1- Normal-functioning lungs use ACE (Angiotensin Converting Enzyme) to convert the Angiotensin (1) to Angiotensin (2).
As we know there are many oral forms of the ACE-inhibitor (Angiotensin Converting Enzyme inhibitor), which inhibit conversion of Angiotensin (1) into Angiotensin (2).
2- ACE-inibitor drugs are valuable in many hypertensive patients.
It has an onset time of about 30 minutes and it is not an option in emergency hypertension.
Is there an inhaled ACE-inhibitor to work directly in lungs, to have a faster effect, less adverse effect by using a smaller dose and direct targeting?
Or is there an Inhaled ACE-inhibitor drug so as to be given in emergency cases? And if not available, what are the medical, pharmaceutical and scientific reasons for its unavailability?
* One of the adverse effects of ACE-i is the dry irritating cough and it can be solved by adding an inhaled furosemide to the mixture (Inhaled: ACE-i + furosemide):
1- Dr. Franova S, The influence of inhaled furosemide on adverse effects of ACE-inhibitors in airways, Bratisl Lek Listy 2001; 102 (7): 309-313:
"...The mechanism of this respiratory adverse effect is related to the inhibition of ACE and the accumulation of bradykinin, substance P, prostanoids and inflammatory neuropeptides in the airways..."
"...The results showed the protective effect of inhaled furosemide against the respiratory adverse effects induced by ACE-inhibitors administration..."
Note: this was an experimental study in animals, is there a study done in humans?
http://www.bmj.sk/2001/10207-01.PDF
ACE is known also as kininase II, consequently ACE contributes to degradation of kinins (brady and takykinins); these kynins may cause bronchoconstriction and cough if orally administered ; the levels of kynins may increase as consquence of ACE inhibitors intake, either as usual by mouth or presumably by aerosl. That's wy, in my opinion, the use of ihaled ACE inhibitors do not have EBM data and is not easy to be introduced as alternative way
The first problem is the solubility and biological availability of ACEs...when administered by some routes.