アンジオテンシン変換酵素阻害薬（イミダプリル）により出現した血管浮腫の早期発見における服薬指導の役割 症例報告

Abstract

A 62-year-old female coronary outpatient underwent an angiography examination at Kosei Hospital because of frequent chest pain and chest oppression. The angiography examination showed the patient to have hypertension and refractory variant angina, and the patient was thus administered angiotensin converting enzyme inhibitor (ACE-inhibitor), imidapril, and Ca2+-blocker, diltiazem. Within 24 hours after taking imidapril, the patient experienced an episode of symptomatic angioedema on her lower lip, which quickly resolved after discontinuing the drug therapy. ACE-inhibitor has been reported to cause angioedema, which appears from 1 to 21 days after drug administration. In view of the increasing use of ACE inhibitors, the features of this unusual adverse reaction need to be widely recognized by both patients and medical staff members, since angioedema of the larynx can result in patient death.This clinical case suggests that the angioedema induced by imidapril needs to be carefully monitored from the beginning of the drug therapy and the patients should be informed of any adverse reactions whenever ACE inhibitors such as imidapril are administered. In addition, drug consultations by pharmacists may also play an important role in the early detection of adverse reactions in outpatients.