Disulfiram works by inhibiting aldehyde dehydrogenase. When alcohol is consumed with disulfiram, which metabolite accumulates causing the flushing, nausea, and vomiting reaction?
- A Acetaldehyde ✓
- B Acetic acid
- C Methanol
- D Acetone
Correct answer: A. Acetaldehyde
Explanation
Alcohol (ethanol) is oxidised first to acetaldehyde by alcohol dehydrogenase, then to acetic acid by aldehyde dehydrogenase (ALDH). Disulfiram irreversibly inhibits ALDH, causing acetaldehyde accumulation. Even small amounts of alcohol lead to high acetaldehyde levels, producing the disulfiram-ethanol reaction: flushing, throbbing headache, nausea, vomiting, hypotension, and tachycardia. This aversion forms the basis of its use in alcohol abstinence maintenance. Acetic acid is the normal end-product; methanol and acetone are not in the ethanol metabolic pathway.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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