Explain what is meant by Disulfiramlike reaction and discuss

Explain what is meant by Disulfiram-like reaction and discuss how this is relevant to the anti-parasitic drugs.

Solution

The disulfiram reaction is a very uncomfortable reaction characterized by severe flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, and may be accompanied by tachycardia and hypotension.

Disulfiram is a drug used for the treatment of chronic alcoholism by producing an acute sensitivity to ethanol (drinking alcohol). Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase. In the body, alcohol is converted to acetaldehyde, which is then broken down by aldehyde dehydrogenase. If the dehydrogenase enzyme is inhibited, acetaldehyde builds up and causes unpleasant effects. 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.All these symptoms are together referred as \" Disulfiram-like reaction\"

There are a number of medications that produce the disulfiram-like reaction when ingested with alcohol. Most of these include antiparasitic drugs like tinidizole, metronidizole etc.

Consuming alcohol while taking these antiparsitic drugs such as metronidazole or tinidazole has long been thought to have a disulfiram-like reaction with effects that can include nausea, vomiting, flushing of the skin, tachycardia, and shortness of breath.