You may remember, while doing the course that there is a question on angioedema secondary to angiotensin converting enzyme inhibitors. Well, the New England journal has an amazing picture published along with an interesting case history, which you can access here.
Angioedema due to ACE inhibitors is due to selective increase in bradykinin levels, which results in vasodilatation and subsequent edema. Upper respiratory tract involvement can result in breathlessness. Treatment is with anti-histamines and steroids.
It has been noted that patients who develop angioedema secondary to ACE inhibitors can also develop the same with angiotensin receptor blockers, though the mechanism is not clear.
For the purposes of the MRCP
1. Remember that ACE inhibitors (ramipril, perindopril etc) can cause angioedema.
2. There is no way of predicting whether ACE inhibitors will cause angioedema, so do not withold prescribing unless there has been a previously documented incident.
3. Patients who have had angioedema secondary to ACE inhibitors can have the same reaction to angiotensin receptor blockers, so be cautious.
For further information, this article should help.
Angioedema due to ACE inhibitors is due to selective increase in bradykinin levels, which results in vasodilatation and subsequent edema. Upper respiratory tract involvement can result in breathlessness. Treatment is with anti-histamines and steroids.
It has been noted that patients who develop angioedema secondary to ACE inhibitors can also develop the same with angiotensin receptor blockers, though the mechanism is not clear.
For the purposes of the MRCP
1. Remember that ACE inhibitors (ramipril, perindopril etc) can cause angioedema.
2. There is no way of predicting whether ACE inhibitors will cause angioedema, so do not withold prescribing unless there has been a previously documented incident.
3. Patients who have had angioedema secondary to ACE inhibitors can have the same reaction to angiotensin receptor blockers, so be cautious.
For further information, this article should help.
No comments:
Post a Comment