Angiotensin converting enzyme inhibitors like enalapril, also increase (level I action) of which of the following? (AIPG 2011)
a. In 0.1 - 2% of patients, ACE inhibitors induce a rapid swelling in nose, throat, mouth, glottis, larynx, lips and / or tongue (angioneurotic edema).
b. It is not dose related and nearly always develops within first week of therapy, usually within the first few hours after the initial dose.
c. Airway obstruction and respiratory distress may lead to death. Although the mechanism of angioneurotic edema is unknown, it may involve accumulation of bradykinin, induction of tissue specific autoantibodies, or inhibition of complement 1-esterase inactivator.