伊那力農
伊那力農（Inamrinone，原名氨力農 Amrinone）是一種**雙吡啶類正性肌力藥物**與血管擴張劑。 - 作為短期治療充血性心臟衰竭（CHF）的**二線藥物**。 - 價格非常昂貴，且需要密集的醫療監測。 > **臨床提示：** 該藥物名稱從 amrinone 更改為 inamrinone，是為了避免與抗心律不整藥物胺碘酮（amiodarone）混淆而導致致命的給藥錯誤。
作用機制: 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.
各物種劑量
- 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Severe aortic or pulmonic valve disease
- Hypersensitivity to inamrinone or bisulfites
不良反應
- Arrhythmias
- Hypotension
- Vomiting
- Diarrhea
- Thrombocytopenia (particularly with prolonged therapy)
- Hepatotoxicity
- Hypersensitivity reactions (variable symptomatology: pericarditis to myositis)
藥物相互作用
- Digoxin · Additive inotropic effect; generally considered a positive drug interaction.
- Disopyramide · May cause excessive hypotension when used concurrently.
監測
- Blood pressure
- Heart rate/rhythm (continuous ECG recommended)
- Body weight
- Platelet counts
過量
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 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。