Inamrinone

A to Z Drug Facts

 Action Positive inotropic agent with vasodilator activity.

 Indications Short-term management of CHF in patients whose condition can be closely monitored and who have not responded adequately to digitalis, diuretics, or vasodilators.

 Contraindications Hypersensitivity to bisulfites.

 Route/Dosage

ADULTS: IV Initial dose: 0.75 mg/kg bolus slowly over 2 to 3 min. Maintenance: 5 to 10 mcg/kg/min; additional 0.75 mg/kg bolus may be given 30 min after initiating therapy, not to exceed total daily dose of 10 mg/kg.

 Interactions

None well documented.

INCOMPATIBILITIES: Dextrose-containing solutions: Chemical interaction occurs slowly over 24 hr when mixed directly. Furosemide: Do not inject furosemide into IV line containing inamrinone; immediate precipitate forms.

 Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Arrhythmia; hypotension. GI: Nausea; vomiting. HEMATOLOGIC Thrombocytopenia.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Arrhythmias: Supraventricular and ventricular arrhythmias have occurred. Fluid balance: Vigorous diuretic therapy may cause inadequate response to inamrinone therapy; liberalization of fluids may be needed. CVP monitoring has been advocated. Hepatotoxicity: Dose may be reduced or drug may be discontinued if there are alterations in liver enzymes; if alterations occur with clinical symptoms, drug is discontinued. Post MI: Not recommended during acute phase. Severe aortic or pulmonic valvular disease: Not recommended. Sulfite sensitivity: May cause allergic-type reaction in susceptible patients. Thrombocytopenia: More common in patients on prolonged therapy.

 Administration/Storage

IV infusion

• Administer as supplied or dilute in 0.5% or 0.9% saline to a concentration of 1 to 3 mg/mL.
• Do not dilute in dextrose-containing solutions, although product may be injected into running dextrose infusion through Y-connector or directly into tubing. Do not infuse product and furosemide through same line.
• Administer maintenance infusion 5 to 10 g/kg/min, preferably with infusion pump; adjust rate according to patient response.
• Use diluted solutions within 24 hr.
• Protect ampules from light.
• Store at room temperature.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Determine presence or history of asthma.
• Review baseline ECG and assess ongoing cardiac monitoring. Notify physician of any arrhythmias.
• Assess cardiac rate and rhythm throughout therapy.
• Assess vital signs, especially BP and pulse, before and during therapy. Notify physician of excessive hypotension; slow or stop infusion.
• Monitor I&O, including changes (increase or decrease) in output.
• Monitor laboratory values for alterations in liver enzymes, renal function, platelets, and serum electrolytes. Notify physician of any changes.
• Monitor for nausea and vomiting and for signs of hepatotoxicity.

 Patient/Family Education

• Instruct patient to avoid sudden position changes to prevent orthostatic hypotension.
• Advise patient to notify physician of shortness of breath and increased chest pain.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts