Intramuscular implantation of the drug "Disulfiram"

Publication date: January 21, 2020

The anti-alcohol drug Disulfiram is quite often used in drug treatment practice. Indications for its use are:

• chronic alcoholism;
• prevention of relapses during treatment.

The drug is presented in different release forms:

• pills;
• small implant capsules;
• oily solution for injections.

It can be taken orally, administered intramuscularly and placed in capsule form by subcutaneous filing.

Disulfiram in the blood: how the drug works

Coding is carried out only by a narcologist; the patient must be absolutely sober. Before the procedure, the patient must maintain sobriety for 3-5 days. The drug itself is harmless; over time, Disulfiram is completely eliminated from the body. During the period of active treatment, after taking a small dose of alcohol, unpleasant sensations begin. A rapid heartbeat can lead to a panic attack, and a person may feel hot or cold.

Poor circulation causes blood to rush to the face. There is almost always nausea and a gag reflex. In this state, fear of death often arises. This leads to the fact that the alcoholic simply will not have the desire to even hold on to the glass. The sight of a bottle of vodka will cause negative associations.

Disulfiram prevents the formation of the enzyme that breaks down ethyl alcohol into two key components - water and carbon dioxide. The medicine inhibits this process at the moment when C2H5OH becomes poison - acetaldehyde. If the patient begins to drink alcohol, severe food poisoning occurs in his body. The symptoms described above will appear. After the experience, the alcoholic will feel a clear disgust for alcohol-containing liquids, even beer will cause negative emotions.

Methodology

Before implantation, sewing in the Disulfiram ampoule, the patient must visit a narcologist, accompanied by a relative. The doctor conducts an examination and once again talks in detail about the principles of action of the drug.

Coding is carried out in the clinic or at the patient’s home. When the ampoule is sewn in, the patient’s body area is treated with an antiseptic. An incision is made into the skin. The area is then sutured and a sterile bandage is applied on top.

When sewn in, the removal of Disulfiram from the body occurs gradually.

About release forms

When answering the question of how much Disulfiram is excreted from the body, it is necessary to take into account the form of release. The pharmaceutical industry produces a huge number of drugs based on Disulfiram. The difference lies in the mass or proportion of active components. Very often, substances differ in the period of clearing the body of its presence. This medicine is available in three forms:

1. Pallets for implantation. A special syringe container is sewn into the patient intramuscularly. To do this, make a small incision on the skin surface. The drug retains its effect, it is tied to the dosage. The standard period is from three to six months. All this time, a small dose of Disulfiram is present in the body. If the patient takes alcohol, vasodilation will occur. Due to the blood flow to the implant location in the body, the percentage of the active component will increase. Because of this, severe poisoning will occur, as described above. Even death is possible.
2. Tablet for oral administration. The doctor almost always prescribes one tablet per day. If treatment is successful, the dose is usually reduced. Drinking drinks containing alcohol is strictly prohibited.
3. Solution for intravenous, intramuscular administration. The principle of penetration of a substance into the body does not differ from conventional medical procedures. It takes one minute to inject into the buttock or vein. The drug instantly accumulates in the muscles at the injection point. The blood circulation process will make its concentration uniform.

The drug Disulfiram: how long does it take to leave the body?

When answering the question of how long it takes for Disulfiram to be eliminated, it is important to take into account the general condition of the patient and the percentage of the drug. The form of its release is taken into account. The drug is taken:

• Oral. When taking tablets orally, the validity period is two days. But many instructions state that a small amount of medication can last up to two weeks.
• Implants. The drug, sewn under the skin, can remain in the body for five to nine months. Sometimes the maximum period reaches one year! A small amount of Disulfiram accumulates in fatty tissues and is excreted very slowly. This treatment method is considered the most effective. The patient's chance of relapse is minimal. If the sewn-in ampoule is removed ahead of schedule, the effect of the remaining medication lasts another 60 days.
• Intravenously or intramuscularly. The withdrawal time for a Disulfiram injection is six to nine months. Many instructions state that residues can remain in the blood for one year!

It is important to know and remember: the treatment method, method of administration, and dose are prescribed only by the attending physician. Before this, a full examination of the body is carried out, everything will depend on the individual condition of the patient!

Filing with “Disulfiram” - features of the operation

While everything is clear with taking pills and the injection method, the procedure for sewing in an ampoule often raises questions among patients. It is a simple micro-operation that should be performed under sterile operating room conditions.

On the appointed day, the client arrives at the drug treatment clinic. The doctor talks to him. The doctor explains in detail how the encoding works and how to behave after its completion. If everything is clear to the patient and he has not changed his decision to be coded, he is asked to sign a consent.

