II. Class
- Rapidly acting inotropic agent
- Phosphodiesterase Inhibitor
III. Mechanism
- Hemodynamic effects similar to Dobutamine
- Moderate Dose (2.0 to 15 ug/kg/min)
- Increased Cardiac Output
- Decreased Peripheral Resistance
- Decreased Preload
- High Dose
- Tachycardia
- May precipitate Myocardial Ischemia
- Moderate Dose (2.0 to 15 ug/kg/min)
- Inotropic and Vasodilator effects not reversed
- Adrenergic blocking drugs do not effect
- Norepinephrine depletion does not effect
IV. Pharmacokinetics
- Long Half-Life: 4-6 hours
V. Indications
- Severe Congestive Heart Failure refractory to:
VI. Contraindications
- Allergy to Sulfating agents
VII. Dosing
- Preparation
- Dilute Amrinone Lactate in NS or 1/2NS
- Do not dilute directly in dextrose solutions
- May be infused in a line with dextrose solution
- Final Concentration: 1-3 mg/ml
- Dilute Amrinone Lactate in NS or 1/2NS
- Load: 0.75 mg/kg (max: 1 mg/kg) bolus over 10-15 min
- Maintenance Infusion
- Start: 2-5 ug/kg/min
- Titrate to: 10-15 ug/kg/min
VIII. Monitoring
- Central hemodynamics
IX. Adverse Effects
-
Thrombocytopenia (2-3%)
- Occurs within 48-72 hours
- Resolves after discontinuing Amrinone
- Dose dependent effect
- Nausea and Vomiting
- Myalgia
- Fever
- Hepatic dysfunction
-
Arrhythmia
- Ventricular irritability
X. Precautions
- May provoke Myocardial Ischemia
- Carefully follow central hemodynamics
- Avoid Tachycardia
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Definition (MSH) | A positive inotropic cardiotonic (CARDIOTONIC AGENTS) with vasodilator properties, phosphodiesterase 3 inhibitory activity, and the ability to stimulate calcium ion influx into the cardiac cell. |
Definition (NCI) | A synthetic bipyridine phosphodiesterase inhibitor with inotropic and vasodilator properties. Inamrinone inhibits type III phosphodiesterase, which is abundant in cardiac and vascular tissues, thereby preventing the degradation of cyclic adenosine monophosphate (cAMP) and increasing intracellular concentrations of this secondary messenger. Elevated levels of cAMP increase the contractile force of the cardiac muscle and produce positive inotropic effects. Although the mechanism of action is not fully understood, inamrinone causes smooth muscle relaxation, resulting in peripheral vasodilation (reduced afterload) and a decreased pulmonary vascular resistance (reduced preload). |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D000676 |
SnomedCT | 412411004, 412412006, 373502005, 50163006 |
English | Amrinone, (3,4'-Bipyridin)-6(1H)-one, 5-amino-, 5-Amino-(3,4'-bipyridine)-6(1H)-one, Amrinon, Imamrinone, inamrinone (medication), inotropes inamrinone, Amrinone [Chemical/Ingredient], amrinon, amrinone, Amrinone (product), Amrinone (substance), inamrinone, Inamrinone (product), Inamrinone (substance), Imamrinone (product), Imamrinone (substance), Inamrinone, AMRINONE, INAMRINONE |
Swedish | Amrinon |
Czech | amrinon |
Finnish | Amrinoni |
Russian | AMRINON, АМРИНОН |
Japanese | アムリノン |
Croatian | AMRINON |
French | 5-Amino-(3,4'-bipyridine)-6(1H)-one, Amrinone |
Polish | Amrynon |
Spanish | amrinona (producto), amrinona (sustancia), amrinona, inamrinona (producto), inamrinona (sustancia), inamrinona, Amrinona |
German | Amrinon |
Italian | Amrinone |
Portuguese | Amrinona |