RESUMO
AIM: In view of the increase in the use of ethanol-containing hand sanitizers throughout the world due to the current COVID-19 pandemic, we wished to review the possible risks to patients treated with disulfiram, following a case report in which an apparent DER (disulfiram-ethanol reaction) was attributed to the cutaneous absorption of alcohol from hand sanitizers as well as by inhalation of vapour. METHOD: Simple experiments to assess the levels of absorption by each route separately. RESULTS: Our results strongly suggest that while amounts of alcohol sufficient to cause a DER may be inhaled when hand sanitizers are used in confined spaces, absorption can be avoided by dispersal of the fumes, and absorption from the skin alone does not occur in pharmacologically significant quantities. CONCLUSION: Warnings about absorption of alcohol through the skin from hand sanitizers and products such as perfumes, deodorants and after-shave (whose use is often warned against when disulfiram is prescribed) should be modified accordingly.
Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Dissulfiram/efeitos adversos , Dissulfiram/química , Etanol/química , Etanol/farmacocinética , Higienizadores de Mão/efeitos adversos , Higienizadores de Mão/farmacocinética , Pneumonia Viral/complicações , Administração por Inalação , Testes Respiratórios/métodos , COVID-19 , Dissulfiram/farmacocinética , Dissulfiram/uso terapêutico , Etanol/administração & dosagem , Etanol/efeitos adversos , Higienizadores de Mão/administração & dosagem , Higienizadores de Mão/química , Humanos , Pandemias , SARS-CoV-2 , Absorção Cutânea/efeitos dos fármacosAssuntos
Acidose/diagnóstico , Etanol/intoxicação , Higienizadores de Mão/intoxicação , Prurido/tratamento farmacológico , Estupor/diagnóstico , Acidose/sangue , Acidose/induzido quimicamente , Administração Cutânea , Etanol/administração & dosagem , Etanol/farmacocinética , Higienizadores de Mão/administração & dosagem , Higienizadores de Mão/química , Higienizadores de Mão/farmacocinética , Humanos , Masculino , Pessoa de Meia-Idade , Concentração Osmolar , Automedicação/efeitos adversos , Absorção Cutânea , Estupor/sangue , Estupor/induzido quimicamenteRESUMO
While uncommon, ingestion of ethanol-based hand sanitizers by children may be associated with significant intoxication. We report the case of a 7-year-old with acute alcohol intoxication following hand sanitizer ingestion. Alcohol elimination in this patient followed zero-order kinetics with a clearance rate of 22.5 mg/kg/h, consistent with the limited pharmacokinetic information available for children who experience alcohol intoxication from more traditional sources.