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Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

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In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
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Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Telmisartan induced urticarial vasculitis.

Vikram K Mahajan1, Ravinder Singh1, Mrinal Gupta1

  • 1Department of Dermatology, Venereology and Leprosy, Dr. R. P. Government Medical College, Kangra (Tanda), Himachal Pradesh, India.

Indian Journal of Pharmacology
|November 25, 2015
PubMed
Summary

Urticarial vasculitis, a rare side effect, can occur with telmisartan and hydrochlorothiazide. This adverse reaction highlights the need for vigilance with angiotensin II receptor blockers.

Keywords:
Angiotensin-converting-enzyme inhibitorsangiotensin II receptor blockerecchymosisurticaria

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Area of Science:

  • Dermatology
  • Pharmacology

Background:

  • Hypertension is a common condition managed with medications like telmisartan and hydrochlorothiazide.
  • Angiotensin II receptor blockers (ARBs) are widely prescribed for hypertension.

Observation:

  • A 53-year-old male patient presented with urticarial vasculitis.
  • The condition developed after initiating a combination of telmisartan and hydrochlorothiazide for hypertension.

Findings:

  • Treatment with prednisolone and cetirizine resolved the urticarial vasculitis.
  • Lesions recurred upon continued use of telmisartan and hydrochlorothiazide.
  • Re-challenge confirmed telmisartan as the causative agent, not hydrochlorothiazide.

Implications:

  • This case highlights an uncommon cutaneous adverse reaction associated with ARBs.
  • Clinicians should be aware of potential urticarial vasculitis with telmisartan use.
  • Increased recognition of this side effect is crucial given the widespread use of ARBs.