Drug-induced angioedema

Drug-induced angioedema is a known complication of the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II antagonists (ARBs), and Angiotensin-Neprilysin Inhibitor LCZ969.[1]: 120  The angioedema appears to be dose dependent as it may resolve with decreased dose.[1]: 120 

Drug-induced angioedema
Other namesAcquired angioedema
SpecialtyDermatology

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.[2] 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.[3]

Risk factor

Some common ACE Inhibitors are:

Some common ARBs are:

Incidence

The chance of drug-induced angioedema is extremely uncommon, however, as studies show incidence of less than 1%.[4] The reason this adverse effect may occur is due to the build-up of bradykinin, a vasodilator. This causes blood vessels to dilate and allow for fluid buildup in the mucosal surfaces.

See also

References
  1. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  2. Winters, Michael. “Clinical Practice Guideline: Initial Evaluation and Management of Patients Presenting
  3. J Community Hosp Intern Med Perspect. 2014; 4(4): 10.3402/jchimp.v4.25260
  4. 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

2. Angiotensin-Neprilysin Inhibition versus Enalapril in Heart Failure (PARADIGM-HF Investigators); NEJM.org, September 11, 2014; Vol.371, No.11.


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