Some time ago, 56-year-old Mr. Li was hospitalized in a local hospital due to a lung infection. He was discharged from the hospital on December 16 after anti-inflammatory, phlegm and other treatments. At noon on the day he was discharged from the hospital, Mr. Li had a glass of wine with his family during dinner, and then he developed symptoms such as flushing, obvious chest tightness, fatigue, and confusion, and soon fainted. In an emergency, his family rushed him to the hospital's emergency center.
It stands to reason that Mr. Li has always drunk a good amount of alcohol, why did he drink so much and be admitted to the hospital?
In fact, Mr. Li had used the antibiotic Laoxycephalosporin during his hospitalization, and he drank alcohol just after being discharged from the hospital, which caused Mr. Liu to have a "disulfiram-like reaction" and was hospitalized in a coma. Disulfiram-like reaction is the joint action of cephalosporins and alcohol in the body, interrupting the process of alcohol metabolism in the human body, resulting in "acetaldehyde accumulation" in the body and toxic reactions.
Disulfiram-like reaction occurs after drinking or drinking alcohol after drinking, the symptoms generally appear within 5~30 minutes, the slowest is 4 hours, mild facial flushing and fever, headache, palpitations, chest tightness, nausea and vomiting, dizziness, increased heart rate, severe blood pressure decrease, dyspnea, chest pain, arrhythmia, loss of consciousness, heart failure, shock, and even death.
Approaching the Spring Festival, it must be indispensable to have dinner and drink, so it is necessary to remind that the probability of drinking alcohol and using cephalosporins overlapping for a period of time is increasing, and you must remember to take medicine without drinking, and drinking without taking medicine. If you have symptoms such as facial flushing, blurred vision, headache, shortness of breath, chest tightness, nausea, vomiting, increased heart rate, and weakness in the limbs after drinking, you should be alert to disulfiram-like reactions.
Here are some of the medicines that "counter wine":
1. Some antibacterial drugs, such as cefsulone, cefazolex, cefimondol, laoxycephalosporin, cefhydroxazole, cefoxylarazole, cefthalithali, ceftriaxone, ceftazidime, cefmetazole and other cephalosporins, amoxicillin, metronidazole, tinidazole and furazolidone containing thiomethyltetrazolium groups can inhibit acetaldehyde dehydrogenase, so that acetaldehyde accumulation in the drinker produces disulfiram reaction.
2. Ethanol can increase the inhibitory effect of barbiturates, chlorpromazine, tricyclic antidepressants and diazepam sedative drugs, especially in elderly patients with sleep apnea. Anti-allergic drugs are used in combination with ethanol to enhance central inhibition.
3. Ethanol has the effect of dilating blood vessels, and the combination of aspirin, acetaminophen and its compound preparations, and other non-steroidal antipyretic and analgesic drugs will enhance the irritation of the gastrointestinal tract, and in severe cases, damage the gastrointestinal mucosa and cause bleeding. Among them, alcohol is combined with acetaminophen, which can increase liver toxicity.
4. Combined with heartache, nitroglycerin, isosorbide mononitrate, etc., the coronary artery dilation effect is enhanced, and the adverse reactions such as skin congestion, nausea, vomiting, and headache are aggravated.
5. The combination of insulin and sulfonylurea hypoglycemic drugs and ethanol can enhance the hypoglycemic effect, and even lead to hypoglycemic coma or irreversible neurological lesions.
6. High-purine diet, such as beer, will weaken the efficacy of anti-gout drugs and induce gout.
7. Taking monoamine oxidase inhibitors such as furazolidone, moclobemide, linezolid, should not eat tyramine-containing foods that are rich, stored for too long or fermented with cheese, such as beer, wine, etc., otherwise it is easy to cause or aggravate increased blood pressure, and even cause hypertensive crisis and cerebral hemorrhage. For the above-mentioned high-tyramine foods, not only should they be avoided during the period of taking the drug, but also two weeks after the drug was stopped, they should still be paid attention to prevent the occurrence of adverse reactions.