What is the recommended observation time to monitor patients after an ACE inhibitor overdose if they are asymptomatic?
A retrospective review of 33 patients who presented after an ACE inhibitor overdose found that maximal blood pressure lowering occurred around 5 hours after ingestion irrespective of type of ACE inhibitor and co-ingestions. The recommended observation time of 6 hours after ingestion would allow for detection of hypotension along with a safety margin.
Lucas C, Christie GA, Waring WS. Rapid onset of haemodynamic effects after angiotensin converting enzyme-inhibitor overdose: implications for initial patient triage. Emerg Med J. 2006;23(11):854-857. doi:10.1136/emj.2006.038836
Submitted by: Natasha Tobarran, DO on behalf of The Medical Toxicology Fellowship, Virginia Commonwealth University