Disulfiram reaction & Other drugs causing it.

Alcohol intake is strictly prohibited when we take these drugs!Let us know what these drugs are.

 

First lets know something about Disulfiram.

Disulfiram (Antabuse), is an aversive agent that inhibits the metabolism of alcohol. The usual dose of disulfiram is 250 mg once daily.

 

Disulfiram is an irreversible and nonspecific enzyme-inhibitory agent which inhibits the enzyme acetaldehyde-dehydrogenase (ALDH),leading to an accumulation of acetaldehyde in the body ,leading to the ethanol-disulfiram reaction.

Disulfiram irreversibly inhibits the oxidation of acetaldehyde by competing with the cofactor nicotinamide adenine dinucleotide (NAD) for binding sites on ALDH . Ultimately, disulfiram reduces the rate of oxidation of acetaldehyde, causing a 5- to 10-fold increase in the concentration of acetaldehyde. An increased serum acetaldehyde concentration is thought to be responsible for the unpleasant side effects associated with the disulfiram-ethanol reaction.source:medscape

 

The disulfiram-ethanol reaction (DER) is the classic manifestation of patients with disulfiram toxicity. This reaction occurs after the ingestion of even small amounts of ethanol with the concomitant use of disulfiram or disulfiram-like agents.

Disulfiram-ethanol reaction:

• Head, neck, and chest flushing - Histamine-induced vasodilation
• Throbbing headaches
• Nausea, vomiting (may be refractory), diarrhea, and abdominal pain
• Weakness, dizziness, confusion, and anxiety
• Vertigo and ataxia
• Orthostatic hypotension - Hypotensive flushing reaction with warm extremities
• Diaphoresis
• Palpitations and dysrhythmias
• Pruritus
• Refractory cyanosis (eg, methemoglobinemia)

 

Drugs that may produce disulfiramlike reactions with ethanol include the following:

• Mushrooms (eg, Coprinus atramentarius [inky cap], Clitocybe claviceps)
• Antibiotics

1. metronidazole,Tinidazole is chemically similar to metronidazole and so may cause the same reaction
2. sulfonamides(trimethoprim-sulfamethoxazole)
3. some cephalosporins( eg: cephamandole, cefoperazone, cefmenoxime, cefotetan, Moxalactam)- due to METHYLTETRAZOLETHIOL side chain.
4. nitrofurantoin,
5. chloramphenicol
6. furazolidine
7. Antimalarial Quinacrine

• Oral hypoglycemics (eg: chlorpropamide, tolbutamide)- these sulphonylureas compete with acetaldehyde for binding sites on ALDH.
• Pesticides (eg: carbamates, monosulfiram [Tetmosol])
• Chloral hydrate
• Antifungals (griseofulvin)

high yield facts of drugs in pharmacology

drugs causing gingival hyperplasia:

• phenytoin(dilantin)-antiepileptic
• cyclosporine-immunosuppresant
• calcium channel blockers especially nifedipine

to know pathogenesis & further data,check this

drugs causing pseudotumor cerebri:

first lets know what it is?Pseudotumor cerebri literally means "false brain tumor" because its symptoms mimic those of brain tumors.

• tetracyclines,naldixic acid,nitrofurantoin
• indomethacin-NSAID
• oral contraceptive pills
• vitamin A
• isotretinon-retinoic acid derivative used for acne
• lithium-used in bipolar disorder
• danazol-antigonadotropic drug

drugs causing photosensitivity:

check this emedicine site for a comprehensive list

main ones-

• tetracycline,fluroquinolones-antibiotics
• NSAIDs
• ACE(angiotensin converting enzyme)inhibitors-antihypertensives
• tricyclic antidepressants
• phenothiazines
• oral contraceptives.