Recently, a man in Loudi had a “disulfiram-like reaction” after drinking alcohol after a cephalosporin infusion, which was nearly life-threatening. After timely treatment by the medical staff of Hunan Provincial Occupational Disease Prevention and Control Institute, the patient recovered and was discharged.
Uncle Xu, a 61-year-old worker from Loudi City, was working in Changsha. Due to the aggravation of chronic obstructive pulmonary disease, he was treated with cephalosporins at a hospital near his home. March 10 was the last day of the infusion. At around 19:00 that night, he invited a few friends to have a party. He drank a few glasses of liquor while he was happy. As a result, he suffered from chest tightness, shortness of breath, rapid heartbeat and other discomforts, and his friends quickly sent him to him. Go to Hunan Provincial Occupational Disease Prevention and Control Hospital for treatment.
Tang Mei’an, Deputy Chief Physician of the Third Division of Occupational Diseases, introduced that after examination and consultation, it was found that Uncle Xu had a typical “” Disulfiram-like reaction.
So, what is a disulfiram-like reaction? What are the characteristics of a disulfiram-like reaction? What are the drugs that can cause disulfiram-like symptoms?
Dr. Tang Mei’an introduced that disulfiram-like reaction, also known as drunkenness reaction, refers to the inhibition of acetaldehyde dehydrogenase by disulfiram and the normal metabolism of ethanol, so that drinking a small amount of ethanol can also cause acetaldehyde poisoning reaction.
Drinking after the use of drugs with disulfiram-like reactions, patients can develop symptoms within 5 minutes, usually within half an hour, and rarely within 1 hour. In mild cases, weakness, dizziness, drowsiness, hallucinations, whole body flushing, headache, nausea, vomiting, and drop in blood pressure may occur. In severe cases, severe reactions such as respiratory depression, collapse, convulsions, cardiac dysfunction, and even life-threatening shock may occur.
She reminded that the severity of disulfiram-like reactions was proportional to the dose of the drug and the amount of alcohol consumed. The reaction of drinking liquor is heavier than drinking beer and alcoholic beverages. Drinking during the treatment period was more severe than drinking after the drug was discontinued. The elderly, children, patients with cardiovascular and cerebrovascular diseases and those who are sensitive to ethanol are more serious.
The common clinical disulfiram-like reactions are mostly caused by oral administration of cephalosporins with tetrazolium side chains. These include: cefmetazole, cefamandole, cefoperazone, cefmenoxime, cefotiam, laoxetine, etc. In addition, metronidazole (antibiotics), furazolidone (antibiotics), tolbutamide (hypoglycemic drugs), chlorpropamide (hypoglycemic drugs) and other drugs can also cause disulfiram-like reactions.
She emphasized that when using the above-mentioned drugs, you must follow the doctor’s advice, and you should not drink alcohol three days before and seven days after the drug. If a disulfiram-like reaction occurs, immediately stop drinking alcohol, induce vomiting, and gastric lavage if possible; keep the airway open to remove vomit and secretions from the oral and nasal cavity; turn the head to one side to prevent vomit blocking the airway and causing suffocation. Most importantly, seek immediate medical attention or call emergency services.
Xiaoxiang Morning News reporter Xia Sheng correspondent Wen Na