Intravenous use of amrinone for the treatment of the failing heart.
Amrinone, a new nonadrenergic, nonglycosidic agent with combined positive inotropic and vasodilating properties, was approved recently for parenteral use in the treatment of left ventricular failure. Its mechanism of action is mediated primarily by selective phosphodiesterase fraction III inhibition, although at high doses alterations of calcium transport may occur. Acute hemodynamic changes produced by amrinone include augmentation of cardiac output and decreases in pulmonary capillary wedge pressure, right atrial pressure and systemic vascular resistance. Heart rate and blood pressure remain unaltered. Myocardial oxygen consumption declines concomitantly with the decrease in systolic wall tension. The efficacy of amrinone is comparable to that of dobutamine and dopamine. Synergistic interactions with catecholamines and vasodilators are described. Adverse effects are minimal, with dosage limited predominantly by decreases in filling pressures.
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D
Mancini
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T
LeJemtel
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Sonnenblick
D000631:Aminopyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000676:Amrinone; D005117:Cardiac Complexes, Premature / Q000139:chemically induced; D002302:Cardiac Output / Q000187:drug effects; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D009200:Myocardial Contraction / Q000187:drug effects; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption / Q000187:drug effects; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D013921:Thrombocytopenia / Q000139:chemically induced; D014665:Vasodilator Agents / Q000008:administration & dosage
D000631:Aminopyridines; D002316:Cardiotonic Agents; D010726:Phosphodiesterase Inhibitors; D014665:Vasodilator Agents; D000676:Amrinone