"Cephalexin and alcohol, you will be sick after taking it" - Understanding disulfiram-like reaction

It is already widely known that you should not drink alcohol when taking cephalosporin, and disulfiram-like reaction is not a strange name, but do you know what it is?

Disulfiram is an alcohol abstinence drug. After taking this drug, even if you drink a small amount of alcohol, your body will feel severe discomfort, thus achieving the purpose of quitting drinking.

In 1948, Jacobsen and others in Copenhagen found that disulfiram, a vulcanization catalyst for rubber, can cause facial flushing, headache, abdominal pain, sweating, palpitations, dyspnea and other symptoms after being absorbed by the human body in trace amounts, especially after drinking alcohol. People call this symptom after drinking alcohol after exposure to disulfiram a disulfiram-like reaction.

Disulfiram-like reaction, also known as disulfiram-like reaction or drunkenness reaction, refers to the fact that disulfiram inhibits acetaldehyde dehydrogenase and blocks the normal metabolism of ethanol, causing acetaldehyde poisoning even after drinking a small amount of ethanol. So in simple terms, disulfiram-like reaction is a clinical manifestation of ethanol poisoning. It is just that because the drug inhibits the metabolism of ethanol, a serious poisoning reaction will occur after contacting a small amount of alcohol.

Clinical manifestations of disulfiram-like reactions

The main symptoms are chest tightness, shortness of breath, facial flushing, palpitations, and panic. In severe cases, it may manifest as shock.

Drugs that can cause disulfiram-like reactions

1. Antimicrobial drugs

2. Hypoglycemic drugs, such as chlorpropamide, tolbutamide, phenformin, glibenclamide, gliclazide, tolazamide, insulin, etc. (Alcohol itself has the effect of lowering blood sugar, and it can slow down the metabolism of sulfonylurea drugs, thereby enhancing their effects. In severe cases, it may cause hypoglycemia coma; in addition, sulfonylureas can reduce patients' tolerance to ethanol.

3. Other drugs: warfarin, trifluoperazine, tolazoline, chloral hydrate, etc.

In addition, it should be noted that many foods and medicines also contain alcohol, such as chocolate with alcohol filling, Huoxiang Zhengqi water, beer duck, and even when you wipe your skin with alcohol, you will absorb alcohol. There are also many drugs that use ethanol as a solvent, such as nimodipine, hydrocortisone, Kangfuxin liquid, etc.

First aid measures

If the symptoms are mild, you can drink more water to promote the metabolism of drugs and alcohol. The body can adjust itself. You can lie down and rest in time, or go to a cool and ventilated place to rest. If vomiting is severe, avoid aspiration. If the patient is confused, unresponsive, or even has low blood pressure, it is recommended to go to the hospital for treatment in time.

Summarize

When using drugs that may cause a disulfiram-like reaction, it is required not to drink alcohol for 3 days before taking the drug and not to drink alcohol or consume alcohol-containing drugs or foods within 7 days after taking the drug, because after acetaldehyde dehydrogenase is inhibited, it usually takes 4 to 5 days to recover; the best way is: do not drink alcohol while taking any medication. After all, alcohol is harmful to the human body and also interacts with many drugs.