TETURAMUM (Teturamum; synonym: Antabusum, Antabus, Antaethyl, Anticol Disulfiramum, Stopethyl etc.; joint venture. B) — means for treatment of an alcoholism. Tetraethyl thiuram disulphide; With 10 H 20 N 2 S 4 .
Crystal powder, white with weak yellowish-greenish shade. It is almost water-insoluble, difficult alcohol-soluble.
Technical T. it is widely used in the industry by production of rubber. Accidental observation that the workers occupied in this production avoid the use of alcoholic drinks in connection with emergence at them after alcohol intake of unpleasant subjective feelings and objective frustration was premises to studying of T. as means for treatment hron. alcoholism.
It was established that alcohol intake against the background of use of T. leads to emergence so-called Antabusum - alcoholic reaction, edges it is shown by a hyperemia and feeling of heat in a face and an upper part of a trunk, feeling of constraint in a breast, difficulty of breath, noise in the head, decrease in the ABP, tachycardia, sensation of fear, feeling of «the coming death», nausea, vomiting. Duration and intensity of manifestations Antabusum - alcoholic reaction depends on a dose of T. and amounts of the accepted alcohol. With increase in amount of the accepted alcohol duration and weight of its main manifestations increases; in nek-ry cases develops collapse (see) and short-term loss of consciousness.
Emergence Antabusum - alcoholic reaction is caused by accumulation in an organism of one of products of metabolism of alcohol of the acetic aldehyde having high toxicity. In usual conditions acetic aldehyde is quickly inactivated under the influence of an aldegiddegidrogenaza and nek-ry other enzymes. Teturamum it is irreversible inhibits aldegiddegidrogenaza and thereof interferes with an inactivation of acetic aldehyde. Besides, T. inhibits also other enzymes (aldehyde oxidase, glitseraldegid-phosphodehydrogenases) metabolizing acetic aldehyde. The inhibition of enzymes results from binding of T. with their sulphhydryl groups.
Assume that in the mechanism of action of T. also its influence on contents in c can matter. N of page of nek-ry monoamines. So, it is established that it inhibits a tyrosinehydroxylase, and one of its metabolites (diethyldithiocarbamate) oppresses dopamine - a beta hydroxylase owing to what in c. the N of page decreases the level of noradrenaline and the balance between it and dopamine changes.
At hron. alcoholism of T. usually use as supportive application in addition to psychotherapeutic methods of treatment (see an alcoholism, treatment). Before purpose of T. inspire in the patient that in case of alcohol intake against the background of treatment heavy complications will arise drug inevitably. Duration of treatment of T. the hl is individual and depends. obr. from portability of drug.
Appoint T. according to the existing schemes of treatment hron. alcoholism. Usually it is appointed inside in daily doses from 0,25 to 0,5 — 0,9 g. The average duration of a course of treatment is 1V2 — 2 month. After that if necessary carry out the supporting treatment, appointing T. on 0,05 — 0,15 g a day within several months. In the absence of contraindications against the background of reception of T. carry out so-called Antabusum - alcoholic tests, i.e. cause Antabusum - alcoholic reaction, allowing the patient to drink 30 — 50 ml of vodka. Such tests carry out only in the presence of the doctor in a hospital or a special office. During a course of treatment carry usually out from 2 to 6 Antabusum-alko-golnykh of tests.
In modern medical practice of T. it is used for treatment hron. alcoholism also in the form of implantation dosage forms. Fr. drug esperal concerns to them (Esperal), to-ry apply by implantation under skin of a front abdominal wall. Pharmacokinetic researches showed that level T. and its metabolite of diethyldithiocarbamate in blood of patients after implantation esperalya below, than at appointment in tablets T., Antabusum - alcoholic reaction is also insufficient for emergence. In this regard certain researchers consider that treatment hron. alcoholism the specified drug has purely psychotherapeutic character. In the USSR for a wedge, uses Radoterum — similar esperalyu drug T is offered. for implantation use, AN of the Latvian SSR developed in Ying-those organic synthesis.
Side effects T. are usually shown by a headache, drowsiness, increased fatigue, decrease in a sexual potentiality, and sometimes nausea, vomiting, pains in heart, allergic reactions. Sometimes during the carrying out Antabusum - alcoholic test there can be acute psychoses.
Drug it is contraindicated at diseases of cardiovascular system, pulmonary insufficiency, organic mental disorders, neuropathies, psychoses, pregnancy, disturbances of functions of a liver and kidneys, epilepsy, epileptiform attacks, glaucoma.
T. it is not necessary to appoint along with alpha and beta adrenoblockers, vasodilators, MAO inhibitors, tricyclic antidepressants and neuroleptics.
Form of release: tablets on 0,1; 0,15 and 0,25 g.
Bibliography: Korablev M. V., To at r-@ and t of H. M and E in e M. A c. Molecular bases of the mechanism of antialcoholic action of Teturamum, Zhurn. neuropath. and psikhiat., t. 81, No. 2, page 128, 1981, bibliogr.; Wilson A. Disulfi-ram implantation in alcoholism treatment, J. Stud. Alcohol, V. 36, p. 555, 1975.
Yu. V. Burov.