Thalanayar Prashanth M, Ghobrial Ibrahim, Lubin Fritz, Karnik Reena, Bhasin Robin
Department of Internal Medicine, University of Pittsburgh Medical Center, McKeesport, PA, USA.
J Community Hosp Intern Med Perspect. 2014 Sep 29;4(4). doi: 10.3402/jchimp.v4.25260. eCollection 2014.
Angioedema associated with angiotensin converting enzyme inhibitors (ACEIs) is due to the accumulation of bradykinin and its metabolites. Angiotensin receptor blockers (ARBs) produce anti-hypertensive effects by blocking the angiotensin II AT1 receptor action; hence bradykinin-related side effects are not expected. However, we notice the occurrence of ARB-induced angioedema as not a very rare side effect. Visceral drug-induced angioedema has been reported with ACEIs, not with ARBs. This underlying review will help educate readers on the pathophysiology and recent guidelines pertaining to ACEI- and ARB-induced visceral angioedema.
血管紧张素转换酶抑制剂(ACEIs)相关的血管性水肿是由于缓激肽及其代谢产物的蓄积所致。血管紧张素受体阻滞剂(ARBs)通过阻断血管紧张素II AT1受体的作用产生抗高血压效应;因此,预计不会出现与缓激肽相关的副作用。然而,我们注意到ARB引起的血管性水肿并非罕见的副作用。有报道称ACEIs可导致内脏药物性血管性水肿,而ARBs则未出现这种情况。本综述将有助于让读者了解与ACEI和ARB引起的内脏血管性水肿相关的病理生理学及最新指南。