II. Class

  1. Rapidly acting inotropic agent
  2. Phosphodiesterase Inhibitor

III. Mechanism

  1. Hemodynamic effects similar to Dobutamine
    1. Moderate Dose (2.0 to 15 ug/kg/min)
      1. Increased Cardiac Output
      2. Decreased Peripheral Resistance
      3. Decreased Preload
    2. High Dose
      1. Tachycardia
      2. May precipitate Myocardial Ischemia
  2. Inotropic and Vasodilator effects not reversed
    1. Adrenergic blocking drugs do not effect
    2. Norepinephrine depletion does not effect

IV. Pharmacokinetics

  1. Long Half-Life: 4-6 hours

V. Indications

  1. Severe Congestive Heart Failure refractory to:
    1. Diuretics
    2. Vasodilators
    3. Conventional inotropic agents (Digoxin)

VI. Contraindications

  1. Allergy to Sulfating agents

VII. Dosing

  1. Preparation
    1. Dilute Amrinone Lactate in NS or 1/2NS
      1. Do not dilute directly in dextrose solutions
      2. May be infused in a line with dextrose solution
    2. Final Concentration: 1-3 mg/ml
  2. Load: 0.75 mg/kg (max: 1 mg/kg) bolus over 10-15 min
  3. Maintenance Infusion
    1. Start: 2-5 ug/kg/min
    2. Titrate to: 10-15 ug/kg/min

VIII. Monitoring

  1. Central hemodynamics

IX. Adverse Effects

  1. Thrombocytopenia (2-3%)
    1. Occurs within 48-72 hours
    2. Resolves after discontinuing Amrinone
    3. Dose dependent effect
  2. Nausea and Vomiting
  3. Myalgia
  4. Fever
  5. Hepatic dysfunction
  6. Arrhythmia
    1. Ventricular irritability

X. Precautions

  1. May provoke Myocardial Ischemia
    1. Carefully follow central hemodynamics
    2. Avoid Tachycardia

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Ontology: Inamrinone (C0002697)

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
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