A 59 years old female patient taking medications for hypertension and congestive cardiac failure. She suddenly develops skin rashes along with swelling of tongue, lips as well as eyes, causing her breathing difficulty. Which one of the following medications is the reason for the untoward effects?
Correct Answer: Captopril
Description: Answer: c) Captopril.* In 0.1% to 0.5% of patients, ACE inhibitors induce a rapid swelling in the nose, throat, mouth, glottis, larynx, lips, and/or tongue.* This untoward effect, called angioedema, apparently is not dose-related, and if it occurs, it does so within the first week of therapy, usually within the first few hours after the initial dose.* Airway obstruction and respiratory distress may lead to death.* It may involve accumulation of bradykinin, induction of tissue-specific autoantibodies, or inhibition of complement 1-esterase inhibitor.* Once ACE inhibitors are stopped, angioedema disappears within hours.* Although it is rare, angioedema of the intestine (visceral angioedema) also has been reported in association with ACE inhibitors.* Visceral angioedema is characterized by emesis, watery diarrhea, and abdominal pain.* Most cases of visceral angioedema occur in the absence of oropharyngeal edema.
Category:
Pharmacology
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