PHOSPHODIESTERASE INHIBITORS (CARDIOTONIC–INOTROPIC AGENTS)

What is Milrinone classified as?

A cardiotonic-inotropic agent and phosphodiesterase-3 (PDE3) inhibitor.

What is Milrinone primarily used for?

Short-term IV therapy for patients with acute decompensated heart failure or as bridge therapy until transplant or device placement.

How does Milrinone affect contractility?

It increases contractility through a positive inotropic effect.

What is a key mechanism of action of Milrinone?

It inhibits phosphodiesterase, leading to increased cAMP in myocardial cells and stronger contractions.

What should be monitored before administering Milrinone?

Check allergies, weight, kidney function, baseline EKG, BP, HR, and perform a CBC.

What route can Milrinone be taken as?

IV Only

What is a notable contraindication for Milrinone usage?

Allergy to milrinone or bisulfites, and severe aortic or pulmonic valvular disease.

What are some adverse effects of Milrinone?

Ventricular dysrhythmias, hypotension, chest pain/angina, supraventricular dysrhythmias, thrombocytopenia, hypokalemia, hypomagnesemia, headache.

What is a crucial nursing implication during Milrinone administration?

Monitor cardiac rhythm, BP, and I&O, and never mix in same IV line.

What med you should NOT specifically mix Milrinone with in the same IV line?

Furosemide

What dosage adjustment is necessary for patients with renal impairment?

The dosage must be reduced due to slower clearance and higher toxicity risk.

Why is Milrinone not recommended for routine short-term use?

It may increase mortality in some cases.

What patient education should be provided regarding Milrinone?

Patients should be informed that the drug is for short-term support and to report any irregular heartbeat, low BP, or dizziness.