Milrinone
Encyclopedia
Milrinone is a phosphodiesterase 3 inhibitor. It potentiates the effect of cyclic adenosine monophosphate
(cAMP).
Milrinone also enhances contraction of the left ventricle
by increasing Ca2+-ATPase
activity on the cardiac sarcoplasmic reticulum
. This increases calcium
ion
uptake.
It has positive inotropic, vasodilating and minimal chronotropic
effects.
It is used in the management of heart failure only when conventional treatment with vasodilators and diuretic
s has proven insufficient. This is due to the potentially fatal adverse effects of milrinone, including ventricular arrhythmias.
Whereas beneficial hemodynamic
effects are shown (at least short-term), several studies have shown no or a negative effect on mortality rates of hospitalized patients receiving milrinone.
One negative side to the use of milrinone is the long half-life (1 to 2 hours). This can result in a prolonged weaning and possible adverse outcomes from stopping this medication rapidly.
Cyclic adenosine monophosphate
Cyclic adenosine monophosphate is a second messenger important in many biological processes...
(cAMP).
Milrinone also enhances contraction of the left ventricle
Left ventricle
The left ventricle is one of four chambers in the human heart. It receives oxygenated blood from the left atrium via the mitral valve, and pumps it into the aorta via the aortic valve.-Shape:...
by increasing Ca2+-ATPase
ATPase
ATPases are a class of enzymes that catalyze the decomposition of adenosine triphosphate into adenosine diphosphate and a free phosphate ion. This dephosphorylation reaction releases energy, which the enzyme harnesses to drive other chemical reactions that would not otherwise occur...
activity on the cardiac sarcoplasmic reticulum
Endoplasmic reticulum
The endoplasmic reticulum is an organelle of cells in eukaryotic organisms that forms an interconnected network of tubules, vesicles, and cisternae...
. This increases calcium
Calcium
Calcium is the chemical element with the symbol Ca and atomic number 20. It has an atomic mass of 40.078 amu. Calcium is a soft gray alkaline earth metal, and is the fifth-most-abundant element by mass in the Earth's crust...
ion
Ion
An ion is an atom or molecule in which the total number of electrons is not equal to the total number of protons, giving it a net positive or negative electrical charge. The name was given by physicist Michael Faraday for the substances that allow a current to pass between electrodes in a...
uptake.
It has positive inotropic, vasodilating and minimal chronotropic
Chronotropic
Chronotropic effects are those that change the heart rate.Chronotropic drugs may change the heart rate by affecting the nerves controlling the heart, or by changing the rhythm produced by the sinoatrial node...
effects.
It is used in the management of heart failure only when conventional treatment with vasodilators and diuretic
Diuretic
A diuretic provides a means of forced diuresis which elevates the rate of urination. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way.- Medical uses :...
s has proven insufficient. This is due to the potentially fatal adverse effects of milrinone, including ventricular arrhythmias.
Whereas beneficial hemodynamic
Hemodynamics
Hemodynamics, meaning literally "blood movement" is the study of blood flow or the circulation.All animal cells require oxygen for the conversion of carbohydrates, fats and proteins into carbon dioxide , water and energy in a process known as aerobic respiration...
effects are shown (at least short-term), several studies have shown no or a negative effect on mortality rates of hospitalized patients receiving milrinone.
One negative side to the use of milrinone is the long half-life (1 to 2 hours). This can result in a prolonged weaning and possible adverse outcomes from stopping this medication rapidly.