The disulfiram reaction is a very uncomfortable reaction characterized by severe flushing, and may be accompanied by tachycardia and hypotension.There are a number of medications that produce the disulfiram-like reaction when ingested with alcohol.
Although we always think of metronidazole, there have been other drugs causing this reaction.
Other common medications that produce this reaction:
1. Sulfonylureas: chlorpropamide, tolbutamide, glyburide
2. Cardiovascular medications: Isosorbide dinitrate, nitroglycerin.
Management
If you suspect you are experiencing a disulfiram-like reaction, stop any alcohol intake immediately.Mild cases can often be managed with rest and hydration if the symptoms are confined to facial flushing and mild nausea.Severe cases require immediate medical attention. Health professionals will treat the reaction with supportive care, including IV fluids to boost blood pressure, anti-nausea medications, and sometimes epinephrine if the patient is in danger of shock.
Have you ever noticed any patient coming with this condition in emergency duty hours?How did you diagnose , what management you preferred?
MBH/PS