"Brother Jin, today is my birthday, you have to have a drink with me!" Xiao Zhang said enthusiastically.
Mr. Jin thought that he had taken cephalosporin antibiotics and wanted to refuse, but when he saw Xiao Zhang's expectant eyes, he felt that there should be no big problem, so he took the wine glass and drank it all.
Soon, Mr. Jin felt a wave of nausea attack, he covered his chest, vomited, and before he could stand firmly, suddenly his eyes were black, his body was weak, and he fell heavily to the ground.
Someone immediately called the emergency number. Regrettably, despite being hospitalized in time, Mr. Kim passed away.
The doctor sighed and said, "How can you drink alcohol after eating cephalosporin?" ”
1. Is it a rumor that cephalosporin will drink wine and leave?
Pharmacist Ju Nana, Department of Western Pharmacy, Chengdu Hospital of Integrated Traditional Chinese and Western Medicine (No. 1 Hospital), said that a series of abnormalities such as dyspnea may occur in some people with cephalosporin with wine, which is actually a disulfiram-like reaction.
So, how did the dangerous "disulfiram-like reaction" happen?
First of all, let's understand the metabolic process of alcohol after it enters the body.
About 90 percent of ethanol needs to be catabolized in the liver, and about 2 to 10 percent of ethanol is excreted directly from the body through sweat, urine, and breathing.
In the first step, ethanol is produced into acetaldehyde with the help of alcohol dehydrogenase (ADH).
In the second step, acetaldehyde is catalyzed by acetaldehyde dehydrogenase (ALDH) and turns into acetic acid, which slows down the entire metabolic process.
Step 3: Acetic acid can then form acetyl-CoA, enter the tricarboxylic acid cycle (also known as the citric acid cycle), and finally be metabolized into carbon dioxide and water for excretion.
So, after alcohol enters the body, you need to give the liver enough time to process it.
Disulfiram or some cephalosporin antibiotics contain a component of the "methylthiotetrazolium group", which inhibits the activity of acetaldehyde dehydrogenase in the liver.
Acetaldehyde dehydrogenase is an important enzyme that converts ethanol (alcohol) into acetic acid, and when its activity is inhibited, the acetaldehyde accumulated in the body cannot be effectively converted into acetic acid, resulting in a sharp increase in the concentration of acetaldehyde in the blood, which may increase to ten times the normal value, and then cause a series of adverse reactions.
In addition, acetaldehyde stimulates the release of catecholamines, which in turn activates the sympathetic nerves, which not only reduces mitochondrial respiration and fat oxidation, but also may cause irreversible inhibition of the cardiovascular system.
Overall, the accumulation of acetaldehyde is not to be taken lightly, and its effects are far more complex and far-reaching than you think.
Second, how dangerous is cephalosporin wine?
The risk of taking cephalosporin after drinking is not a rumor, but it is too exaggerated to say that "cephalosporin goes down the stomach and leaves as soon as you drink it".
A retrospective analysis of 78 patients with cephalosporin-induced disulfiram-like reactions (CIDLR) was studied.
Of these, 73 patients were controlled within 1 to 3 hours, their symptoms completely disappeared within 24 hours, and serum electrolyte levels returned to the normal range, but 5 patients died despite symptomatic treatment:
One of the patients, after receiving intravenous cephalosporin antibiotics, drank two bottles of beer, about 1,000 ml, while attending a wedding. About 30 minutes after drinking, the patient developed symptoms such as facial flushing, difficulty breathing, and unsteady gait, and even though he was rushed to the emergency room, he still could not be saved.
Another patient, who was 21 years old, went to the clinic with a cold and fever after drinking about 200 ml of alcohol. At the time of the visit, he did not disclose the fact that he had been drinking, and subsequently received an intravenous injection of 1 gram of cephalosporin. During the infusion, he experienced sudden chest pain and difficulty breathing, and died shortly after arriving at the emergency room.
Therefore, the risk index of "cephalosporin alcohol" should not be underestimated, and once these symptoms appear, it is necessary to arouse high vigilance:
Facial abnormalities: Erythema appears on the skin of the face, and the conjunctival part of the eye is congested.
Difficulty breathing: Breathing becomes difficult, feeling out of breath, and feeling nauseous and throwing up.
Hallucinatory trance: A state of hallucinations or confusion.
Headache and chest pain: A rhythmic pain in the head and severe pain in the chest.
Shock: In extreme cases, shock can occur, which is an acute circulatory failure state that requires urgent medical intervention.
3. Except for cephalosporin, don't drink alcohol after taking these drugs
Taking drugs after drinking may seem like a trivial matter, but in fact it hides a crisis. The combination of alcohol and certain drugs can bring you unexpected side effects and even life-threatening.
Drug 1: Sedative sleeping pills
Including BZD drugs (such as alprazolam, diazepam, etc.) and non-BZD drugs (such as zolpidem, zopiclone, etc.), combined with alcohol may enhance the central nervous system depression, resulting in sedation, dizziness, drowsiness, and may even inhibit breathing.
Drug 2: Antidepressant
Certain antidepressant medications combined with alcohol may enhance their sedative effects and affect cognition and physical coordination.
Drug 3: Anesthetic
The use of anesthetics, such as propofol, in combination with alcohol before surgery may increase the risk of liver damage.
Drug 4: Anti-tumor drugs
Alcohol may reduce the efficacy of these drugs and even promote the metastasis and spread of tumor cells.
Fourth, how to drink to reduce the harm of alcohol? It is very useful to master 3 tricksa
Chinese wine culture is prevalent, and many gatherings are indispensable to take a few sips, so how to minimize the harm caused by drinking? Experts give three ways to reduce the adverse effects of drinking.
1. Avoid drinking alcohol on an empty stomach
Drinking alcohol on an empty stomach will cause alcohol to be absorbed faster, so it is best to eat something to cushion your stomach before drinking, slow down the rate of gastric emptying, and reduce the irritation of drinking alcohol to the stomach.
2. Unnecessary mixed voice
Don't mix different wines. Gao Qilong, chief physician of the Department of Integrated Traditional Chinese and Western Medicine of Henan Provincial Cancer Hospital, said that drinking alcohol in this way will lead to unintentional excessive intake of alcohol, which will cause greater harm to the human body.
3. Don't drink too fast
Li Tian, director of the second district of the Department of Urology of the Fifth Affiliated Hospital of Guangzhou Medical University, said that it is best to drink alcohol carefully and slowly, and drinking too quickly may cause blood ethanol concentration to soar into a state of drunkenness in a short period of time.
Resources:
[1] "How far is the distance between cephalosporin and wine?", China Forum Medical News, 2023-08-23
[2] "How to choose so many kinds of "cephalosporin" for clinical application?", Lilac Garden Medication Guide.2023-08-04
[3] "Cephalosporin + Wine, How Much Will It Kill If You Drink It?99% of People Can't Imagine It".HealthCircle.2022-07-21
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