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Toxicity, Disulfiram: Multimedia

Author: Samara Soghoian, MD, MA, Clinical Assistant Professor of Emergency Medicine, New York University School of Medicine, Bellevue Hospital Center
Coauthor(s): Sage W Wiener, MD, Assistant Professor, Department of Emergency Medicine, State University of New York Downstate, Director of Medical Toxicology, Department of Emergency Medicine, Kings County Hospital Center; José Eric Díaz-Alcalá, MD, FAAEM,, Consulting Staff in Medicine Service, Division of Emergency Medicine/Medical Toxicology, Veterans Affairs Caribbean Healthcare System; Medical Director, Puerto Rico Poison Control Center, San Juan, Puerto Rico
Contributor Information and Disclosures

Updated: Aug 20, 2008

Multimedia

The pathway of ethanol metabolism. Disulfiram red...Media file 1: The pathway of ethanol metabolism. Disulfiram reduces the rate of oxidation of acetaldehyde by competing with the cofactor nicotinamide adenine dinucleotide (NAD) for binding sites on aldehyde dehydrogenase (ALDH).
The pathway of ethanol metabolism. Disulfiram red...

The pathway of ethanol metabolism. Disulfiram reduces the rate of oxidation of acetaldehyde by competing with the cofactor nicotinamide adenine dinucleotide (NAD) for binding sites on aldehyde dehydrogenase (ALDH).

Disulfiram, prodrug for active metabolites.Media file 2: Disulfiram, prodrug for active metabolites.
Disulfiram, prodrug for active metabolites.

Disulfiram, prodrug for active metabolites.

More on Toxicity, Disulfiram

Overview: Toxicity, Disulfiram
Differential Diagnoses & Workup: Toxicity, Disulfiram
Treatment & Medication: Toxicity, Disulfiram
Follow-up: Toxicity, Disulfiram
Multimedia: Toxicity, Disulfiram
References

References

  1. Baker JR, Jatlow P, McCance-Katz EF. Disulfiram effects on responses to intravenous cocaine administration. Drug Alcohol Depend. Mar 16 2007;87(2-3):202-9. [Medline].

  2. Vaccari A, Ferraro L, Saba P, et al. Differential mechanisms in the effects of disulfiram and diethyldithiocarbamate intoxication on striatal release and vesicular transport of glutamate. J Pharmacol Exp Ther. Jun 1998;285(3):961-7. [Medline].

  3. Filosto M, Tentorio M, Broglio L, et al. Disulfiram neuropathy: two cases of distal axonopathy. Clin Toxicol (Phila). Apr 2008;46(4):314-6. [Medline].

  4. Burman WJ, Terra M, Breese P, et al. Lack of toxicity from concomitant directly observed disulfiram and isoniazid-containing therapy for active tuberculosis. Int J Tuberc Lung Dis. Sep 2002;6(9):839-42. [Medline].

  5. Milne HJ, Parke TR. Hypotension and ST depression as a result of disulfiram ethanol reaction. Eur J Emerg Med. Aug 2007;14(4):228-9. [Medline].

  6. de Mari M, De Blasi R, Lamberti P, et al. Unilateral pallidal lesion after acute disulfiram intoxication: a clinical and magnetic resonance study. Mov Disord. Apr 1993;8(2):247-9. [Medline].

  7. Ellenhorn MJ. Disulfiram. In: Ellenhorn's Medical Toxicology. Vol 2. Lippincott Williams & Wilkins; 1997:1356-62.

  8. Enghusen Poulsen H, Loft S, Andersen JR, et al. Disulfiram therapy--adverse drug reactions and interactions. Acta Psychiatr Scand Suppl. 1992;369:59-65; discussion 65-6. [Medline].

  9. Forns X, Caballeria J, Bruguera M, et al. Disulfiram-induced hepatitis. Report of four cases and review of the literature. J Hepatol. Nov 1994;21(5):853-7. [Medline].

  10. Heath MJ, Pachar JV, Perez Martinez AL, et al. An exceptional case of lethal disulfiram-alcohol reaction. Forensic Sci Int. Sep 1992;56(1):45-50. [Medline].

  11. Hirschberg M, Ludolph A, Grotemeyer KH, et al. Development of a subacute tetraparesis after disulfiram intoxication. Case report. Eur Neurol. 1987;26(4):222-8. [Medline].

  12. Kirubakaran V, Faiman MD, Liskow B, et al. Plasma measurements of disulfiram and its metabolites in a case of severe disulfiram-ethanol reaction. Psychiatr J Univ Ott. Sep 1986;11(3):166-8. [Medline].

  13. Krauss JK, Mohadjer M, Wakhloo AK, et al. Dystonia and akinesia due to pallidoputaminal lesions after disulfiram intoxication. Mov Disord. 1991;6(2):166-70. [Medline].

  14. Kuffner EK. Disulfiram and disulfiram-like reactions. In: Flomenbaum NE, Goldfrank LR, Hoffman RS, Howland MA, Lewin NA, Nelson LS. Goldfrank's Toxicology Emergencies. 8th ed. McGraw-Hill; 2006:1176-1183.

  15. Laplane D, Attal N, Sauron B, et al. Lesions of basal ganglia due to disulfiram neurotoxicity. J Neurol Neurosurg Psychiatry. Oct 1992;55(10):925-9. [Medline].

  16. Mahajan P, Lieh-Lai MW, Sarnaik A, et al. Basal ganglia infarction in a child with disulfiram poisoning. Pediatrics. Apr 1997;99(4):605-8. [Medline].

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Further Reading

Keywords

disulfiram toxicity, disulfiram, disulfiram poisoning, disulfiram exposure, alcohol treatment, Antabuse, acetaldehyde syndrome, disulfiram-ethanol reaction, DER, tetraethylthiuram disulfide, TETD, management of alcoholism, deterrent to ethanol abuse

Contributor Information and Disclosures

Author

Samara Soghoian, MD, MA, Clinical Assistant Professor of Emergency Medicine, New York University School of Medicine, Bellevue Hospital Center
Samara Soghoian, MD, MA is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Sage W Wiener, MD, Assistant Professor, Department of Emergency Medicine, State University of New York Downstate, Director of Medical Toxicology, Department of Emergency Medicine, Kings County Hospital Center
Sage W Wiener, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Emergency Medicine, American College of Medical Toxicology, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

José Eric Díaz-Alcalá, MD, FAAEM,, Consulting Staff in Medicine Service, Division of Emergency Medicine/Medical Toxicology, Veterans Affairs Caribbean Healthcare System; Medical Director, Puerto Rico Poison Control Center, San Juan, Puerto Rico
José Eric Díaz-Alcalá, MD, FAAEM, is a member of the following medical societies: American Academy of Emergency Medicine and American College of Medical Toxicology
Disclosure: Nothing to disclose.

Medical Editor

David C Lee, MD, Research Director, Department of Emergency Medicine, Associate Professor, North Shore University Hospital and New York University Medical School
David C Lee, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

John T VanDeVoort, PharmD, Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals
John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists
Disclosure: Nothing to disclose.

Managing Editor

John G Benitez, MD, MPH, FACMT, FACPM, FAAEM, Associate Professor, Department of Medicine, Clinical Pharmacology Division, Vanderbilt University; Managing Director, Tennessee Poison Center
John G Benitez, MD, MPH, FACMT, FACPM, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Medical Toxicology, American College of Preventive Medicine, Society for Academic Emergency Medicine, Undersea and Hyperbaric Medical Society, and Wilderness Medical Society
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD, Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital
Disclosure: Nothing to disclose.

 
 
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