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PubMed1986

Inhibition of the metabolism of N-nitrosoacetoxymethylmethylamine in the rat by disulfiram.

The stability of N-nitrosoacetoxymethylmethylamine (NAMM) in rat serum in vitro, the half-life in blood in vivo and the exhalation rate of 14CO2 after the application of 14C-labelled NAMM were studied with and without disulfiram (DSF) pre-treatment. It was found that the metabolism of NAMM is inhibited by DSF in vitro as well as in vivo. The influence is thought to be due to inhibition of esterase activity, as shown by comparing the kinetics of the degradation of NAMM with those of p-nitrophenylacetate. In contrast to this result the exhalation of 14CO2 does not seem to be influenced by the esterase inhibiting effect of DSF.

Animals↗
PubMed1987

Influence of disulfiram on the metabolism of the urinary bladder carcinogen N-butyl-N-(4-hydroxybutyl)nitrosamine in the rat.

The effect of feeding disulfiram (DSF) to rats on the metabolism of N-butyl-N-(4-hydroxybutyl)nitrosamine (BHBN) was examined in order to study the mechanism by which DSF inhibits bladder cancer induction by BHBN. After 2 weeks of feeding 0.5% DSF in the diet, animals were given [14C]BHBN (25 mg/kg) and the urine and expired CO2 were collected for 8 h. Radioactivity in expired air was very low, but DSF caused a significant reduction in expired 14CO2 (control 1.0% of dose; DSF 0.6%), presumably by inhibition of alpha-hydroxylation pathways. There was no difference in the excretion of total urinary radioactivity (control 84%; DSF 85%). Urine was analyzed by h.p.l.c. for BHBN, N-butyl-N-(3-carboxypropyl)nitrosamine (BCPN), N-butyl-N-2-hydroxy-3-carboxypropyl)nitrosamine (BHCPN) and N-butyl-N-carboxymethylnitrosamine (BCMN). DSF did not alter the urinary excretion of BCPN (control 64% of dose; DSF 61%), whereas BHCPN excretion was increased (control 11% of dose; DSF 22%) and urinary levels of BCMN were decreased (control 10% of dose; DSF 4%). The metabolism of BHBN was also studied in isolated hepatocytes from control and DSF-fed rats. Hepatocytes were incubated in Liebovitz's L-15 medium containing 0.5 mM [14C]BHBN and aliquots of the medium were removed for h.p.l.c. analysis at 0.5, 1, 2 and 4 h. Metabolic rates are expressed as mumol/h/5 million cells. There was no difference in the overall rate of metabolism of BHBN in control and DSF-fed rats. BHBN was very rapidly oxidized to BCPN and the rate was not affected by DSF treatment (control 1.82; DSF 1.76). The rate of accumulation of BHCPN was increased 3.5-fold in the DSF-fed rats (control 0.06; DSF 0.21) and BCMN could not be detected. Taken together, these data show that (i) DSF may inhibit the low extent of alpha-hydroxylation of BHBN or BCPN; (ii) DSF does not inhibit the rapid oxidation of BHBN to BCPN and (iii) DSF appears to inhibit the metabolism of BHCPN.

Animals↗
PubMed1980

gamma-Glutamyltransferase and the inhibition of azo dye-produced neoplasia by concomitant administration of disulfiram.

The concentration and total amount of DNA in the livers of SD rats fed 3'-methyl-4-dimethylaminoazobenzene (3'-Me-DAB) gradually increased and reached a maximum in developing tumors. In SD rats fed 3'-Me-DAB plus disulfiram (DSF), the concentration of DNA was higher than in controls, but it soon became stabilzed and the total amount of DNA in the liver did not differ substantially from that in rats fed DSF alone. In rats given 3'-Me-DAB, neoplastic nodules and liver carcinomas appeared after 3 months, but in those fed both compounds these formations were absent even after 6 months. The activity of gamma-glutamyltransferase (GT-ase), a marker of chemically induced carcinogenesis in rat liver, gradually increased to extremely high levels in tumors even after 75 days when the diet of the animals was changed to a normal one. In rats fed 3'-Me-DAB plus DSF, GT-ase activity increased for the greater part of 80 days, gradually leveled off around the 100th day, and returned to almost normal levels when the rats were given a normal diet after 100 days. We concluded that DSF 1) did not interfere with 3'-Me-DAB-induced proliferation of preneoplastic cells and the increase in GT-ase associated with this reversible adaptation to the influx of 3'-Me-DAB; and 2) inhibited malignant transformation and, consequently, prevented the formation and proliferation of neoplastic cells and the increase in constitutive GT-ase related to neoplasia.

