Emergency Management of Patients with Hereditary Angioedema: Collaborative Roles of Nurses and Pharmacists

Authors

  • Bader Mohammed G Alotaibi
  • Salem Hejji Awadh Alanazi
  • Awatif Saleh Ghaled Alenazy
  • Khalaf Mahala Alhazml
  • Reem Nuwaysir shallah Alruwaili
  • Afrah Nail Atia Alrwily
  • Reem Naem Asimar Alruwaili
  • Saleh Atallah Khalaf Alanazi
  • Fawaz Muattish Falah Alenazy
  • N1ouf Ali Alruwaili
  • Goot Mohammad Atallah Albqi
  • Majidah Owaidh Jurbua Alruwaili

DOI:

https://doi.org/10.22399/ijcesen.4823

Keywords:

Hereditary Angioedema, Emergency Management, Nursing Role, Pharmacist Role, Interdisciplinary Collaboration, Bradykinin-Mediated Angioedema

Abstract

The emergency management of patients with hereditary angioedema (HAE) represents a critical clinical scenario where timely, targeted intervention is essential to prevent morbidity and mortality, particularly from life-threatening laryngeal edema. This process relies fundamentally on a synergistic, interdisciplinary collaboration between nurses and pharmacists within the emergency department. Nurses provide frontline vigilance through rapid assessment, continuous monitoring for airway compromise, and administration of specific therapies, while pharmacists ensure the immediate availability, accurate preparation, and safe dispensing of complex, often costly, HAE-specific medications. Their integrated roles—spanning diagnostic support, acute pharmacological management, supportive care, and patient education—streamline the emergency response, reduce time-to-treatment, and minimize errors. This collaborative model not only optimizes outcomes during acute attacks but also facilitates a seamless transition to long-term care, underscoring the necessity of a structured, team-based approach in managing this rare and unpredictable disorder.

References

[1] Cicardi M, Bork K, Caballero T, Craig T, Li HH, Longhurst H, Reshef A, Zuraw B. Evidence-based recommendations for the therapeutic management of angioedema owing to hereditary C1 inhibitor deficiency: consensus report of an International Working Group. Allergy. 2012;5:147–157.

[2] Craig TJ, Levy RJ, Wasserman RL, Bewtra AK, Hurewitz D. et al. Efficacy of human C1 esterase inhibitor concentrate compared with placebo in acute hereditary angioedema attacks. J Allergy Clin Immunol. 2009;5:801–808.

[3] Bork K, Frank J, Grundt B, Schlattmann P, Nussberger J, Kreuz W. Treatment of acute edema attacks in hereditary angioedema with a bradykinin receptor-2 antagonist (Icatibant) J Allergy Clin Immunol. 2007;5:1497–1503.

[4] Bissler JJ, Donaldson VH, Davis AE. Contiguous deletion and duplication mutations resulting in type 1 hereditary angioneurotic edema. Hum Genet. 1994;5:265–269.

[5] Cedzynski M, Madalinski K, Gregorek H, Swierzko AS, Nowicka E. et al. Possible disease-modifying factors: the mannan-binding lectin pathway and infections in hereditary angioedema of children and adults. Arch Immunol Ther Exp (Warsz) 2008;5:69–75.

[6] Bas M, Greve J, Stelter K, Bier H, Stark T, Hoffmann TK, Kojda G. Therapeutic efficacy of icatibant in angioedema induced by angiotensin-converting enzyme inhibitors: a case series. Ann Emerg Med. 2010;5:278–282.

[7] Bowen T, Cicardi M, Farkas H, Bork K, Kreuz W. et al. Canadian 2003 International Consensus Algorithm For the Diagnosis, Therapy, and Management of Hereditary Angioedema. J Allergy Clin Immunol. 2004;5:629–637.

[8] Cicardi M, Castelli R, Zingale LC, Agostoni A. Side effects of long-term prophylaxis with attenuated androgens in hereditary angioedema: comparison of treated and untreated patients. J Allergy Clin Immunol. 1997;5:194–196.

[9] Bernstein JA, Ritchie B, Levy RJ, Wasserman RL, Bewtra AK. et al. Population pharmacokinetics of plasma-derived C1 esterase inhibitor concentrate used to treat acute hereditary angioedema attacks. Ann Allergy Asthma Immunol. 2010;5:149–154.

[10] Szegedi R, Szeplaki G, Varga L, Prohászka Z, Széplaki Z. et al. Long-term danazol prophylaxis does not lead to increased carotid intima-media thickness in hereditary angioedema patients. Atherosclerosis. 2008;5:184–191.

[11] Bork K, Barnstedt SE. Treatment of 193 episodes of laryngeal edema with C1 inhibitor concentrate in patients with hereditary angioedema. Arch Intern Med. 2001;5:714–718.

