Let's start by sharing a few true stories:

One day I saw a young male patient in the emergency room with a flushed face and chest tightness and shortness of breath.

What caught my attention, besides the patient's condition, was the medical gauze wrapped around his arms and lower extremities.

The first thing that flashed through my mind at the time was a disease: pulmonary embolism."

Because it was clear that this was a patient who was bedridden after surgery and had the respect of chest tightness and shortness of breath.

But, the truth of the matter is not as simple as I thought.

It turned out that the patient was discharged from the hospital after an infusion on the day of the incident. After discharge, several friends came to the patient's home to celebrate the patient's recovery and discharge.

The patient who could not resist persuasion to drink alcohol developed the above symptoms after consuming about 100 grams of white wine and was eventually readmitted to the hospital.

And it was some kind of cephalosporin that the patient was infused with prior to the incident.

There's also a story that happened to a certain distant relative of mine that makes you laugh and cry.

The relative, who was in his 50s, was admitted to a local hospital with sudden chest tightness and shortness of breath and a drop in blood pressure.

A relative called me for advice, "Said to consider myocardial infarction and to do an intervention."

As soon as I heard my relative's symptoms and the local doctor's advice, I didn't hesitate to tell him, "Do whatever tests you need to do."

After all, this relative had suffered from high blood pressure for years and was barely on medication. It's not unusual to develop an acute coronary syndrome.

In the end, angiography revealed no abnormalities, and pulmonary embolism/diabetic ketoacidosis/lung infection, which are common diseases capable of chest tightness and shortness of breath, were completely ruled out.

So what was the culprit that led to this distant relative's illness?

It turned out that the relative began to have a toothache three days ago, took cephalosporin tired antibiotics and then consumed alcohol twice, eventually bursting with still symptoms.

And that disease is exactly that: a "disulfiram-like reaction."

Of course not everyone will experience adverse reactions to acetaldehyde aggregation after using cephalosporin and alcohol - there are individual differences.

But, the point is: who can guarantee that you are not the unlucky one?

And, in addition to certain cephalosporins, there are some tinidazoles, ornidazoles, chloramphenicol, ketoconazole, ashwagandha, certain hypoglycemic drugs, and so on.

So, to be on the safe side period, we should do the following: take pills, don't drink alcohol, drink alcohol, don't take pills!

Let more people know a little bit more!

Author Bio:The Last Dopamine, Emergency Medicine Physician at a tertiary care hospital, Medical Science Writer. 2015/2016/2017 Quality Headline of the Year.

Drinking and not driving seems to be known to everyone, but with the popularization of health knowledge, more and more people know the knowledge of taking cephalosporin without alcohol, we know the harm of drinking and driving, but we may have questions, why can't you drink when you take cephalosporin?

I. What's wrong with the dreaded disulfiram reaction?

Disulfiram itself is an alcohol withdrawal medication, and taking the drug can cause severe discomfort in the body even after consuming a small amount of alcohol, while achieving abstinence from alcohol. Therefore, disulfiram is quite widely used in alcohol withdrawal treatment. The so-called disulfiram reaction, on the other hand, refers to the situation where drinking alcohol after taking other medications occurs a reaction with the same symptoms as taking disulfiram. Most of the disulfiram reaction will appear facial flushing, conjunctival congestion, visual blurring, headache and dizziness, nausea and vomiting and other symptoms, the serious cases will appear acute liver and kidney function damage, and even death and other malignant consequences, the patient occurs disulfiram reaction in addition to the above, the checkup can also be a drop in blood pressure, heart rate accelerated and other changes. Therefore, disulfiram reaction is not only a symptomatic manifestation, but can also be life-threatening in severe cases. In this case, eating cephalosporin without alcohol can be understood by everyone, right?

IIRC, it's not just cephalosporins that actually have disulfiram reactions, but other drugs as well?

In fact, in addition to the cephalosporins can occur disulfiram reaction, there are many drugs will also occur disulfiram reaction, such as commonly used nitroimidazole drugs, such as metronidazole, tinidazole, ornidazole and other anti-anaerobic drugs, as well as such as furazolidone, chloramphenicol, ketoconazole, ashwagandha, and so on, the drugs, but also disulfiram reaction can occur. Secondly there are other medications, which also have a corresponding disulfiram reaction. So, it is better to be careful about drinking once you use these types of drugs. Though not every person will have a disulfiram reaction after using this type of medication, but even if there is a 1% chance of it happening, once it happens to a particular person, it is 100%. Don't leave it to chance, it's better to be careful, after all, as the saying goes - "you can't be too careful"!

