Neurosurgery notes/Pharmacology/Vasodilators/Phosphodiesterase inhibitor

Phosphodiesterase inhibitor

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Vasodilators
  • Milrinone
    • Phosphodiesterase Inhibition → prevents removal (hydrolysis of) cGMP in the smooth musculature → vasodilation in both arteries and veins
      • Phosphodiesterase is an enzyme that hydrolyzes the second messenger cyclic adenosine monophosphate(cAMP) and guanosine monophosphate(cGMP), terminating their effects
      • Vasodilatory effects of milrinone are more potent than beta-2 agonists, including dobutamine and isoproterenol.
    • Indication
      • Intraarterial followed by systemic milrinone for 14 days demonstrated a significant enlargement in diameter of vasospastic intracranial arteries. The systemic dose started at 50 μg/kg/min and was titrated to 1.5 μg/kg/min.
    • Pharmacokinetics
      • Plasma half-life: 2 to 2.5 hours.
      • Metabolism: liver
      • Excretion: urine