Captopril
Captopril is a specific competitive inhibitor of angiotensin I-converting enzyme (ACE). During an episode of AD, 25mg of captopril is recommended for sublingual administration.
Author Year; Country Score Research Design Sample Size |
Methods | Outcome |
Esmail et al. 2002; Canada |
Population: 26 consecutive patients older than 15 years with SCI above T6. Treatment: administration of a) captopril 25mg sublingually if systolic blood pressure (SBP) was at or above 150mmHg, b) 5mg of immediate-release nifedipine if SBP remained elevated 30 minutes after captopril administration. Outcome Measures: SBP |
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Discussion
From one pre-post study (n=26) (Esmail et al. 2002), captopril was safe and effective in 4 out of 5 episodes for AD management. This prospective open labelled study and numerous experts’ opinion suggest the use of the captopril as a primary medication in management of AD (Consortium for Spinal Cord Medicine 2001; Frost 2002; Anton & Townson 2004).
Conclusion
There is level 4 evidence (from one pre-post study: Esmail et al. 2002) for the use of captopril in the acute management of AD in SCI.