Aliskiren: A New Harbinger of Hypotension?

Abstract

We present a case of significant, persistent, and relatively refractory hypotension during general anesthesia in a reasonably healthy 50-year-old man thought to be caused by a direct rennin inhibitor. This case is of particular significance because the medication thought responsible for the hemodynamic abnormalities is a relatively novel antihypertensive agent and remains largely unknown to clinical anesthesia providers.

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E. Palmer and A. Oken, "Aliskiren: A New Harbinger of Hypotension?," Open Journal of Anesthesiology, Vol. 3 No. 2, 2013, pp. 102-103. doi: 10.4236/ojanes.2013.32025.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] US Food and Drug Administration, “FDA News Release P07-38,” 2011.http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2007/ucm108862.html
[2] M. Azizi, R. Webb, J. Nussberger and N. Hollenberg, “Renin Inhibition with Aliskiren: Where Are We Now, and Where Are We Going?” Journal of Hypertension, Vol. 24, No. 2, 2006, pp. 243-256. doi:10.1097/01.hjh.0000202812.72341.99
[3] P. Colson, J. Ribstein, A. Mimran, D. Grolleau, P. A. Chaptal and B. Roquefeuil, “Effect of Angiotensin-Converting Enzyme Inhibition on Blood Pressure and Renal Function during Open Heart Surgery,” Anesthesiology, Vol. 72, No. 1, 1990, pp. 23-27. doi:10.1097/00000542-199001000-00005
[4] A. P. Yates and D. N. Hunter, “Anaesthesia and Angiotensin-Converting Enzyme Inhibitors. The Effect of Enalapril on Perioperative Cardiovascular Stability,” Anaesthesia, Vol. 43, No. 11, 1988, pp. 935-938. doi:10.1111/j.1365-2044.1988.tb05655.x
[5] S. Brabant, D. Eyraud, M. Bertrand and P. Coriat, “Refractory Hypotension after Induction of Anesthesia in a Patient Chronically Treated with Angiotens in Receptor Antagonists,” Anesthesia and Analgesia, Vol. 89, No. 4, 1999, pp. 887-888.
[6] P. Coriat, C. Richer, T. Douraki, C. Gomez, K. Hendricks, J.-F. Giudicelli and P. Viars, “Influence of Chronic Angiotensin-Converting Enzyme Inhibition on Anesthetic Induction,” Anesthesiology, Vol. 81, No. 2, 1994, pp. 299-307. doi:10.1097/00000542-199408000-00006
[7] U. Thaker, V. Geary, P. Chalmers and F. Sheikh, “Low Systemic Vascular Resistance during Cardiac Surgery: Case Reports, Brief Review, and Management with Angiotensin II,” Journal of Cardiothoracic Anesthesia, Vol. 4, No. 3, 1990, pp. 360-363. doi:10.1016/0888-6296(90)90046-I
[8] M. Auron, B. Harte, A. Kumar and F. Michota, “ReninAngiotensin System Antagonists in the Perioperative Setting: Clinical Consequences and Recommendations for Practice,” Postgraduate Medical Journal, Vol. 87, No. 1029, 2011, pp. 472-481. doi:10.1136/pgmj.2010.112987
[9] Novartis Pharmaceuticals Corporation, “Tekturna? (Aliskiren) Tablets [Prescribing Information]. East Hanover (NJ),” 2009. http://www.pharma.us.novartis.com/product/pi/pdf/tekturna.pdf
[10] Aliskiren (Drug Evaluation), “Drugdex System, MICROMEDEX Healthcare Series [Proprietary Database on the Internet]. Greenwood Village (CO): Thomson MICROMEDEX,” 2011.
[11] AHFS Drug Information, “Bethesda (MD): American Society of Health Systems Pharmacists,” 2011

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