In a single-center retrospective observational study examining the risk of adverse events associated with Disulfiram-ethanol reaction (DER) and the use of fomepizole in patients, DER may be responsible for life-threatening vasodilatation requiring vasopressors and accompanied by marked ECG alterations. What was the cause of this adverse event?
Vasodilatation is related to the direct effects of acetaldehyde on the vascular smooth muscles. Additionally, diethyldithiocarbamate, a disulfiram metabolite, reduces norepinephrine synthesis by inhibiting the dopamine-betahydroxylase.
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Contributed by: Otis Green, MD, PGY2, Emergency Medicine Resident, UF Health Jacksonville on behalf of the Florida Poison Information Center Network