Phosphodiesterase Inhibitors

Question 1

Phosphodiesterase Inhibitors

Classification

Answer 1

Second class of drugs that act as cardiotonic (inotropic) agents

Question 2

Phosphodiesterase Inhibitors

Types

Answer 2

Inamrinone

Milrinone

Question 3

Inamrinone

Answer 3

Approved only for use in patients with HF that has not responded to digoxin, diuretics, or vasodilators

Question 4

Milrinone

Answer 4

Shot-term management of HF in patients who are receiving digoxin and diuretics

Question 5

Indications

Answer 5

Short-term treatment of HF in patients unresponsive to digitalis, diuretics, or vasodilators

Question 6

Mechanism of Action

Answer 6

Blocks the enzyme phosphodiesterase, leads to an increase in myocardial cell cyclic adenosine monophosphate (cAMP), which increases calcium levels in the cell, causing a stronger contraction and prolonged response to sympathetic stimulation; directly relaxes vascular smooth muscle

Question 7

Contraindications

Answer 7

Allergy

Severe aortic or pulmonic disease, MI, fluid volume deficit, and ventricular arrhythmias

Question 8

Adverse Effects

Answer 8

Arrhythmias
Hypotension
Nausea, vomiting
Thrombocytopenia
Pericarditis
Pleuritis
Fever
Chest pain
Burning at injection site

Question 9

Drug-Drug Interaction

Answer 9

Furosemide

Question 10

Assessment

Answer 10

HX & Physical exam: known allergies, acute aortic or pulmonic valvular disease, acute MI or fluid volume deficit, and ventricular arrhythmias; pregnancy/lactation; cardiac status and heart sounds; lab results