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Disulfiram-alcohol reaction

January 01, 1970

Disulfiram-alcohol reaction (DAR) is the effect of the interaction in the human body of alcohol drunk with disulfiram or some mushrooms.[1][2] The DAR is key to disulfiram therapy that is widely used for alcohol-aversive treatment and management of other addictions (e.g. cocaine[3][4] use).[5][6] Once disulfiram-treated patients take alcohol, even in small doses, they experience strong unpleasant sensations (flush, nausea, lightheadedness, headache, sweating, vomiting, and vertigo).[7]

Disulfiram-alcohol reaction (DAR)
Other namesDisulfiram ethanol reaction (DER), Antabuse effect, Acetylhyde sindrome
Alcohol flush reaction is a visible effect of DAR.
SpecialtyToxicology
SymptomsFlush, nausea, lightheadedness, headache, sweating, vomiting, vertigo, etc
CausesIngestion of disulfiram with alcohol

Disulfiram has been used to treat alcoholism since 1948 after its accidental discovery in Denmark.[8][9][10]

Pharmacology edit

DAR symptoms usually begin within 5–15 minutes of the ingestion of alcohol by a patient who has taken disulfiram 3–12 hours before.[8]

Increased acetaldehyde content in blood is considered to be the cause of the toxic effect.[11][12] Disulfiram inhibits several human aldehyde dehydrogenases (ALDH),[13] most importantly the version coded for by gene ALDH2 which metabolizes acetaldehyde.[14] The reaction is found to depend on a disulfiram-induced predisposition reflected by alkalosis, the blood acetaldehyde level, and an individual predisposition reflected by dopamine β-hydroxylase activity.[15]

The intensity of a patient's experience of DAR varies with race of the subject.[16]

It has long been known that disulfiram can cause hepatitis and can be fatal (1 case per 30,000 patients), although due to dosage reductions in recent decades, such cases are extremely rare.[17] Death, however, from the reaction itself without significant liver damage is also possible as an atypical case.[18][19]

Unintended initiations edit

DAR can occur from skin contact of a disulfiram-treated patient with alcohol-containing skin care products such as colognes, sunscreen lotions, aftershave lotions, and alcohol-based tar gels,[20] but a significant toxic effect does not appear to be achieved in this way.[21] During the COVID-19 pandemic, there were also cases of DAR initiation due to the use of alcohol-based hand sanitizers.[22]

Some mushrooms contain substances that, when combined with alcohol, cause DAR.[23] They include lurid bolete (Boletus luridus),[24] inky cap (Coprinopsis atramentaria),[25][26] and club-foot (Clitocybe clavipes).[27] Because of the similarities to disulfiram (tetraethylthiuram disulfide) poisoning, it was long speculated that disulfiram was the active ingredient in common inkcap. In 1975, coprine was identified as the compound in the common inkcap, with the mechanism identified in 1979.[28][29][30]

