Angioedemul în tratamentul cu inhibitori ai enzimei de conversie a angiotensinei

Angiotensin-converting enzyme inhibitors (ACEI) are very effective antihypertensive drugs that have become a mainstay in antihypertensive therapy over the past decades; their increased use has also caused an increased total number of side effects. Angioedema is a potential adverse drug reaction, which can become lethal due to total airway obstruction. The mechanism is still not fully understood, but it is believed that vasoactive molecules such as bradykinin and substance P are involved, as well as genetic polymorphisms of key pathway enzymes. Concomitant therapy with dipeptidyl peptidase inhibitors causes an increased risk of angioedema in patients treated with ACEI. Angioedema is usually treated by a conservative clinical approach using artificial ventilation in more severe cases, glucocorticoids and antihistamines. Evaluation of ACEI treated patients who present with angioedema must include allergy consultation, followed by adequate measures of drug discontinuation.