Amrinone
(Synonyms: 氨力农; Inamrinone) 目录号 : GC42792An inhibitor of PDE3
Cas No.:60719-84-8
Sample solution is provided at 25 µL, 10mM.
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Amrinone is an inhibitor of phosphodiesterase 3 (PDE3; IC50 = 19.5 µM). It increases developed tension and contractile force in isolated cat papillary muscle. Amrinone (1-10 mg/kg) has positive inotropic effects, increasing the rate and force of heart contraction in anesthetized and unanesthetized dogs.
Cas No. | 60719-84-8 | SDF | |
别名 | 氨力农; Inamrinone | ||
Canonical SMILES | NC1=CC(C2=CC=NC=C2)=CNC1=O | ||
分子式 | C10H9N3O | 分子量 | 187.2 |
溶解度 | DMF: 0.3 mg/ml,DMSO: 0.5 mg/ml | 储存条件 | Store at -20°C |
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1 mg | 5 mg | 10 mg | |
1 mM | 5.3419 mL | 26.7094 mL | 53.4188 mL |
5 mM | 1.0684 mL | 5.3419 mL | 10.6838 mL |
10 mM | 0.5342 mL | 2.6709 mL | 5.3419 mL |
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Amrinone: is it the inotrope of choice?
J Cardiothorac Anesth 1989 Dec;3(6 Suppl 2):45-57.PMID:2521051DOI:10.1016/0888-6296(89)90059-8.
In the treatment of acute heart failure, conventional therapy with epinephrine, norepinephrine, dopamine, and dobutamine may be used effectively to treat inotropic abnormalities. However, the addition of a vasodilator to catecholamine therapy may be needed to help improve lusitropic function. Because it seems to exert positive inotropic and lusitropic effects, the phosphodiesterase inhibitor Amrinone may be a valuable addition to the anesthesiologist's armamentarium for the treatment of acute heart failure. When used as adjunctive therapy with catecholamines, Amrinone has been shown to exert a significant additive and synergistic effect. Amrinone may also be the inotrope of choice in patients who are refractory to therapy with conventional inotropes, due to its positive inotropic and lusitropic effects, combined with its vasodilating effects. Because of its broad pharmacodynamic spectrum, Amrinone may effectively control all of the major elements involved in myocardial performance--preload, afterload, contractility, and heart rate.
Amrinone: pharmacokinetics and pharmacodynamics
J Cardiothorac Anesth 1989 Dec;3(6 Suppl 2):10-4.PMID:2521045DOI:10.1016/0888-6296(89)90054-9.
Amrinone is a selective inhibitor of phosphodiesterase fraction 3 in both cardiac and smooth muscle. Intravenous administration in humans produces increased contractility and vasodilation of venous capacitance and arterial conductance vessels. The elimination half-life in healthy patients is reported to be 2.6 to 4.1 hours, making it the only long-acting positive inotropic agent available that can be administered either as an intravenous bolus or by infusion. A low incidence of side effects, often minor, has been reported with intravenous use. Thrombocytopenia does not seem to be a problem with short-term use. Amrinone represents a new approach in the pharmacologic therapy for ventricular dysfunction following cardiac surgery.
Amrinone metabolism
Clin Pharmacol Ther 1981 Mar;29(3):394-401.PMID:7471610DOI:10.1038/clpt.1981.54.
High-performance liquid chromatographic methods for the analysis of Amrinone in plasma and for both Amrinone and its N-acetyl metabolite in urine were developed and applied to measure specimens obtained from a number of healthy men who had received intravenous or oral Amrinone. The intravenous doses ranged from 0.8 to 2.2 mg/kg. Terminal elimination of Amrinone from the bloodstream followed apparent first-order kinetics. Half-life, after the drug had distributed to the tissues, was estimated by a log-linear least-squares regression; mean half-life was 2.6 +/- 1.4 hr. During the first 24 hr after medication, unchanged Amrinone excreted in the urine of these subjects represented 10% to 40% of the dose. N-Acetyl metabolite in the urine represented less than 2% of the dose. In the oral study, doses ranged from 25 to 250 mg (0.31 to 3.5 mg/kg) and the maximum plasma concentration attained was proportional to the dose. The first order terminal elimination half-life was possibly dose-related. In only one subject were there unequivocal amounts of the N-acetyl metabolite in the plasma.
The role of Amrinone in potential heart transplant patients with pulmonary hypertension
J Cardiothorac Anesth 1989 Dec;3(6 Suppl 2):33-7.PMID:2521049DOI:10.1016/0888-6296(89)90057-4.
Orthotopic heart transplantation is contraindicated in patients with pulmonary hypertension and an elevated pulmonary vascular resistance. In an attempt to make otherwise unacceptable patients possible candidates for heart transplantation, Amrinone was administered intravenously to 27 individuals with a transpulmonary gradient and pulmonary vascular resistance in the abnormal range. Twenty-four of 27 patients (89%) responded positively. Twenty-one of 27 (78%) went on to transplantation and 20 of 21 (95%) survived the procedure. A second study compared Amrinone therapy with conventional therapy in 38 potential transplant candidates with pulmonary hypertension. Amrinone was more effective in reducing pulmonary hypertension than conventional therapy with high-dose diuretics, digitalis, and captopril (86% v 63%). Survival rate of those awaiting transplantation was also significantly higher in the Amrinone group (91% v 63%). Although the protocol for comparing the two regimens does not allow for extrapolation of the results (Amrinone was administered in-hospital under close monitoring, whereas conventional therapy was self-administered at home), the findings confirm the clinical impression that Amrinone seems more effective and safer than conventional therapy in the treatment of potential heart transplant patients with pulmonary hypertension.
Perioperative experience with Amrinone
Eur J Anaesthesiol Suppl 1992;5:15-9.PMID:1600963doi
Amrinone is the only phosphodiesterase fraction III inhibitor currently available in the USA for the treatment of perioperative biventricular failure. Patients with chronic congestive heart failure (CHF) show down-regulation of the beta 1-adrenergic receptor with a decrease in receptor density and altered responses to catecholamines. Intravenous administration of Amrinone can transiently restore beta 1-adrenergic responses in patients who have CHF. Amrinone's mechanism of vasodilatation, independent of the beta 1-adrenergic receptor, nitrates, and calcium entry blockers, proves an important therapeutic option for pulmonary hypertension. The elimination half-life of Amrinone in volunteers is 2.6-4.1 h, and 3.5 h when administered into the cardiopulmonary bypass (CPB) circuit. Different loading and infusion doses have been reported for Amrinone. Investigators have demonstrated that increases in cardiac output following Amrinone administration are directly related to plasma concentration. In cardiac surgical patients, following a dose of 0.75 mg kg-1 administered into the CPB circuit, plasma concentrations are subtherapeutic after 10 min. We believe that, when using Amrinone to facilitate separation from CPB, a bolus dose of 1.5 mg kg-1 or more should be administered. If therapeutic levels need to be maintained in patients with biventricular failure, an infusion should also be administered after the bolus dose. Additive effects have been demonstrated when catecholamines are administered concomitantly with Amrinone and other PDE III inhibitors to increase cyclic AMP in cardiac muscle and improve contractility. The use of Amrinone with catecholamines is also important clinically, because together they attenuate the vasoconstrictive effects of catecholamines alone, while the catecholamines support perfusion pressure. Amrinone represents a novel drug for managing biventricular dysfunction in cardiac surgical patients.