III. What should I do after a disulfiram reaction?

Once the disulfiram-like reaction, should promptly stop using the relevant drugs, and stop using alcoholic beverages, most of the mild cases can be relieved on their own, but if the more serious cases, it is necessary to go to the hospital for treatment. If just occurred and serious, need to timely gastric lavage to exclude alcohol, reduce the absorption of alcohol, if necessary, the use of glucocorticosteroids or alcohol drugs symptomatic treatment, can be rehydration to promote the metabolism of alcohol. If the situation is more serious, it is necessary to carry out the relevant life support, such as respiratory support, circulatory support, blood pressure support and symptomatic treatment.

Drinking and not driving, taking drugs and not drinking, maybe after reading this article you will have a clearer picture in your mind.

Dear, do you understand? You can follow me and I'll tweet you newer and more generalized science every day!

Because during the period of taking cephalosporins and within 7 days after stopping the drug, if there is drinking alcohol or oral intake of alcohol-containing substances, may cause "disulfiram-like reaction", the patient will have facial flushing, headache, abdominal pain, sweating, palpitations and other discomforts, as if drunkenness, alcoholism manifestations. Therefore, we prohibit people who drink alcohol to eat cephalosporin, and prohibit people who eat cephalosporin to drink alcohol.

What is meant by disulfiram-like reaction? To know this exact definition, we first need to understand the drug disulfiram.

Disulfiram, a drug for alcohol withdrawal, used to be used frequently, but is now used sparingly. A person who takes disulfiram beforehand and then drinks, then even if he used to be able to drink a thousand cups, he may now have a violent reaction to a small amount of alcohol, so as to achieve the purpose of abstinence from alcohol. This is because the body can experience discomfort such as facial flushing, sweating, palpitations and headaches after absorbing disulfiram.

One of the structures of cephalosporins is similar to disulfiram, and a reaction similar to disulfiram occurs, so we call it "disulfiram-like reaction". So if you take a cephalosporin and then drink alcohol, you will experience chest tightness, shortness of breath, difficulty breathing, increased heart rate, headache, nausea, vomiting and other symptoms of intoxication. In severe cases hallucinations, mental abnormalities, and even shock have been reported.

In fact, besides cephalosporins, there are other medications that can cause disulfiram-like reactions, such as metronidazole, furazolidone, and xylazine, to name a few. Treatment is mainly to give dexamethasone anti-inflammatory and anti-allergy treatment, and other symptomatic supportive treatment. Generally the prognosis is good, it can subside on its own, will not affect life (individual may), do not worry. However, it is still quite hard to bear during an episode of disulfiram-like reaction.

Can you take cephalosporins after drinking alcohol? Those who haven't tried it probably don't know, but those who have experienced it really know the fear. In the summer of '16 at night around midnight, received a call from Guangdong for advice. The caller is a man, the last few days because of the cold and is taking cephalosporin, the night because of socializing and drinking, the result is that in the middle of the night began to appear nausea and vomiting, and finally to the hospital to do the relevant treatment. In the future, this friend can really drink and cephalosporin drugs strictly separate, the reason is that the reaction between the two.

Cephalosporins can inhibit the production of "acetaldehyde decarboxylase" in the liver, so that acetaldehyde accumulation in the body. Therefore, if you usually do not drink a thousand glasses of wine, after taking cephalosporin antibiotics and drinking alcohol, you will be "one glass of wine". At the same time, some similar to the "drunk" disulfiram reaction, facial flushing, chest tightness and shortness of breath, and in severe cases even produce anaphylactic shock, life-threatening.

In fact, not only cephalosporin antibiotics, but also some other medications should not drink alcohol while taking them. When we have a cold, we not only take antibiotics, but also take other drugs, such as ibuprofen, paracetamol and so on, these drugs related to colds or fever are also strictly prohibited to drink alcohol while taking.

Most cold remedies contain an ingredient called acetaminophen. Acetaminophen, also known as "paracetamol", as the name suggests, relieves low-grade fever and aching limbs caused by colds. When acetaminophen meets alcohol, it can be very toxic to the human liver, and in severe cases, can even lead to liver failure.

When friends get together or communicate with clients, drinking can bring them closer together, but if you are not feeling well, try to avoid drinking, after all, your health is still the most important thing.

If you have a good suggestion for this issue, you are welcome to leave a comment below!

I am Wang Guizhen, welcome to pay attention to [Wang Guizhen dietitian] headline number, together to talk about health, so that we eat healthy, eat at ease!

