Milrinone

General

• Type: Vasopressors
• Dosage Forms:
• Common Trade Names:

Adult Dosing

Dosing

• Normal renal function:

0.25 - 0.75 mcg/kg/min

• Creatinine clearance < 50mL/min, reduce infusion rate

Rate of Titration

• Q2H; slower titration rate if renal insufficiency

Special Populations

• Pregnancy Rating:
• Lactation:
• Renal Dosing
  • Adult
  • Pediatric
• Hepatic Dosing
  • Adult
  • Pediatric

Contraindications

• Allergy to class/drug

Adverse Reactions

• Tachyarrhythmias
• Hypotension
• Myocardial ischemia

Pharmacology

• Half-life:
• Metabolism:
• Excretion:
• Mechanism of Action:

Primary Receptor

• PDE-3 inhibitor

Relative Effects

• ↑HR
• ↑↑↑SV
• ↓SVR

Notes

• Can use as alternative to dobutamine in patients with cardiogenic shock and on b-blockers
• Causes pulmonary vasodilation, may be good choice in patients with RV failure
• ↑cAMP in cardiac myocytes and vascular smooth muscle, thereby ↑HR and ↑SV while decreasing ↓SVR
• Use with caution in patient with renal failure and hypovolemia

Indication

low cardiac output states due to impaired myocardial contractility

References

Authors

Ross Donaldson, Daniel Ostermayer, Neil Young