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Drug-induced angioedema
| Field | Value |
|---|---|
| name | Drug-induced angioedema |
| synonyms | Acquired angioedema |
| field | dermatology |
Drug-induced angioedema is a known complication of the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II antagonists (ARBs), and some neprilysin inhibitors. The angioedema appears to be dose dependent as it may resolve with decreased dose.
Presentation
Angioedema presents itself as an abrupt onset of non-pitting, non-itchy swelling that involves the mucosal layers. Some common locations of angioedema are the face, particularly the lips and around the eyes, hands and feet, and genitalia. A rare, yet serious complication is one inside the abdomen, the symptom usually being severe stomach upset, which is much less obvious than the other locations.
Risk factor
Some common ACE Inhibitors are:
- Benazepril (Lotensin)
- Captopril (Capoten)
- Enalapril (Vasotec)
- Lisinopril (Prinivil, Zestril)
- Ramipril (Altace)
Some common ARBs are:
- Candesartan (Atacand)
- Losartan (Cozaar)
- Olmesartan (Benicar)
- Valsartan (Diovan)
Incidence
Cases of drug-induced angioedema are uncommon, with studies showing an incidence of less than 1%. The reason this adverse effect may occur is due to the build-up of bradykinin, a vasodilator. This causes blood vessels to dilate and allows for fluid buildup in the mucosal surfaces.
References
References
- James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. p. 120. {{ISBN. 0-7216-2921-0.
- Campbell, Duncan J.. (2018-09-19). "Neprilysin Inhibitors and Bradykinin". Frontiers in Medicine.
- Winters, Michael. “Clinical Practice Guideline: Initial Evaluation and Management of Patients Presenting
- J Community Hosp Intern Med Perspect. 2014; 4(4): 10.3402/jchimp.v4.25260
- Banerji, Aleena. “Multicenter study of patients with angiotensin-converting enzyme inhibitor-induced angioedema who present to the emergency department.” Annals of Allergy, Asthma & Immunology (2008); 100: 327-332. Web. 2 Nov 2014
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