The patient is then taken to the operating room. The capsule is in an individual sterile bag. The doctor treats the surgical field and administers local anesthesia. Then a small incision (about 6 mm) is made and the implantation capsule is inserted under the skin. Then he sutures the wound and applies a bandage.

After filing, the active substance of the drug is released in small portions evenly. Due to this, the anti-alcohol effect can last from one to three years.

Antidote

Often, drugs that contain disulfiram are forcibly administered to a person, against his will. Almost always such a patient tries to find an antidote. But it doesn’t exist, and it won’t be possible to remove the substance ahead of time. If a strong reaction to alcoholic beverages occurs, doctors begin gradual intoxication. This is a rather long, complex process. You will need to administer ascorbic acid, Ephedrine, and H1 blockers. This can take from twelve hours to two days. But Disulfiram will not be completely removed - the degree of human poisoning will simply decrease.

Such procedures are carried out only in emergency cases; the removal itself can have a negative impact on the body. A serious dose of ascorbic acid often leads to irreversible consequences and physiological damage. This can cause stomach ulcers or cirrhosis of the liver. There are known cases of impotence and cancer. Many narcologists recommend being extremely careful when using the drug. You can always consult a psychiatrist or undergo a simpler course of therapeutic treatment.

About side effects

By its nature and formula, the drug is considered harmless. The danger comes only after drinking alcohol. It is important for a person to be careful in choosing a diet. Even the slightest alcohol content can lead to undesirable consequences. Alcohol is always present in small doses in kvass, syrup, koumiss, sauerkraut, fruit juice, and confectionery. Long-term observations and tests have revealed a number of negative consequences from the drug. The patient may experience:

• Chronic fatigue.
• Migraine.
• Feeling of an unpleasant taste in the mouth.
• Partial memory loss.
• Yellowing of the skin.
• Darkening of urine.
• Intoxication of the kidneys and liver.

This reaction can occur when taking small doses of alcoholic beverages. If you drink 500 milliliters, serious, irreparable consequences can occur. Tachycardia and skin pallor may occur. A little later, seizures, convulsions, and convulsions may occur. Call an ambulance immediately; before it arrives, you can give laxatives.

There are cunning people who undergo treatment with Disulfiram and begin to drink alcohol in small doses. There are no serious side effects, but there is a feeling of moderate intoxication. Systematic intake of 60-70 milliliters of vodka leads to deplorable, irreversible situations. Problems with the liver, heart and blood vessels may occur.

Disulfiram

Name: Disulfiram Pharmacological action: The drug Disulfiram affects the enzyme system of ethanol metabolism in the body. By inhibiting aldehyde dehydrogenase, it stops the natural metabolism of ethyl alcohol to safe metabolites. As a result, the concentration of the toxic metabolite of alcohol, acetaldehyde, increases. It is this that causes the effects of the drug when using alcoholic beverages. Acute dyspepsia, hot flashes, severe asthenia, tachycardia, and threatening hypotension are observed. Such acetaldehyde intoxication causes an aversion to alcohol and stops a person from deciding to drink it. The main effect of the drug is anti-alcohol.

Indications for use: The drug Disulfiram in oral form is indicated for the prevention of relapse in the treatment of alcoholism. Implants with disulfiram are used for the treatment of chronic alcoholism and for detoxification therapy for chronic nickel poisoning.

Method of administration: Internal administration provides daily doses of disulfiram - 125-500 mg/day. The implant contains 800 mg of disulfiram with gradual release.

The procedure for subcutaneous or intramuscular implantation in the left iliac region: - disinfection of the injection site; — local anesthesia; — making an incision (6 mm); - introduction of 2 implantation tablets parallel to the skin surface using a trocar; - introduction of the remaining 6 tablets (two each so that all 8 tablets are positioned crosswise relative to the incision site; - suture; - application of a sterile dressing.

The implantation procedure can be repeated after 8 months.

Side effects: The use of the drug Disulfiram may be accompanied by: - ​​disorientation; - metallic taste; - skin rash; - hepatitis; — neuropsychic disorders; - itching; — polyneuritis of the lower extremities; - headache; - memory loss; - unpleasant odors of skin and discharge during colostomy; — optic neuritis; - anaphylaxis.

The combined use of the drug Disulfiram and alcohol is accompanied by: - ​​collapse; — heart rhythm disturbances (even fatal); - cerebral edema; - development of a coma; - attacks of angina pectoris; - convulsions; - respiratory failure; - myocardial infarction.

If you drink alcohol while on Disulfiram therapy, you must immediately undergo detoxification therapy and place the patient under medical supervision. If serious side effects develop, administer analeptics and other drugs depending on the symptomatic manifestations.

Long-term use of the drug may be accompanied by: - ​​alcohol-type psychoses; - hepatitis; - gastritis; — thrombosis of cerebral vessels (in cardiac patients); - exacerbations of polyneuritis.

