Description of the medicine: Amrinone (Amrinone)
AMRINON (Amrinone) *. 5-amino [3, 4'-bipyridine] -6 (1H) -one, or amino-5 (bipyridin-3, 4 ') (1H) -one-6.
Synonyms: Inocor, Wincoram (Some companies also produce nitrosorbide and corazole under the name "Inosor.").
Amrinon is the first synthetic cardiotonic drug of non-steroidal structure and non-adrenergic nature, which found application in medical practice. The drug has a positive inotropic, as well as a vasodilating effect; in patients with congestive heart failure, accuracy increases cardiac output, reduces pulmonary pressure and reduces peripheral vascular resistance.
The drug is intended only for short-term therapy of acute congestive heart failure. Sufficient experience with the use of amrinone has not yet been accumulated and it should be prescribed with caution, strictly monitoring the patient's condition (Individual cardiac glycosides (digitoxin) have been used since the end of the last century, and the optimal conditions for their use have been specified for decades, and amrinone and its analogues have appeared only recently. ) Use the drug only in intensive care units, under the control of the state of hemodynamics. Enter intravenously. Before administration, the solution of amrinone in ampoules is diluted in isotonic solution to tria chloride (but not glucose). The diluted solution can be stored for no more than 24 hours.
To obtain a quick therapeutic effect, 0.5 mg / kg (bolus) is first administered at a rate of about 1 mg per second. Then, injections (pain) in a dose of 0.5-1.5 mg / kg can be repeated at the same speed with intervals of 10-15 minutes. Further, infusion is carried out at the rate of 5 - 10 mcg (0.005
0.01 mg) per 1 kg of body weight per minute. The maximum total dose during the first hour, equal to 4 mg / kg, is usually sufficient to obtain a pronounced therapeutic effect.
It is also possible to carry out immediately continuous infusion at 30 mg / kg per minute for 2 to 3 hours. The rate of administration is selected individually for each patient. The total daily dose should not exceed 10 mg / kg.
When using amrinone, hypotension, tachycardia, supraventricular and ventricular arrhythmias, impaired renal function, thrombocytopenia, as well as headache, gastrointestinal disturbances, and an increase in body temperature are possible.
The drug should not be prescribed to patients with contraindications to increased cardiac output: with obstructive cardiomyopathy, obstructive lesions of the heart valves, as well as with acute hypovolemia, supraventricular arrhythmia, aortic aneurysm, acute arterial hypotension, acute renal failure, thrombocytopenia. There is not enough experience with the use of amrinone in children, and in adults with acute myocardial infarction.
It is not a bad idea to prescribe the drug to women during pregnancy and lactation.
It is necessary to introduce solutions strictly intravenously, since severe irritation of the surrounding tissues is possible.