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Amrinone lactate
Amrinone lactate (Inocor)
Amrinone lactate
(AM-rih-nohn)
Pregnancy Category: C
Inocor (Rx)
Classification:
Cardiac inotropic agent
Action/Kinetics:
Causes an increase in CO by increasing the force of contraction of the heart, probably by inhibiting cyclic AMP phosphodiesterase, thereby increasing cellular levels of c-AMP. It reduces afterload and preload by directly relaxing vascular smooth muscle. Time to peak effect: 10 min. t1/2, after rapid IV: 3.6 hr; after IV infusion: 5.8 hr. Steady-state plasma levels: 2.4 mcg/mL by maintaining an infusion of 5-10 mcg/kg/min. Duration: 30 min-2 hr, depending on the dose. Excreted primarily in the urine both unchanged and as metabolites. Children have a larger volume of distribution and a decreased elimination half-life.
Uses:
Congestive heart failure (short-term therapy in clients unresponsive to digitalis, diuretics, and/or vasodilators). Can be used in digitalized clients.
Contraindications:
Hypersensitivity to amrinone or bisulfites. Severe aortic or pulmonary valvular disease in lieu of surgery. Acute MI.
Special Concerns:
Safety and efficacy not established in children. Use with caution during lactation.
Side Effects:
GI: N&V;, abdominal pain, anorexia. CV: Hypotension, supraventricular and ventricular arrhythmias. Allergic: Pericarditis, pleuritis, ascites, allergic reaction to sodium bisulfite present in the product. Other: Thrombocytopenia, hepatotoxicity fever, chest pain, burning at site of injection.
Overdose Mangement:
Symptoms: Hypotension. Treatment: Reduce or discontinue drug administration and begin general supportive measures.
Drug Interactions:
Excessive hypotension when used with disopyramide.
How Supplied:
Injection: 5 mg/mL
Dosage
•IV
CHF.
Initial: 0.75 mg/kg as a bolus given slowly over 2-3 min; may be repeated after 30 min if necessary. Maintenance, IV infusion: 5-10 mcg/kg/min. Do not exceed a daily dose of 10 mg/kg, although up to 18 mg/kg/day has been used in some clients for short periods. |
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