Animals↗
PubMed1980

Inhibitory effect of disulfiram on rat mammary tumor induction by N-2-fluorenylacetamide and on its metabolic conversion to N-hydroxy-N-2-fluorenylacetamide.

The effect of an antioxidant, disulfiram (DSF), on the carcinogenicities of N-2-fluorenylacetamide (2-FAA) and N-hydroxy-N-2-fluorenylacetamide (N-OH-2-FAA) was examined. DSF given in a diet at a concentration of 0.9% for 1 week before and throughout the carcinogen treatment (0.1 mmol/kg 3 times a week for 4 weeks) reduced the incidence of mammary tumors induced with 2-FAA by 50% and extended the mean latency period of malignant tumors from 5 to 10 months. By contrast, DSF had no effect on mammary carcinogenesis by N-OH-2-FAA. Consistent with these results was the demonstration of the inhibitory effect of DSF on the first step of metabolic activation of 2-FAA, i.e., N-hydroxylation. N-hydroxylation of 2-FAA was significantly inhibited in hepatic microsomes of untreated and 2-FAA-treated male and female rats by DSF given orally. A similar inhibition was shown in vitro after preincubation of hepatic microsomes with DSF. Measurements of cytochrome P450 after pretreatment of rats or microsomes with the inhibition showed no appreciable changes in the hemoprotein content. It was concluded, therefore, that the inhibitory effect of DSF on N-hydroxylation of 2-FAA is accomplished through mechanism(s) other than depression of the cytochrome P450 level. Because both 2-FAA and DSF bind to cytochrome P450 producing a type I spectrum, DSF may interfere with the binding of 2-FAA and thus alter its metabolism.

2-Acetylaminofluorene↗
PubMed1990

A randomized phase II study of cisplatin alone versus cisplatin plus disulfiram.

Preclinical evidence has suggested that disulfiram (DS) and related compounds can decrease the toxicity and enhance the therapeutic index of cisplatin (CP). To study this further, we have performed a prospective randomized study wherein 53 patients with CP-sensitive malignancies were assigned to therapy with CP 100 mg/m2 alone (group I) or CP 100 mg/m2 and oral DS 2,000 mg/m2 (group II). Both groups were comparable with regard to sex distribution, age, performance status, prior chemotherapy, and radiotherapy. Twenty-three patients were not evaluable for response (3 refused follow-up, 18 had less than two courses, one had an early death, and one had excessive toxicity during the first cycle of treatment). Of the 30 evaluable patients (16 in group I, 14 in group II), only one in group II achieved a complete response. There was no statistically significant difference in response rate, time to progression, or median survival between the two groups. Fifty-two patients (98.1%) were evaluable for toxicity. Significant differences in toxicities were observed between the two groups: patients in group I encountered lower [Eastern Cooperative Oncology Group (ECOG) 0-1)] grades of nausea, vomiting, and ototoxicity, and patients in group II experienced higher grades (ECOG 2-3) of toxicity in general. In addition, there was no difference in nephrotoxicity between the two groups, as measured by the change in serum creatine or 24-h urine creatinine clearance over the first course of treatment. We conclude that, contrary to previously published reports, DS does not afford significant nephroprotection against CP and, in fact, enhances gastrointestinal and ototoxicities.

Aged↗
PubMed1989

Modulation of 7,12-dimethylbenz[a]anthracene-induced transmammary carcinogenesis by disulfiram and butylated hydroxyanisole in mice.

The individual as well as combined chemopreventive actions of disulfiram (DSF) and butylated hydroxyanisole (BHA) on 7,12-dimethylbenz[a]anthracene (DMBA)-induced transmammary carcinogenesis in mice were examined. When nursing mothers receiving normal diet were treated with DMBA (1 mg/mouse) on days 6, 8 and 10 postpartum, the tumor incidence in their 50-week-old F1 progeny was 44.1%. When nursing mothers receiving 0.75% BHA diet, 0.5% DSF diet and 0.75% BHA + 0.5% DSF diet were similarly treated with DMBA, the tumor incidences in their 50-week-old F1 progeny were 14.7% (P less than 0.05), 12.5% (P less than 0.05) and 5.8% (P less than 0.01), respectively. It is concluded that diets containing BHA (0.75%) and DSF (0.5%), singly or in combination, can inhibit transmammary carcinogenesis in Swiss albino mice.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1980

Testicular and epididymal aldehyde dehydrogenase in rodents: modulation by ethanol and disulfiram.