See also edit

References edit

  1. ^ Elenbaas, R. M. (August 1977). "Drug therapy reviews: management of the disulfiram-alcohol reaction". American Journal of Hospital Pharmacy. 34 (8): 827–831. PMID 331944.
  2. ^ Johansson, Benny; Angelo, Helle R.; Christensen, Jens Knud; Møller, Ib Walther; Rønsted, Per (March 1991). "Dose-Effect Relationship of Disulfiram in Human Volunteers. II: A Study of the Relation between the Disulfiram-Alcohol Reaction and Plasma Concentrations of Acetaldehyde, Diethyldithiocarbamic Acid Methyl Ester, and Erythrocyte Aldehyde Dehydrogenase Activity". Pharmacology & Toxicology. 68 (3): 166–170. doi:10.1111/j.1600-0773.1991.tb01216.x. PMID 1647526.
  3. ^ Barth, Kelly S.; Malcolm, Robert J. (2010). "Disulfiram: An Old Therapeutic with New Applications". CNS & Neurological Disorders Drug Targets. 9 (1): 5–12. doi:10.2174/187152710790966678. PMID 20201810.
  4. ^ O'Shea, Brian (December 2000). "Disulfiram revisited". Hospital Medicine. 61 (12): 849–851. doi:10.12968/hosp.2000.61.12.1483. PMID 11211585.
  5. ^ Beyeter, Christine; Fisch, Hans-Ulrich; Preisig, Rudotf (March 1985). "The Disulfiram-Alcohol Reaction: Factors Determining and Potential Tests Predicting Severity". Alcoholism: Clinical and Experimental Research. 9 (2): 118–124. doi:10.1111/j.1530-0277.1985.tb05531.x. PMID 3890590.
  6. ^ Tayyareci, Yelda; Acarel, Esra (January 2009). "Acute myocardial infarction associated with disulfiram-alcohol interaction in a young man with normal coronary arteries". Turk Kardiyoloji Dernegi Arsivi. 37 (1): 48–50. PMID 19225254.
  7. ^ Amuchastegui, Tomas; Amuchastegui, Marcos; Donohue, Thomas (February 2014). "Disulfiram--alcohol reaction mimicking an acute coronary syndrome". Connecticut Medicine. 78 (2): 81–84. PMID 24741856.
  8. ^ a b Murthy, K. Krishna; Praveenlal, K. (July 1988). "An Experience with Disulfiram in the management of Alcohol Dependence Syndrome". Indian Journal of Psychological Medicine. 11 (2): 145–148. doi:10.1177/0975156419880213. S2CID 220676012.
  9. ^ Altun, Gurcan; Altun, Armagan; Erdogan, Okan (October 2006). "Acute Myocardial Infarction Due to Disulfiram (Antabus)–Alcohol Interaction". Cardiovascular Drugs and Therapy. 20 (5): 391–392. doi:10.1007/s10557-006-0493-8. PMID 17119876. S2CID 30117045. ProQuest 213848944.
  10. ^ Glatt, M. M. (April 1959). "Disulfiram and Citrated Calcium Carbimide in the Treatment of Alcoholism". Journal of Mental Science. 105 (439): 476–481. doi:10.1192/bjp.105.439.476. PMID 13665310.
  11. ^ Raby, K. (March 1954). "Relation of blood acetaldehyde level to clinical symptoms in the disulfiram-alcohol reaction". Quarterly Journal of Studies on Alcohol. 15 (1): 21–32. doi:10.15288/qjsa.1954.15.021. PMID 13155779.
  12. ^ Wicht, Francis; Fisch, Hans-Ulrich; Nelles, Joachim; Raisin, Juergen; Allemann, Peter; Preisig, Rudolf (April 1995). "Divergence of Ethanol and Acetaldehyde Kinetics and of the Disulfiram-Alcohol Reaction between Subjects with and without Alcoholic Liver Disease". Alcoholism: Clinical and Experimental Research. 19 (2): 356–361. doi:10.1111/j.1530-0277.1995.tb01515.x. PMID 7625569.
  13. ^ Agarwal, Rakesh (2022). "Diffuse subendocardial ischemia secondary to disulfiram-alcohol ingestion". Indian Journal of Pharmacology. 54 (2): 146–147. doi:10.4103/ijp.ijp_930_21 (inactive 31 January 2024). PMC 9249151. PMID 35546467.{{cite journal}}: CS1 maint: DOI inactive as of January 2024 (link)
  14. ^ Omran, Z (15 May 2021). "Development of new disulfiram analogues as ALDH1a1-selective inhibitors". Bioorganic & Medicinal Chemistry Letters. 40: 127958. doi:10.1016/j.bmcl.2021.127958. PMID 33744437. S2CID 232311209.
  15. ^ Sauter, A M; Boss, D; von Wartburg, J P (September 1977). "Reevaluation of the disulfiram-alcohol reaction in man". Journal of Studies on Alcohol. 38 (9): 1680–1695. doi:10.15288/jsa.1977.38.1680. PMID 916687.
