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Antabuse and How It Works
Antabuse is the oldest medication approved by the FDA for the treatment of alcoholism. Unlike new medications for alcoholism that either block the effects of alcohol or block the craving to take a drink, Antabuse works by making alcoholics extremely sick, every time someone taking it takes a drink.
The disulfiram-ethanol reaction (DER) is characterized by headache, generalized flushing, malaise, dyspnoea, palpitations and vomiting. In addition, patience also experience hypotension and tachycardia. In cases of severe reactions, cardiovascular collapse can ensue. Nevertheless, the DER is usually not too severe. Fatalities have been reported, but occur quite rarely.
Disulfiram can cause side effects without reaction with alcohol. Serious ill effects, such as peripheral neuritis, convulsions or psychosis are quite rare. More common side effects are drowsiness, nausea and anorexia, depression, headaches and impotence. Drowsiness may be counteracted by taking the drug at night.
Disulfiram Taken Orally
The drug disulfiram (Antabuse) can be taken either orally or implanted by way of intramuscular implantation of sterile pellets. Each approach has its unique advantages. A daily oral dose of one 200 mg tablet generally provides, after the drug has been consumed for a few days, enough of the substance in the body to produce an unpleasant and alarming reaction if alcohol is consumed.
The main advantage of Antabuse in the pill form is the cost. The cost of monthly supply of disulfiram is only a few dollars. The major difficulty with oral deterrents against drinking is that of gaining patient compliance. Patients who are prescribed disulfiram may not start taking their medication. More frequently though, they stop it prematurely or due to their intention to resume drinking.
An alternative method of medicine delivery takes the form of the subcutaneous or intramuscular implantation of sterile pellets of disulfiram. This type of alcohol treatment is commonly referred to as coding patients. The procedure was introduced over 20 years ago in the country of France and is extensively practiced in Eastern Europe and former Soviet Union countries at the present time. The implanted drug enters into blood stream, while it slowly dissolves, thus maintaining appropriate drug concentration in blood during 10-13 months. Studies show that between 93 and 95 percent patients who underwent Antabuse implant have shown good results.
Antabuse Implant Process
Using local anesthesia (e.g. Lidocaine), a surgeon will implant between eight and ten pellets of disulfiram in a single procedure. Disulfiram comes in 100 mg sterile pellets and those are encapsulated in a glass container. The pellets are surgically placed in the fibers of your stomach muscles called rectus abdominis. Alternatively, your surgeon may choose to make an incision of 10 to 15 mm in the left iliac fossa. The inch long incision is sutured with absorbable sutures, and there is no need to visit the surgeon again to remove them.
After the surgery it may be necessary for the patient to take Disulfiram orally for about a week, until the implant starts dissolving. In addition, the patient is prescribed antibiotics to prevent infection and antihistamine to reduce inflammatory response.
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