Milrinone Lactate
| (MILL-rih-nohn LAK-tate) |
| Primacor |
| Class: Cardiovascular |
Action Has direct arterial vasodilator activity and positive inotropic effect; ncreases myocardial contractility.
Indications Short-term treatment of CHF.
Contraindications Standard considerations.
Route/DosageADULTS: IV Loading dose: 50 mcg/kg over 10 min; adjust infusion rate according to hemodynamic and clinical response.
Interactions None well documented. INCOMPATIBILITIES: Precipitate forms if furosemide is injected into same IV line as milrinone; do not administer both in same IV line.
Lab Test Interferences None well documented.
Adverse ReactionsCV: Ventricular arrhythmia (eg, ventricular ectopic activity, nonsustained ventricular tachycardia, sustained ventricular tachycardia, ventricular fibrillation); supraventricular arrhythmia; hypotension; angina. CNS: Headaches; tremor. Thrombocytopenia. OTHER: Hypokalemia.
PrecautionsPregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Cardiovascular effects: Do not use in patients with severe obstructive aortic or pulmonic valvular disease; may exacerbate hypertrophic subaortic stenosis; may cause supraventricular and ventricular arrhythmias; may shorten atrioventricular node conduction. Renal impairment: Use drug with caution; monitor renal function. Dosage reduction, based on creatinine clearance, may be needed.
| PATIENT CARE CONSIDERATIONS |
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Administration/Storage- For short-term (up to 5 days) IV use only.
- Prepare drug for IV infusion by diluting with 0.45% or 0.9% Sodium Chloride Injection D5W.
- Use infusion pump for administration.
- Adjust maintenance infusion rate on the basis of hemodynamic and clinical response (maximum rate is 0.75 mcg/kg/min or 1.13 mg/kg/day).
- Store at room temperature and protect from light.
Assessment/Interventions- Obtain patient history, including drug history and any known allergies.
- Evaluate renal function and identify whether patient has severe obstructive aortic or pulmonic valvular disease.
- Provide close cardiac and BP monitoring.
- Be especially observant for supraventricular and ventricular arrhythmias and excessive decreases in BP and report to physician.
- Carefully monitor fluid and electrolyte changes as well as renal function during therapy.
- Observe IV site for signs of irritation. Rotate injection site every 48 hr.
- Correct hypokalemia by potassium supplementation prior to and during use of drug.
- Observe for other common side effects (headaches, hypokalemia, tremor and thrombocytopenia) and report to physician.
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Patient/Family Education- Explain what medication does.
- Inform patient that treatment with this drug usually does not exceed 5 days.
- Instruct patient to report these symptoms to physician: headache or tremors.
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