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Amrinone

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  1. Class
    1. Rapidly acting inotropic agent
    2. Phosphodiesterase inhibitor
  2. 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
  3. Pharmacokinetics
    1. Long Half-life: 4-6 hours
  4. Indications
    1. Severe Congestive Heart Failure refractory to:
      1. Diuretics
      2. Vasodilators
      3. Conventional inotropic agents (Digoxin)
  5. Contraindications
    1. Allergy to Sulfating agents
  6. 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
  7. Monitoring
    1. Central hemodynamics
  8. 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
  9. Precautions
    1. May provoke Myocardial Ischemia
      1. Carefully follow central hemodynamics
      2. Avoid Tachycardia

Inamrinone (C0002697)

Definition (MSH)A positive inotropic cardiotonic (CARDIOTONIC AGENTS) with vasodilator properties, phosphodiesterase 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 degredation 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).
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishAmrinon, Amrinone, AMRINONE PREPARATION, Imamrinone, Inamrinone, INAMRINONE PREPARATION
Spanishamrinona, inamrinona
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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