A 21-year-old woman presents to the emergency department after a night of alcohol consumption.Her medical complaints include flushing,thirst,palpitations,and vertigo.Her daily medication list includes albuterol,Atrovent,and Advair.She was treated in her physician's office yesterday with cefoperazone for a urinary tract infection.The medication most likely causing her current medical complaint is

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Hypoprothrombinemia has been reported,especially with agents (cefotetan and cefoperazone)with a methylthiotetrazole (MTT)side chain.The MTT side chain may also induce a disulfiramlike reaction in patients who concurrently ingest alcohol (disulfiram inhibits the metabolism of alcohol).The symptoms of this uncomfortable reaction include flushing,nausea,thirst,palpitations,chest pain,vertigo,and death in some cases.

A 21-Year-Old Woman Presents to the Emergency Department After a Night