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Milrinone, sold under the brand name Primacor, is a pulmonary vasodilator [2] used in patients who have heart failure. It is a phosphodiesterase 3 inhibitor that works to increase the heart's contractility and decrease pulmonary vascular resistance.
Milrinone, one of the first PDE3 inhibitors used clinically. A PDE3 inhibitor is a drug which inhibits the action of the phosphodiesterase enzyme PDE3. They are used for the therapy of acute heart failure and cardiogenic shock.
Specifically, in patients experiencing inadequate blood perfusion (with blood pressure below 80 mmHg), the American Heart Association / American College of Cardiology (ACC/AHA), recommends the use of Dobutamine and Milrinone. [75] Whereas in clinically stable patients with sufficient perfusion, cardiac inotrope use is advised against. [76]
The following are medications commonly prescribed cardiac pharmaceutical agents. The specificity of the following medications is highly variable, and often are not particularly specific to a given class. As such, they are listed as are commonly accepted.
Molecules that inhibit PDE3 were originally investigated for the treatment of heart failure, but, because of unwanted arrhythmic side-effects, they are not studied for that indication any longer. Nonetheless, the PDE3 inhibitor milrinone is approved for use in heart failure in intravenous form.
Early studies in patients with heart failure showed that amrinone produced short-term hemodynamic improvement, but had limited long-term clinical benefit. [7] Some serious side effects of long term administration included sustained ventricular tachycardia resulting in circulatory collapse, worsening myocardial ischemia, acute myocardial ...
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