  16. ^ Zeiner, Arthur R. (1981). "Are Differences in the Disulfiram-Alcohol Reaction the Basis of Racial Differences in Biological Sensitivity to Ethanol?". Drug Dependence and Alcoholism. pp. 573–581. doi:10.1007/978-1-4684-3614-3_69. ISBN 978-1-4684-3616-7.
  17. ^ Chick, Jonathan (1999). "Safety Issues Concerning the Use of Disulfiram in Treating Alcohol Dependence". Drug Safety. 20 (5): 427–435. doi:10.2165/00002018-199920050-00003. PMID 10348093. S2CID 19476907.
  18. ^ Amador, Elias; Gazdar, Adi (December 1967). "Sudden Death during Disulfiram—Alcohol Reaction". Quarterly Journal of Studies on Alcohol. 28 (4): 649–654. doi:10.15288/qjsa.1967.28.649. PMID 6082192.
  19. ^ Heath, M.J.; Pachar, J.V.; Perez Martinez, A.L.; Toseland, P.A. (September 1992). "An exceptional case of lethal disulfiram-alcohol reaction". Forensic Science International. 56 (1): 45–50. doi:10.1016/0379-0738(92)90145-M. PMID 1398376.
  20. ^ Stoll, David (7 November 1980). "Disulfiram-Alcohol Skin Reaction to Beer-Containing Shampoo". JAMA: The Journal of the American Medical Association. 244 (18): 2045. doi:10.1001/jama.1980.03310180015010. PMID 6448928.
  21. ^ Haddock, Neil F. (March 1982). "Cutaneous Reactions to Lower Aliphatic Alcohols Before and During Disulfiram Therapy". Archives of Dermatology. 118 (3): 157–159. doi:10.1001/archderm.1982.01650150019013. PMID 7065662.
  22. ^ Ghosh, Abhishek; Mahintamani, Tathagata; Balhara, Y P S; Roub, Fazl E; Basu, Debashish; Bn, Subodh; Mattoo, S K; Mishra, Eepsita; Sharma, Babita (4 January 2021). "Disulfiram Ethanol Reaction with Alcohol-Based Hand Sanitizer: An Exploratory Study". Alcohol and Alcoholism. 56 (1): 42–46. doi:10.1093/alcalc/agaa096. PMC 7665335. PMID 33150930.
  23. ^ Johansson, B. (November 1992). "A review of the pharmacokinetics and pharmacodynamics of disulfiram and its metabolites". Acta Psychiatrica Scandinavica. 86 (S369): 15–26. doi:10.1111/j.1600-0447.1992.tb03310.x. PMID 1471547. S2CID 23832065.
  24. ^ Budmiger, H.; Kocher, F. (21 August 1982). "Hexen-Röhrling (Boletus luridus) mit Alkohol. Schweiz. Medizinische Wochenschrift" [Boletus luridus and alcohol. Case report]. Schweizerische Medizinische Wochenschrift (in German). 112 (34): 1179–1181. PMID 7134946.
  25. ^ Lash, Erica; Hack, Jason B. (August 2019). "Disulfiram and Hypotension in a 53-year-old Woman". Rhode Island Medical Journal. 102 (6): 44–46. PMID 31398969.
  26. ^ Lash, Erica; Hack, Jason B (2019). "Disulfiram and Hypotension in a 53-year-old Woman". Rhode Island Medical Journal (2013). 102 (6): 44–46. PMID 31398969.
  27. ^ Cochran, Kenneth W.; Cochran, Martha W. (September 1978). "Clitocybe Clavipes : Antabuse-Like Reaction to Alcohol". Mycologia. 70 (5): 1124–1126. doi:10.1080/00275514.1978.12020326. PMID 569766.
  28. ^ Lindberg, Per; Bergman, Rolf; Wickberg, Börje (1975). "Isolation and structure of coprine, a novel physiologically active cyclopropanone derivative from Coprinus atramentarius and its synthesis via 1-aminocyclopropanol". Journal of the Chemical Society, Chemical Communications (23): 946–947. doi:10.1039/C39750000946.
  29. ^ Lindberg, Per; Bergman, Rolf; Wickberg, Börje (1977). "Isolation and structure of coprine, the in vivo aldehyde dehydrogenase inhibitor in Coprinus atramentarius; syntheses of coprine and related cyclopropanone derivatives". Journal of the Chemical Society, Perkin Transactions 1 (6): 684–691. doi:10.1039/P19770000684.
  30. ^ Wiseman, Jeffrey S.; Abeles, Robert H. (May 2002). "Mechanism of inhibition of aldehyde dehydrogenase by cyclopropanone hydrate and the mushroom toxin coprine". Biochemistry. 18 (3): 427–435. doi:10.1021/bi00570a006. PMID 369602.

