View source for Milrinone

{{drugbox
| verifiedrevid = 309089678
| IUPAC_name = 2-methyl-6-oxo-1,6-dihydro-3,4'-bipyridine-5-carbonitrile
| image = Milrinone.svg
| CASNo_Ref = {{cascite}}
| CAS_number = 78415-72-2
| ATC_prefix = C01
| ATC_suffix = CE02
| ATC_supplemental = 
| PubChem = 4197
| DrugBank = APRD00010
| smiles = N#CC1=CC(=C(C)NC1=O)c2ccncc2
| C = 12 | H = 9 | N = 3 | O = 1
| molecular_weight = 211.219 g/mol
| bioavailability = 100% (as IV bolus, infusion)
| protein_bound = 70 to 80%
| metabolism = Hepatic (12%)
| elimination_half-life = 2.3 hours (mean, in CHF)
| excretion = Urine (85% as unchanged drug) within 24 hours
| pregnancy_US = C
| legal_status = Rx-only
| routes_of_administration = IV only
}}
'''Milrinone''' (Primacor) is a [[phosphodiesterase 3 inhibitor]]. It potentiates the effect of [[cyclic adenosine monophosphate]] (cAMP).

Milrinone also enhances relaxation of the [[left ventricle]] by increasing Ca<sup>2+</sup>-[[ATPase]] activity on the cardiac sarcoplasmic [[endoplasmic reticulum|reticulum]]. This increases [[calcium]] [[ion]] uptake.

It has positive [[inotropic]], [[vasodilator|vasodilating]] and minimal [[chronotropic]] effects. 
It is used in the management of [[heart failure]] only when conventional treatment with [[vasodilator]]s and [[diuretic]]s has proven insufficient. This is due to the potentially fatal adverse effects of milrinone, including [[arrhythmia|ventricular arrhythmias]].

Whereas beneficial [[hemodynamics|hemodynamic]] effects are shown (at least short-term), several studies have shown no or a negative effect on mortality rates of hospitalized patients receiving milrinone.

One negative side to the use of milrinone is the short half-life (1 to 2 hours).  This can result in a prolonged weaning and possible adverse outcomes from stopping this medication rapidly.  
==Synthesis==
[[File:Milrinone.png|500px]]

Singh, B.; 1983, {{US patent|4,413,127}}.

==External links==
* [http://ajpheart.physiology.org/cgi/content/full/279/4/H1898 Mechanism of action]

{{Phosphodiesterase inhibitors}}
{{Cardiac stimulants excluding cardiac glycosides}}

[[Category:Inotropic agents]]
[[Category:Vasodilators]]
[[Category:Nitriles]]
[[Category:Pyridines]]
[[Category:PDE3 inhibitors]]
[[Category:2-Pyridones]]


{{cardiovascular-drug-stub}}

[[es:Milrinona]]
[[fa:میلرینون]]
[[uk:Мілринон]]
[[Category:2Fix]]