Angioneurotic edema

Angioedema (also called angioneurotic edema)-swelling of the skin and mucous membranes, especially around and in the mouth and throat... 

Allergic reactions (anaphylactic shock, angioneurotic edema) ... 

Hypersensitivity—rash, angioneurotic edema, fever, urticaria... 

Impaired wound healing, thin fragile skin, petechiae, ecchymoses, erythema, increased sweating, suppression of skin test reactions, subcutaneous fat atrophy purpura, striae, hyperpig mentation, hirsutism, acneiform eruptions, urticaria, angioneurotic edema... 

Treatment of superficial Local irritation (jtching, burning, infections involving angioneurotic edema, urticaria,... 

Hereditary angioneurotic edema with Ci esterase inhibitor... 

Synthesis of Cl inhibitor in fibroblasts from patients with type I and type II hereditary angioneurotic edema. J Clin Invest 1991 87 1614-1620. 

Pearson K, Buchignani J. Shimkin P. Frank M Hereditary angioneurotic edema of the gastrointestinal tract. Am J Roetgenol Radium Ther Nucl Med 1972 116 256-261. 

Quastel M, Harrison R, Cicardi M, Alper C, Rosen F Behavior in vivo of normal and dysfunctional Cl inhibitor in normal subjects and patients with hereditary angioneurotic edema. J Chn Invest 1983 71 1041-1046. 

Kramer J, Rosen F, Colten H, Rajczy K, Strunk R Transinhibifion of Cl inhibitor synthesis in type I hereditary angioneurotic edema. J Chn Immunol 1993 91 1258-1262. 

Austen KF, Sheffer AL Detection of hereditary angioneurotic edema by demonstration of a reduction in the second component of human complement. N Engl J Med 1965 272 649-656. 

Juhhn L, Michaelsson G Vascular reactions in hereditary angioneurotic edema. Acta Derm Venereol 1969 40 20-25. 

Geha R, Quinti I, Austen K, Cicardi M, Sheffer A, Rosen F Acquired Cl-inhibitor deficiency associated with anti-idiotypic antibody to monoclonal immunoglobuhns. N Engl J Med 1985 312 534-540. Donaldson V, Hess E, McAdams A Lupus-erythe-matosus-like disease in three umelated women with hereditary angioneurotic edema. Arm Intern Med 1977 86 312-313. 

Undesired effects. The magnitude of the antihypertensive effect of ACE inhibitors depends on the functional state of the RAA system. When the latter has been activated by loss of electrolytes and water (resulting from treatment with diuretic drugs), cardiac failure, or renal arterial stenosis, administration of ACE inhibitors may initially cause an excessive fall in blood pressure. In renal arterial stenosis, the RAA system may be needed for maintaining renal function and ACE inhibitors may precipitate renal failure. Dry cough is a fairly frequent side effect, possibly caused by reduced inactivation of kinins in the bronchial mucosa. Rarely, disturbances of taste sensation, exanthema, neutropenia, proteinuria, and angioneurotic edema may occur. In most cases, ACE inhibitors are well tolerated and effective. Newer analogues include lisinopril, perindo-pril, ramipril, quinapril, fosinopril, benazepril, cilazapril, and trandolapril. 

Allergic reactions (eg, bronchospasm, urticaria, pruritus, angioneurotic edema, or swelling of the lips, eyelids, tongue, and nasal mucosa) due to anaphylactic shock caused by stinging insects (primarily of the order Hymenoptera, that includes bees, wasps, hornets, yellow jackets, bumble... 

CNS Dizziness (mefenamic acid, meloxicam, piroxicam, flurbiprofen, diciofenac, fenoprofen) headache (ketorolac, fenoprofen, indomethacin, diclofenac, flurbiprofen, meclofenamate, meloxicam, nabumetone, naproxen, tolmetin, ketoprofen, sulindac, celecoxib, mefenamic acid, piroxicam, ibuprofen) somnolence/drowsiness (fenoprofen, naproxen) asthenia (tolmetin, etodolac) malaise (etodolac) fatigue (indomethacin) insomnia (meloxicam). Dermatologic Rash/dermatitis, including maculopapular type (ibuprofen, sulindac, meclofenamate, oxaprozin, nabumetone, mefenamic acid, meloxicam) desquamation angioneurotic edema ecchymosis petechiae purpura alopecia pruritus (nabumetone, naproxen) eczema skin discoloration hyperpigmentation skin irritation peeling skin eruptions (naproxen). 

Adverse reactions may include drowsiness ataxia dizziness slurred speech headache vertigo weakness impairment of visual accommodation euphoria overstimulation paradoxical excitement nausea vomiting diarrhea palpitations tachycardia various arrhythmias syncope hypotensive crises allergic/idiosyncratic reactions leukopenia acute nonthrombocytopenic purpura petechiae ecchymoses eosinophilia peripheral edema fever hyperpyrexia chills angioneurotic edema bronchospasm oliguria anuria anaphylaxis erythema multiforme exfoliative dermatitis stomatitis proctitis Stevens-Johnson syndrome bullous dermatitis paresthesias agranulocytosis aplastic anemia thrombocytopenic purpura. 

Adverse reactions may include dry skin and mucous membranes, flushing, hyperthermia, tachycardia, urinary retention (especially in children), pruritus, gum swelling, angioneurotic edema, urticaria, anaphylaxis, dizziness, drowsiness, sedation, headache, malaise, lethargy, restlessness, euphoria, depression, numbness of extremities, confusion, anorexia, nausea, vomiting, abdominal discomfort, toxic megacolon, and pancreatitis. 

Allergic symptoms include urticaria angioneurotic edema laryngospasm bronchospasm hypotension vascular collapse death maculopapular to exfoliative dermatitis vesicular eruptions erythema multiforme reactions resembling serum sickness (eg, chills, fever, edema, arthralgia, arthritis, malaise) laryngeal edema skin rashes prostration. 

Hypersensitivity Anaphylactoid purpura, anaphylaxis, angioneurotic edema, myocarditis, pericarditis, polyarthralgia, pulmonary infiltrates with eosinophilia, systemic lupus erythematous exacerbation, urticaria hypersensitivity syndrome (cutaneous reaction, eosinophilia, and one or more of the following Hepatitis, pneumonitis, nephritis, myocarditis, pericarditis, fever, lymphadenopathy). Muscuioskeietai - ArVr ra g a, arthritis, bone discoloration, joint stiffness and swelling, myalgia, polyarthralgia. 

The following reactions are common Vestibular ototoxicity (eg, nausea, vomiting, vertigo) paresthesia efface rash fever urticaria angioneurotic edema eosinophilia. 

Sensitivity reactions such as transient irritation, burning, stinging, itching, inflammation, angioneurotic edema, urticaria, and vesicular and maculopapular dermatitis have occurred in some patients. 

The main side effects of ACE-inhibitors are cough, hypotension and angioneurotic edema, hypokalemia. Contraindications are stenosis of the renal arteries, kidney transplantation and pregnancy. 

Hypotension, in particular in combination with diuretics, is a well-known adverse reaction to ACE-inhibitors when used in patients with heart failure. Dry cough, possibly mediated by the accumulation of bradykinin, is also a well-known side-effect in 5-15% of the patients treated with an ACE-inhibitor. Impaired renal function may be worsened by ACE-inhibitors. Allergic reactions, sometimes rather intense, may be observed occasionally. In rare cases angioneurotic edema has been described. ACE inhibitors should be avoided in women who are likely... 

Hypersensitivity reactions, including dermatitis, angioneurotic edema, pruritus, rash, and urticaria may occur. 

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