Medical Intensive Care Unit, Cochin Hospital, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France.
Am J Emerg Med. 2013 Jan;31(1):270.e1-3. doi: 10.1016/j.ajem.2012.05.002. Epub 2012 Jul 16.
Shock is a common reason for medical intensive care unit admission, with septic and cardiogenic accounting for most of the etiologies. However, the potential severity of adverse side effects of drugs indicates that any medication should be carefully scrutinized for potential pharmacokinetic and pharmacodynamic interactions that may result. We herein report the case of a life-threatening shock mimicking successively anaphylactic, cardiogenic, and septic shock, which was finally related to disulfiram ethanol reaction. Indeed, disulfiram ethanol reaction is known to provoke unpleasant symptoms through vasodilatation in various organs. However, extreme manifestations of vasodilatory shock may lead to circulatory failure and lactic acidosis. Because of large prevalence of alcoholism and disulfiram medication, emergency physicians and medical specialists should be aware of this life-threatening condition, with its misleading presentation.
休克是重症监护病房常见的入院原因，其中感染性休克和心源性休克是最常见的病因。然而，药物潜在的严重不良反应表明，任何药物都应该仔细检查是否存在可能的药代动力学和药效动力学相互作用。本文报告了一例危及生命的休克，其先后表现为过敏性、心源性和感染性休克，最终与双硫仑乙醇反应有关。实际上，双硫仑乙醇反应通过在不同器官中引起血管扩张，从而导致不愉快的症状。然而，血管扩张性休克的极端表现可能导致循环衰竭和乳酸性酸中毒。由于酗酒和使用双硫仑的情况很普遍，急诊医生和医学专家应该意识到这种危及生命的情况，及其具有误导性的表现。
