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A 52-year-old male is currently an inpatient on a hospital ward. He developed rapid-onset swelling of the lips and face during his hospital stay. He reports no itching or urticaria. His vital signs remain stable, and there is no wheezing on chest auscultation.


The patient was admitted after presenting to the emergency department with a high fever, productive cough, and right-sided pleuritic chest pain. A chest X-ray showed a right lower lobe consolidation, and he was subsequently diagnosed with community-acquired pneumonia.


His current medication chart includes:

  • Lisinopril – 10 mg PO once daily
  • Paracetamol – 1 g PO every 6 hours PRN
  • Ceftriaxone – 1 g IV once daily
  • Ondansetron – 4 mg IV every 8 hours PRN
  • Metoprolol – 25 mg PO twice daily


Which of the following medications is the most likely cause of his condition?

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