Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Angiotensin converting enzyme (ACE) inhibitors are a novel class of antihypertensive and anticongestive heart failure agents with wide patient and physician acceptability. By blocking the formation of angiotensin II in blood and tissue, all ACE inhibitors significantly lower systemic vascular resistance, lower blood pressure, and improve cardiac function, while maintaining or enhancing perfusion of vital organs: kidneys, brain, and heart. Captopril is the first oral ACE inhibitor with an active sulfhydryl group. Enalapril and lisinopril are potent nonsulfhydryl inhibitors of ACE characterized by weak chelating properties. The side effects of skin rashes, pruritus, taste abnormalities, oral ulcers, pemphigus, and blood dyscrasias have been considered to be strongly characteristic of penicillaminelike drugs, including the sulfhydryl ACE inhibitors. The class effects of cough, angio-edema, hyperkalemia, nonoliguric functional renal insufficiency, and hypotension can occur with equal frequency with all ACE inhibitors. It is unclear whether the many yet investigational ACE inhibitors would have distinct advantages over captopril, enalapril, lisinopril, and enalaprilat. This paper reviews the comparative structure and clinical pharmacology of the three commercially available but chemically different oral ACE inhibitors.
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PMID:Angiotensin converting enzyme inhibitors: comparative structure, pharmacokinetics, and pharmacodynamics. 228 12

Anti-hypertensive drugs, including diuretics and beta-blocking drugs, belong to a group of therapeutics used by about a fourth of the Danish population. As with cytostatics, antibiotics, and topical remedies, they rather frequently cause adverse drug reactions (ADR) in the skin. No exact statistical information is available concerning the extent of such side effects. The information obtained by Danish National Board of Health's Committee on Adverse Drug Reactions shows that 10-60% of ADR from diuretics, beta-blocking agents, and anti-hypertensive drugs are dermatological. The skin symptoms are not unique for any specific drug. But certain symptoms occur more frequently than others. Thiazides can give vasculitis, a phototoxic/-allergic eruption, erythema multiforme, or eczema. The combination of amiloride (5 mg) and hydrochlorothiazide (50 mg) carries the highest number of recorded ADR; 59% of these are in the skin. Half of the skin ADR are phototoxic eczema. Furosemide may give eczema, purpura, a bullous eruption, or Steven-Johnson's syndrome in rare cases. Methyldopa can induce eczematous eruptions on hands and feet, a lichenoid eruption, a lupus erythematosus-like eruption, or purpura. Hydralazine may give lupus erythematosus-like eruptions, eczema, or urticaria. Non-specific beta-blocking drugs can induce a morbilliform rash and may aggravate psoriasis. Captopril may induce pruritus in up to 15% of the patients and skin eruptions in 2%. The most serious dermatological side effect, exfoliative dermatitis, is very rarely seen following the use of anti-hypertensive drugs or diuretics.
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PMID:Adverse reactions in the skin from anti-hypertensive drugs. 289 92

Eleven patients with severe, treatment-resistant essential or renovascular hypertension were treated with captopril after withdrawal of various multiple drug regimes. If supine diastolic blood pressure remained greater than 90 mm Hg on a maximum daily dose of 450 mg captopril, a diuretic and then a beta-adrenoceptor blocker were added. Patient-volunteered complaints were carefully noted. Mean (+/- SE) systolic and diastolic blood pressures fell from 225 +/- 6.8/131 +/- 4.4 mm Hg on various multiple drug regimes to 182 +/- 9.0/105 +/- 5.0 mm Hg on a regime including captopril. The reported and observed incidence of adverse effects were as follows: maculopapular rash (one patient); urticaria and pruritus (three patients); loss of taste (one patient); tachycardia (four patients); increased frequency of trivial infections (three patients); severe myalgia (one patient); and deterioration in renal function (one patient). However, these patients were able to continue captopril after either temporary withdrawal or dose reduction. Captopril was discontinued permanently in five patients, in two because of poor blood pressure control, in one who developed persistent severe urticaria, and in one because of marked proteinuria. In the fifth patient intractable diarrhoea occurred. Captopril lowers blood pressure very effectively in patients with severe hypertension refractory to other agents. Adverse effects are common but acceptable in this situation where prognosis is poor if blood pressure is not adequately controlled.
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PMID:Efficacy and adverse effects of captopril in severe refractory hypertension. 617 29

Captopril (Lopirin, Squibb, von Heyden) is an inhibitor of the angiotensin-I converting enzyme. In congestive heart failure angiotensin mediated vasoconstriction and aldosterone secretion is reversed by captopril. Both effects of captopril induce reduction of cardiac preload and afterload. The clinical state of patients with congestive heart failure therefore improves since cardiac output increased and pulmonary pressures decrease. Captopril acts orally and the dosage used for the treatment of congestive heart failure ranges from 50 to 150 mg daily. After oral ingestion of a single dose the maximum haemodynamic effect is observed after 45-90 min. No tolerance induction or tachyphylaxis has been observed during maintenance therapy over a period of 18 months. There are some reversible adverse reactions like pruritus, skin rash and partial or complete taste loss which are dose related. Serious side effects include leucopenia, agranulocytosis, renal failure and membranous glomerulonephritis. Therefore regular urinary and blood analysis is necessary during captopril therapy.
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PMID:[Captopril in congestive heart failure (author's transl)]. 621 Jul 98

A case of acute renal failure associated with captopril administration is reported. A woman, age 57, with a two-year history of hypertension presented with a generalized maculopapular rash preceded by pruritus after three weeks of captopril therapy. Her serum creatinine level on admission was 11.0 mg/dl. Renal biopsy was compatible with acute tubular necrosis without evidence of interstitial nephritis. A skin biopsy did not show any evidence of vasculitis. Captopril was discontinued, and her renal failure reversed over the course of nine days. A year later, the patient has good blood pressure control with stable renal function. Captopril has been associated with renal failure in patients with preexisting renovascular hypertension, and with acute interstitial nephritis in one case. The presentation of this case was similar to the latter case, but the renal biopsy did not show any evidence of acute interstitial nephritis.
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PMID:Acute renal failure, skin rash, and eosinophilia associated with captopril therapy. 622 49

With an informatized sample of 123 patients taking Captopril and treated for a total duration of 1,321 month/patients, the frequency of the dermatological symptoms induced by the drug is related. Pruritus is found in 10,5 p. 100 and rashes in 2,4 p. 100 of cases. The results are compared with those of preceeding reports, although some authors have found a higher percentage because of highin doses of the drug. The clinical features of the rashes and the proposed mechanisms are also reported.
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PMID:[Captopril-induced eruptions: occurrence over a 3-year period]. 622 31