Enoximone

Enoximone - is a selective phosphodiesterase III inhibitor resulting in ↑ CO, and ↓PCWP and SVR, without significant ↑ in HR and myocardial oxygen consumption. It has a long half-life and haemodynamic effects can persist for 8–10 h after the drug is stopped.

Uses
Severe congestive cardiac failure
Low cardiac output states ( + dobutamine)

Contraindications
Severe aortic or pulmonary stenosis (exaggerated hypotension)
HOCM (exaggerated hypotension)

Administration
• IV infusion: 0.5–1.0 mg/kg (this dose can be omitted as can cause hypotension), then 5–20 μg/kg/min maintenance

Requires direct arterial BP monitoring
Adjustment of the infusion rate should be made according to haemodynamic response
Total dose in 24 h should not > 24 mg/kg
Available in 20-ml ampoules containing 100 mg enoximone (5 mg/ml)
Dilute this 20 ml solution with 20 ml sodium chloride 0.9% giving a solution containing enoximone 2.5 mg/ml

How not to use enoximone
Glucose 5% or contact with glass may result in crystal formation
Do not dilute with very alkaline solution (incompatible with all catecholamines in solution)

Adverse effects
Hypotension
Arrhythmias

Cautions
In septic shock enoximone can cause prolonged hypotension

Organ failure
Renal: reduce dose

Renal replacement therapy
No further dose modification is required during renal replacement therapy