Disulfirami

Disulfirami is not a standard term in pharmacology and may be a misspelling or alternate form of disulfiram, a medication used to support abstinence in individuals with alcohol use disorder. Disulfiram is sold under brand names such as Antabuse and Antabus and is prescribed as part of a comprehensive treatment program that includes counseling and social support.

Mechanism of action: Disulfiram inhibits aldehyde dehydrogenase (ALDH), an enzyme involved in metabolizing acetaldehyde, a toxic byproduct of alcohol breakdown. When a person taking disulfiram consumes alcohol, acetaldehyde accumulates, producing an aversive reaction that can include flushing, tachycardia, nausea, vomiting, headache, and dizziness. This hypersensitivity aims to motivate the patient to abstain from drinking.

Indications and administration: Disulfiram is indicated as a deterrent therapy for adults with chronic alcoholism who are capable of maintaining abstinence. It is administered orally, typically in once-daily dosing after medical evaluation. The aversive effect only occurs with concurrent alcohol use, and the duration of the drug’s influence persists while the medication is present in the body.

Safety, contraindications, and interactions: Disulfiram is contraindicated in individuals with severe liver disease, heart disease with failure risk, or pregnancy without medical advice. It should not be used by those who are uncertain about their ability to remain abstinent. Interactions with alcohol-containing products or certain medications (for example, metronidazole and isoniazid) can provoke severe reactions. Hepatic monitoring is recommended, as liver toxicity is a potential risk.

Overview: Disulfiram remains an adjunctive option in the treatment of alcohol use disorder, emphasizing the importance of adherence to a broader, multidisciplinary treatment plan. If disulfirami refers to disulfiram, current practice relies on careful patient selection, counseling, and monitoring to maximize safety and efficacy.