Retired Psychiatrist and addiction Physician, London, SE1, London, UK.
CHU Brugmann, Free University of Brussels, 1020, Brussels, Belgium.
Alcohol Alcohol. 2020 Jun 25;55(4):354-356. doi: 10.1093/alcalc/agaa045.
In view of the increase in the use of ethanol-containing hand sanitizers throughout the world due to the current COVID-19 pandemic, we wished to review the possible risks to patients treated with disulfiram, following a case report in which an apparent DER (disulfiram-ethanol reaction) was attributed to the cutaneous absorption of alcohol from hand sanitizers as well as by inhalation of vapour.
Simple experiments to assess the levels of absorption by each route separately.
Our results strongly suggest that while amounts of alcohol sufficient to cause a DER may be inhaled when hand sanitizers are used in confined spaces, absorption can be avoided by dispersal of the fumes, and absorption from the skin alone does not occur in pharmacologically significant quantities.
Warnings about absorption of alcohol through the skin from hand sanitizers and products such as perfumes, deodorants and after-shave (whose use is often warned against when disulfiram is prescribed) should be modified accordingly.
鉴于当前 COVID-19 大流行期间,全世界使用含乙醇的手部消毒剂的情况有所增加,我们希望在报告 1 例疑似 DER(双硫仑-乙醇反应)病例后,对使用双硫仑的患者可能出现的风险进行评估,该病例归因于皮肤从手部消毒剂吸收酒精以及吸入蒸气。
通过简单的实验来分别评估每种途径的吸收水平。
我们的结果强烈表明,尽管在密闭空间中使用手部消毒剂时可能会吸入足以引起 DER 的酒精量,但通过散发烟雾可以避免吸收,而单独从皮肤吸收则不会达到有意义的药理学数量。
应相应修改关于从手部消毒剂和香水、除臭剂、须后水等产品(当开具双硫仑时,通常会警告不要使用这些产品)通过皮肤吸收酒精的警告。