Heart Disease: Treating Severe Heart Failure

Inotropic therapy is used in end-stage heart failure to help relieve and control heart failure symptoms so that you are better able to perform your daily activities. These medications are only used when other medications no longer control heart failure symptoms.

Inotropic therapy, also known as heart pump medication, stimulates an injured or weakened heart to pump harder. The primary purpose of this medication is to increase the force of the heart muscle's contractions. Inotropic therapy may also speed up the heart's rhythm.

Heart pump medications include:

• Dobutrex (dobutamine)
• Primacor (milrinone)

How Should I Take This Medicine?

Inotropic therapy is first administered in the hospital where you can be closely monitored.

Dobutamine and milrinone are intravenous (through the vein) medications administered by an infusion pump to help ensure the dose is accurate. These medications may be ordered by your doctor to be given continuously or periodically over 6 to 72 hours, one or more times per week.

Even if you feel well, do not discontinue your inotropic therapy medication from your intravenous catheter line or from your infusion pump without consulting your doctor. If you are discharged from the hospital with an inotropic medication, a home health nurse will provide specific directions on how to care for your intravenous site, catheter, and infusion pump.

What Side Effects Could I Experience?

Notify your doctor or nurse right away the first time any of these side effects occur:

• Headache
• Increased heart rate
• High blood pressure
• Nausea
• Vomiting
• Shortness of breath
• Faintness, dizziness or lightheadedness
• Mild leg cramps or tingling sensation

If any of the following side effects occur, STOP THE INFUSION and contact your doctor right away:

• Irregular, fast heartbeat (more than 120 beats per minute)
• Pain or swelling at infusion site
• Fever of 101°F (38.3°C) or higher
• Pump malfunction (then call the pharmacy immediately for a replacement)

Should I Avoid Certain Food or Medicine?

Yes.

• Carefully follow the low-sodium (low-salt) diet and daily exercise program advised by your doctor.
• Alcohol increases the side effects of this medication and should be avoided.

Other Guidelines

• Keep all appointments with your doctor and the laboratory so your response to this medication can be monitored.
• Be sure that you always have enough infusion bags of your medication. Check your supply before vacations, holidays or other occasions when you may be unable to obtain it.
• Never administer other intravenous medications through the same intravenous line.
• Take precaution to prevent infection while you are taking this medication. Your doctor will give you information on how to prevent infection.

Reviewed by the doctors at The Cleveland Clinic Heart Center (2005).