As soon as the rainy season in Shanghai passes, the scorching summer is coming, and you can start the summer night life of "barbecue + beer".
"I ate cephalosporin today, so I can't drink alcohol." In most people's common sense, "you can't drink alcohol if you eat cephalosporin" has become a consensus.
Most of the friends who drink alcohol often also know that it can lead to a "disulfiram-like reaction" that affects life safety. But most of my friends have heard about it and don't know why.
Zhang Jun, director of the emergency department of Fengcheng Hospital, came to talk about disulfiram-like reactions.
Let's start with two emergency cases:
01
Mr. Chen, a 56-year-old "old drunkard", drank two taels of white wine at a family dinner, and his face was red, dizzy and flustered, sweating profusely, vomiting, and even a little incoherent.
Isn't this a new problem for the old revolution? Mr. Chen, who usually has a pound, is now drunk like mud.
The experienced Dr. Pei Jie received Mr. Chen, asked about his medical history in detail, and it turned out that because of toothache, Mr. Chen self-metronidazole for three consecutive days, but stopped taking the medicine one day ago.
Dr. Pei quickly made the diagnosis: disulfiram-like reaction. He was also treated with oxygen, naloxone, hangover, and rehydration diuresis. Mr. Chan improved after one hour of treatment in the emergency room.
02
Miss Li was dating her boyfriend, drank a bottle of beer, blushed, dizzy, nauseous and vomiting, and rushed into the emergency room accompanied by her boyfriend.
Miss Li took a cefixime because she had a cold before drinking, and when she heard that "cephalosporin is paired with wine, she will leave", so she clamored for gastric lavage.
Dr. Huang Guolan received Miss Li, after checking her body temperature of 37.6°C, blood routine: WBC 1.2*10^9/L, considering upper respiratory tract infection and acute gastritis, she was given anti-infection, gastric protection, and fluid rehydration treatment. Ms. Lee got better after rehydration.
Then the question arises again, doesn't it say "cephalosporin with wine, just go"? How can metronidazole also have a disulfiram-like reaction, but cefixime is not considered? Why does Mr. Chen still have disulfiram-like reactions after stopping the drug for more than 24 hours?
Why does a disulfiram-like reaction occur?
The process of alcohol metabolism, alcohol is also called ethanol, after drinking, after the body detects the ethanol component, the liver catabolizes the ethanol, mainly through the action of ethanol dehydrogenase, the generation of acetaldehyde, and acetaldehyde has a certain harmful effect on the human body, has a stimulating effect on the nerves, resulting in a series of nausea and vomiting drunkenness.
However, acetaldehyde dehydrogenase in the body acts on acetaldehyde, converting acetaldehyde into acetic acid, which is broken down into water and carbon dioxide in the body, and finally excreted from the body.
Chosen to work as a worker
In this process, we can find that ethanol dehydrogenase and acetaldehyde dehydrogenase play a major role, in general, the content of ethanol dehydrogenase in our body is basically the same, and the ability to metabolize alcohol is mainly determined by acetaldehyde dehydrogenase.
The main reason is that the content of acetaldehyde dehydrogenase in the body of friends who can drink is more, which can quickly decompose acetaldehyde and metabolize it in the body.
Disulfiram
Disulfiram refers to the alcohol abstinence sulfur drugs, which are used to treat psychosis caused by ethanol poisoning, and are commonly used in clinical abstinence. Disulfiram drugs have the effect of inhibiting acetaldehyde dehydrogenase in the liver, which has a certain hindering effect on alcohol metabolism. The acetaldehyde formed by the action of ethanol dehydrogenase cannot be metabolized out of the body.
The drug makes me mess
Therefore, even if friends just drink a little alcohol, under the action of the drug, it inhibits the acetaldehyde dehydrogenase in the liver, and will promote the oxidation of ethanol into acetaldehyde in the body, resulting in the accumulation of acetaldehyde in the body, resulting in acetaldehyde poisoning, a series of adverse reactions such as general weakness, flushing, headache, vomiting, blood pressure drop, hallucinations, dizziness, drowsiness, and even shock, death.
This series of reactions is called disulfiram-like reaction, also known as alcohol sulfur-like reaction, disulfiram-like reaction occurs rapidly, symptoms appear as early as 5 minutes, generally more than 30 minutes, a few within an hour, and a very small number of symptoms will appear after an hour.
Which drugs can cause disulfiram-like reactions
It is not only cephalosporins that cause disulfiram-like reactions, nor are all cephalosporins have disulfiram-like reactions, but the probability of disulfiram-like reactions in all drugs is relatively high in cephalosporins.
Drugs that can cause disulfiram-like reactions
In addition to alcohol, what other "invisible killers" are there?
We all know about not drinking alcohol after taking disulfiram-like drugs. But we don't know that not only direct drinking, but also some drugs and drinks containing alcohol We also need to pay attention to, such as: beer, drunk shrimp, wine-stuffed meatballs, wine-hearted chocolates and other common foods and snacks, as well as Huoxiang Zhengqi water, ten drops of water, asaroxin brain injection, nimodipine injection, compound licorice liquid, hydrocortisone injection, thrombotong injection and other drugs containing ethanol also need to avoid using at the same time with such drugs, even if alcohol wipes the body, you need to be cautious, so for the sake of insurance, Avoid using alcohol-based cosmetics during this time to avoid disulfiram-like reactions.
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The two protagonists of the disulfiram-like reaction to the end
How long is it safe not to see each other?
How long after drinking alcohol can I eat cephalosporin mainly depends on how long it takes for alcohol to be metabolized from the body, because alcohol and cephalosporins will have a disulfiram-like reaction, causing chest tightness, shortness of breath and even life-threatening. The metabolism of alcohol in the body is mainly related to the amount of alcohol consumed and the metabolic capacity. Generally, people who drink a small amount of alcohol and have a strong metabolic ability can metabolize it after 24 hours, and for patients who drink a lot of alcohol and have poor metabolic ability, it takes a long time. Therefore, it is best to wait a week after drinking alcohol before taking cephalosporins.
Similarly, it takes a certain amount of time for alcohol to be metabolized in the body. It generally takes 48 to 72 hours for alcohol to be completely metabolized in the body. However, in people with liver and kidney insufficiency, the metabolic time may take longer. Therefore, to be on the safe side, it is necessary to take cephalosporin antibiotics more than 72 hours after drinking. In the absence of alcohol, it is safe to use cephalosporin antibiotics according to the need for the condition, and doctors generally consult the appropriate allergy history before using it.