January 01, 1970
disulfiram, alcohol, reaction, effect, interaction, human, body, alcohol, drunk, with, disulfiram, some, mushrooms, disulfiram, therapy, that, widely, used, alcohol, aversive, treatment, management, other, addictions, cocaine, once, disulfiram, treated, patien. Disulfiram alcohol reaction DAR is the effect of the interaction in the human body of alcohol drunk with disulfiram or some mushrooms 1 2 The DAR is key to disulfiram therapy that is widely used for alcohol aversive treatment and management of other addictions e g cocaine 3 4 use 5 6 Once disulfiram treated patients take alcohol even in small doses they experience strong unpleasant sensations flush nausea lightheadedness headache sweating vomiting and vertigo 7 Disulfiram alcohol reaction DAR Other namesDisulfiram ethanol reaction DER Antabuse effect Acetylhyde sindromeAlcohol flush reaction is a visible effect of DAR SpecialtyToxicologySymptomsFlush nausea lightheadedness headache sweating vomiting vertigo etcCausesIngestion of disulfiram with alcohol Disulfiram has been used to treat alcoholism since 1948 after its accidental discovery in Denmark 8 9 10 Contents 1 Pharmacology 2 Unintended initiations 3 See also 4 ReferencesPharmacology editDAR symptoms usually begin within 5 15 minutes of the ingestion of alcohol by a patient who has taken disulfiram 3 12 hours before 8 Increased acetaldehyde content in blood is considered to be the cause of the toxic effect 11 12 Disulfiram inhibits several human aldehyde dehydrogenases ALDH 13 most importantly the version coded for by gene ALDH2 which metabolizes acetaldehyde 14 The reaction is found to depend on a disulfiram induced predisposition reflected by alkalosis the blood acetaldehyde level and an individual predisposition reflected by dopamine b hydroxylase activity 15 The intensity of a patient s experience of DAR varies with race of the subject 16 It has long been known that disulfiram can cause hepatitis and can be fatal 1 case per 30 000 patients although due to dosage reductions in recent decades such cases are extremely rare 17 Death however from the reaction itself without significant liver damage is also possible as an atypical case 18 19 Unintended initiations editDAR can occur from skin contact of a disulfiram treated patient with alcohol containing skin care products such as colognes sunscreen lotions aftershave lotions and alcohol based tar gels 20 but a significant toxic effect does not appear to be achieved in this way 21 During the COVID 19 pandemic there were also cases of DAR initiation due to the use of alcohol based hand sanitizers 22 Some mushrooms contain substances that when combined with alcohol cause DAR 23 They include lurid bolete Boletus luridus 24 inky cap Coprinopsis atramentaria 25 26 and club foot Clitocybe clavipes 27 Because of the similarities to disulfiram tetraethylthiuram disulfide poisoning it was long speculated that disulfiram was the active ingredient in common inkcap In 1975 coprine was identified as the compound in the common inkcap with the mechanism identified in 1979 28 29 30 See also editAlcohol intolerance Disulfiram like drug Mushroom poisoningReferences edit Elenbaas R M August 1977 Drug therapy reviews management of the disulfiram alcohol reaction American Journal of Hospital Pharmacy 34 8 827 831 PMID 331944 Johansson Benny Angelo Helle R Christensen