Angioedema

Tarbox, James; Bansal, Amit; Peiris, Alan N.

doi:10.1001/jama.2018.4860

Cited by 10 publications

(15 citation statements)

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“…Angioedema and respiratory symptoms require the administration of antihistamine, corticosteroid, or symptomatic management. 100 In such cases, N-acetylcysteine should be discontinued, and if necessary, it can be re-started 1 hour after the administration of antihistamine in the absence of signs and symptoms of anaphylaxis. 101 , 102 Patients with a history of atopy (asthma and allergy) are recommended to receive prophylactic antihistamine 15 minutes prior to N-acetylcysteine administration to eliminate the excess risk of adverse reactions.…”

Section: Discussionmentioning

confidence: 99%

N-Acetylcysteine as Adjuvant Therapy for COVID-19 – A Perspective on the Current State of the Evidence

Wong¹,

Lee²,

Kua³

2021

JIR

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The looming severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a long-lasting pandemic of coronavirus disease 2019 around the globe with substantial morbidity and mortality. N-acetylcysteine, being a nutraceutical precursor of an important antioxidant glutathione, can perform several biological functions in mammals and microbes. It has consequently garnered a growing interest as a potential adjunctive therapy for coronavirus disease. Here, we review evidence concerning the effects of N-acetylcysteine in respiratory viral infections based on currently available in vitro, in vivo, and human clinical investigations. The repurposing of a known drug such as N-acetylcysteine may significantly hasten the deployment of a novel approach for COVID-19. Since the drug candidate has already been translated into the clinic for several decades, its established pharmacological properties and safety and side-effect profiles expedite preclinical and clinical assessment for the treatment of COVID-19. In vitro data have depicted that N-acetylcysteine increases antioxidant capacity, interferes with virus replication, and suppresses expression of pro-inflammatory cytokines in cells infected with influenza viruses or respiratory syncytial virus. Furthermore, findings from in vivo studies have displayed that, by virtue of immune modulation and anti-inflammatory mechanism, N-acetylcysteine reduces the mortality rate in influenza-infected mice animal models. The promising in vitro and in vivo results have prompted the initiation of human subject research for the treatment of COVID-19, including severe pneumonia and acute respiratory distress syndrome. Albeit some evidence of benefits has been observed in clinical outcomes of patients, precision nanoparticle design of N-acetylcysteine may allow for greater therapeutic efficacy.

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Section: Discussionmentioning

confidence: 99%

N-Acetylcysteine as Adjuvant Therapy for COVID-19 – A Perspective on the Current State of the Evidence

Wong¹,

Lee²,

Kua³

2021

JIR

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“…Angioedema, also known as Quincke's disease, was first described in the setting of isolated angioedema of the uvula [4] but is now commonly defined as the swelling of the deep layers of the skin or mucosal surfaces [1]. There are multiple etiologies of angioedema, with the main causes being allergic or nonallergic [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…Angiotensin-converting enzyme inhibitor (ACE-i)-induced angioedema is a self-limiting but potentially lifethreatening side effect of ACE-i use. Angioedema is defined as the swelling of the deep layers of the skin or mucosal surfaces [1]. In the context of ACE-i-induced angioedema, edema is thought to occur from the inhibition of ACE-mediated bradykinin and substance P degradation.…”

Section: Introductionmentioning

confidence: 99%

Imaging Review of Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema of the Head and Neck

Baig¹,

Stein²,

Haymes³

et al. 2021

Cureus

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“…Angioedema is one of the dreaded side effects of this medication with an incidence of 0.1-0.7 among its recipients [ 5 ]. Angioedema is defined as swelling caused by the extravasation of plasma into the surrounding interstitium due to a break in vascular integrity [ 8 ]. It most commonly affects the tongue, face, upper airway for instance pharynx, larynx, and subglottic area [ 9 ], visceral involvement has also been established [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

The First Occurrence of Angioedema After Discontinuation of Angiotensin-Converting Enzyme Inhibitor

Kainat¹,

Phang²,

Ain³

et al. 2021

Cureus

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Angioedema is one of the dreaded side effects of angiotensin-converting enzyme (ACE) inhibitors. It has been well established in the literature and the timing of onset is variable from months to years after initiation of therapy. Patients remain at risk of recurrence of angioedema even after discontinuation of the drug if they developed it once while on the drug. While only recurrences of ACE inhibitor-induced angioedema are described in the literature, our patient did not develop angioedema while being on the drug and had the first occurrence of angioedema one month after the medication was discontinued. We argue that since our patient did report an ACE inhibitor-related dry cough, this case emphasizes the strength of the relation between the two common side effects of the ACE inhibitors. This favors that among the risk factors that predispose individuals to develop angioedema, ACE inhibitor-associated cough is a major one. Although the mechanism of ACE inhibitor-related cough is poorly understood, bradykinin seems to be the common culprit mediator for these two side effects. Hence, clinicians need to be aware of this potential threat and be cautioned when they witness an ACE inhibitor-related cough.

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Angioedema

Cited by 10 publications

References 0 publications

N-Acetylcysteine as Adjuvant Therapy for COVID-19 – A Perspective on the Current State of the Evidence

N-Acetylcysteine as Adjuvant Therapy for COVID-19 – A Perspective on the Current State of the Evidence

Imaging Review of Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema of the Head and Neck

The First Occurrence of Angioedema After Discontinuation of Angiotensin-Converting Enzyme Inhibitor

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