Methyl alcohol Disulfiram

The answer is a. (Hardman, pp 1086—1089.) Intolerance of alcohol (disulfiram-like reaction) has been noted only with certain cephalosporins. Cephalosporins with the methylthiotetrazole side chain have been associated with a disulfi ram-like reaction because the methyl thiotetrazole group has a configuration similar to disulfi ram, which blocks the metabolism of alcohol at the acetaldehyde step. Accumulation of acetaldehyde is associated with the symptoms. The methyl thiotetrazole side chain also results in hypopro thrombi nemia by interfering with the synthesis of vitamin K-dependent clotting factors. 

The adverse effects associated with cefazolin are generally similar to those described for penicillins. Cefazolin contains a methylthiodiazolethiol side chain and may further cause hypoprothrombinemia and a disulfiram-like reaction with alcohol similar to that seen witli cephalosporins containing the related A-methyl-thiotetrazole side chain. 

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