Enalaprilat induced acute parotitis.

Drug induced acute parotitis is a very uncommon complication reported with a few drugs only. There is no case of acute bilateral parotitis reported previously with i.v. enalaprilat. We present here a female patient who developed acute bilateral parotitis within minutes of i.v. enalaprilat injection and recovered within 24 hours of stopping the drug and with symptomatic treatment.

Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

Angiotensin-converting enzyme inhibitors have been shown to improve splanchnic perfusion in distinct shock states. We hypothesized that enalaprilat potentiates the benefits of early fluid resuscitation in severe experimental sepsis, particularly in the splanchnic region. Anesthetized and mechanically ventilated mongrel dogs received an intravenous infusion of live Escherichia coli over a period of 30 min. Thereafter, two interventions were performed: fluid infusion (normal saline, 32 mL/kg over 30 min) and enalaprilat infusion (0.02 mg kg-1 min-1 for 60 min) in randomized groups. The following groups were studied: controls (fluid infusion, N = 4), E1 (enalaprilat infusion followed by fluid infusion, N = 5) and E2 (fluid infusion followed by enalaprilat infusion, N = 5). All animals were observed for a 120 min after bacterial infusion. Mean arterial pressure, cardiac output (CO), portal vein blood flow (PVBF), systemic and regional oxygen-derived variables, and lactate levels were measured. Rapid and progressive reductions in CO and PVBF were induced by the infusion of live bacteria, while minor changes were observed in mean arterial pressure. Systemic and regional territories showed a significant increase in oxygen extraction and lactate levels. Widening venous-arterial and portal-arterial pCO2 gradients were also detected. Fluid replacement promoted transient benefits in CO and PVBF. Enalaprilat after fluid resuscitation did not affect systemic or regional hemodynamic variables. We conclude that in this model of normotensive sepsis inhibition of angiotensin-converting enzyme did not interfere with the course of systemic or regional hemodynamic and oxygen-derived variables.

Evaluation of the efficacy, safety and tolerability of intravenous enalaprilat in the treatment of grade III essential hypertension in Indian patients.

Hypertensive emergency is a common problem requiring an effective, safe and easily administrable agent to reduce the blood pressure. Favorable data on injectable enalaprilat have been reported from the West but no Indian study has been done in such settings. We studied 10 patients (5 male, 5 female), with mean age 47+/-0.6 years and mean blood pressure 196+/-18.95/119.4+/-19.53 mmHg, who were given 1.25 mg intravenous enalaprilat. Reduction in their blood pressure started at 5 min with peak reduction noted at 4 hours (155.25+/-29.54/93.5+/-13.55 mmHg). No adverse symptoms or biochemical changes were noted. Thus, we conclude that intravenous enalaprilat is an effective, safe and well tolerated agent for managing severe hypertension in patients requiring an emergency reduction in blood pressure.