[12] Cicardi M, Levy RJ, McNeil DL, Li HH, Sheffer AL. et al. Ecallantide for the treatment of acute attacks in hereditary angioedema. N Engl J Med. 2010;5:523–531.

[13] Farkas H, Gyeney L, Gidófalvy E, Füst G, Varga L. The efficacy of short-term danazol prophylaxis in hereditary angioedema patients undergoing maxillofacial and dental procedures. J Oral Maxillofac Surg. 1999;5:404–408.

[14] Varga L, Biro A, Széplaki G, Tóth L, Horváth A, Füst G, Farkas H. Anti-cholesterol antibody levels in hereditary angioedema. J Cell Mol Med. 2007;5:1377–1383.

[15] Schneider L, Lumry W, Vegh A, Williams AH, Schmalbach T. Critical role of kallikrein in hereditary angioedema pathogenesis: a clinical trial of ecallantide, a novel kallikrein inhibitor. J Allergy Clin Immunol. 2007;5:416–422.

[16] Gluszko P, Undas A, Amenta S, Szczeklik A, Schmaier AH. Administration of gamma interferon in human subjects decreases plasminogen activation and fibrinolysis without influencing C1 inhibitor. J Lab Clin Med. 1994;5:232–240.

[17] Visy B, Fust G, Bygum A, Bork K, Longhurst H. et al. Helicobacter pylori infection as a triggering factor of attacks in patients with hereditary angioedema. Helicobacter. 2007;5:251–257.

[18] Bowen T, Hebert J, Ritchie B, Burnham J, MacSween M. et al. Management of hereditary angioedema: a Canadian approach. Transfus Apher Sci. 2003;5:205–214.

[19] Craig TJ, Wasserman RL, Levy RJ, Bewtra AK, Schneider L. et al. Prospective study of rapid relief provided by C1 esterase inhibitor in emergency treatment of acute laryngeal attacks in hereditary angioedema. J Clin Immunol. 2010;5:823–829.

[20] Kunschak M, Engl W, Maritsch F, Rosen FS, Eder G, Zerlauth G, Schwarz HP. A randomized, controlled trial to study the efficacy and safety of C1 inhibitor concentrate in treating hereditary angioedema. Transfusion. 1998;5:540–549.

[21] Szeplaki G, Varga L, Valentin S, Kleiber M, Karádi I. Adverse effects of danazol prophylaxis on the lipid profiles of patients with hereditary angioedema. J Allergy Clin Immunol. 2005;5:864–869.

[22] Brozek JL, Akl EA, Alonso-Coello P, Lang D, Jaeschke R. et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009;5:669–677.

[23] Cicardi M, Mannucci PM, Castelli R, Rumi MG, Agostoni A. Reduction in transmission of hepatitis C after the introduction of a heat-treatment step in the production of C1-inhibitor concentrate. Transfusion. 1995;5:209–212.

[24] Waytes AT, Rosen FS, Frank MM. Treatment of hereditary angioedema with a vapor-heated C1 inhibitor concentrate. N Engl J Med. 1996;5:1630–1634.

[25] Bas M, Bier H, Greve J, Kojda G, Hoffmann TK. Novel pharmacotherapy of acute hereditary angioedema with bradykinin B2-receptor antagonist icatibant. Allergy. 2006;5:1490–1492.

[26] Goring HD, Bork K, Späth PJ, Bauer R, Ziemer A, Hintner H, Wüthrich B. Hereditary angioedema in the German-speaking region [in German] Hautarzt. 1998;5:114–122.

[27] Weiler JM, Quinn SA, Woodworth GG, Brown DD, Layton TA, Maves KK. Does heparin prophylaxis prevent exacerbations of hereditary angioedema? J Allergy Clin Immunol. 2002;5:995–1000.

[28] Birjmohun RS, Kees Hovingh G, Stroes ES, Hofstra JJ, Dallinga-Thie GM. et al. Effects of short-term and long-term danazol treatment on lipoproteins, coagulation, and progression of atherosclerosis: two clinical trials in healthy volunteers and patients with hereditary angioedema. Clin Ther. 2008;5:2314–2323.

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Published

2024-08-30

How to Cite

Bader Mohammed G Alotaibi, Salem Hejji Awadh Alanazi, Awatif Saleh Ghaled Alenazy, Khalaf Mahala Alhazml, Reem Nuwaysir shallah Alruwaili, Afrah Nail Atia Alrwily, … Majidah Owaidh Jurbua Alruwaili. (2024). Emergency Management of Patients with Hereditary Angioedema: Collaborative Roles of Nurses and Pharmacists. International Journal of Computational and Experimental Science and Engineering, 10(4). https://doi.org/10.22399/ijcesen.4823

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Section

Research Article