ABSTRACT
Adverse effects of prescribed drug therapy are now the fourth leading cause of all deaths in the USA and probably in most developed countries. Safer prescribing involves reducing the incidence of prescription-related acute hospital admissions and deaths, not to mention the unnecessary symptoms and morbidity caused by adverse drug interactions (ADIs). ADIs can usefully be divided into six categories: interactions occurring during drug absorption, interactions occurring during drug distribution, interactions between drugs at their site of action, additive and antagonistic effects of two drugs, interactions occurring during drug metabolism, and interactions due to mismatching of two drugs' plasma half-lives. The drug disulfiram is sometimes used to help alcoholics to abstain, as it causes most unpleasant symptoms if they drink alcohol - nausea, vomiting, flushing, headache and palpitations. Patients should be warned accordingly, for the disulfiram reaction can result in cardiovascular collapse, convulsions and death, if the 'dose' of alcohol is very high, as it often is in chronic drinkers.
