Indications

• Chronic Ethanol Abuse (see Ethanol, [[Ethanol]])

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Pharmacology

• Aldehyde Dehydrogenase Inhibitor

Disulfiram is a thiuram derivative which interferes with aldehyde dehydrogenase.

When taken concomitantly with alcohol, there is an increase in serum acetaldehyde levels. High acetaldehyde causes uncomfortable symptoms including flushing, nausea, thirst, palpitations, chest pain, vertigo, and hypotension.

This reaction is the basis for disulfiram use in postwithdrawal long-term care of alcoholism.

Metabolism

• xxxx

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Administration

• xxxx

Dose Adjustment

• Hepatic:
• Renal:

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Adverse Effects

Dermatologic Adverse Effects

• Acneiform Eruption
• Dermatitis
• Rash

Neurologic Adverse Effects

• Somnolence
• Fatigue (see Fatigue, [[Fatigue]])
• Headache (see Headache, [[Headache]])
• Peripheral Neuropathy (see Peripheral Neuropathy, [[Peripheral Neuropathy]])
• Psychosis (see Psychosis, [[Psychosis]])

Gastrointestinal Adverse Effects

• Cholestatic Hepatitis (see xxxx, [[xxxx]])
• Fulminant Hepatic Failure (see Fulminant Hepatic Failure, [[Fulminant Hepatic Failure]])
• Metallic/Garlic-Like Aftertaste

Genitourinary Adverse Effects

• Impotence/Erectile Dysfunction (see Erectile Dysfunction, [[Erectile Dysfunction]])

Ophthalmologic Adverse Effects

• Optic Neuritis (see Optic Neuritis, [[Optic Neuritis]])

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Adverse Effects (Disulfiram Intoxication)

Neurologic Adverse Effects

• Encephalopathy/Coma (see xxxx, [[xxxx]])

Otolaryngologic Adverse Effects

• Vocal Fold Immobility (see xxxx, [[xxxx]])

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Adverse Effects (Disulfiram-Ethanol Reaction)

General Comments

• Histamine-Like Reaction: due to accumulation of acetaldehyde

Allergic Manifestations

• Angioedema (see Angioedema, [[Angioedema]])

Cardiovascular Manifestations

• Hypotension (see Hypotension, [[Hypotension]])
• Sinus Tachycardia (see Sinus Tachycardia, [[Sinus Tachycardia]])

Dermatologic Manifestations

• Flushing (see Flushing, [[Flushing]])

Gastrointestinal Manifestations

• Gastritis (see Gastritis, [[Gastritis]])

Treatment of Disulfiram-Ethanol Reaction

• Fomepizole (see Fomepizole, [[Fomepizole]]): alcohol dehydrogenase inhibitor
  • May Be Effective

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References

• xxxx