![]() ![]() Titrate according to hemodynamic and clinical response. Rate: Based on patient's weight (see Route/Dosage section).Do not use solutions that are discolored or contain particulate matter. Stability of premixed infusions based on manufacturer's expiration date. Admixed solutions are stable for 72 hr at room temperature. Premixed infusions are already diluted and ready to use. Compatible diluents include 0.45% NaCl, 0.9% NaCl, and D5W. Dilute 10 mg (10 mL) of milrinone in 40 mL of diluent or 20 mg (20 mL) of milrinone in 80 mL of diluent. Continuous Infusion: Dilution: Milrinone drawn from vials must be diluted.Rate: Administer the loading dose over 10 min.May also be diluted in 0.9% NaCl, 0.45% NaCl, or D5W for ease of administration. IV Push: Dilution: Loading dose may be administered undiluted.+ + + Action + + Increases myocardial contractility. Dose should be decreased or discontinued. Pharmacologic: phosphodiesterase-3 inhibitors + + + Indications + + Short-term treatment of CHF unresponsive to conventional therapy with digoxin, diuretics, and vasodilators. High Alert: Overdose manifests as hypotension. Correct hypokalemia prior to administration to decrease the risk of arrhythmias. Monitor electrolytes and renal function frequently during administration. ![]() The risk of ventricular arrhythmias is increased in patients with a history of arrhythmias, electrolyte abnormalities, abnormal digoxin levels, or insertion of vascular catheters. Arrhythmias are common and may be life threatening. Monitor ECG continuously during infusion.Correct effects of previous aggressive diuretic therapy to allow for optimal filling pressure. Assess patient for resolution of signs and symptoms of HF (peripheral edema, dyspnea, rales/crackles, weight gain) and improvement in hemodynamic parameters (increase in cardiac output and cardiac index, decrease in pulmonary capillary wedge pressure). Monitor intake and output and daily weight. More recently, intravenous (IV) milrinone has shown promise as long-term therapy for CHF on an outpatient basis.Note: PRIMACOR Flexible Containers (200 mcg/mL in 5 Dextrose Injection) are for intravenous infusion only and should not. 50 mcg/kg: Administer slowly over 10 minutes. Slow or discontinue if BP drops excessively. Milrinone inodilator effective in patient receiving beta blockers or with down regulation of cardiac adrenoreceptors (chronic cardiac failure) less. PRIMACOR (milrinone lactate) should be administered with a loading dose followed by a continuous infusion (maintenance dose) according to the following guidelines: LOADING DOSE. By inhibiting Type III phosphodiesterase, milrinone increases intracellular cyclic adenosine monophosphate. Milrinone may also be used for purposes not listed in this medication guide. Milrinone (Inocor-Sanofi-Winthrop) represents a second generation phosphodiesterase inhibitor currently approved for intravenous administration in the treatment of decompensated congestive heart failure. Monitor heart rate and BP continuously during administration. Milrinone is a vasodilator that is used as a short-term treatment for life-threatening heart failure. ![]()
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