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ACE inhibitor angioedema — GPhC CRA MCQ

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EasyAdverse Drug Reactions and Drug SafetyACE inhibitor angioedemaGPhC CRA

A 61-year-old man taking ramipril for hypertension develops lip and tongue swelling without a rash. He is breathless and attends the pharmacy counter with his partner. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Call 999 and advise ramipril should be stopped pending urgent medical review

ACE inhibitor-associated angioedema may occur without urticaria and can threaten the airway. Breathlessness with tongue swelling is a medical emergency. Ramipril should not be continued until urgent clinical review has occurred. Antihistamines may not be sufficient because the reaction is often bradykinin-mediated.

Reference: BNF; NICE CKS