Determination of Disulfiram and its Metabolites in Human Blood

Summary: This work was initiated by the lack of a sensitive method for the determination of disulfiram and its metabolites in blood of patients treated with this drug. A method is described which allows the separate determination of carbon disulfide, free diethyldithiocarbamate and disulfides derived from disulfiram with adequate precision in 10 ml patient blood. It is based on a spectrophotometric determination of a yellow compound formed by trapping carbon disulfide produced from diethyldithiocarbamate and disulfiram in an ethanolic solution of diethylamine and copper(II)-acetate. Good quantitation of disulfiram and diethyldithiocarbamate in blood was achieved by trapping carbon disulfide produced when formic acid and cystein were added to the samples. During daily administration of 200 mg disulfiram to humans, concentrations of zero to 0.6 [Ag carbon disulfide and 0.2 to 1.0 /ug diethyldithiocarbamate per ml blood were found using this method. Zusammenfassung: Nachweis von Disulfiram und seinen Metaboliten im menschlichen Blut Nach unserer Erfahrung gibt es keine Methode mit ausreichender Empfindlichkeit, um Disulfiram und seine Metaboliten im Patientenblut zu bestimmen. Wir beschreiben ein Verfahren, mit dem CS2, Diäthyldithiocarbamat und vom Disulfiram stammende Disulfide getrennt mit hinreichender Genauigkeit aus 10 ml Blut bestimmt werden können. Grundlage ist die spektrophotometrische Bestimmung einer gelben Verbindung, die aus CS2 in einer äthanolischen Lösung von Diäthylamin und Cu(II)-acetat entsteht. CS2 wird aus Diäthyldithiocarbamat und Disulfiram durch Ameisensäure bzw. Ameisensäure/Cystein freigesetzt. Bei Tagesdosen von 200 mg Disulfiram wurden 0 bis 0,6 /ug CS2 und 0,2 bis 1,0 jug Diäthyldithiocarbamat pro ml Patientenblut gefunden

Amöben-Appendicitis mit konsekutiver perforierter Pancolitis [Amebic appendicitis with subsequent perforated pancolitis]

Amoebic appendicitis is very rare, occurring in about 0.5 to 1% of acute appendicitis in tropical countries. The most severe complication is transmural amoebic colitis with perforation, described in 1.6 to 3.2% of cases. The mortality of such cases can be very high (up to 80%). We present a Swiss patient with amoebic appendicitis followed by severe perforated colitis; a total colectomy was necessary and the patient survived. Because of the good results of amoebicidal therapy and because of the severity of the complication after colitis we suggest that patients with signs of acute appendicitis after travel in tropical areas should be screened