イナムリノン
イナムリノン（旧名アムリノン）は、**ビピリジン系強心薬**および血管拡張薬です。 - うっ血性心不全（CHF）の短期管理のための**二次選択薬**です。 - 非常に高価であり、厳密なモニタリングが必要です。 > **臨床のポイント：** 抗不整脈薬のアミオダロン（amiodarone）との混同による致命的な医療過誤を防ぐため、薬名がアムリノンからイナムリノンに変更されました。
作用機序: Inamrinone acts primarily as a **phosphodiesterase III (PDE3) inhibitor**. - **Inhibition of PDE3** → decreased breakdown of intracellular cyclic AMP (cAMP) → increased intracellular calcium in the myocardium → **positive inotropy** (direct stimulation of cardiac contractility). - In vascular smooth muscle, increased cAMP leads to relaxation → **vasodilation**, which effectively reduces both cardiac preload and afterload.
動物種別の用量
- Positive inotropic agent · 1-3 mg/kg IV followed by 30-100 micro-grams/kg/min IV infusion · IV · CRI
- Positive inotropic agent · 1-3 mg/kg IV as a slow IV bolus followed by a 10-100 micrograms/kg/min IV CRI; ½ the initial bolus may be administered 20-30 minutes after the first bolus. · IV · CRI
- Positive inotropic agent · 1-3 mg/kg IV as a slow IV bolus followed by a 10-100 micrograms/kg/min IV CRI; ½ the initial bolus may be administered 20-30 minutes after the first bolus. · IV · CRI
- Positive inotropic agent · 1-3 mg/kg IV followed by a 30-100 micrograms/kg/min IV CRI · IV · CRI
- Positive inotropic agent · 2 mg/kg bolus IV , followed by 30-300 micrograms/kg/min IV infusion · IV · CRI
- For patients coming off cardiopulmonary bypass with poor cardiac contractility · 0.25-0.6 mg/kg loading, then 5-45 micrograms/kg/min CRI · IV · CRI
- Adjunctive treatment for calcium channel blocker overdose · 30-100 micrograms/kg/min CRI. · IV · CRI · Alternative to dopamine or dobutamine; used with fluids, IV calcium, and potentially glucagon.
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Severe aortic or pulmonic valve disease
- Hypersensitivity to inamrinone or bisulfites
有害事象
- Arrhythmias
- Hypotension
- Vomiting
- Diarrhea
- Thrombocytopenia (particularly with prolonged therapy)
- Hepatotoxicity
- Hypersensitivity reactions (variable symptomatology: pericarditis to myositis)
薬物相互作用
- Digoxin · Additive inotropic effect; generally considered a positive drug interaction.
- Disopyramide · May cause excessive hypotension when used concurrently.
モニタリング
- Blood pressure
- Heart rate/rhythm (continuous ECG recommended)
- Body weight
- Platelet counts
過量投与
Because **hypotension** is the primary problem that would generally be seen, circulatory support should be instituted immediately. Only one human case of accidental massive overdose resulting in death has been reported (causal relationship not unequivocally established).
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。