amrinone (Inocor, inamrinone)

Introduction

Tradename: Inocor. (amrinone lactate)

Indications

• short term treatment of refractory acute heart failure
• may improve hemodynamics in patients receiving:
  • dopamine
  • dobutamine
  • digoxin

Dosage

• 0.75 mg/kg bolus IV over 2-3 min, then
• 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
• max: 10 mg/kg/24 hours

Injection: 5 mg/mL. 20 mL.

Pharmacokinetics

• IV: onset of action is within 2-5 minutes
• peak effect occurs within 10 minutes
• duration of action is dose-dependent
  • 30 minutes with low doses
  • up to 2 hours with higher doses

elimination via kidney

Monitor

• hemodynamic monitoring
• CBC
• electrolytes, especially K+
• renal & liver function

Adverse effects

• not common
  • hypotension
    • in patients with:
      • receiving vasodilators
      • with volume contraction
    • may be infuson-related
  • atrial & ventricular arrhythmia
  • thrombocytopenia (may be dose-related)
  • nausea
• uncommon (< 1%)
  • chest pain, fever, vomiting, abdominal pain, anorexia, pain or burning at the site of injection, hepatotoxicity

• drug adverse effects of antihypertensive agents

Mechanism of action

• hemodynamic effects)
• similar to dobutamine, but more vasodilatory properties
• comparable to milrinone

More general terms

• amine
• enzyme inhibitor
• inotropic agent
• vasodilator agent

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5281003
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5282238