Thursday, April 14, 2011

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ACE inhibitors - dry cough

ACE inhibitors e.g enalapril remain one of the drug of choice to initiate anti hypertensive therapy. It acts by inhibiting the angiotensin converting enzyme and thus prevent the conversion of angiotensin I to angiotensin II. The latter is a potent vasoconstrictor. Since it is not being produced there is a resulting vasodilation and thus a decrease in the blood pressure.
At the same time ACE inhibitors prevent the breakdown of bradykinin and sunbstance P. These 2 agents are potent protussive mediators in the respiratory tract and thus will cause dry cough.
This is an indication to shift to angiotensin receptor blocker e.g. losartan.

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