scleroderma...... - thrombolyser

[ArchivalUser]

amngst ACEI captopril is DOC or ENALAPRIL in scleroderma renal crisis

[ArchivalUser]

(Correct Answer = C)

Short-acting angiotensin-converting enzyme inhibitors, such as captopril, are the drugs of choice in the treatment of scleroderma renal crisis.

The most appropriate next step in this patient's management is hospitalization and initiation of therapy with a short-acting angiotensin-converting enzyme (ACE) inhibitor, such as captopril. This patient has scleroderma renal crisis with new-onset hypertension, slightly increased creatinine, decreased platelets, and anemia with associated lower-extremity edema. Close monitoring and aggressive titration of a short-acting ACE inhibitor are indicated to rapidly decrease her blood pressure to the low normal range.

Scleroderma renal crisis is associated with an increase in renin levels. Therefore, treatment with an ACE inhibitor is more appropriate than diuretic therapy. Outpatient therapy with enalapril is not sufficiently aggressive to treat this patient's condition. Rapid onset and progression of renal failure frequently accompany this presentation. Intravenous labetalol is not a first-line agent for treating scleroderma renal crisis. In addition, labetalol may worsen this patient's symptoms of Raynaud's phenomenon and is therefore not the most appropriate choice in this clinical scenario. However, this agent may be used if additional blood pressure control is needed.

[ArchivalUser]

thx thrombo

[ArchivalUser]

I understand ACEI id doc for renal HTN. But what decides follow-up or hosptalization?

[ArchivalUser]

Sorry I see the answer.