Profile cover photo
Profile photo
Ted Houk
dad, runner, healer, piper
dad, runner, healer, piper

Ted's posts

Post has attachment
Cedar: Thuja (/ˈθjuːdʒə/ thew-jə)[2] is a genus of coniferous trees in the Cupressaceae (cypress family)

Post has attachment
Blockade of programmed death 1 (PD-1), an inhibitory receptor expressed by T cells, can overcome immune resistance. We tried BMS-936558, antibody blocking PD-1 in melanoma NSCLC prostate RCC colorectal cancers

Post has attachment
Royal Navy Scottish surgeon, James Lind treated scurvy w citrus c1753, 1st controlled trial. 40y later, British Navy required Lime juice. Patient got it stopping 750mg thrice daily suddenly. We reviewed a careful taper if running out.

Post has attachment
Late patients seen Wednesday. Home before beautiful sunset.

Post has attachment
Kill an invader in your house. Learn how to fire guns, lock them up, or sell them legally. Another street gun out there.


Post has attachment
Caterpillar on driveway 05:00 no other traffic.

Like Antabuse: MONOGRAPH TITLE: Metronidazole; Tinidazole/Ethyl Alcohol

SIGNIFICANCE LEVEL: 1-Most Significant; Documented (more clinical data may
be needed): Action to reduce risk of adverse interaction usually required.

MECHANISM OF ACTION: In vitro studies show that metronidazole produces an
inhibition of aldehyde dehydrogenase and other alcohol-oxidizing
enzymes.(1-5) This results in the accumulation of acetaldehyde, which is
responsible for the disulfiram-like reaction.
A similar process may occur with tinidazole.(6)

CLINICAL EFFECTS: Concurrent use of oral metronidazole with alcohol has
been associated with a disulfiram-type reaction resulting in symptoms of
hypotension, tachycardia, nausea, sweating, facial flushing, headache, and
vomiting.(7-10) It has been suggested that some patients find this
combination of agents a pleasant experience, citing giddiness and excitement
as rationale for abuse.(11)

PATIENT MANAGEMENT: Patients should be advised of the possible affects that
may result from ingestion or application of products that contain alcohol
while taking metronidazole.
Patients receiving tinidazole should be instructed to avoid alcohol
during and for 3 days after taking tinidazole.(6)
Patients should be informed about unsuspected sources of alcohol such as
elixirs and topical preparations.

DISCUSSION: In a case report,(12) a patient developed disulfiram-like
reactions after receiving concurrent metronidazole and intravenous
sulfamethoxazole-trimethoprim, which is solubilized in a 10% alcohol base.
In another case report, a female patient using vaginal inserts containing
metronidazole once daily at bedtime ingested two or three drinks containing
30ml of vodka on the fifth day of metronidazole therapy.(13) About a half
hour later, the patient inserted the metronidazole vaginal tablet and awoke
one hour later with a severe burning sensation in her stomach, a severe
headache, and nausea accompanied by a cold sweat. These symptoms resolved
in about four hours. Other studies have failed to observe a disulfiram-like
reaction between alcohol and metronidazole.(14-20)


1.Gupta NK, Woodley CL, Fried R. Effect of metronidazole on liver alcohol
dehydrogenase. Biochem Pharmacol 1970 Oct;19(10):2805-8.
2.Kitson TM. The disulfiram--ethanol reaction: a review. J Stud Alcohol 1977
3.Edwards JA, Price J. Metronidazole and atypical human alcohol
dehydrogenase. Biochem Pharmacol 1967 Oct;16(10):2026-7.
4.Fried R, Fried LW. The effect of Flagyl on xanthine oxidase and alcohol
dehydrogenase. Biochem Pharmacol 1966;15:1890-94.
5.Paltrinieri E. Inhibitory action of
hydroxy-2-ethyl-1-methyl-2-nitro-5-imidazole on alcohol-dehydrogenase.
Farmaco Sci 1967 Dec;22(12):1054-6.
6.Tindamax (tinidazole) US prescribing information. Presutti Laboratories,
Inc. August, 2007.
7.Penick SB, Carrier RN, Sheldon JB. Metronidazole in the treatment of
alcoholism. Am J Psychiatry 1969 Feb;125(8):1063-6.
8.Taylor JA. Metronidazole--a new agent for combined somatic and psychic
therapy of alcoholism. A case study and preliminary report. Bull Los Angel
Neuro Soc 1964 Sep;29:158-62.
9.Lehmann HE, Ban TA, Naltchayan E. Metronidazole in the treatment of the
alcoholic. Psychiatr Neurol (Basel) 1966;152(6):395-401.
10.Alexander I. 'Alcohol-antabuse' syndrome in patients receiving
metronidazole during gynaecological treatment. Br J Clin Pract 1985 Jul;
11.Giannini AJ, DeFrance DT. Metronidazole and alcohol--potential for
combinative abuse. J Toxicol Clin Toxicol 1983 Jul;20(5):509-15.
12.Edwards DL, Fink PC, Van Dyke PO. Disulfiram-like reaction associated
with intravenous trimethoprim-sulfamethoxazole and metronidazole. Clin
Pharm 1986 Dec;5(12):999-1000.
13.Plosker GL. Possible interaction between ethanol and vaginally
administered metronidazole. Clin Pharm 1987 Mar;6(3):189, 192-3.
14.Gelder MG, Edwards G. Metronidazole in the treatment of alcohol
addiction. A controlled trial. Br J Psychiatry 1968 Apr;114(509):473-5.
15.Goodwin DW. Metronidazole in the treatment of alcoholism: a negative
report. Am J Psychiatry 1967 Apr;123(10):1276-8.
16.Egan WP, Goetz R. Effect of metronidazole on drinking by alcoholics. Q J
Stud Alcohol 1968 Dec;29(4):899-902.
17.Gallant DM, Bishop MP, Camp E, Tisdale C. A six-month controlled
evaluation of metronidazole (Flagyl) in chronic alcoholic patients. Curr
Ther Res Clin Exp 1968 Feb;10(2):82-7.
18.Platz A, Panepinto WC, Kissin B, Charnoff SM. Metronidazole and
alcoholism. (An evaluation of specific and non specific factors in drug
treatment). Dis Nerv Syst 1970 Sep;31(9):631-6.
19.Strassman HD, Adams B, Pearson AW. Metronidazole effect on social
drinkers. Q J Stud Alcohol 1970 Jun;31(2):394-8.
20.Lowenstam I. Metronidazole and placebo in the treatment of chronic
alcoholism. A comparative study. Psychosomatics 1969 May-Jun;10(3):43-5.

Post has attachment
Charles Kushner - Jared's dad, just a little time in federal prison.

Post has attachment
Ivanka & Jared: Last Week Tonight with John Oliver (HBO) - YouTube

Post has attachment
Gene, Harry and I downtown before I handed the president’s cane over to Dr Bernita Taylor. Proof that I have a suit.
Wait while more posts are being loaded