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amrinone (Inocor, inamrinone)

Tradename: Inocor. (amrinone lactate) Indications: 1) short term treatment of refractory acute heart failure 2) may improve hemodynamics in patients receiving: a) dopamine b) dobutamine c) digoxin Dosage: 1) 0.75 mg/kg bolus IV over 2-3 min, then 2) infusion 100 mg in 100 mL normal saline (1 mg/mL) @ 5-10 ug/kg/min, 70 kg: 21 mL/hr = 5 ug/kg/min 3) max: 10 mg/kg/24 hours Injection: 5 mg/mL. 20 mL. Monitor: 1) hemodynamic monitoring 2) CBC 3) electrolytes, especially K+ 4) renal & liver function Pharmacokinetics: 1) IV: onset of action is within 2-5 minutes 2) peak effect occurs within 10 minutes 3) duration of action is dose-dependent a) 30 minutes with low doses b) up to 2 hours with higher doses Adverse effects: 1) not common a) hypotension - in patients with: - receiving vasodilators - with volume contraction - may be infuson-related b) atrial & ventricular arrhythmia c) thrombocytopenia (may be dose-related) d) nausea 2) uncommon (< 1%) - chest pain, fever, vomiting, abdominal pain, anorexia, pain or burning at the site of injection, hepatotoxicity Mechanism of action: - hemodynamic effects) 1) similar to dobutamine, but more vasodilatory properties 2) comparable to milrinone

Interactions

drug interactions drug adverse effects of antihypertensive agents

General

amine enzyme inhibitor inotropic agent vasodilator agent

Properties

INHIBITS: phosphodiesterase MISC-INFO: elimination route KIDNEY pregnancy-category C safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 124
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. Deprecated Reference