Jens Knud Moller Ib Walther Ronsted Per March 1991 Dose Effect Relationship of Disulfiram in Human Volunteers II A Study of the Relation between the Disulfiram Alcohol Reaction and Plasma Concentrations of Acetaldehyde Diethyldithiocarbamic Acid Methyl Ester and Erythrocyte Aldehyde Dehydrogenase Activity Pharmacology amp Toxicology 68 3 166 170 doi 10 1111 j 1600 0773 1991 tb01216 x PMID 1647526 Barth Kelly S Malcolm Robert J 2010 Disulfiram An Old Therapeutic with New Applications CNS amp Neurological Disorders Drug Targets 9 1 5 12 doi 10 2174 187152710790966678 PMID 20201810 O Shea Brian December 2000 Disulfiram revisited Hospital Medicine 61 12 849 851 doi 10 12968 hosp 2000 61 12 1483 PMID 11211585 Beyeter Christine Fisch Hans Ulrich Preisig Rudotf March 1985 The Disulfiram Alcohol Reaction Factors Determining and Potential Tests Predicting Severity Alcoholism Clinical and Experimental Research 9 2 118 124 doi 10 1111 j 1530 0277 1985 tb05531 x PMID 3890590 Tayyareci Yelda Acarel Esra January 2009 Acute myocardial infarction associated with disulfiram alcohol interaction in a young man with normal coronary arteries Turk Kardiyoloji Dernegi Arsivi 37 1 48 50 PMID 19225254 Amuchastegui Tomas Amuchastegui Marcos Donohue Thomas February 2014 Disulfiram alcohol reaction mimicking an acute coronary syndrome Connecticut Medicine 78 2 81 84 PMID 24741856 a b Murthy K Krishna Praveenlal K July 1988 An Experience with Disulfiram in the management of Alcohol Dependence Syndrome Indian Journal of Psychological Medicine 11 2 145 148 doi 10 1177 0975156419880213 S2CID 220676012 Altun Gurcan Altun Armagan Erdogan Okan October 2006 Acute Myocardial Infarction Due to Disulfiram Antabus Alcohol Interaction Cardiovascular Drugs and Therapy 20 5 391 392 doi 10 1007 s10557 006 0493 8 PMID 17119876 S2CID 30117045 ProQuest 213848944 Glatt M M April 1959 Disulfiram and Citrated Calcium Carbimide in the Treatment of Alcoholism Journal of Mental Science 105 439 476 481 doi 10 1192 bjp 105 439 476 PMID 13665310 Raby K March 1954 Relation of blood acetaldehyde level to clinical symptoms in the disulfiram alcohol reaction Quarterly Journal of Studies on Alcohol 15 1 21 32 doi 10 15288 qjsa 1954 15 021 PMID 13155779 Wicht Francis Fisch Hans Ulrich Nelles Joachim Raisin Juergen Allemann Peter Preisig Rudolf April 1995 Divergence of Ethanol and Acetaldehyde Kinetics and of the Disulfiram Alcohol Reaction between Subjects with and without Alcoholic Liver Disease Alcoholism Clinical and Experimental Research 19 2 356 361 doi 10 1111 j 1530 0277 1995 tb01515 x PMID 7625569 Agarwal Rakesh 2022 Diffuse subendocardial ischemia secondary to disulfiram alcohol ingestion Indian Journal of Pharmacology 54 2 146 147 doi 10 4103 ijp ijp 930 21 inactive 31 January 2024 PMC 9249151 PMID 35546467 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint DOI inactive as of January 2024 link Omran Z 15 May 2021 Development of new disulfiram analogues as ALDH1a1 selective inhibitors Bioorganic amp Medicinal Chemistry Letters 40 127958 doi 10 1016 j bmcl 2021 127958 PMID 33744437 S2CID 232311209 Sauter A M Boss D von Wartburg J P September 1977 Reevaluation of the disulfiram alcohol reaction in man Journal of Studies on Alcohol 38 9 1680 1695 doi 10 15288 jsa 1977 38 1680 PMID 916687 Zeiner Arthur R 1981 Are Differences in the Disulfiram Alcohol Reaction the Basis of