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1 Survey of the Incidence of Dry Cough Caused by ACE Inhibitors MOTOHIRO YAGI*, MIKIO SAITO, MANABU ABE and KATSUJI UNO Pharmacy, Suibarago Hospital õ Received October 24, 1996 Accepted September 3, 1997 We interviewed 539 patients (268 males, 271 females) treated with angiotensin converting enzyme (ACE) inhibitors to survey the incidence of dry cough caused by ACE inhibitors. In addition, we identified the latent patients with dry cough induced by ACE inhibitors and surveyed the incidence of discontinuance or change in the ACE inhibitors after the interview. The incidence of dry cough induced by the ACE inhibitors cough was found in 4.9%. After the interview, the incidence of discontinuance was 18.9%, and a serious dry or change in the ACE inhibitor administration was 20.6% in all patients with dry cough, 68.0% in the patients with a serious dry cough and 5.2% in the patients with a slight dry cough. All patients who either discontinued or changed the ACE inhibitors soon stopped soffering from dry cough. These results indicate that dry cough caused by the ACE inhibitors may be a clinically severe problem. Moreover, the detection and suitable treatment of latent patients with dry cough induced by ACE inhibitors is also important in order to perform proper drug therapy. Key words ACE inhibitors, dry cough, incidence, latent patients, suitable direction Okayama-cho, Suibara-machi, Kitakanbara-gun, Niigata, Japan

3 Table 1. Incidence of Dry Cough in 539 Patients Treated by ACE Inhibitors Table 2. Discontinuance or Change of ACE Inhibitor for Dry Cough a: significantly different( p<0.001),x2 -test Fig.1. Relationship between the Incidence of Dry Cough Induced by ACE Inhibitors and Age or Sex

4 Table 3. Incidence of Dry Cough Induced by Each ACE Inhibitor a: significantly different (p<0.05), x2-lest Table 4. Time Zone of the Emergency of Dry Cough Induced by ACE Inhibitors *Si gnificantly different (p<0.005),x2-test

5 574 病 Fig. 2.The Number with Table 5. a: asthma 6. 薬学Vol.23, of the Patients Duration The Effect a: non-steroidal Table 院 of ACE whom of Drugs to the Dry Cough Association between by ACE bronchitis, Appeared by ACE Inhibitors drugs and Dry Cough or chronic Dry Cough Inhibitors anti-inflammatory The No.6 (1997) b:>10 Respiratory Disease or Smoking Inhibitors cigarettes /day らの報告2.では %と考 1.空 ACE阻察咳の発現頻度害薬の副作用の中で薬物治療上,最も問題となると考えられる空咳の発現頻度は,伊藤る.発現率の相違は,(1)調方法,(3)調る.患査三1列数の3点かなりの培があ査方法,(2)空咳の判定に起因すると考'えられ者の自発的訴えを待つ方法では,潜在的な空咳発現音を見逃してしまう可能性があり,実際

8 5) Yves Lacourciere, Jean Lefebvre, Gisele Nakhle, Elisabeth P. Faison, Duane B. Snavely and Edward B. Nelson, J. Hypertens, 12, S 49 7) E. Jaspard, L. Wei and G. F. Alhenc, J. Biol. Chem., 268, (1993). 10) C. I.Johnston, Fredrick A. O. Mendelsohn, Rose B. Cubela, Bruce Jackson, Masahiro Ko- hzuki and Bruno Fabris, J. Hypertens, 6, S (1988). 14) I. U. Puolijoki, M. M. Nieminen, L. O. Siitonen, A. H. S. Landensuo and P. M. O. Reinikainen, Respiration, 55, (1989). 15) M. G. Nicholls, and N. L. Gilchrist, Lancet, 1, 872 (1987).

VOL. 37 NO. 3 Key words: Drug allergy, LMIT, Penams, Cephems, Cross-reactivity

VOL. 37 NO. 3 Key words: Drug allergy, LMIT, Penams, Cephems, Cross-reactivity CHEMOTHERAPY MAR. 1989 Mble 1. Allcrgy in parients nduced by penams VOL. 37 NO. 3 Table 2. Allergy in patients induced by