Milrinone - PDE-3 Inhibitor

Question 1

What is the loading dose of Milrinone?

A) 10-20 mcg/kg over 5 minutes
B) 25-50 mcg/kg over 10 minutes
C) 50-75 mcg/kg over 15 minutes
D) 0.25-0.75 mcg/kg/min over 10 minutes

Answer 1

B) 25-50 mcg/kg over 10 minutes

Question 2

What is the recommended continuous infusion rate for Milrinone?

A) 0.1-0.5 mcg/kg/min
B) 0.25-0.75 mcg/kg/min
C) 1-2 mcg/kg/min
D) 5 mcg/kg/min

Answer 2

B) 0.25-0.75 mcg/kg/min

Question 3

What are the concentrations available for Milrinone infusion preparations?

Select 2:

A) 20 mg in 100 mL (200 mcg/mL)
B) 10 mg in 50 mL (200 mcg/mL)
C) 50 mg in 250 mL (200 mcg/mL)
D) 40 mg in 200 mL (200 mcg/mL)

Answer 3

A) 20 mg in 100 mL (200 mcg/mL)

C) 50 mg in 250 mL (200 mcg/mL)

Question 4

Which of the following are correct about the pharmacokinetics of Milrinone?

Select all that apply:

A) Onset of action is 1-2 minutes
B) Peak effect occurs in 10 minutes
C) Duration of action is 8 hours
D) Half-life is approximately 2.5 hours

Answer 4

A) Onset of action is 1-2 minutes
B) Peak effect occurs in 10 minutes
C) Duration of action is 8 hours
D) Half-life is approximately 2.5 hours

Question 5

What is the mechanism of action (MOA) of Milrinone?

Select 3:

A) Inhibits phosphodiesterase-3 (PDE-3)
B) Acts as an inodilator, increasing cardiac output (CO)
C) Causes vasoconstriction in pulmonary vessels
D) Relaxes peripheral and pulmonary smooth muscle

Answer 5

A) Inhibits phosphodiesterase-3 (PDE-3)

B) Acts as an inodilator, increasing cardiac output (CO)

D) Relaxes peripheral and pulmonary smooth muscle

Question 6

In which clinical situations is Milrinone particularly useful?

Select 3:

A) Low cardiac output (CO)
B) Right ventricular (RV) dysfunction
C) Pulmonary hypertension (HTN)
D) Severe hypotension due to hypovolemia

Answer 6

A) Low cardiac output (CO)
B) Right ventricular (RV) dysfunction
C) Pulmonary hypertension (HTN)

Question 7

What is a recommended loading dose of Milrinone for increased pulmonary artery (PA) pressures?

A) 10 mcg/kg
B) 25 mcg/kg
C) 50 mcg/kg
D) 100 mcg/kg

Answer 7

C) 50 mcg/kg

Question 8

In which situations is Milrinone preferred over Dobutamine?

Select 3:

A) High filling pressures are present
B) Continued beta-blockade is required
C) The patient has decreased responsiveness to catecholamines
D) The patient has high blood pressure (BP) and requires vasoconstriction

Answer 8

A) High filling pressures are present
B) Continued beta-blockade is required
C) The patient has decreased responsiveness to catecholamines

Question 9

Which of the following are potential effects of rapid administration of Milrinone?

Select all that apply:

A) Increased systemic vascular resistance (SVR)
B) Decreased systemic vascular resistance (SVR)
C) Decreased venous return
D) Hypotension

Answer 9

B) Decreased systemic vascular resistance (SVR)
C) Decreased venous return
D) Hypotension

Rapid admin may ↓SVR & venous return ⇒ hypotension

Question 10

What beneficial effect does Milrinone have in the acute phase after cardiopulmonary bypass (CPB)?

A) Attenuates systemic inflammation
B) Increases heart rate to improve cardiac output
C) Enhances vasoconstriction to prevent hypotension
D) Provides anti-inflammatory effects

Answer 10

A) Attenuates systemic inflammation