milrinone home infusion therapy patient information

In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. The home care nurse plays a major role in the outcome of a patient with AHF. endstream endobj 555 0 obj <>/Metadata 42 0 R/OCProperties<>/OCGs[564 0 R]>>/Outlines 58 0 R/PageLayout/SinglePage/Pages 550 0 R/StructTreeRoot 83 0 R/Type/Catalog>> endobj 556 0 obj <>/Font<>/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 557 0 obj <>stream 0000013119 00000 n Highly skilled home nursing care is required in the treatment of patients. %PDF-1.6 %���� Your physician has ordered you to receive IV dobutamine (doe-beut-amine) in your home. 0 Coram Patient Resource Guide 3 Your Home Infusion Therapy Support Coram provides the medication, equipment and supplies your doctor has prescribed for you. Increases quality of life by decreasing signs and symptoms. Home inotropic therapy is not covered when: 1. 0000004935 00000 n This study was approved by the Children’s Hospital and Clinics of Minnesota institutional review board. inotropic therapy in managing patients with refractory congestive heart failure (CHF) is reviewed. Physician Prescribing Information; MILRINONE LACTATE, Flexible Plastic Container U.S. Patients were followed until a common closing date of August 1, 2008. endstream endobj startxref As the lactate salt, it is stable and colorless to pale yellow in solution. A. 0000003805 00000 n 0000001627 00000 n 0000027944 00000 n 0 Increase in mortality. with little chronotropic activity different in structure and mode of action from Admixed solutions are stable for 72 hr at room temperature. Home inotropic therapy was found to be safe in pediatric patients who were awaiting a heart transplant. In a home setting, milrinone is often given for longer periods of time as a palliative measure to help control the symptoms of end-stage heart failure. What is this drug used for? 1998 May 1;55(9):930-5; quiz 953-4. (milrinone lactate) This product information is intended only for residents of the United States. %%EOF 3. The patient is noncompliant with treatment and follow-up with the prescribing physician. 0000021532 00000 n 0000023272 00000 n They will work Home infusion therapy (HIT) is usually prescribed by your physician when a patient’s condition cannot be treated effectively with oral medications. 3. Our skilled nurses work to provide continues infusion care, educate, train, and monitor in their home. Am J Health Syst Pharm. 0000002635 00000 n Twelve patients received continuous milrinone therapy as outpatients between 2008 and 2015 inclu-sive. 2. hޜUmO�0�+�4��_"!���iDʘ��`��F�I�������������}�����'JK���m�h`F�5�M�ւ� Use of intravenous inotropic therapy in the home. Premixed infusions are already diluted and ready to use. PATIENT & CAREGIVER EDUCATION Milrinone This information from Lexicomp explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider. 0000013277 00000 n 0000001158 00000 n 0000024202 00000 n Patient Selection Patients on maximal medical therapy who continue to have refractory symptoms at rest (New York Heart Association Class IV) may benefit from home IV inotrope therapy. 0000003594 00000 n Milrinone Home Infusion RISKS Catheter related bloodstream infections. 0000003706 00000 n Total inpatient hospice stay was 11 days, after which the patient was discharged home with home hospice services. Every patient has individual needs for dobutamine therapy; therefore, your course will be planned to meet your special needs. trailer 0000007293 00000 n 202 0 obj <>stream The primary end point was all-cause mortality as ascertained both by the hospital records and the Social Security Death Index. Still, that isn’t a reason to rule out hospice use of dobutamine or milrinone, says Mulder. 1. 0000006487 00000 n ... Common Inotropic therapy medications are Milrinone, Dopamine, and Dobutamine. Family burden. Adults . %%EOF Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. <<4385C31A2CECB04BA283E193D03C2420>]/Prev 124185/XRefStm 1449>> All patients were tolerating IV milrinone therapy as inpatients before discharge on home infusions. 563 0 obj <>/Filter/FlateDecode/ID[<35610C041280F8418E44D2A74A6752BE><8F1F74E79DE4C741800DF52D75E9177D>]/Index[554 23]/Info 553 0 R/Length 62/Prev 137879/Root 555 0 R/Size 577/Type/XRef/W[1 2 1]>>stream Milrinone is given as a continuous infusion. 0000027545 00000 n Before initiation of this medication, a right heart catheterization may be a consideration for obtaining hemodynamic measurements to establish the patient’s baseline parameters and to gauge the patient response to continuous infusion. Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. It is slightly soluble in methanol, and very slightly soluble in chloroform and in water. h�b```����� cB�� @ށ�亴R�F�k�9^2g�R�����V�V-ӅWX����h�Y"����@ʁ�A�AI���AP��Q��AH��QL1yJ 0000017782 00000 n The infusion rates are based on the patient's weight, and for the little ones can be 2 mL/hour or even lower. 161 42 The role of home i.v. Hypotension. In a retrospective descriptive study, of 106 patients discharged on inotropic infusions (most often milrinone), 85% underwent transplantation. "The patient is going to die of heart failure whether or not the patient is … Prescribing Information Milrinone is an off-white to tan crystalline compound with a molecular weight of 211.2 and an empirical formula of C 12 H 9 N 3 O. Results: A total of 18 (25%) patients died, 6 (8%) patients were withdrawn from the program (3 by their primary physicians and 3 because of significant travel limitations); 4 (5%) patients required continuous intravenous home therapy; and 44 (61%) patients were discharged with significant improvement in their heart failure symptoms. The National Home Infusion Association (NHIA) is an organization for clinicians, managers, businesses, and institutions that provide infusion therapy services to patients in home care and outpatient settings. This was a retrospective study of 60 patients listed for a cardiac transplant and committed to home intravenous milrinone therapy. When it is infused at home, Milrinone, which is an intravenous inodilator agent, reduces the number of hospitalizations. Patient Assistance Programs. Milrinone 1 mg/ml Solution for injection or infusion is indicated for the short-term treatment (48 hours) of severe congestive heart failure unresponsive to conventional maintenance therapy (glycosides, diuretics, vasodilators and/or angiotensin converting enzyme (ACE) inhibitors). Enables patient to go home from the hospital. 0000012843 00000 n 0000012133 00000 n Eligible patients must have either failed a trial of weaning inotropic support in the inpatient setting or … A. Author information: (1)Division of Pharmacy Practice, Massachusetts College of Pharmacy, Boston, MA 02115, USA. 0000007151 00000 n Milrinone decreases the overall treatment costs of AHF. The milrinone infusion was weaned over a period of approximately 24 hours, following our guidelines. "��q�pip��o7opqLΫz��d8 zh(K�"����r�d�ʓl�Gė��. Your Coram Team and Resources Your Coram team is highly skilled. 0000008180 00000 n (For information about certification for clinicians and institutions, see Box 1.) We provide the information and support you will need to succeed with infusion therapy at home. xref Milrinone is a vasodilator that works by relaxing the muscles in your blood vessels to help them dilate (widen). m2a�B��"�p0я1�F��x(`Zp8:"�n��R�?N�jU>���ғ��\7n�q��d��8�V�! 0000007320 00000 n He died comfortably one week later at home. Patients Benefitted Significantly Overall, According to Results Presented at NHIA Meeting. Dobutamine Therapy in the Home Care Setting. This lowers blood pressure and allows blood to flow more easily through your veins and arteries. We will use a small pump that weighs about a pound to give your dobutamine. Dilute 10 mg (10 mL) of milrinone in 40 mL of diluent or 20 mg (20 mL) of milrinone in 80 mL of diluent. In the short term, dobutamine and milrinone can prolong life. The patient or caregiver is unwilling or unable to manage or continue with the home infusion program. BANNOCKBURN, Ill., July 12, 2017 — Advanced heart failure patients who receive home infusion of inotropic therapy benefit from improved quality of life, according to Option Care research presented at the 2017 National Home Infusion Association (NHIA) Annual Conference & Exposition. startxref 0000023970 00000 n Home infusion therapy involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. �5@(00ި��@� va?�W����*���8�3n``�W K�00>SҌ@�uiU�@YV�.�'u�$K �� Ƀ:� Soluble in chloroform and in water Guide 3 your home generally, these are very patients. 'S weight, and dobutamine point was all-cause mortality as ascertained both by the Children ’ life... Ordered you to receive IV dobutamine ( doe-beut-amine ) in your home a reason to rule hospice... Outpatients between 2008 and 2015 inclu-sive milrinone home infusion therapy patient information by decreasing signs and symptoms individual needs dobutamine! 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