The distribution of (newly found) NAD-dependent aldehyde dehydrogenase (ALDH) was determined in the rat testis and epididymis as a function of age. There were changes in specific activity of testicular ALDH as a function of age. Epididymal ALDH, which is found evenly distributed between the caput and cauda epididymis, increased initially from the 20th day after birth to th 50th day and remained little altered thereafter in both the caudet and the caput portion of the epididymis. Testicular and epididymal ALDH were found species-dependent with the hamster testis and the rat epididymis showing greater specific activities from the rest of the species studied, respectively. Determinations of testicular ALDH in various mouse strains indicate that it is strain-dependent. Intake of 25% (v/v) ethanol solution as the sole drinking fluid for 10 consecutive days inhibited testicular ALDH in the three mouse strains studied. Administration of disulfiram, 15 mg/kg/day for 60 consecutive days, exerted inhibitory action on testicular and epididymal ALDH in the rat. Intraperitoneal injection of pyrazol, 100 mg/kg once daily for 7 days, resulted in inhibition of epididymal but not of testicular ALDH. It is suggested that testicular and epididymal ALDH may play a role in the toxic action of ethanol-derived acetaldehyde on the gonad.

Alcohol Oxidoreductases↗
PubMed1978

Radioactive and nonradioactive methods for the in vivo determination of disulfiram, diethyldithiocarbamate, and diethyldithiocarbamate-methyl ester.

Although disulfiram (tetraethylthiuram disulfide; DSF) has been used in the treatment of alcoholism for almost a quarter of a century, little is known about its in vivo metabolism. One reason for this is that few analytical methods are available that can determine DSF and its various metabolites in biologic fluids and tissues. This article describes two simple procedures for the determination of these substances.

Blood Chemical Analysis↗
PubMed1980

Disulfiram distribution and elimination in the rat after oral and intraperitoneal administration.

35S disulfiram (DSF), 7 mg/kg, was administered as a single dose to rats both orally (p.o.) or intraperitoneally (i.p.). The 35S DSF was rapidly absorbed by either route. Kidney, pancreas, liver, and the gastrointestinal tract exhibited the greatest uptake of radioactivity, while the least was found in brain. Preferential tissue uptake was similar with both routes of administration. Seven percent of the dose was excreted in the feces. Approximately 12% of the dose was eliminated by the breath as CS2. The 35S-DSF was rapidly metabolized to the 35S-diethyldithiocarbamate-glucuronide and 35S inorganic sulfate. Approximately 93% of the radioactivity was accounted for 48 hr after p.o. or i.p. 35S administration.

Administration, Oral↗
PubMed1981

The disulfiram (Antabuse)-Alcohol reaction in male alcoholics: its efficient management by 4-methylpyrazole.

4-methylpyrazole (4-MP), an inhibitor of alcohol dehydrogenase, rapidly abolished the accumulation of acetaldehyde following alcohol ingestion both in volunteers pretreated with the Antabuse analog calcium carbimide and in an antabuse-treated alcoholic. 4-MP also attenuated other typical symptoms, including facial flushing and tachycardia, thus suggesting its usefulness in the acute treatment of severe disulfiram-alcohol reactions.

Adult↗
PubMed1983

Alcohol-induced euphoria enhanced by disulfiram and calcium carbimide.

In a double-blind study, subjects were treated with either disulfiram or calcium carbimide, inhibitors of acetaldehyde elimination, prior to consumption of low doses of alcohol. Self-rating scales, individual interviews, and observations by independent judges revealed that experimental subjects manifested enhanced changes in mood and euphoria compared to placebo control subjects.

Acetaldehyde↗
PubMed1991

Disulfiram implant: a double-blind placebo controlled follow-up on treatment outcome.

Seventy-six alcohol-dependent patients participated in a study of the clinical effect of implanted disulfiram (DS). The patients were randomized to a DS group (n = 40), receiving a subcutaneous abdominal implantation of 10 x 100 mg DS tablets and a placebo group (PL group) receiving an implantation of 9 x 100 mg calcium phosphate tablets together with one calcium phosphate tablet containing 1 mg DS. Both groups believed they were receiving DS. At admission there was no significant difference between the DS and PL groups with regard to demographic characteristics, psychosocial adjustment, drinking variables, medical disorders, or laboratory results. After a study period of approximately 300 days, 63 patients (33 DS; 30 PL) were assessed using a battery of tests. There was no significant difference between the groups with regard to reduction in average alcohol consumption, number of days to the first alcohol intake after implantation, or level of psychosocial function. Nevertheless, both groups reduced their ethanol consumption significantly, probably due to the psychological deterrent effect. The DS implant did result in a significantly higher incidence of wound complications. This study does not support the idea that a 1-g DS implant has any significant clinical effect different from the implant containing only 1 mg DS (placebo).

