A 48-year-old man on ICU following cardiac surgery develops a low cardiac output state. He is started on IV milrinone. After 30 minutes, his blood pre...

Question

A 48-year-old man on ICU following cardiac surgery develops a low cardiac output state. He is started on IV milrinone. After 30 minutes, his blood pressure drops from 85/55 to 65/35 despite an improvement in cardiac output from 3.0 to 4.5 L/min. What is the mechanism of the hypotension?

Accepted Answer

Milrinone inhibits phosphodiesterase-3 (PDE3) in vascular smooth muscle, causing vasodilation and reduced SVR - the 'inodilator' effect

Answer

Milrinone-induced myocardial depression

Answer

Anaphylaxis to milrinone

Answer

Milrinone-induced arrhythmia causing hypotension

Answer

Volume depletion from milrinone-induced diuresis

uk-fficm MCQ (SBA): Milrinone Pharmacology

A 48-year-old man on ICU following cardiac surgery develops a low cardiac output state. He is started on IV milrinone. After 30 minutes, his blood pressure drops from 85/55 to 65/35 despite an improvement in cardiac output from 3.0 to 4.5 L/min. What is the mechanism of the hypotension?