Probleme in der Therapie mit ACE-Hemmern

  • A. Overlack
Part of the Aktuelle Therapieprinzipien in Kardiologie und Angiologie book series (THERAPIEPRINZ.)

Zusammenfassung

Die Therapie mit Captopril, dem ersten allgemein verfügbaren ACE-Hemmer, war in ihrer Anfangsphase durch eine hohe Frequenz von Nebenwirkungen stark belastet. Captopril wurde in hoher Dosierung bei schwerer Hypertonie, häufig begleitet von einer Niereninsuffizienz, gegeben. Bei diesen Patienten traten in einem hohen Prozentsatz Exantheme, Geschmacksveränderungen, Proteinurie und Neutropenie auf (DiBianco 1986). Von diesen Nebenwirkungen waren meist Patienten mit Niereninsuffizienz und Autoimmun- oder Kollagenerkrankungen betroffen. Nachdem sich gezeigt hatte, daß ACE-Hemmer auch in niedriger Dosierung wirksam sind, ohne ihre Effektivität zu verlieren (Veterans Administration 1982) und sich diese Erkenntnis schnell in die klinische Praxis umgesetzt hatte, haben sich Anzahl und Schwere der Nebenwirkungen deutlich verringert. Gleichzeitig hat sich das Spektrum der Nebenwirkungen verändert. Die früher üblichen Nebenwirkungen sind selten geworden. Heute stehen andere Komplikationen der Therapie mit ACE-Hemmern, wie der erst spät als Nebenwirkung erkannte trockene Husten, im Vordergrund.

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© Springer-Verlag Berlin Heidelberg 1996

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  • A. Overlack

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