Disulfiram reaction

Abstract

Disulfiram is a drug used for treating chronic alcoholism. The disulfiram-ethanol reaction is a result of increased blood levels of acetaldehyde, which is the product of alcohol dehydrogenase induced ethanol oxidation in the liver. Acetaldehyde is a toxin, which is broken down by acetaldehyde dehydrogenase to acetic acid, which is then eliminated from the body. Disulfiram inhibits the enzyme acetaldehyde dehydrogenase, therefore causing the increased concentration of blood acetaldehyde after ethanol consumption, which results in ill effects of ethanol, nausea and vertigo. We are presenting a case of a 31 year-old patient who was treated with disulfiram for chronic alcohol abuse. Half an hour before being admitted for examination at the Emergency Medical Aid Department he had ingested a large quantity of alcohol. Upon examination, based on the following symptoms: agitation, tachycardia, hypotension, skin erythema with hives, the diagnosis of disulfiram reaction was made. He was referred and transported to the University Clinical Center Banja Luka for further evaluation and observation. During transport, he was treated with oxygen, i.v. fluids, corticosteroids and analgesics. He was attached to a ECG monitor. Emergency Medical Aid doctors must be educated to recognize and initially treat patients with disulfiram reaction.

Keywords

• alcoholism
• disulfiram
• acetaldehyde