Contraindications: Disulfiram is not prescribed for: - diabetes mellitus; - epilepsy; - pulmonary emphysema; - thyrotoxicosis; - bronchial asthma; — presence of neuropsychiatric diseases; - severe liver failure; — carrying out therapy with metronidazole, phenytoin, alcohol-containing drugs, isoniazid; — pathologies of the hematopoietic system; - pregnancy; - pulmonary tuberculosis; - neuritis of the auditory nerve; - ulceration of the gastrointestinal tract; — severe cardiac pathologies; - lactation; - malignant tumors; - optic neuritis; - gastrointestinal bleeding; - glaucoma; - hypersensitivity to disulfiram, its structural and pharmacological analogues.

Disulfiram is prescribed with caution for: - liver pathologies; — indications for patients over 60 years of age; — the presence of ulcerative lesions of the gastrointestinal tract in remission form; — diseases of the bronchopulmonary system with respiratory dysfunction; - endarteritis; - history of psychosis due to disulfiram drugs; - renal failure.

Pregnancy: Disulfiram is dangerous to the fetus. Pregnant women are prohibited from using it. Reliable contraception is necessary during therapy.

Interaction with other drugs:

Overdose: Exceeding therapeutic doses of disulfiram is accompanied by: - ​​coma; — collapse; - dangerous neurological reactions.

Symptomatic therapy is indicated in a hospital setting, carried out in parallel with detoxification measures.

Release form: Disulfiram is available in tablets for oral and implantation use, in the form of an oil solution. The packaging is as follows: - 10 implantation tablets/glass bottle; — 20 tablets oral/packaging; - oil solution.

Storage conditions: Storage temperature for Disulfiram tablets, oil solution, implantation form – up to 25 degrees Celsius. The guaranteed shelf life of tablets is 5 years, the oil solution and implantation form of release is 2 years.

Synonyms: Exorran, Crotenal, Tetradin, Refusal, Antiethyl, Disethyl, Aversan, Teturam, Antabuse, Lidevin, Espenal, Abstinil, Alcophobin, Esperal, Antikol, Antietan, Contrapot, Noxal, Stoptil, Tetlong, Abrifid, Radotera.

Composition: 1 tablet for implantation of Disulfiram contains 0.1 g of disulfiram. Auxiliary components: mannitol, sodium chloride, PEG-6000.

1 disulfiram oral tablet contains 500 mg or 250 mg disulfiram. Auxiliary components: calcium diphosphate, hydroxypropylcellulose, MCC, polyoxyl 40 stearate, sodium starch stearate, stearic acid.

Additionally: The patient must be warned about a categorical ban on the consumption of alcohol and alcohol-containing drinks. A pronounced disulfiram-like reaction occurs after 50 ml of vodka. When paresthesia appears in cardiac patients, urgent hospitalization is necessary to exclude cerebral thrombosis. Implantation of the drug should be carried out after a course that reduces the patient’s craving for alcohol. Polyneuropathy is relieved by the use of B vitamins. The formation of a small tubercle at the implantation site is normal.

Attention! The description of the drug " Disulfiram " on this page is a simplified and expanded version of the official instructions for use. Before purchasing or using the drug, you should consult your doctor and read the instructions approved by the manufacturer. Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.

Contraindications

The drug is prescribed only after a thorough medical examination. Disulfiram is usually prescribed to those who have not been helped by simpler and safer treatments. If the patient drank alcohol 48 hours before the appointment, then the first dose is postponed to a later date. The substance is strictly contraindicated for those with mental disorders. Problems always occur in those who suffer from liver and respiratory failure. The drug is not prescribed to those who have heart, vascular, or gastrointestinal diseases. It’s bad if the patient has a stomach ulcer or erosion. The use of Disulfiram is dangerous for pregnant and lactating women. The instructions prohibit administering the substance to adolescents; it is highly undesirable to treat elderly people with it.

It is important to know: treating alcoholism is a complex process. Much of the success will depend on the patient himself, his desire and desire to be cured. Introducing Disulfiram against your will can end in disaster. Before starting treatment, it is advisable to undergo a course of therapy with a psychiatrist. Ignoring this point can lead to serious illnesses and mental disorders. Narcologists speak positively about this drug. Many patients were able to overcome alcoholism and become normal people.

Cost of treatment

The cost of using Disulfiram is discussed individually. This depends on the chosen coding method, as well as on the duration of the drug.

The final cost is influenced by the number of medical services that were performed before coding. The patient may require withdrawal from binge drinking and a course of treatment for concomitant diseases that have developed or worsened due to alcohol dependence. In some cases, there is a need for professional psychological help or rehabilitation.

The rehabilitation center has developed several programs for patients with different income levels. Coding is not a solution to all problems; you should complete a full course, including rehabilitation and social adaptation.