ACE Inhibitors and Angioedema
Medgeeks with Andrew Reid
Medgeeks
4.8 • 996 Ratings
🗓️ 24 January 2019
⏱️ 7 minutes
🧾️ Download transcript
Summary
Today, I want to talk about a specific topic, that I've seen about 5 times total in my career:
Ace inhibitor induced angioedema
The first question we should ask is, why do we care (aside from it being fatal)?
Well, many patient's have hypertension, and many of them are placed on an ACE inhibitor. This makes ACE inhibitors the number one cause of drug induced angioedema in the United States.
The most important thing to remember is the pathophysiology.
Today, we'll do a quick review of...
- The pathophysiology behind why this occurs
- Why steroids and antihistamines will NOT help in this situation
- How our patient will present
- How long after an ACE is started will angioedema present?
- Diagnosing ACE induced angioedema
- Treating and managing your patient
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Transcript
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| 0:00.0 | All right team back from med geeks so we got a good one today. It's going to be a quick one. |
| 0:05.8 | Today I want to talk about a specific topic actually that I see from time to time |
| 0:10.8 | Not often. I probably seen only five times in my life, but ACE inhibitor-induced |
| 0:16.4 | angioedema. |
| 0:18.2 | Why do we care about this besides the fact that, yes, it can kill you?. Well many people in this world have |
| 0:24.6 | hypertension and many of them are on an ace inhibitor making ace inhibitors |
| 0:29.2 | the leading cause of drug-induced angiodeema in the United States. |
| 0:34.3 | From an epidemiology standpoint, this diagnosis affects about 0.3 to 0.7% of people annually. |
| 0:43.2 | It's actually a common reason for ER visits more than you would think, |
| 0:46.8 | and it's also much more common in African American descent. |
| 0:50.8 | So the most important thing to remember about ACE inhibitor induced angiodyma is the pathophysiology. |
| 0:59.0 | So let's do a quick kind of summary of this. So ACE inhibitors. So, Ace Inhibitors, they affect the enzyme ace, angiotensin converting enzyme. |
| 1:09.7 | And this enzyme plays an important role in the renin angiotensin |
| 1:13.2 | al-dostroon pathway, the RAS pathway. Normally ACE |
| 1:18.5 | leads to the conversion of angiotensin 1 to angiotensin 2, which has many effects on the body, in particular leads to arterial vasoconstriction, |
| 1:29.3 | which increases systemic vascular resistance and in turn increases your blood pressure. |
| 1:34.0 | So that's why ACE inhibitors were invented. |
| 1:36.4 | They counteract this and they lead to vasodilation, reduce blood pressure. |
| 1:42.0 | So when the ACE is inhibited the angio-tensin 2 |
| 1:45.9 | doesn't do its thing you get vasodilation reduction of blood pressure. So ACE |
| 1:50.6 | also promotes the breakdown of Brady Kainin |
| 1:54.7 | through converting Angio Tinson 1 to Angio Tinson 2. |
... |
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