The night before last I was dragged to a party by a friend and asked to drink. I don't drink in the first place, and it just so happened that a few days earlier I was coughing up phlegm from a cough. Took a cephalosporin. I then told everyone. Immediately no one advised me.

As you can see, the dangers of drinking alcohol and taking cephalosporins at the same time are now commonly known.

In fact, a disulfiram-like reaction occurs when cephalosporins are taken with alcohol over an identical period of time.

There is an alcohol withdrawal drug called disulfiram. What it does is that it makes people who are addicted to alcohol feel very uncomfortable when they take disulfiram and drink even a little bit of alcohol. It makes the alcoholic drink less or not drink at all. To achieve the purpose of quitting drinking.

And after taking disulfiram, and drinking the physical discomfort that occurs, we call disulfiram yang reaction. Often occur facial flushing, facial and conjunctival congestion, head and neck vasodilatation, headache, dizziness, nausea, vomiting, sweating, dry mouth, chest pain, blurred vision; serious cases of myocardial infarction, convulsions, and even death.

At this time, on physical examination, blood pressure falls, heart rate accelerates, and the electrocardiogram may show changes in myocardial ischemia. Their severity is directly proportional to the dose of medication and the amount of alcohol consumed. The results may be more severe in the elderly and infirm and in those sensitive to ethanol.

Cephalosporin antibiotics alone have a markedly similar effect to disulfiram. Moreover, not only cephalosporin antibiotics, but also many other drugs have been found by the medical community to have similar effects to disulfiram.

For example, nitroimidazoles such as metronidazole, tinidazole, ornidazole, and teknidazole have been found in clinical practice. There is also a disulfiram-like reaction with, for example, furazolidone, chloramphenicol, ketoconazole, ashwagandha, sulfonamides, and so on.

In general, a disulfiram-like reaction occurs 15-30 minutes after the administration of a drug and the consumption of alcohol. In other words, when a patient takes a medication and then drinks alcohol, or when a patient drinks alcohol and then takes the medication in question, a life-threatening disulfiram reaction occurs within 15 to 30 minutes.

Also, how long should we actually drink alcohol after using these medications, or how long is it safe to take these medications after we've had a drink?

Generally, it needs to be based on how long it takes for these drugs to metabolize in the body. Or the time it takes for alcohol to metabolize in our bodies. The problem is that every person does not necessarily have the same metabolism time for drugs, or alcohol. Statistically, some people who use cephalosporins within a week of drinking alcohol also experience a disulfiram-like reaction.

So, we generally use a week's time as an interval. That is, the two cannot be reused within a week.

Also, it is important for us to note: Alcohol-containing foods such as patchouli and alcoholic chocolates can also lead to a disulfiram-like reaction. This can also be seen clinically.

When you are prescribed cephalosporins in the hospital, your doctor will instruct that you should not drink alcohol at the same time, as this can cause dizziness, nausea, vomiting and other symptoms, and in severe cases, even death! This reaction is called a disulfiram-like reaction.

So, what are disulfiram and disulfiram-like reactions?

Disulfiram (disulfiram) is an alcohol withdrawal medication that is taken to achieve abstinence from alcohol by causing severe discomfort in the body even when small amounts of alcohol are consumed, also known as the withdrawal sulfur-like reaction.

Disulfiram-like reactions - Many drugs have effects similar to those of disulfiram, and if alcohol is consumed after use, facial flushing, conjunctival congestion, blurred vision, severe pulsating or throbbing headache and dizziness of the blood vessels in the head and neck, nausea, vomiting, sweating, dry mouth, chest pain, myocardial infarction, acute heart failure, respiratory distress, acute liver convulsions and death, etc. On examination, there may be a drop in blood pressure, accelerated heart rate (up to 120 beats/min) and normal or partially altered electrocardiogram (e.g., ST-T changes). Its severity is proportional to the dose of the drug and the amount of alcohol consumed, the elderly, children, cardiovascular and cerebral vascular disease and ethanol sensitivity is more serious, this reaction usually occurs 15-30 minutes after the use of the drug and alcohol consumption.

One wonders why there is such a severe reaction.

The mechanism of action of disulfiram lies in the fact that disulfiram inhibits the enzyme acetaldehyde dehydrogenase in the liver when combined with ethanol, so that after ethanol is oxidized to acetaldehyde in the body, it can no longer continue to decompose and oxidize it, leading to a series of reactions resulting from the accumulation of acetaldehyde in the body.

