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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.
It is important to note that certain medications, such as Milrinone and Digoxin, possess overlapping classifications due to their ability to engage multiple mechanisms of action. Their inotropic properties make cardiactonic agents critical in addressing inadequate perfusion , and acute heart failure conditions including cardiogenic shock , as ...
Nonetheless, the PDE3 inhibitor milrinone is approved for use in heart failure in intravenous form. [1] Both PDE3A and PDE3B are expressed in vascular smooth muscle cells and are likely to modulate contraction. Their expression in vascular smooth muscle is altered under specific conditions such as elevated cAMP and hypoxia. [1]
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 .
Phosphodiesterase-5. A phosphodiesterase inhibitor is a drug that blocks one or more of the five subtypes of the enzyme phosphodiesterase (PDE), thereby preventing the inactivation of the intracellular second messengers, cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) by the respective PDE subtype(s).
Amrinone decreases the pulmonary capillary wedge pressure while increasing cardiac output, as it functions as an arterial vasodilator and increases venous capacitance while decreasing venous return. [5] There is a net decrease in myocardial wall tension, and O 2 consumption when using amrinone.
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Medications used include: diuretic agents, vasodilator agents, positive inotropes, ACE inhibitors, beta blockers, and aldosterone antagonists (e.g., spironolactone). Some medications which increase heart function, such as the positive inotrope milrinone, lead to increased death, and are contraindicated. [9] [10]