In 1948, Jacobsen et al. in Copenhagen found that disulfiram, a vulcanization catalyst for rubber, could cause facial flushing, headache, abdominal pain, sweating, palpitations, and difficulty in breathing when absorbed in small amounts, especially after drinking alcohol. Drugs can cause disulfiram-like reactions, and there is no shortage of people who are ineffective in resuscitation, and the dangers of pharmacogenic disulfiram-like reactions are drawing increasing attention. An example: old friends who have not seen for many years to meet, Wang was very excited, at home for the old friends, unknowingly a few glasses of wine down the belly. But just when the two people are very happy, Wang suddenly fell to the ground and passed out. The family rushed Wang to the hospital. The doctor asked Lao Wang what is special, the family said he did not have heart disease, hypertension, diabetes, just the past two days some cold, but after eating cephalosporin has been some relief …… heard here, the doctor interrupted them and said, he ate cephalosporin after how can he drink? After saying that, they began emergency resuscitation. Fortunately, after resuscitation old Wang gradually woke up. Disulfiram-like reactions, also known as withdrawal sulfur-like reactions, are toxic reactions caused by “acetaldehyde accumulation” in the body as a result of drinking alcoholic beverages (or exposure to alcohol) after the application of drugs. Many drugs have effects similar to those of disulfiram. If alcohol is consumed after drug use, weakness, facial flushing, conjunctival congestion, blurred vision, severe throbbing of blood vessels in the head and neck or pulsating headache, headache, dizziness, nausea, vomiting, flushing, sweating, dry mouth, chest pain, confusion, tachycardia, acute heart failure, hypotension, dysphonia, acute liver injury, convulsions, and even myocardial infarction may occur. On examination, there may be a drop in blood pressure, accelerated heart rate (up to 120 beats/min) and normal or partially altered electrocardiogram. The severity of drug-induced disulfiram-like reactions is proportional to the dose of the drug and the amount of alcohol consumed, more in men than in women, more in adults than in children, and more by injection than by other routes of administration. Drugs that cause pharmacogenic disulfiram-like reactions are: Cephalosporin antibiotics: cefoperazone, cefoperazone-sulbactam, cefpimidine, cefamandole, cefmetazole, cefmenoxime, cefmenoxime, cefonic acid, cefotiamide, cephalexin, cefotaxime, ceftazidime, ceftriaxone, cefsulodin, cefazoxime, cefazolin, cefixime, cefaclor, cefodizime, cefadroxil, cefadroxil, cefadroxil, cefadroxil, cefadroxil, cefadroxil. Cefradine, cefoxitin, cefadroxil, cefadroxil, etc. Imidazole antibacterial drugs: metronidazole, metronidazole disodium phosphate, tinidazole, ornidazole, etc. Other anti-microbial drugs: furazolidone, furantoin, chloramphenicol, ketoconazole, ashwagandha, erythromycin, compound sulfamethoxazole, isoniazid, quinacrine, etc. Hypoglycemic drugs: chlorosulfonylurea, methylsulfonylurea, phenelzine, glibenclamide, gliclazide, glipizide, tolarsulfonylurea, hexosulfonylurea acetate, insulin, etc. Other drugs: warfarin, trifluoperazine, tolazurin, chloral hydrate, insulin, hydrocyanide, cyproterone acetate. Alcohol-containing drug preparations such as deciduous water, patchouli oral solution, medicinal wine preparations, tinctures, spiritus, etc.; alcohol-containing topical disinfectant skin preparations and topical rubbing baths to cool down alcohol, etc. Special attention should be paid to: alcoholic beverages including champagne, beer, wine, red wine, yellow wine, white wine, etc., and alcoholic foods such as beer duck and chocolate with wine hearts can also cause pharmacogenic disulfiram-like reactions. If you drink alcohol after taking drugs, you need to pay extra attention to the following conditions: facial flushing, vasovagal headache, dizziness, vertigo, bulbar conjunctival congestion, blurred vision, chest tightness, panic, palpitations, shortness of breath, irritability, hallucinations, nausea, vomiting, fatigue, rapid heartbeat, excessive sweating, etc., abdominal pain, diarrhea, confusion, babbling, slurred speech, dry mouth, etc., severe or accompanied by a drop in blood pressure or elevation, difficulty in whistling, convulsion, drowsiness or lethargy, incontinence, abnormal electrocardiogram, sense of frequent death, pain in the precordial region (angina pectoris), shock, myocardial infarction, etc. If any of these symptoms occur, you must go to a regular hospital for treatment, otherwise your life may be at risk. Since the rate of misdiagnosis of pharmacogenic disulfiram-like reactions is very high, it is easy to misdiagnose the disease as acute coronary syndrome, alcohol allergic reaction, etc. Therefore, it is recommended that you seek treatment from an experienced physician to avoid delaying your condition. Although there is no specific treatment for pharmacogenic disulfiram-like reactions, as long as timely treatment and proper measures are taken, there are usually no sequelae left. Mild cases require only symptomatic treatment, while severe cases must be given high priority. Severe patients should first pay attention to minimizing the period of hypotension, and the application of norepinephrine to raise blood pressure is more effective. Symptomatic treatment may include: oxygenation, fluid infusion (with vitamin C, vitamin B1, vitamin B6, 10% potassium chloride, ATP, CoA, etc.), diuresis, gastrodia for vomiting, and nitrates for angina pectoris. Naloxone, wake-up call, geranium, raw vein injection, and dexamethasone injection have also been reported to be effective in the treatment of pharmacogenic disulfiram-like reactions.