Why do cephalosporins also produce disulfiram reactions? That would have to be analyzed in terms of the molecular structure of disulfiram:

Many cephalosporins contain N-methyl tetrazolium group, the substituent group is similar to the molecular structure of disulfiram, in vivo its competition with coenzyme Ⅰ for the active center of acetaldehyde dehydrogenase, which can prevent acetaldehyde from continuing to oxidize, leading to the accumulation of acetaldehyde, thus causing withdrawal sulfur-like reaction. See this everyone will understand, the key to the occurrence of disulfiram reaction is to see whether the drug structure and disulfiram molecular structure of the existence of similar groups, cephalosporins many drugs contain N-methyl tetrazolium group, so the occurrence of the same as disulfiram and the withdrawal of sulfur-like reaction is not surprising.

Which cephalosporins can produce such a reaction is a matter of concern: cefoperazone, cefoperazone sulbactam, ceftriaxone, cefazolin, cefmetazole, cefminox, cephalexin, cefmetaxime, cefamandole, these molecular structures contain N-methyl tetrazolium group, among which cefoperazone causes disulfiram-like reaction of the most frequent and most sensitive reports. Disulfiram-like reactions have occurred in patients who have eaten alcoholic chocolates, taken patchouli, or even treated their skin with alcohol alone after use.

Ceftriaxone, cefazolin, these drugs do not have N-methyl tetrazolium group in the molecule, but still cause disulfiram-like reaction, there may be two reasons: First, ceftriaxone, cefazolin molecules have methylthio-triazine side chain can also cause such a reaction; Second, the metabolism of these drugs in vivo after the production of products similar to the molecule with the N-methyl tetrazolium group, which inhibits the metabolism of acetaldehyde.

In addition, we need to remind you to pay attention to is, in addition to cephalosporins need to pay attention to can not drink at the same time, there are also the following drugs will produce the same reaction, such as: nitroimidazole drugs: metronidazole (mirtazapine), tinidazole, olanidazole, sexanidazole; other antimicrobials: furazolidone (diarrhea), chloramphenicol, ketoconazole, ashwagandha, sulphonamides (sulphamethoxazole), and so on. If you are taking these medications, you should be especially aware of the need to avoid alcohol and alcohol-containing products.

Clinical Pharmacist: Tianxin Hu

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

Because cephalosporin antibiotics and alcohol are prone to disulfiram-like reaction, there is generalized vasodilatation, facial flushing, congestion, blurred vision, headache, nausea, vomiting, sweating, accelerated heart rate and drop in blood pressure, severe acute heart failure, respiratory distress, acute liver injury, acute kidney injury, as well as shock and death. Therefore, alcohol should be avoided during the use of cephalosporins and within one week of stopping the drug. In addition to not drinking alcohol, you should also avoid taking ethanol-containing drugs (such as Huo Xiang Zheng Qi Shui, nourishing Yin Qing Lung syrup, etc.), food (such as flavoring agents, fermented vinegar, alcohol-centered chocolates, etc.), as well as supplements (such as ginseng and royal jelly) and so on. In addition, drugs that can cause such reactions, in addition to cephalosporin antibiotics, are metronidazole, dysentery, as well as biguanide and sulfonylurea hypoglycemic drugs, etc., can not drink alcohol after use.

The reason for this is the disulfiram-like reaction that occurs between alcohol and cephalosporins. What is a disulfiram-like reaction?

First of all, alcohol is metabolized in the liver, the process of metabolism is: ethanol is oxidized into acetaldehyde, acetic acid, and finally into carbon dioxide and water in the body, in which the key enzyme of the reaction is acetaldehyde dehydrogenase. Secondly, cephalosporins contain the structure of "methylthiotetrazole side chain". When alcohol enters the liver and cephalosporins are taken within 7 days, the methylthiotetrazole side-chain structure in cephalosporins will inhibit the enzyme acetaldehyde dehydrogenase in the body, causing acetaldehyde to build up in the body, and therefore, a disulfiram-like reaction occurs.A disulfiram reaction is actually a toxic reaction caused by the accumulation of acetaldehyde in the body. The disulfiram reaction causes nausea and vomiting, shortness of breath, dizziness and headache, and in severe cases, anaphylactic shock can even occur.

Therefore, if you have a cold and your doctor prescribes medicines with cephalosporins in them, in order to prevent a disulfiram-like reaction, even if there is a New Year's Eve get-together at home, you should avoid alcohol, preferably after a week.

Hi, thanks for the invitation!

Strictly speaking, as long as you are on medication, it is no longer appropriate to drink alcohol. Whether it's red wine, beer or liquor, as long as you've taken your medication, it's also not appropriate to drink alcohol for one to two days after you stop taking your medication.

