Författare: Kongstad Tobias, Islander Gunilla

Titel: Högt luftvägshinder orsakat av ACE-hämmarutlöst angioödem. Livshotande och underrapporterad biverkning [summary] 2012 nr 14 sid 758-61

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Ämnesord:
Läkemedelsbiverkningar, rapportering
Angioödem
Angiotensinreceptorblockerare
ACE-hämmare
Luftvägshinder
Bradykinin
Enalapril
Riskfaktorer









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Summary:
ACE-inhibitors and/or angiotensin receptor antagonists are used by ~10% of the Swedish population. Adverse effects of these drugs include angioedema, causing potentially life-threatening airway obstruction. Our aim was to identify and describe this condition in a Swedish ICU, but also to review adverse drug effect reporting. Medical records from all ICU patients treated for airway obstruction in a tertial referral University hospital during a five year period were reviewed retrospectively. Twenty-five patients (male/female = 14/11) with airway obstruction caused by ACE-inhibitors (n = 24) or angiotensin receptor antagonists (n = 1) were identified. Ten patients were intubated. Nine patients reported previous episodes of similar, milder edema. Adverse drug effect reporting was low nationwide although increasing. Six deaths attributed to airway obstruction caused by ACE-inhibitor induced angioedema were reported to the Swedish National Medical Products Agency.

Tobias Kongstad, Gunilla Islander

Correspondence: Gunilla Islander, VO Intensiv- och perioperativ vård, Skånes universitetssjukhus, SE-221 85 Lund, Sweden Gunilla.Islander@skane.se

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