Mechanism of action
Inhibitor of cAMP phosphodiesterase III isoenzyme -> decrease the hydrolysis of cAMP
Increase of cAMP leads to:
-> increase in adenyl cyclase
-> increase protein kinases
-> increased phosphorylation of proteins -
> net influx of Ca2+ into muscle
Milrinone effect = ‘inodilator’ -> inotropy -> vascular and bronchial muscle relaxation inotropy + decreased SVR -> increased SV
Milrinone might be used in patients on b-blockers and with b-adrenoceptor downregulation (as occurs in chronic CHF)
Milrinone lowers pulmonary vascular resistance (PVR).
Milrinone is not recommenden in patients with myocardial infarction => increases mortality.
Indications and dose
Side-effects
Hypotension
Arrhythmias (less than dobutamine)
Headache
Pharmacokinetics
Onset: 5-15 minutes
Metabolism: Hepatic
Half-life of elimination: 2.5 hours
Excretion: Urine
Directions for administration
For intravenous infusion dilute in 500 ml of 5% glucose or 0.9% sodium chloride.
Medicinal forms
1 vial = 10 mg in 10 ml
References