There are several broad categories of drugs that react particularly fatally to alcohol, and taking them and then drinking alcohol can trigger a series of extreme discomforts known medically as disulfiram reactions, which can be life-threatening.

What is the disulfiram reaction

The reaction caused by taking medication and then drinking alcohol is called a disulfiram reaction. Disulfiram itself is a kind of alcohol cessation drug, disulfiram in combination with ethanol can inhibit the enzyme of acetaldehyde dehydrogenase in the liver, so that ethanol oxidized to acetaldehyde in the body can not continue to decompose and oxidize, resulting in a series of reactions caused by the accumulation of acetaldehyde in the body. If alcohol is consumed after the drug is used, facial flushing, conjunctival congestion, blurred vision, violent pulsation of blood vessels in the head and neck or pulsating headache, dizziness, nausea, vomiting, sweating, dry mouth, chest pain, myocardial infarction, acute heart failure, respiratory distress, acute liver injury, convulsions and death will occur.

Cephalosporins + alcohol = poison

A "disulfiram-like reaction" occurs when alcohol is consumed after taking a cephalosporin drug or taking a cephalosporin anti-inflammatory injection!

So what exactly is it? It is also known as withdrawal sulfur-like reaction, mainly because of oral cephalosporins after consuming alcohol, resulting in the accumulation of acetaldehyde in the body to produce a toxic reaction. The main manifestations are chest tightness, shortness of breath, laryngeal edema, cyanosis of the lips, dyspnea, increased heart rate, decreased blood pressure, hallucinations, trance, and even anaphylactic shock.

In addition, the severity of disulfiram-like reactions is positively proportional to the dose of the drug applied and the amount of alcohol consumed. Consumption of liquor is more severe than beer or alcoholic beverages, and consumption of alcohol during the administration of the drug is more severe than consumption of alcohol after the drug is discontinued. In people with underlying cardiovascular disease, the reaction may be severe enough to cause respiratory depression, heart failure, or even death.

That's why you should never take cephalosporins with alcohol.

Cephalosporin + alcohol may cause disulfiram reaction

What is a disulfiram reaction?

Alcohol is chemically composed of ethanol, which is first broken down into acetaldehyde in the body, which is then converted into acetic acid by the action of the enzyme acetaldehyde dehydrogenase, and acetic acid is eventually metabolized into water and carbon dioxide and excreted from the body.

And disulfiram (a drug for alcohol withdrawal) can inhibit the enzyme acetaldehyde dehydrogenase in the liver when combined with ethanol, so that after ethanol is broken down into acetaldehyde in the body, it can not continue to be broken down, resulting in the accumulation of acetaldehyde and causing poisoning. It can cause facial flushing, conjunctival congestion, blurred vision, violent pulsation of blood vessels in the head and neck or throbbing headache, dizziness, nausea, vomiting, sweating, dry mouth, chest pain, myocardial infarction, acute heart failure, respiratory distress, acute liver injury, convulsions and death.

Many medications have similar effects to disulfiram, and cephalosporins are one of them.

Drugs that may cause a "disulfiram-like reaction"

What is the severity of the reaction related to?

Related to dose of medication, amount of alcohol consumed, time of day, and individual.

Simply put, the more medicine you take, the more alcohol you drink, and the closer the time between taking medicine and drinking alcohol, the more likely you are to have a reaction. The onset of the reaction can occur 5 to 10 minutes after the person taking the medicine has consumed alcohol, and the reaction can last anywhere from 30 minutes to several hours, and can even be fatal in severe cases.

Infants, young children and the elderly, due to the prolonged drug clearance half-life, need to be even more vigilant in avoiding alcohol consumption during medication.

Although infants and young children will not drink alcohol, but many foods and medications are hidden ethanol, I have seen children taking cephalosporin + wine core chocolate caused disulfiram reaction reports, parents need to pay special attention.

Drugs containing alcohol

What can you do to help yourself in an accident?

So, how long is it safe to go between drinking alcohol and taking medication? Inevitably after reading the article someone will wonder about this.

In fact, the general correct way to proceed is that if you take a cephalosporin, you should not drink alcohol for 1 week. Likewise, if you drink alcohol, you should not take cephalosporins for 1 week afterward.

And in case you can't tell if it's an allergic reaction or a disulfiram reaction, if you have anti-allergy medication at home, take it first. The other thing is to hurry and seek medical attention! Find the nearest hospital, don't seek for a big hospital and delay the best time to save your life! If you know what you are allergic to, try to explain the allergens as clearly as possible to help the doctor make a diagnosis.