Sharif M N, Evans B L, Pylypchuk G B
Department of Internal Medicine, University of Saskatechewan, Saskatoon, Canada.
Ann Pharmacother. 1994 Jun;28(6):720-2. doi: 10.1177/106002809402800606.
To report a case of chronic, nonproductive cough secondary to the angiotensin-converting enzyme (ACE) inhibitor quinapril, with complete resolution after switching to another ACE inhibitor, fosinopril.
All relevant articles from January 1985 through February 1993 were identified, primarily through MEDLINE search and review of pertinent articles' bibliographies.
A 68-year-old woman developed a dry, irritating cough within one month of starting quinapril therapy for the treatment of essential hypertension. The patient was a nonsmoker with no respiratory illnesses. The cough continued for the duration of therapy with quinapril. One month after changing to fosinopril therapy, the patient reported complete resolution of the cough. She remains cough-free to date.
Cough induced by ACE inhibitors is a frequently documented adverse effect. It is severe enough to require discontinuation of therapy in 1-10 percent of patients. The cough is considered to be a class-related adverse effect with cross-reactions between ACE inhibitors routinely reported. At this time, changing to another ACE inhibitor or additive therapy with nonsteroidal antiinflammatory drugs is not recommended. Discontinuation of the ACE inhibitor results in rapid alleviation of the cough, although this is not always necessary, as most patients may experience a cessation or decrease in cough. We report a case of cough following the administration of quinapril, with complete resolution after changing to the alternative ACE inhibitor fosinopril in a patient with essential hypertension.
Cough has been encountered commonly after the administration of ACE inhibitors. Frequency of cough is variable and although this complication has been described as a class effect, patients with a persistent, severe ACE inhibitor-induced cough may benefit from a trial of fosinopril therapy. This may be particularly useful in patients unable to tolerate an alternative class of antihypertensive agents.
报告1例由血管紧张素转换酶（ACE）抑制剂喹那普利引起的慢性无痰咳嗽病例，换用另一种ACE抑制剂福辛普利后咳嗽完全缓解。
确定了1985年1月至1993年2月期间的所有相关文章，主要通过医学文献数据库检索及查阅相关文章的参考文献。
一名68岁女性在开始使用喹那普利治疗原发性高血压后1个月内出现干咳、刺激性咳嗽。该患者不吸烟，无呼吸系统疾病。咳嗽在使用喹那普利治疗期间持续存在。改用福辛普利治疗1个月后，患者报告咳嗽完全缓解。至今仍无咳嗽。
ACE抑制剂引起的咳嗽是一种常见的不良反应。严重到足以使1%至10%的患者停药。这种咳嗽被认为是类相关不良反应，常规报道ACE抑制剂之间存在交叉反应。目前，不建议换用另一种ACE抑制剂或加用非甾体抗炎药治疗。停用ACE抑制剂可使咳嗽迅速缓解，不过并非总是必要的，因为大多数患者咳嗽可能会停止或减轻。我们报告1例服用喹那普利后咳嗽的病例，在一名原发性高血压患者换用替代ACE抑制剂福辛普利后咳嗽完全缓解。
服用ACE抑制剂后咳嗽很常见。咳嗽发生率各不相同，尽管这种并发症被描述为类效应，但持续性、严重的ACE抑制剂引起的咳嗽患者可能从福辛普利治疗试验中获益。这对无法耐受其他类抗高血压药物的患者可能特别有用。
