A 57-year-old woman with type 2 diabetes and hypertension is started on lisinopril 10 mg daily. Two weeks later, she presents with a persistent dry cough, dyspnea, and wheezing. Vital signs show BP 128/76 mmHg, HR 82, RR 22, temperature 37.2°C, and SpO2 98% on room air. Chest X-ray reveals no infiltrates or pulmonary edema. She denies fever, sputum production, or recent upper respiratory infection. Which mechanism best explains this adverse effect?

  1. A)Increased aldosterone secretion
  2. B)Enhanced prostaglandin degradation
  3. C)Direct beta 2 receptor stimulation
  4. D)Accumulation of bradykininGABARITO
  5. E)Blockade of sodium channels in airway nerves

Explicação

ACE inhibitors decrease conversion of angiotensin I to angiotensin II and also decrease breakdown of bradykinin. Accumulation of bradykinin contributes to the classic dry cough and, in some cases, angioedema. Ver explicação completa e trilha adaptativa →

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