PMID- 23620310
OWN - NLM
STAT- MEDLINE
DCOM- 20140424
LR  - 20140303
IS  - 1940-1574 (Electronic)
IS  - 0003-3197 (Linking)
VI  - 65
IP  - 4
DP  - 2014 Apr
TI  - Milrinone in advanced heart failure: dose and therapeutic monitor outside 
      intensive care unit.
PG  - 343-9
LID - 10.1177/0003319713485808 [doi]
AB  - Advanced chronic heart failure (ACHF) patients often require inotropes before 
      transplantation or ventricular assist device implantation. Milrinone, an inotrope 
      and vasodilator, may accumulate in cardiorenal syndrome with serious adverse 
      effects. We investigated the potential for therapeutic drug monitoring of 
      milrinone levels using High Performance Liquid Chromatography Mass Spectrometry 
      (HPLC-MS). 22 ACHF patients (15 males, 49+/-9 years) received milrinone 50 microg/kg 
      intravenously (i.v.) during heart catheterization. Milrinone levels were 216+/-71 
      ng/ml (within the reported therapeutic range: 100-300 ng/ml), followed by 
      improvements in cardiac index, pulmonary artery and wedge pressures (p < 0.005). 
      18 ACHF patients (17 males, 50+/-12 years, 13 had renal dysfunction) received 
      continuous i.v. milrinone (5-26 days) at 0.1-0.2 microg/kg/min, titrated according to 
      plasma milrinone levels. No adverse events occurred. Therapeutic levels were 
      achieved with doses of 0.2+/-0.06 microg/Kg/min, below those recommended in Summary of 
      Product Characteristics. Milrinone therapy can be noninvasively monitored by 
      HPLC-MS, while avoiding toxicity in ACHF.
FAU - Charisopoulou, Dafni
AU  - Charisopoulou D
AD  - 1Royal Brompton and Harefield NHS Trust, UK.
FAU - Leaver, Neil
AU  - Leaver N
FAU - Banner, Nicholas R
AU  - Banner NR
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130425
PL  - United States
TA  - Angiology
JT  - Angiology
JID - 0203706
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Vasodilator Agents)
RN  - JU9YAX04C7 (Milrinone)
SB  - IM
MH  - Adult
MH  - Cardiac Catheterization
MH  - Cardiotonic Agents/*administration & dosage/adverse effects/blood
MH  - *Chromatography, High Pressure Liquid
MH  - Chronic Disease
MH  - Drug Dosage Calculations
MH  - Drug Monitoring/*methods
MH  - Female
MH  - Heart Failure/diagnosis/*drug therapy/physiopathology
MH  - Hemodynamics/drug effects
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - *Mass Spectrometry
MH  - Middle Aged
MH  - Milrinone/*administration & dosage/adverse effects/blood
MH  - Treatment Outcome
MH  - Vasodilator Agents/*administration & dosage/adverse effects/blood
OTO - NOTNLM
OT  - advanced chronic heart failure
OT  - high-performance liquid chromatography mass spectrometry
OT  - inotropes
OT  - milrinone
OT  - renal failure
EDAT- 2013/04/27 06:00
MHDA- 2014/04/25 06:00
CRDT- 2013/04/27 06:00
PHST- 2013/04/27 06:00 [entrez]
PHST- 2013/04/27 06:00 [pubmed]
PHST- 2014/04/25 06:00 [medline]
AID - 0003319713485808 [pii]
AID - 10.1177/0003319713485808 [doi]
PST - ppublish
SO  - Angiology. 2014 Apr;65(4):343-9. doi: 10.1177/0003319713485808. Epub 2013 Apr 25.