Acetaldehyde↗
PubMed1992

Dose-ranging study of depot disulfiram in alcohol abusers.

The object of this early Phase 2 study was to determine the dosage of depot disulfiram (DSF) required to induce sustained sensitivity to alcohol. Sixteen abstinent alcohol abusers were studied in an unblinded ascending-dose trial of DSF suspended in either (1) 5% methylcellulose or (2) 0.1% polysorbate 80. Five pairs of subjects received a single subcutaneous dose of Formulation A (1.0, 2.0, 2.5, 3.0, or 3.5 g). Three pairs were treated with Formulation B (60, 75, or 90 mg/kg) plus an oral loading dose of DSF (15 mg/kg). Subjects were challenged with oral alcohol (0.15 g/kg) before treatment, and on days 7, 14, 21, and 28. Subjective and objective responses to alcohol challenges (skin temperature, breath acetaldehyde, pulse rate, and blood pressure) were measured, and mobilization of DSF was assessed by carbon disulfide levels in breath. Treatment with Formulation B (75 or 90 mg/kg) plus an oral-loading dose (15 mg/kg) was consistently followed by sustained sensitivity to alcohol. Some subjects experienced the subjective and objective features of the DSF-ethanol reaction for 28 days, but these reactions achieved statistical significance only on day 7 for objective changes and on days 7 and 14 for subjective discomfort. Breath carbon disulfide was detectable until day 28 in all subjects receiving more than 1.0 g DSF, demonstrating sustained release of the drug. Treatment with depot DSF merits further study for its potential benefits in chronic alcohol abuse.

Adult↗
PubMed1995

Divergence of ethanol and acetaldehyde kinetics and of the disulfiram-alcohol reaction between subjects with and without alcoholic liver disease.

Despite standardization, marked interindividual variation in the severity of the disulfiram-alcohol reaction (DAR) has been observed. We studied the DAR in 51 consecutive alcoholics with (n = 16) and without (n = 35) significant alcoholic liver disease. Clinical signs of the DAR were much weaker in the patients with compared with those patients without liver disease. Because acetaldehyde is thought to be the main cause of the DAR, we studied ethanol and acetaldehyde kinetics in 13 patients (6 females, 7 males) with alcoholic liver disease (documented by biopsy, clinical and/or radiological findings, and by quantitative liver function) [galactose elimination capacity (GEC) 4.2 +/- SD 1.0 mg/min/kg; aminopyrine breath test (ABT) 0.14 +/- 0.10% dose x kg/mmol CO2] and 13 age- and sex-matched controls (alcoholics without significant liver disease, GEC 7.1 +/- 0.7; ABT 0.81 +/- 0.35). Clinical signs of acetaldehyde toxicity during the DAR (flush, nausea, tachycardia, and blood pressure drop) were absent in alcoholic liver disease, but clearly evident in controls. Blood ethanol kinetics were similar in both groups, Cmax and area under the concentration-time curve (AUC) being 6.27 +/- 1.82 and 368.9 +/- 72.9 mmol x min/liter in alcoholic liver disease, and 6.62 +/- 1.71 and 377.6 +/- 124.5 in controls, respectively. In contrast, there was a strong (p < 0.001) difference in Cmax and AUC of acetaldehyde, respective values being 33.46 +/- 21.52 and 1463.8 +/- 762.5 mumol x min/liter in alcoholic liver disease, and 110.87 +/- 56.00 and 4162.0 +/- 2424.6 in controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetaldehyde↗
PubMed1981

Influence of disulfiram on the serum concentration of carbamazepine in patients with epilepsy.

Treatment of alcoholics with phenytoin and disulfiram (DI) simultaneously is complicated and inexpedient because of the marked drug interaction. The aim of this study was to investigate whether an interaction exists between DI and carbamazepine (CBZ). The serum levels of CBZ and the metabolite CBZ-10, 11-epoxide were measured by high-pressure liquid chromatography in seven out-patients with epilepsy, on monotherapy with CBZ, before and during two weeks administration of DI. Five patients completed the investigation. None were alcoholics. The changes in the serum levels were insignificant, i.e. without clinical important. Moreover, uncontrolled clinical experience has not indicated any interaction between DI and CBZ. Thus the influence of DI on the metabolism of CBZ is probably negligible. CBZ is suggested, therefore, when anticonvulsive therapy is needed by alcoholics in treatment with DI.

Adult↗