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The Disulfiram‐Alcohol Reaction: Factors Determining and Potential Tests Predicting Severity
Author(s) -
Beyeter Christine,
Fisch HansUlrich,
Preisig Rudotf
Publication year - 1985
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.1985.tb05531.x
Subject(s) - disulfiram , alcohol , medicine , pharmacology , chemistry , organic chemistry
13 ambulatory alcoholics (3 woman, 10 men) who consented to alcohol‐avorsive treatment with dtsuffiram were sutojectad to detailed investigations before, during, and after the disumram‐alcohol reaction (DAR). The studies included quantitative estimation of aver function (aminopyrine breath test, ABT; galactose elimination capacity, GEC) prior to the DAR, measurement of alcohol and ecetaMehyde plasma levels together with pulse rate and blood pressure during the DAR, and the effects of disulfiram on erythrocyte acetaMehyde‐oxidizing capacity (AOC). As expected, the severity of the DAR showed considerable interindividuai variation. However, the maximal fan in diastolic blood pressure was closely (r = 0.83; p < 0.001; n = 13) related to peak acetaidehyde plasma level (AAPL). The decrease m systolic blood pressure was age dependent, individuals >40 years exhibiting a larger drop for a given AAPL. The dependence of acetaidehyde formation on liver function was suggested by a significant correlation (r = 0.88; p < 0.01; n = 8) between ABT and AAPL; this relationship was influenced by the prior intake of enzyme‐inducing drugs. Measurements of AOC indicated that a disulfiram‐induced maximal suppression is achieved already after 6 days of treatment reaching levels of 0.7 ± 0.6 nmol/ml/min (so) (compared to pretreatment values of 4.1 ±0.9). Mean values in untreated alcoholics and in subjects with alcoholic or nonalcoholic liver disease were not significantly different from controls. It is concluded that AAPL appears to be the single, most important factor determining severity of the cardiovascular response in the DAR, and that the ABT (following disulfiram pretreatment) may be a suitable test for predicting changes in AAPL. Finally, AOC measurements dearly define subjects under treatment with disulfiram.