Compatibile sol: D5W, NS, 1/2NS.
Infusions rates: 0.375 - 0.75 mcg/kg/min
Common dilution: 20 mg/100 mL
Max. conc: 400 mcg/mL
First dose: Pharmacy (RN for 9 ICU only)
Hemodynamic effects: PDE III inhibitors described as "inodilators."
Improve CO by reducing SVR and PVR. Moderate positive inotrope. Reduce myocardial oxygen demand. The also have lusitropic (relaxant) properties, and may reduce SVR significantly. May sometimes need an alpha-agent (pheylephrine or norepinephrine).
Tachycardia produced may be offset by beta-blockers.
Indications: Persistent low cardiac ouput rate despite use of one of the catecholamines (dobutamine, dopamine, or epinephrine) or when their use is limited by tachycardia, or arrhythmias.
Especially valuable in patients with RV dysfunction assoicated with elevation in PVR, such as patient with pulmonary HTN from mitral valve disease or those awaiting cardiac transplantation.
Their lusitropic properties may be of value in Pts with significant diastolic dysfunction that may contribute low CO state with preserved systolic function.
Advantages/Disadvantages: Have long elimination half-lives 2.3 hrs. Thus an intraoperative bolus during CPB may be enough without need for continuous infusion. Expensive med. Because the hemodynamic effects perisist for several hours after the drug infusion is d/ced, the patient must be observed carefully for deteriorating myocardial function for several hours as the drug effects wear off.