Q: Hypotension secondary to Milrinone therapy can be managed more efficiently with which pressor?

A) Norepinehrine

B) Dopamine

C) Vasopressin

D) Phenylephrine

E) Epinephrine

Answer: Vasopressin

Certainly any pressor can be use for hypotension but literature point towards vasopressin as better choice of pressor in milrinone induced hypotension. Low-dose vasopressin decreased the PVR/SVR ratio that was increased by milrinone. Considering the importance of maintaining systemic perfusion pressure as well as reducing right heart afterload, milrinone–vasopressin may provide better hemodynamics than milrinone–norephinephrine during the management of right heart failure.

Comparative hemodynamic effects of vasopressin and norepinephrine after milrinone-induced hypotension in off-pump coronary artery bypass surgical patients - Eur J Cardiothorac Surg 2006;29:952-956