Details About Overdose or Poisoning Generic Salt :: Inamrinone, Formerly Amrinone
Inamrinone (Formerly Amrinone)
Drug Pharmacology ::
I. Pharmacology. Inamrinoneis a positive inotropic agent with vasodilator activity. It is not abeta-adrenergic receptor agonist, and its exact mechanism of action isunknown. It appears to work by inhibiting myocardial cellphosphodiesterase activity, thereby increasing cellular concentrationsof cyclic AMP. Cardiac afterload and preload are reduced owing to adirect vasodilator effect.
Drug Indications ::
Indications. Inamrinonemay be useful as a third-line inotropic agent for patients withbeta-blocker, mixed beta- and alpha-blocker (eg, labetalol), or calciumantagonist overdose when intravenous fluids, atropine, beta agonists,and glucagon have failed to restore cardiac output and blood pressure.
Drug Contra-Indications ::
III. Contraindications. Known hypersensitivity to inamrinone or sulfites (used as a preservative).
Drug Adverse Effects ::
IV. Adverse effects
Hypotensionmay result from direct vasodilator effects, especially in patients whoare volume depleted. Give adequate intravenous fluids prior to and withinamrinone administration.
Theformulation contains sodium metabisulfite as a preservative, which cancause acute allergic-like reactions in patients (especially asthmatics)who are sensitive to sulfites.
Inamrinone may aggravate outflow obstruction in patients with hypertrophic subaortic stenosis.
Inamrinone affects platelet survival time, resulting in a dose- and time-dependent thrombocytopenia.
E. Use in pregnancy. FDAcategory C (indeterminate). Animal studies are conflicting, and thereare no good human data (see Table III–1). Use only if the benefitjustifies the potential risk (eg, a severe beta-blocker or calciumantagonist overdose unresponsive to other measures).
F. Name changed from amrinone to inamrinone to prevent confusion with amiodarone.
Drug Lab Interactions ::
Drug or laboratory interactions. Thepositive inotropic effects of inamrinone are additive with otherinotropic agents, including digitalis glycosides. These drugs can beused together, but the patient should be monitored for cardiacdysrhythmias.
Drug Dose Management ::
Dosage and method of administration
The initial dose is 0.75 mg/kg as a bolus over 2–3 minutes. This is followed by an infusion at 5–10 mcg/kg/min.
Themanufacturer recommends that the total daily dose not exceed 10 mg/kg.However, up to 18 mg/kg/day has been given to some patients.
Drug Chemical Formulations ::
Inamrinone lactate: 5 mg/mL in 20-mL ampules containing 0.25 mg/mL sodium metabisulfite as a preservative.
Suggested minimum stocking level to treat a 70-kg adult for the first 24 hours is 10 ampules.