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Disulfiram is a Food and Drug Administration-approved medication for alcohol dependence. This activity discusses disulfiram's use as an intervention for both short and long-term management of alcohol dependency in motivated individuals. Participants will explore its mechanism of action, adverse event profile, contraindications, pharmacology, monitoring protocols, and pertinent drug interactions, facilitating a comprehensive understanding among healthcare team members. This knowledge equips professionals to tailor treatment strategies to individual patient needs, fostering informed decision-making while mitigating potential adverse effects. By focusing on the pharmacological intricacies of disulfiram, healthcare providers gain the knowledge to administer personalized care, thereby aiding patients on their journey to sobriety. Objectives: Identify the Food and Drug Administration-approved indications for disulfiram therapy. Identify the mechanism of action of disulfiram corresponding to its indicated use. Evaluate the adverse drug reactions of disulfiram. Implement effective collaboration and communication among interprofessional team members to improve outcomes and treatment efficacy for patients who might benefit from disulfiram therapy. Access free multiple choice questions on this topic.

Signs and Symptoms of Overdose One case report features a 4-year-old girl who accidentally ingested 4–5 tablets of disulfiram, resulting in hypoglycemia and encephalopathy. After management in the intensive care unit, the child exhibited normalization of blood sugars after 8 hours and displayed characteristic MRI brain findings, including bilateral globus pallidus hyperintensity in T2-weighted and diffusion-weighted images. The conclusion underscores the potential severity of acute disulfiram poisoning in children and emphasizes the importance of considering it in the diagnosis of idiopathic encephalopathy with extrapyramidal symptoms.[21] Management of Overdose Contact the local poison control center in case of an overdose. No information is available on the treatment of disulfiram overdose, and there is no antidote available. Supportive care via supplemental oxygen, cardiac monitoring, and intravenous fluids may be necessary. Consult a physician if symptoms are severe. Cases of ingestion of 5 g or greater resulted in parkinsonism, choreoathetosis, and thalamic syndrome. Doses should not exceed 500 mg/d for treatment of alcohol dependence, and doses for malignancy remain as yet undetermined.

Disulfiram may be prescribed by the primary care provider, psychiatrist, nurse practitioner, or physician assistant. However, all healthcare workers, including the nursing staff and pharmacist, must be familiar with its adverse effect profile. The agent is not well tolerated, and when consumed with alcohol, it can produce severe adverse effects that can even lead to a heart attack. Today, this drug is not used to treat alcoholism because it is not deemed to be safe.[22] When using disulfiram requires an interprofessional team approach. Prescribing was covered in the previous paragraph, and the pharmacist should have input regarding dosing and drug-drug interactions by performing complete medication reconciliation and reporting any concerns to the prescribing clinician. Nurses should monitor for treatment effectiveness and adverse reactions to disulfiram and alert the team should any significant adverse event occur. An interprofessional team approach and open communication among healthcare professionals, including nurses, specialists, and pharmacists, can optimize patient outcomes related to disulfiram therapy.