Description of the medicine: Amrinone (Amrinone)
AMRINONE (Amrinone) *. 5-Amino [3, 4'-bipyridine] -6 (1H) -one, or Amino-5 (bipyridin-3, 4 ') (1H) -one-6.
Synonyms: Inocor, Wincoram (Some firms also produce nitrosorbide and corazol under the name Inosor.).
Amrinone is the first synthetic cardiotonic drug of non-steroidal structure and non-adrenergic nature, which has found application in medical practice. The drug has a positive inotropic, as well as vasodilating action; In patients with congestive cardiac failure, the accuracy increases cardiac output, reduces pressure in the pulmonary artery and reduces peripheral vascular resistance.
The drug is intended only for short-term therapy of acute congestive heart failure. Sufficient experience in the use of amrinone has not yet been accumulated and should be prescribed with caution, strictly following 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 refined over decades, and amrinone and its analogues have only recently appeared. ). Use the drug only in intensive care units, under the control of the state of hemodynamics. Enter intravenously. Before administration, amrinone solution in ampoules is diluted in isotonic solution on tri chloride (but not glucose). The diluted solution can be stored for no more than 24 hours.
To obtain a rapid therapeutic effect, first, administer 0.5 mg / kg (bolus) at a rate of about 1 mg per second. Then, injections (bolus) at a dose of 0.5-1.5 mg / kg at the same rate can be repeated at intervals of 10-15 minutes. Further infusion is carried out at the rate of 5-10 μg (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 a continuous infusion of ZO μg / kg per minute at once for 2 to 3 hours. The rate of administration is chosen individually for each patient. The total daily dose should not exceed 10 mg / kg.
When using amrinone, hypotension, tachycardia, supraventricular and ventricular arrhythmias, renal dysfunction, thrombocytopenia, as well as headache, gastrointestinal disorders, and increase in body temperature are possible.
The drug can not be prescribed to patients with contraindications to cardiac output: with obstructive cardiomyopathy, obstructive cardiac valve lesions, as well as acute hypovolemia, supra ventricular arrhythmia, aortic aneurysm, acute arterial hypotension, acute kidney failure, thrombocytopenia. There is not enough experience with the use of amrinone in children, and in adults with acute myocardial infarction.
Do not prescribe the drug to women during pregnancy and lactation.
You need to inject the solutions strictly intravenously, since a strong irritation of the surrounding tissues is possible.