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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.
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]
Amrinone, milrinone and enoximone are used clinically for short-term treatment of cardiac failure in the presence of cardiogenic shock. [1]PDE3 inhibitors are indicated as inotropics for the therapy of acute heart failure if catecholamines are ineffective. [2]
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]
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]
Amrinone, also known as inamrinone, and sold as Inocor, is a pyridine phosphodiesterase 3 inhibitor. [1] It is a drug that may improve the prognosis in patients with congestive heart failure. [2] Amrinone has been shown to increase the contractions initiated in the heart by high-gain calcium induced calcium release (CICR). [3]
Certain medications, such as dobutamine or milrinone, enhance the heart's pumping function and are often used first-line to improve the low blood pressure and delivery of blood to the rest of the body. [4] Patients who have cardiogenic shock unresponsive to medication therapy may be candidates for more advanced options such as a mechanical ...
The 3,4′-bipyridine derivatives inamrinone and milrinone are used occasionally for short term treatment of congestive heart failure. They inhibit phosphodiesterase and thus increasing cAMP, exerting positive inotropy and causing vasodilation. Inamrinone causes thrombocytopenia. Milrinone decreases survival in heart failure.
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