Racial Differences in Biological Sensitivity to Ethanol Drug Dependence and Alcoholism pp 573 581 doi 10 1007 978 1 4684 3614 3 69 ISBN 978 1 4684 3616 7 Chick Jonathan 1999 Safety Issues Concerning the Use of Disulfiram in Treating Alcohol Dependence Drug Safety 20 5 427 435 doi 10 2165 00002018 199920050 00003 PMID 10348093 S2CID 19476907 Amador Elias Gazdar Adi December 1967 Sudden Death during Disulfiram Alcohol Reaction Quarterly Journal of Studies on Alcohol 28 4 649 654 doi 10 15288 qjsa 1967 28 649 PMID 6082192 Heath M J Pachar J V Perez Martinez A L Toseland P A September 1992 An exceptional case of lethal disulfiram alcohol reaction Forensic Science International 56 1 45 50 doi 10 1016 0379 0738 92 90145 M PMID 1398376 Stoll David 7 November 1980 Disulfiram Alcohol Skin Reaction to Beer Containing Shampoo JAMA The Journal of the American Medical Association 244 18 2045 doi 10 1001 jama 1980 03310180015010 PMID 6448928 Haddock Neil F March 1982 Cutaneous Reactions to Lower Aliphatic Alcohols Before and During Disulfiram Therapy Archives of Dermatology 118 3 157 159 doi 10 1001 archderm 1982 01650150019013 PMID 7065662 Ghosh Abhishek Mahintamani Tathagata Balhara Y P S Roub Fazl E Basu Debashish Bn Subodh Mattoo S K Mishra Eepsita Sharma Babita 4 January 2021 Disulfiram Ethanol Reaction with Alcohol Based Hand Sanitizer An Exploratory Study Alcohol and Alcoholism 56 1 42 46 doi 10 1093 alcalc agaa096 PMC 7665335 PMID 33150930 Johansson B November 1992 A review of the pharmacokinetics and pharmacodynamics of disulfiram and its metabolites Acta Psychiatrica Scandinavica 86 S369 15 26 doi 10 1111 j 1600 0447 1992 tb03310 x PMID 1471547 S2CID 23832065 Budmiger H Kocher F 21 August 1982 Hexen Rohrling Boletus luridus mit Alkohol Schweiz Medizinische Wochenschrift Boletus luridus and alcohol Case report Schweizerische Medizinische Wochenschrift in German 112 34 1179 1181 PMID 7134946 Lash Erica Hack Jason B August 2019 Disulfiram and Hypotension in a 53 year old Woman Rhode Island Medical Journal 102 6 44 46 PMID 31398969 Lash Erica Hack Jason B 2019 Disulfiram and Hypotension in a 53 year old Woman Rhode Island Medical Journal 2013 102 6 44 46 PMID 31398969 Cochran Kenneth W Cochran Martha W September 1978 Clitocybe Clavipes Antabuse Like Reaction to Alcohol Mycologia 70 5 1124 1126 doi 10 1080 00275514 1978 12020326 PMID 569766 Lindberg Per Bergman Rolf Wickberg Borje 1975 Isolation and structure of coprine a novel physiologically active cyclopropanone derivative from Coprinus atramentarius and its synthesis via 1 aminocyclopropanol Journal of the Chemical Society Chemical Communications 23 946 947 doi 10 1039 C39750000946 Lindberg Per Bergman Rolf Wickberg Borje 1977 Isolation and structure of coprine the in vivo aldehyde dehydrogenase inhibitor in Coprinus atramentarius syntheses of coprine and related cyclopropanone derivatives Journal of the Chemical Society Perkin Transactions 1 6 684 691 doi 10 1039 P19770000684 Wiseman Jeffrey S Abeles Robert H May 2002 Mechanism of inhibition of aldehyde dehydrogenase by cyclopropanone hydrate and the mushroom toxin coprine Biochemistry 18 3 427 435 doi 10 1021 bi00570a006 PMID 369602 Retrieved from https en wikipedia org w index php title Disulfiram alcohol reaction amp oldid 1213481294, wikipedia, wiki, book, books, library,

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