Podcast #81: Angioedema

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Author: Dr. Nicholas Hatch

Educational Pearls:

  • Angioedema is usually caused by an allergic reaction and can be induced by ACE inhibitors as well as tissue plasminogen activator (TPA).
  • Angioedema is caused by the build up of bradykinins resulting in the leaking of capillaries and swelling of tissue.
  • TPA-induced angioedema is reported to occur in 1.6% of the patients who receive TPA and is more severe than ACE inhibitor-induced angioedema.
  • Giving solu-medrol to treat ACE inhibitor-induced angioedema is the standard of care, although its actual benefit is limited.
  • FFP and icatibant (which is a bradykinin receptor antagonist) have been shown to provide more benefit in treatment of angioedema. These are much more expensive options than solu-medrol, with the 30 mg of SubQ icatibant costing the hospital $5000 dollars per dose.
  •  ACE inhibitor-induced angioedema lasts on average 27 hours before the symptoms subside.

Link to Podcast: http://medicalminute.madewithopinion.com/angioedema/

References: http://www.uptodate.com/contents/ace-inhibitor-induced-angioedema

http://rebelem.com/tpa-associated-angioedema/

http://www.ncbi.nlm.nih.gov/pubmed/12639808

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