Talk:ACE inhibitor

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Please excuse my Australian bias in citing examples of brand names =) Techelf

This Canadian thinks that it's perfectly alright to mention the brandnames in Wikipedia, as the 'lab name' often means nothing to most users of the medication and of Wikipedia. Sometimes, for marketing purposes, the same compound may have different names in different countries, too. It will be useful to mention all the common names. -- PFHLai 22:12, 2004 Jun 28 (UTC)

I was referring to using the Australian brand names (vs say the British), but yeah I agree with you - are the Canadian brand names different from the ones I've got here? I think we should only list the brands of the original maker of the drug though, or else the list would get unmanageable. Techelf10:20, 29 Jun 2004 (UTC)

As a mere science student, I ain't professionally qualified to say much; but I think Canadian brandnames are usually the same as American brandnames, which are sometimes different from British brandnames. It took me awhile, when I first moved to Canada, to figure out things like, say, tylenol in my new home = panadol in my old home. ... I wouldn't worry about getting the list too long. There are only so many English-language markets on this planet, eh ! :-) -- PFHLai 16:14, 2004 Jun 29 (UTC)

I suggest sticking with the generic names with bracketed brand names because this is the standard way doctors do it. Brand names can and will change with geography and time (especially when patents expire). As a side note, patients often tell me about their white pills or their red and white pills and I cringe because it's impossible to identify them ... Alex.tan 10:50, 1 Jul 2004 (UTC)

[edit] Question

I've read that it's not advisable to stop taking ACE inhibitors once you've started taking them, due to their effect on the body's feedback systems. I would like to see information on how to get off them successfully.

Please direct these questions to the Village Pump.

The body's feedback system quite rapidly gets used to the absence of ACE inhibition. It is not generally considered dangerous. There is, however, a possibility that the disease for which you were prescribed an ACEi will recur, e.g. arterial hypertension.

You don't say why you want to stop using an ACEi. Is it the dry cough? There are alternatives. Discuss it with your physician, instead of asking a bunch of strangers on Wikipedia :-). JFW | T@lk 19:58, 8 Jan 2005 (UTC)

As far as any antihypertensive drug therapy, avoid abrupt discontinuation of drug (due to risk of tachycardia, HTN, ischemia, angina, MI, and sudden death) – consult your physician!

Um... Do you have a reference for this? -Techelf 06:51, 18 November 2005 (UTC)

[edit] Update

Sorry, I'm not very wiki savvy and I'm not sure I should update the page. The following can be expounded on a bit:

"A persistent dry cough is a relatively common adverse effect believed to be associated with the increases in bradykinin levels produced by ACE inhibitors"

The increase in bradykinin levels actually causes a cascade including an increase in arachidonic acid metabolites and nitric oxide which can cause inflamation of the lungs. The bradykinin levels themselves don't directly cause the problem.

There are also several effective treatments for the ACE inhibitor induced cough. The most effective are Picotamide and Ozagrel which are thromboxane antagonists and decrease thromboxane production. These drugs are not available in the U.S., however. Sulindac (available in the U.S.), an NSAID (non-steroid anti-inflammatory drug) inhibits prostraglandin synthesis and reduces bradykinins, however it can raise the risk of myocardial infarction. Finally, there's Theophylline which is used for treatment of asthma. Because it has a very narrow therapeutic index (the difference between an effective dose and dangerous dose is slim), it's not usually a good choice.

The other problem with theophylline is that it often raises serum lipids, not such a good thing in the type of patients who need antihypertensives. ----Dan 17:28, 13 October 2006 (UTC)