Refractive hypotension in a patient with disulfiram-ethanol reaction
Journal
American Journal of the Medical Sciences
Journal Volume
333
Journal Issue
1
Pages
53-55
Date Issued
2007
Author(s)
Abstract
Disulfiram (Antabuse) is used for aversive treatment of alcohol dependence with good effects. Through inhibition of aldehyde dehydrogenase, disulfiram heightens serum aldehyde concentration after alcohol ingestion and causes aversive disulfiram-ethanol reaction. Typical symptoms of this reaction include flushing, nausea, dyspnea, tremor, and confusion, which are usually self-limiting. However, severe life-threatening arterial hypotension sometimes develops. We report here a patient with generalized flushing, tremor, and refractive hypotension after ingestion of alcohol 18 hours after disulfiram treatment. Initial volume resuscitation and dopamine infusion failed to restore the blood pressure. Noradrenaline was given and the blood pressure returned to normal range. This case illustrates the intensity of disulfiram-ethanol reaction and underscores the advantageous use of noradrenaline in patients in such a critical condition. ? Copyright 2007 Southern Society for Clinical Investigation.
SDGs
Other Subjects
alcohol; aldehyde; aldehyde dehydrogenase; disulfiram; dopamine; noradrenalin; adult; alcohol abuse; alcohol consumption; alcoholism; anamnesis; article; blood pressure; case report; clinical feature; continuous infusion; disease course; drug infusion; flushing; general condition improvement; human; hypotension; intensive care; male; resuscitation; side effect; tremor; Adult; Alcohol Deterrents; Disulfiram; Ethanol; Humans; Hypotension; Male; Norepinephrine; Vasoconstrictor Agents
Type
journal article