Which class of medication is associated with increased risk of orolingual angioedema after thrombolysis?

Which class of medication is associated with increased risk of orolingual angioedema after thrombolysis?

• A. ACE inhibitors
• B. Beta blockers
• C. Diuretics
• D. Calcium channel blockers

Answer: (A)

The main idea here is bradykinin-mediated angioedema and how it can be amplified by thrombolytic therapy. ACE inhibitors block the enzyme that breaks down bradykinin, so these drugs raise bradykinin levels and predispose to angioedema. Thrombolysis (such as tPA) can also increase bradykinin generation through plasmin activating the kallikrein–kinin system. When both are present, bradykinin accumulates more, making orolingual angioedema more likely after thrombolysis. Other drug classes listed don’t have this specific bradykinin-driven mechanism linked to thrombolysis, so they don’t increase this risk in the same way.

The main idea here is bradykinin-mediated angioedema and how it can be amplified by thrombolytic therapy. ACE inhibitors block the enzyme that breaks down bradykinin, so these drugs raise bradykinin levels and predispose to angioedema. Thrombolysis (such as tPA) can also increase bradykinin generation through plasmin activating the kallikrein–kinin system. When both are present, bradykinin accumulates more, making orolingual angioedema more likely after thrombolysis.

Other drug classes listed don’t have this specific bradykinin-driven mechanism linked to thrombolysis, so they don’t increase this risk in the same way.