QuestionSBA
QuestionChoice
Interstitial lung disease is a category of respiratory conditions causing lung fibrosis. Symptoms typically include breathlessness and a cough. However, it is not caused by ACE-inhibitors.
10007093
c
Interstitial lung disease
QuestionChoice
Aldosterone is a mineralocorticoid hormone produced by the adrenal cortex. It plays a key role in maintaining fluid balance, primarily through it's role in regulating sodium reabsorption. ACE-inhibitors reduce aldosterone levels, helping to drive their antihypertensive effect. However, this is not the mechanism by which they can cause a dry cough.
10007095
e
Excess aldosterone levels due to renin release
QuestionChoice
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition associated with shortness of breath and a cough. Infective exacerbations can occur, in which a bacterial, viral or fungal infection causes an exacerbation of these chronic symptoms. However, is not caused by ACE inhibitors.
10007094
d
Chronic obstructive pulmonary disease (COPD) exacerbation
QuestionChoice
Histamine-mediated bronchoconstriction is typically associated with a cough generated through an allergic response. It is not triggered by an ACE-inhibitor.
10007092
b
Histamine-mediated bronchoconstriction
QuestionChoice
Bradykinin is a peptide derived from the respiratory endothelium. It causes dilation of blood vessels via prostacyclin and nitric oxide release. ACE inhibitors increase bradykinin by inhibiting its degradation, which then causes a dry cough via bronchoconstriction. This patient should be trialled on an angiotensin receptor blocker instead of an ACE-inhibitor to avoid this side effect.
10007091
a
Build up of bradykinin
Concept
Chapter
2693
4215
ACE inhibitors
Topic
169
Cardiovascular pharmacology
13965
A 67-year-old man takes an angiotensin-converting enzyme (ACE) inhibitor, enalapril, for hypertension. He has recently developed a dry and distressing cough, and so consults his GP for advice.

His observations are unremarkable, and he is apyrexial.

Which of the following describes the mechanism by which ACE inhibitors cause a dry cough?
a