A 21-year-old sexually active college student presents to the clinic complaining of odorous green vaginal discharge and itchiness. Multiple oval flagellated motile organisms are seen on wet mount. She is prescribed an antibiotic treatment. While on therapy she goes to a party, where on consumption of one alcoholic beverage she experiences flushing, tachycardia, headaches, and vomiting.The same effects could be observed when alcohol is mixed with which drug?

Tolbutamide

13. The correct answer is E. The patient consumed alcohol while taking metronidazole for her trichomoniasis. Metronidazole and tolbutamide both have disulfiram-like adverse effects when combined with alcohol use. These effects include flushing, tachycardia, headaches, and vomiting. Tolbutamide is a first-generation sulfonylurea that can also produce these effects. Answer A is incorrect. Ampicillin is a penicillin family antibiotic often used to treat gram positive infections or Listeria infections. It does not have disulfiram-like adverse effects. Answer B is incorrect. Erythromycin is a macrolide antibiotic and is not commonly used to treat trichomoniasis. It does not have disulfiram-like adverse effects. Answer C is incorrect. Glipizide is a second-generation sulfonylurea that does not have the disulfiram-like adverse effects of first-generation sulfonylureas. Answer D is incorrect. Imipenem is a carbapenem- type antibiotic with a very broad spectrum of action. The main adverse effect is that it can cause seizures in rare cases. It does not have disulfiram-like adverse effects.