Disulfiram Ethanol Reaction with Ischemic stroke

Abstract

Disulfiram (tetraethylthiuram disulfide) has been used since decades in the treatment of alcohol addiction. It causes aversive behaviour towards alcohol due to Disulfiram Ethanol Reaction (DER). The classical DER includes flushing, sweating, tremors, nausea, vomiting, tachycardia, hypotension and restlessness. Complete recovery is the usual outcome in clinical settings. Life threatening reactions are rare but sometimes occur. Rare complications include shock, myocardial ischemia, hypertension, bronchospasm and methemoglobinemia. We present here a very rare case of ischemic stroke in a hemodynamically stable patient, which developed secondary to disulfiram–ethanol reaction. To the best of our knowledge, this is the first such reported case in literature.

Keywords

• Disulfiram, ethanol reaction, ischemic stroke

Disulfiram Ethanol Reaction with Ischemic stroke

Öz

Disülfriram (tetraethylthiuram disulfide) on yıllardır alkol bağımlılığı tedavisinde kullanılmaktadır. Disülfiram Etanol Reaksiyonu (DER) nedeniyle alkole karşı caydırıcı davranışa neden olur. Klasik DER kızarma, terleme, tremor, bulantı, kusma, taşikardi, hipotansiyon ve huzursuzluk bulgularını içerir. Klinik merkezlerde tam iyileşme olağan sonuçtur. Hayatı tehdit edici reaksiyonlar nadirdir ancak bazen oluşabilir. Nadir reaksiyonlar; şok, miyokardiyal iskemi, hipertansiyon, bronkospazm ve methemoglobinemidir. Bu makalede DER’e sekonder olarak gelişen, hemodinamik olarak stabil bir hastada ortaya çıkan nadir bir iskemik inme vakasını sunduk. Bildiğimiz kadarıyla bu vaka literatürde bildirilen ilk vakadır

Anahtar Kelimeler

• Disulfiram, etanol reaksiyonu, iskemik inme

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