Disulfiram-like drug

Overview

A disulfiram-like drug is a medication that causes an adverse reaction when alcohol is consumed. These drugs are used primarily in the treatment of alcohol use disorder to deter patients from drinking alcohol. The reaction is similar to that produced by disulfiram, a drug that inhibits the enzyme acetaldehyde dehydrogenase, leading to the accumulation of acetaldehyde in the blood.

Mechanism of Action

Disulfiram-like drugs work by inhibiting the acetaldehyde dehydrogenase enzyme. This inhibition prevents the normal metabolism of ethanol into acetic acid, causing a buildup of acetaldehyde, a toxic metabolite. The accumulation of acetaldehyde leads to unpleasant symptoms such as flushing, nausea, vomiting, headache, and palpitations.

Common Disulfiram-like Drugs

Several drugs can cause disulfiram-like reactions when taken with alcohol. These include:

• Metronidazole - An antibiotic often used to treat infections caused by anaerobic bacteria and protozoa.
• Cefoperazone - A cephalosporin antibiotic that can cause a disulfiram-like reaction.
• Chloramphenicol - An antibiotic used for serious infections, known to interact with alcohol.
• Griseofulvin - An antifungal medication that can cause a disulfiram-like reaction.

Clinical Use

Disulfiram-like drugs are used in the management of alcohol dependence as part of a comprehensive treatment plan. They are most effective when combined with psychotherapy and support groups. Patients must be informed about the potential reactions and advised to avoid alcohol in all forms, including in cough syrups and mouthwashes.

Side Effects

The side effects of disulfiram-like drugs are primarily related to the accumulation of acetaldehyde. These include:

• Severe flushing
• Tachycardia
• Hypotension
• Confusion
• Respiratory depression

Precautions

Patients taking disulfiram-like drugs should be monitored for compliance and educated about the risks of consuming alcohol. It is important to review all medications and products for alcohol content to prevent accidental reactions.

Related Pages

• Alcohol use disorder
• Disulfiram
• Acetaldehyde dehydrogenase
• Ethanol metabolism

Chemical structure of disulfiram