Protocol for Intravenous Milrinone Lactate Treatment for Outpatients

Infuse milrinone according to the following administration schedule:

- 50 g/kg IV push slowly over 10 minutes, then

- 0.375 g/kg/min x 1 hour;

- 0.5 g/kg/min x 1 hour;

- 0.375 g/kg/min x 1 hour;

- discontinue infusion.

Intravenous Medication Pump.

Perform telemetry.

Monitor vital signs every 15 min for 1 hour, then as often as needed every hour.

Obtain patient’s body weight both before and after infusion.

Measure electrolyte, BUN, creatine, and magnesium levels at each infusion.

Monitor and record intake and output of fluids.

Use telemetry emergency standing orders for ventricular irritability and symptomatic bradycardia.

Follow hospital’s established guidelines for potassium levels of less than 4.0 mEq/L.

Notify physician if any of the following occur:

- Symptomatic changes in blood pressure of greater than 20 mm Hg up or down from baseline.

- Enhanced ventricular ectopy changed from baseline.

- Onset of increased shortness of breath.

- Symptomatic heart rate changes of greater than 20 beats/min (increase or decrease).

- Significant weight gain, presence of peripheral edema, rales, paroxysmal nocturnal dyspnea, orthopnea, change in functional capacity noted at patient’s arrival.

- Lab results show clinically significant changes.

Reinforce the need for a low-salt diet and the 1,500-cc fluid restriction, review when to call, remind about taking daily weights, and review the need for compliance with medications.