atrial flutter/fibrillation-  milrinone produces a slight shortening of AV node conduction time , indicatind a potential for an increased ventricular response rate in patients.

 

Approved by FDA in December 1987.

Congestive heart failure.

Dosage:
Administer a loading doseof infusion of 50mcg/kg, administer over 10 minutes.
Maintenance- minimum infusion rate- 0.375mcg/kg/min - total daily dose 0.59mg/kg
Maximum infusion rate - 0.75mcgkg/min - toatal daily dose 1.13mg/kg
Standard infusion rate- 0.5mcg/kg/min-  total daily dose 0.77mg/kg

 

Pharmacology:
Milrinone is a member of a new class of bipyridine inotropic/ vasodilator agents with
phosphodiesterase inhibitor activity. In patients with CHF milrinone produces dose-related and plasma drug concentration-related increase in the maximum rate of increase of left ventricular pressure.

Pharmacokinetics:
The steady-state plasma concentrations after about 6 to 12 hours of unchanging maintenance infusion of 0.5mcg/kg/min are about 200ng/ml.

 

Pregnancy:
Use during pregnancy only if the potential benefit justifies the potential risks to the fetus.

Lactation:
Excercise caution when milrinone is administered to nursing women.