Disulfiram like interaction with alcohol is seen with all of the following drugs except :
**Core Concept**
Disulfiram-like interactions occur when certain medications, similar to disulfiram, inhibit aldehyde dehydrogenase (ALDH) or other enzymes involved in the metabolism of alcohol, leading to increased acetaldehyde levels and subsequent symptoms such as flushing, nausea, and headache.
**Why the Correct Answer is Right**
Disulfiram-like interactions are seen with medications that inhibit ALDH or other enzymes involved in alcohol metabolism, such as metronidazole, isoniazid, and some antitubercular drugs. These interactions lead to the accumulation of acetaldehyde, a toxic metabolite of alcohol, resulting in the characteristic symptoms. This is a result of the competition between the medication and ALDH for the same substrate, leading to impaired alcohol metabolism.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because metronidazole is known to cause disulfiram-like interactions with alcohol, leading to increased acetaldehyde levels and subsequent symptoms.
* **Option B:** This option is incorrect because isoniazid is another medication that can cause disulfiram-like interactions with alcohol, resulting in impaired metabolism and increased acetaldehyde levels.
* **Option C:** This option is incorrect because certain antitubercular drugs, such as pyrazinamide and ethambutol, can also cause disulfiram-like interactions with alcohol, leading to increased acetaldehyde levels and symptoms.
**Clinical Pearl / High-Yield Fact**
It's essential to advise patients taking medications that can cause disulfiram-like interactions with alcohol to avoid consuming alcohol, as this can lead to severe symptoms and potentially life-threatening complications.
**Correct Answer:** A.