| Amrinone Pharmacology |
| Amrinone |
| About Amrinone |
| Cardiac inotrope, phosphodiesterase (PDE III) inhibitor, cardiotonic in CHF, vasodilator. |
| Mechanism of Action of Amrinone |
| Amrinone exerts it`s pharmacological action by selective inhibition of phosphodiesterase-3. This isoenzyme is specific for intracellular degradation of cyclic AMP in heart, blood vessels, and bronchial smooth muscles. Thus the drug increases myocardial cyclic AMP and transmembrane influx of Ca2+. It is a positive inotropic drug and also causes direct vasodilatation. It increases cardiac out put and reduces after load. It increases cardiac index, left ventricular ejection fraction, and decreases peripheral vascular resistance, central venous pressure, left ventricular end diastolic volume and pressure. |
| Pharmacokinets of Amrinone |
| Absorption: It is administered intravenously. Distribution: About 10% to 49% is distributed in a protein bound form. Metabolism: Metabolized in liver. Excretion: Excreted through urine |
| Onset of Action for Amrinone |
| 2 to 5 minutes |
| Duration of Action for Amrinone |
| 30 to 120minutes |
| Half Life of Amrinone |
| 4 hours |
| Side Effects of Amrinone |
| 1.Thrombocytopenia 2.Abdominal pain 3.Nausea 4.Diarrhoea 5.Hepatic impairment 6.Fever 7.Arrhythmias 8.Hypersensitivity reactions |
| Contra-indications of Amrinone |
| 1.Hypersensitivity to the drug 2.Acute myocardial infarction 3.Severe aortic valvular diseases 4.Severe pulmonary valvular diseases. |
| Special Precautions while taking Amrinone |
| 1.Hypotension, 2.Aortic or Pulmonary valvular diseases 3.Hypertrophic sub aortic stenosis 4.Hepatic impairment 5.Monitor cardio vascular functioning, heart and BP 6.Maintain fluid and electrolyte balance |
| Pregnancy Related Information |
| Use with caution |
| Old Age Related Information |
| Use with caution |
| Breast Feeding Related Information |
| Use with caution |
| Children Related Information |
| Contraindicated |
| Indications for Amrinone |
| 1.Short term management of heart failure, 2.Cardiac life support in whom other drugs can not be used. |
| Interactions for Amrinone |
| Dextrose and Furosemide: A precipitate forms on admixture with Amrinone. Digitalis: Inotropic effects are additive. |
| Typical Dosage for Amrinone |
| Starts with 0.75mg/kg I.V. bolus over two to three minutes. Then give maintenance dosage of 5 to 10mcg/kg/minute as infusion. Additional bolus of 0.75mg/kg may be given 30 minutes after therapy is initiated. Maximum dose: 10mg/kg/day |
| Schedule of Amrinone |
| H |
| Storage Requirements for Amrinone |
| Store at room temperature and protects from exposure to light. |
| Effects of Missed Dosage of Amrinone |
| Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose. |
| Effects of Overdose of Amrinone |
| Treatment is supportive and symptomatic. Treat hypotension with vasopressors like nor epinephrine. Monitor and maintain fluid and electrolyte balance. |