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Drugs and substances  with disulfiram like reactions

Drugs and substances with disulfiram like reactions






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    Drugs and substances  with disulfiram like reactions Drugs and substances with disulfiram like reactions Presentation Transcript

    • Drugs and substances with Disulfiram like reactions. Salum Mkata CSEE, ACSEE,B.pham.
    • Why is so important? • This topic it’s important because for example about 64% of adults in the United States consumed alcohol in 2008. In that same year, approximately 3.8 billion prescription medications were dispensed.2 Despite this high prevalence, few physicians discuss alcohol use with their patients. In addition, most patients do not consider alcohol a drug capable of interacting with medications.
    • Definitions Disulfiram (sold under the trade names Antabuse and Antabus) : An antioxidant that interferes with the normal metabolic degradation of alcohol in the body,. Disulfiram is a drug discovered in the 1920s and used to support the treatment of chronic alcoholism by producing an acute sensitivity to alcohol. It blocks the processing of alcohol in the body by inhibiting acetaldehyde dehydrogenase, resulting in increased acetaldehyde concentrations in blood and tissues thus causing an unpleasant reaction when alcohol is consumed. Used in the treatment of chronic alcoholism. Also used as a chelator in copper and nickel poisoning. Syn: tetraethylthiuram disulfide. Disulfiram is also being studied as a treatment for cocaine dependence, as it prevents the breakdown of dopamine, a neurotransmitter whose release is stimulated by cocaine
    • Structure
    • Uses : in alcohol abuse  Under normal metabolism, alcohol is broken down in the liver by the enzyme alcohol dehydrogenase to acetaldehyde, which is then converted by the enzyme acetaldehyde dehydrogenase to the harmless acetic acid. Disulfiram blocks this reaction at the intermediate stage by blocking acetaldehyde dehydrogenase. After alcohol intake under the influence of disulfiram, the concentration of acetaldehyde in the blood may be five to 10 times higher than that found during metabolism of the same amount of alcohol alone. As acetaldehyde is one of the major causes of the symptoms of a "hangover", this produces immediate and severe negative reaction to alcohol intake.  Some five to 10 minutes after alcohol intake, the patient may experience the effects of a severe hangover for a period of 30 minutes up to several hours. Symptoms include flushing of the skin, accelerated heart rate, shortness of breath, nausea, vomiting, throbbing headache, visual disturbance, mental confusion, postural syncope, and circulatory collapse.
    • Reaction it interfered
    • Cont. La buveuse ("The Drinker"), a portrait of Suzanne Valadon by Toulouse-Lautrec. Alcohol flush reaction as a result of the accumulation of acetaldehyde, the first metabolite of alcohol
    • Cont. Disulfiram like reaction: • In medicine, the term "disulfiram reaction or effect" refers to an adverse effect of a particular medication in causing an unpleasant hypersensitivity to alcohol, similar to the effect caused by disulfiram administration. • Hence this is kind of alcohol-drug interaction and we will check interactions of alcohol with medications .
    • Drugs that may produce disulfiram like reactions with ethanol include the following: Mushrooms : (eg, Coprinus atramentarius [inky cap], Clitocybe claviceps) Antibiotics : • • • • • • • • • • • metronidazole,Tinidazole is chemically similar to metronidazole and so may cause the same reaction sulfonamides( trimethoprim-sulfamethoxazole) some cephalosporins( eg: cephamandole, cefoperazone, cefmenoxime, cefotetan, Moxalactam)- due to METHYLTETRAZOLETHIOL side chain. nitrofurantoin, chloramphenicol furazolidine 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)
    • Cont. Hence it’s important to consider these before prescribing or dispensing above drugs.
    • Thank you • Please add comments or any addition information to this presentation. Or you can support me to do more.