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Biotransformation

Content

•       Chemical pathways of biotransformation

•       Phase I and phase II metabolism

•       Microsomal and non-microsomal enzymes

•       First pass metabolism

Intended Learning Outcomes

At the end of this lecture, student will be able to

•       Explain chemical pathways of biotransformation

•       Differentiate  between phase I and phase II metabolism

•       Outline microsomal and non-microsomal enzymes

•       Explain the process of first pass metabolism

Biotransformation

•       Alteration of a drug within a living organism

•       Metabolic transformation: Mitochondrial, microsomal, cytosolic

•       Inactive to active: L- dopa – Dopamine

•       Active to inactive: Chloramphenicol conjugate

•       Active to active:

–      More active: Diazepam – Oxazepam

–      Different activity: Pethidine - Norpethidine

•       Excretion unchanged – Aminoglycosides

•       Metabolism : less polar, lipid soluble – more polar, water soluble

•       Spontaneous change into other substances

–      Mechlorethamine – active ethylniminium cations at slightly alkaline pH

–      Atracurium – Hoffman reaction

Prodrug

–      Precursor drug that itself has little or no biological activity

–      Metabolized to a pharmacologically active metabolite

First pass metabolism/ Presystemic metabolism

–      Before reaching systemic circulation gets metabolized

–      Decreased BA, diminished therapeutic response

–      Bypassed: IV, sublingual route

Chemical Pathways of Biotransformation

Phase I

•       Metabolite: active/inactive

•       Degradative reactions

•       Small non polar/polar metabolite

•       Mainly microsomal

•       Few non- microsomal

Phase II

•       Metabolite inactive

•       Synthetic /conjugation reactions

•       Polar metabolite

•       Mitochondrial, microsomal, cytoplasmic

Drug Metabolizing enzymes

Microsomal enzymes

•       Located on smooth ER, lungs, kidney, intestinal mucosa

•       MFOs/ CYP450

•       CYP1A1,2

•       CYP3A4,5

•       CYP2C8, 9

Non - microsomal enzymes

•       Present in cytoplasm, mitochondria, plasma

•       MAO

•       Esterases

•       Amidases

•       Transferases

•       Conjugases

Phase I reactions – oxidations

Microsomal Oxidation

•       Aromatic hydroxylation

–      Phenobarbitone – P-hydroxy phenobarbitone

•       Aliphatic hydroxylation

–      Pentobarbitone – Hydroxy pentobarbitone

•       N – dealkylation

–      Morphine – normorphine

–      Mephobarbitone - phenobarbitone

•       O -dealkylation

–      Codeine - morphine

•       S -dealkylation

–      6-methyl thiopurine - mercaptopurine

•       S – Oxidation

–      Chlorpromazine - Chlorpromazine sulfoxide

•       N – oxidation

–      Trimethylamine – Trimethylamine N - oxide

•       Deamination

–      Amphetamine – phenylacetone derivative

•       Desulfarisation

–      Parathion - paraoxon

Non - microsomal Oxidation

•       Mitochondrial oxidation

–      Adrenaline by MAO to VMA

•       Cytoplasmic oxidation

–      Alcohol by alcohol dehydrogenase to acetaldehyde

•       Plasma oxidation

–      Histamine by histaminase to IAA

Phase I reactions – Reductions

Microsomal reductions

•       Nitro reduction

–      Chloramphenicol to its arylamine metabolite

•       Azo reduction

–      Protonsil to sulfanilamide

•       Keto reduction

–      Cortisone to hydrocortisone

Non – microsomal reductions

Chloral hydrate to trichloro ethanol

Phase I reactions – Hydrolysis

Microsomal hydrolysis

Pethidine to pethidinic acid by hepatic esterase

Non microsomal hydrolysis

•       Esterases, amidases, peptidase, protease, phosphatase

•       Procaine – PABA
atropine – Tropic acid

•       Hydrolysis of beta lactam ring of penicillin

Phase II Reactions

Microsomal Conjugation

•       Glucuronide Conjugation:

•       Parent drugs/phase I metabolites

•       Containing phenolic, alcoholic, -COOH, -NH2, mercapto group

•       Polar readily excreted, often inactive

•       Morphine, paracetomol, aspirin, sulfonamide, bilirubin

Non microsomal Conjugations:

N –Acetyl Conjugation (In cytosol)

•       Isoniazid, PAS, dapsone, sulfonamides, histamine

Sulfate conjugation (In cytosol)

•       Phenolic, alcoholic, aromatic amines undergo

•       Aspirin, methyldopa, paracetamol, chloramphenicol

Aminoacid conjugation (In mitochondria)

•       Aspirin, benzoic acid, nicotinic acid

Methyl Conjugation (In cytosol)

•       Many catecholamines, histamine

Glutathione conjugation (In cytoplasm)

•       Epoxides, NO2 containing drugs, hydroxylamines

•       Ethacrynic acid, sulfobromophthalein

Ribosides & riboside phosphate

•       Aspirin, benzoic acid, nicotinic acid

Summary

•       Phase I: Degradative reactions

•       Phase II: Synthetic/ conjugative reactions

•       Microsomal enzymes: Inducible

•       Prodrug: Precursor drug that itself has little or no biological activity

•       Glucuronide conjugation is microsomal reaction

•       FPM: Before reaching systemic circulation gets metabolized

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