Chong Luke Yong Zheng, Satya Kumar, Kim Bernard, Berkowitz Robert
Cardiol Rev. 2018 Jan/Feb;26(1):35-42. doi: 10.1097/CRD.0000000000000165.
Milrinone is an invaluable agent in the treatment of end-stage heart failure patients who are refractory to optimal medical therapy. In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. Concerns about its adverse effects, such as an increased risk of arrhythmias and hypotension, often limit the doses of milrinone used in clinical practice. In addition, milrinone is infrequently used or avoided entirely in patients with acute renal failure or end-stage renal disease because the drug is primarily cleared by renal excretion. Despite these concerns, studies that comprehensively reconcile the dose-response relationship and adverse events are scarce, and no clear provisions exist to guide milrinone dosing. After a brief discussion of the pharmacokinetics of milrinone, this article examines milrinone dosing, observed hemodynamic benefits, and documented adverse events across different studies.
米力农是治疗对最佳药物治疗无效的终末期心力衰竭患者的一种宝贵药物。除了用于急性失代偿性心力衰竭外，米力农还可作为家庭输注疗法或心脏移植的过渡治疗。对其不良反应的担忧，如心律失常和低血压风险增加，常常限制了临床实践中米力农的使用剂量。此外，急性肾衰竭或终末期肾病患者很少使用米力农或完全避免使用，因为该药物主要通过肾脏排泄清除。尽管存在这些担忧，但全面协调剂量反应关系和不良事件的研究很少，而且没有明确的规定来指导米力农的给药。在简要讨论米力农的药代动力学后，本文研究了不同研究中的米力农给药、观察到的血流动力学益处以及记录的不良事件。
