When taking care of a patient with ACE inhibitor-induced angioedema, only 1 thing matters:
Protect the airway with endotracheal intubation.
Nothing else matters.
Diphenhydramine won’t work.
Methylprednisolone won’t work.
Epinephrine won’t work.
Ecallantide won’t work.
Fresh frozen plasma might help – but you need to thaw it first…too much time wasted!
Icatibant won’t affect clinically meaningful endpoints.
Just protect the patient’s airway and they’ll be fine. Within 24 to 72 hours they’ll be extubated and ready to go home 🙂
-Pharmacy Joe
PS – If you hear stridor, see that the patient is drooling, using accessory muscles to breathe, or has edema of the tongue or floor of the mouth, assume that the physician will want to immediately intubate. I have a detailed Masterclass on Airway Pharmacology in my Hospital Pharmacy Academy. Click here to learn more and join the Academy today.