Chinese New Year is coming, relatives, friends, classmates and colleagues get together, dinner and drinking is essential. Now, many people already know, intravenous injection or taking cephalosporins during the drug, must not drink alcohol, or serious may be fatal. However, there are many other drugs during the use of alcohol or alcoholic beverages can not be consumed, otherwise, the consequences are equally serious. Pharmacogenetic disulfiram-like reactions? “Many people wonder why they should not have access to alcohol and alcoholic products during medication.” In response to this query, it is expected that many people have heard of “disulfiram-like reaction” but not many may really understand it. The disulfiram-like reaction, as the name suggests, became known from the substance disulfiram. Disulfiram is a catalyst used in the vulcanization of rubber, and it was found that people who were exposed to this substance and then came into contact with alcohol would cause a series of symptoms such as tightness in the chest, shortness of breath, flushing of the face, headache, and nausea, which is the disulfiram-like reaction. As a result, disulfiram was also developed as a withdrawal drug and marketed in some countries as a way to build up people’s aversion to alcohol. Later, it was gradually discovered that not only disulfiram itself, but also some other drugs could cause such a reaction. The main of these drugs that are more relevant to us are some cephalosporin antibiotics, including cefoperazone, ceftriaxone and cefotaxime. In addition metronidazole, ketoconazole and some other drugs can also cause similar reactions. Drug-induced disulfiram-like reaction, there is no shortage of people who can not be rescued, the danger of drug-induced disulfiram-like reaction is increasingly attracting attention. Drugs can trigger disulfiram-like reactions simply because they can affect the metabolism of ethanol in the body. When people drink alcohol or use alcoholic products, ethanol enters the body and is first converted to acetaldehyde by the enzyme ethanol dehydrogenase, and then to acetic acid by the enzyme acetaldehyde dehydrogenase. And if acetaldehyde builds up in the body, it can produce uncomfortable symptoms. The nature of the disulfiram-like reaction is the same, some drugs can be combined with the body’s acetaldehyde dehydrogenase enzyme, inhibiting the enzyme activity, so that the body’s tolerance of ethanol is greatly reduced, even a little exposure may be due to the buildup of acetaldehyde in the body and produce symptoms. The more alcohol consumed, the worse the symptoms: The severity of the disulfiram reaction is mainly related to the amount of alcohol exposure and the individual’s sensitivity. The more alcohol absorbed and the more sensitive the individual is, the more severe the symptoms will be. Generally, the reaction is not fatal, it is just unpleasant and can be quickly relieved with symptomatic treatment. However, for more sensitive individuals, or those with poor heart function, the danger still exists, and in severe cases it can lead to respiratory depression, heart failure and even death. Moreover, disulfiram-like reactions may still occur not only during the use of the drug, but also after the drug is discontinued, when the drug has not been completely metabolized in the body. Therefore, when using such a drug, not only during the use of the drug, but also within 1-2 weeks after stopping the drug, you should stay away from alcohol. In general, the severity of drug-induced disulfiram-like reactions is directly proportional to the dose of the drug and the amount of alcohol consumed, with males outnumbering females, adults outnumbering children, and injections outnumbering other routes of administration. Zhao Ningmin would like to remind people who are taking medication that for your health, you must be careful about drinking alcohol after taking certain medications. If you accidentally drink alcohol after taking the drug, the following situations, you need to pay extra attention: facial flushing, headache and dizziness, bulbar conjunctival congestion, blurred vision, panic and shortness of breath, irritability, nausea and vomiting, fatigue and sweating, abdominal pain and diarrhea, confusion, slurred speech, etc., the appearance of the above symptoms, be sure to go to a regular hospital for treatment, otherwise it may be life-threatening. Since the misdiagnosis rate of drug-induced disulfiram-like reaction is very high, it is easy to misdiagnose it as acute coronary syndrome, alcohol allergic reaction and other diseases, therefore, we suggest that you find an experienced physician to avoid delaying your condition. At present, although there is no specific treatment drug for drug-induced disulfiram-like reaction, as long as timely treatment and effective measures, generally will not leave sequelae. Chocolate can also induce disulfiram-like reaction. Drugs that can cause drug-borne disulfiram-like reaction are: 1, cephalosporin antibiotics: cefoperazone, cefoperazone-sulbactam, cefpiramide, cefamandole, cefmetazole, cefmenoxime, cefonoxime, cefonoxime, cefotetil, cephalosporins, ceftizidime, ceftazidime, ceftriaxone, ceftosulfadine, cefazodoxime, ceftolozole, ceftazidime, ceftizoline, cephradine, cefixime, ceftolo, cefdiazepam, Cefadroxil, cefradine, cefoxitin, cephalexin, cephalexin, etc. 2, imidazole antibacterial drugs: metronidazole, metronidazole disodium phosphate, tinidazole, ornidazole and so on. Other anti-microbial drugs: furazolidone, furotoxin, chloramphenicol, ketoconazole, ashwagandha, erythromycin succinate, compound sulfamethoxazole, isoniazid, quinacrine and so on. 3, hypoglycemic drugs: chlorosulfonylpropylurea, methylsulfonylbutylurea, phenelzine, glibenclamide, gliclazide, glipizide, tulasulfonylurea, hexylurea acetate, insulin and so on. 4, other drugs: warfarin, trifluoperazine, tolazurin, chloral hydrate, insulin, hydrocyamine, cyproterone acetate. In addition, in addition to wine and other alcoholic products, there are some easy to be overlooked by the alcohol-containing pharmaceutical preparations, such as ten drops of water, patchouli oral solution, medicinal wine preparations, tincture, spiritus, etc.; alcohol-containing topical disinfectant skin preparations and topical rubbing alcohol for cooling. Special attention should be paid to the fact that alcohol-containing beverages such as champagne, beer, wine, red wine, yellow wine, white wine, etc., and alcohol-containing foods such as beer duck, alcohol-centered chocolates, etc., can also cause pharmacogenetic disulfiram-like reactions when taken concurrently with some medications.