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Disulfiram Like Reaction

disulfiram like reaction

Disulfiram-like reactions

There are a number of medications that produce the disulfiram-like reaction when ingested with alcohol. The disulfiram reaction is a very uncomfortable reaction characterized by severe flushing, and may be accompanied by tachycardia and hypotension. Although we always think of metronidazole, there have been well described cases of bactrim causing this reaction. Tinidazole, a new antiprotozoal used in the treatment of trichomonas, causes this as well. Patients should be advised to avoid alcohol for 24 hours after metronidazole, and 72 hours after bactrim and tinidazole.

A disulfiram-like drug is a drug that causes hypersensitivity to alcohol leading to nausea, vomiting, flushing, dizziness, throbbing headache, chest and abdominal discomfort, and general hangover-like symptoms among others.[1][2] These effects are caused by accumulation of acetaldehyde, a major but toxic metabolite of alcohol formed by the enzyme alcohol dehydrogenase.[1][2] The reaction has been variously termed a disulfiram-like reaction, alcohol intolerance, and acetaldehyde syndrome.

Medical Definition of Disulfaram-like reaction

A process in the body that produces symptoms similar to those that occur when alcohol is consumed after taking disulfaram (Antabuse). Disulfiram is an oral drug used for treating alcoholism that causes unpleasant symptoms when alcohol is consumed. This happens because alcohol is first converted in the body into acetaldehyde by an enzyme called alcohol dehydrogenase. Another enzyme known as acetaldehyde dehydrogenase then converts acetaldehyde into acetic acid. Disulfiram prevents acetaldehyde dehydrogenase from converting acetaldehyde into acetic acid, leading to a buildup of acetaldehyde levels in the blood. These high levels of acetaldehyde levels cause unpleasant symptoms after drinking alcohol such as headache, low blood pressure (hyoptension), severe flushing, palpitations, nausea, thirst, chest pain, and others.


The disulfiram-like reaction was caused by the inhibition of the ethanol metabolism. The ethanol is mainly oxidized into acetaldehyde by alcohol dehydrogenase and other enzymes, eventually is converted into carbon dioxide and water. Some drugs can block aldehyde dehydrogenase and cause a significant increase in acetaldehyde concentrations after ethanol consumption.

The endogenous acetaldehyde level in non-drinkers rarely exceeds 0.2 mg/L. The blood acetaldehyde is only elevated slightly in acute ethanol ingestion, ranging from 0.9 to 1.3 mg/L, because acetaldehyde is cleared rapidly. Following the coadministration of ethanol and its metabolism inhibitor, blood acetaldehyde levels are elevated. No lethal blood acetaldehyde level has been established so far.

what does a disulfiram overdose look like?

Disulfiram or Antabuse is a drug that is used to treat chronic alcoholism. According to a study published in the American Journal of Psychiatry, 88 percent of alcoholics on disulfiram remain abstinent. The maximum recommended dose for the drug is 500 mg per day, and anything above that may result in disulfiram overdose symptoms.

Disulfiram is designed to interfere with the metabolism of alcohol by blocking its oxidation. It causes severe toxicity when ingested together with alcohol. The symptoms of disulfiram-ethanol reaction and the symptoms of an overdose on disulfiram are similar and equally dangerous.

the importance of aftercare

Symptoms of disulfiram overdose usually occur within three hours of ingesting the drug and could last for up to two weeks even after the discontinuance of disulfiram. Some symptoms, such as those relating to gastrointestinal toxicity, may not show up until after two months. In addition, symptoms relating to neurologic toxicity of disulfiram may need to be treated with other drugs such as dopamine.

what services are offered?

Private treatment centers offer a variety of services which may not be available in regular hospitals. First of all, all victims of drug overdose are evaluated by a psychiatrist. This is especially important in cases where the patient has overdosed on purpose. Secondly, the possibility of another overdose is greatly reduced as patients do not have access to drugs unless the drugs have been prescribed by a physician. Finally, patients have unlimited access to several qualified professionals including physicians.

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