Disulfiram effect: Difference between revisions

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**Works by inhibiting acetaldehyde dehydrogenase → buildup of acetaldehyde → unpleasant effects.
**Works by inhibiting acetaldehyde dehydrogenase → buildup of acetaldehyde → unpleasant effects.
**Designed to assist in alcohol cessation.
**Designed to assist in alcohol cessation.
===Disulfiram-like Reaction===
*Certain other medications cause acute ethanol intolerance and similar effects as disulfiram<ref>Karamanakos PN, Pappas P, Boumba VA, et al. Pharmaceutical agents known to produce disulfiram-like reaction: effects on hepatic ethanol metabolism and brain monoamines. Int J Toxicol. 2007 Sep-Oct;26(5):423-32.</ref>
**Mechanism is thought to be the same (i.e. buildup of acetaldehyde)
*Examples
**Antibiotics ([[Metronidazole|metronidazole]], certain [[Cephalosporins|cephalosporins]], chloramphenicol, furazolidone)
**Antifungals ([[Griseofulvin]])
**Quinacrine


==Clinical Features==
==Clinical Features==
 
*Nausea/vomiting
*Headache
*Visual changes
*Flushing


==Differential Diagnosis==
==Differential Diagnosis==
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==Diagnosis==
==Diagnosis==
*Clinical diagnosis
*Clinical diagnosis
==Medications with Similar Effects==
* Antibiotics ([[Metronidazole|metronidazole]], [[Cephalosporins|cephalosporins]] (cefotetan))
* Antifungals ([[Griseofulvin]])


==Management==
==Management==
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==Disposition==
==Disposition==
 
*Discharge


==See Also==
==See Also==

Revision as of 05:26, 9 August 2015

Background

  • Disulfiram (Trade names: Antabuse, Antabus) - causes an acute reaction in the presence of ethanol.
    • Works by inhibiting acetaldehyde dehydrogenase → buildup of acetaldehyde → unpleasant effects.
    • Designed to assist in alcohol cessation.

Disulfiram-like Reaction

  • Certain other medications cause acute ethanol intolerance and similar effects as disulfiram[1]
    • Mechanism is thought to be the same (i.e. buildup of acetaldehyde)
  • Examples

Clinical Features

  • Nausea/vomiting
  • Headache
  • Visual changes
  • Flushing

Differential Diagnosis

Diagnosis

  • Clinical diagnosis

Management

  • Supportive care

Disposition

  • Discharge

See Also

Ethanol toxicity

References

  1. Karamanakos PN, Pappas P, Boumba VA, et al. Pharmaceutical agents known to produce disulfiram-like reaction: effects on hepatic ethanol metabolism and brain monoamines. Int J Toxicol. 2007 Sep-Oct;26(5):423-32.