NDLI: Icatibant in angiotensin-converting enzyme (ACE) inhibitor-associated angioedema.

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Icatibant in angiotensin-converting enzyme (ACE) inhibitor-associated angioedema.

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Icatibant in angiotensin-converting enzyme (ACE) inhibitor-associated angioedema.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Fok, J. S. Katelaris, C. H. Brown, A. F. Smith, W. B.
Description	Country affiliation: Australia Author Affiliation: Fok JS ( Department of Clinical Immunology and Allergy, Royal Adelaide Hospital, Adelaide, South Australia, Australia.); Katelaris CH ( Department of Clinical Immunology and Allergy, Campbelltown Hospital, Sydney, New South Wales, Australia.); Brown AF ( University of Western Sydney, Sydney, New South Wales, Australia.); Smith WB ( School of Medicine, University of Queensland, Brisbane, Queensland, Australia.)
Abstract	BACKGROUND: Angioedema occurs in up to 2% of those taking angiotensin-converting enzyme (ACE) inhibitors. Upper airway angioedema may potentially require endotracheal intubation or cricothyrotomy, and is usually unresponsive to adrenaline. The bradykinin receptor antagonist icatibant is proven to be effective in the treatment of acute attacks of hereditary angioedema, and has also been reported effective in the treatment of angioedema associated with ACE inhibitors. AIM: To describe the use of icatibant for ACE inhibitor-associated airway angioedema. METHODS: We treated 13 consecutive emergency department (ED) patients, who had not improved with adrenaline and/or corticosteroids, with icatibant 30 mg subcutaneously for ACE inhibitor-associated upper respiratory tract angioedema according to an agreed protocol. RESULTS: Four patients were intubated in the ED either before or after receiving icatibant; three of these were extubated within 24 h of treatment. Eight patients received early icatibant and did not require intubation. The time from onset of airway angioedema to ED presentation ranged from 1 h to 3 days (median 4 h); from ED presentation to receiving icatibant, from 30 minutes to 3 days (median 3 h); and to onset of symptom improvement after icatibant, 15 minutes to 7 h (median 2 h). One patient received a second dose of icatibant. CONCLUSION: All patients improved after receiving icatibant, consistent with its bradykinin receptor blocking mechanism. Icatibant rapidly reversed symptoms, and appeared to avert the need for intubation or expedite extubation. Timely use of icatibant in ACE inhibitor-associated angioedema may avert the need for invasive airway procedures and intensive care unit admission.
File Format	HTM / HTML
ISSN	14440903
Issue Number	8
Volume Number	45
e-ISSN	14455994
Journal	Internal Medicine Journal
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2015-08-01
Publisher Place	Australia
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Humans Middle Aged Discipline Internal Medicine Male Journal Article Bradykinin Adult Female Larynx Clinical Decision-making Emergency Service, Hospital Adverse Effects Angioedema Drug Therapy Angiotensin-converting Enzyme Inhibitors Oropharynx Bradykinin B2 Receptor Antagonists Aged, 80 And Over Therapeutic Use Chemically Induced Standards Pathology Aged Intubation, Intratracheal Analogs & Derivatives Methods
Content Type	Text
Resource Type	Article
Subject	Internal Medicine

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