0-Glucuronides

Xenobiotic glucuronidation occurs abundantly in the liver, the intestinal mucosa, and the kidney. Almost all other organs and tissue possess some glucuronidation 

RCH20 CgHgOg RC(0)0 CgHgOg RNHO CgHgOg RC(0)NH0 CgHgOg 

Glucuronidation of many substrates is low or undetectable in fetal mammalian tissues but increases with age. The rate of development is dependent upon the species, tissue, and substrate. The inability of newborns of most mammals, except the rat, to form glucuronides is associated with deficiencies in glucuronosyl transferase activity and the cofactor, UDPGA. The blood serum of newborn babies may contain pregnandiol, which is an inhibitor of glucuronide formation. Suppressed glucuroniation of bilirubin in newborns can result in neonatal jaundice. 

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Glucuronidation. Complexation of the steroid to glucuronic acid, most predominantiy via the C-3 hydroxyl, leads to a considerable portion of the excreted metabohtes of ah. glucocorticoids. In infants, sulfurylation (formation of a sulfate ester) is also predominant (16). 

Other eactions. Most of the metabohtes of cortisol are neutral (alcohol or glucuronide complex) compounds. However, oxidation at C-21 to C-21 carboxyhc acids (17) accounts for some of the identifiable metabohtes of glucocorticoids (18). 

DHBs after absorption distribute rapidly and widely among tissues but bio accumulation is low (121). They are metabolized to their respective benzoquinone and then detoxified by conjugation and excreted in the urine mainly as conjugates. Some deconjugations may occur in the urine. Resorcinol is also excreted in the urine in a free and conjugated state, essentially glucuronide and sulfate. 

Biotransformation reactions can be classified as phase 1 and phase 11. In phase 1 reactions, dmgs are converted to product by processes of functionalization, including oxidation, reduction, dealkylation, and hydrolysis. Phase 11 or synthetic reactions involve coupling the dmg or its polar metaboHte to endogenous substrates and include methylation, acetylation, and glucuronidation (Table 1). 

The process of reabsorption depends on the HpophiHc—hydrophiHc balance of the molecule. Charged and ioni2ed molecules are reabsorbed slowly or not at all. Reabsorption of acidic and basic metaboHtes is pH-dependent, an important property in detoxification processes in dmg poisoning. Both passive and active carrier-mediated mechanisms contribute to tubular dmg reabsorption. The process of active tubular secretion handles a number of organic anions and cations, including uric acid, histamine, and choline. Dmg metaboHtes such as glucuronides and organic acids such as penicillin are handled by this process. 

Only the small amounts of T and T that are free in the circulation can be metabolized. The main route is deiodination of T to T and i-T, and from these to other inactive thyronines (21). Most of the Hberated iodide is reabsorbed in the kidney. Another route is the formation of glucuronide and sulfate conjugates at the 4 -OH in the Hver. These are then secreted in the bile and excreted in the feces as free phenols after hydrolysis in the lower gut. 

Although several metaboUtes of propylthiouracil have been found (36,44), it is mainly excreted in urine as the glucuronide. Its relatively short plasma half-life requires that it be adniinistered four times daily. 

Tocainide is rapidly and well absorbed from the GI tract and undergoes very fitde hepatic first-pass metabolism. Unlike lidocaine which is - 30% bioavailable, tocainide s availability approaches 100% of the administered dose. Eood delays absorption and decreases plasma levels but does not affect bio availability. Less than 10% of the dmg is bound to plasma proteins. Therapeutic plasma concentrations are 3—9 jig/mL. Toxic plasma levels are >10 fig/mL. Peak plasma concentrations are achieved in 0.5—2 h. About 30—40% of tocainide is metabolized in the fiver by deamination and glucuronidation to inactive metabolites. The metabolism is stereoselective and the steady-state plasma concentration of the (3)-(—) enantiomer is about four times that of the (R)-(+) enantiomer. About 50% of the tocainide dose is efirninated by the kidneys unchanged, and the rest is efirninated as metabolites. The elimination half-life of tocainide is about 15 h, and is prolonged in patients with renal disease (1,2,23). 

About 97% of po dose is absorbed from the GI tract. The dmg undergoes extensive first-pass hepatic metaboHsm and only 12% of the po dose is bioavailable. More than 95% is protein bound and peak plasma concentrations are achieved in 2—3 h. Therapeutic plasma concentrations are 0.064—1.044 lg/mL. The dmg is metabolized in the Hver to 5-hyroxypropafenone, which has some antiarrhythmic activity, and to inactive hydroxymethoxy propafenone, glucuronides, and sulfate conjugates. Less than 1% of the po dose is excreted by the kidney unchanged. The elimination half-life is 2—12 h (32). 

Neopterin cyclophosphate Neopterin 2, 3 -cyclic phosphate Neopterin 3 -/3-D-glucuronide Neopterin 3 -triphosphate 6-(L-t/ reo-l, 2, 3 -Trihydroxypropyl)pterin ... 

Bromothymol blue (6.0...7.6) acid lipids, cholesterol glucuronides and gangliosides [241] aryloxybutanolamine derivatives [242] norfenfluramine derivatives [243] ethylamphetamines [244] in volatile mineral oil hydrocarbons [245] phospholipids [91]... 

The duration of action of acetaminophen is limited by the formation of water-soluble derivatives of the phenol (glucuronide and sulfate) that are then excreted via the kidney. Protection i)f the phenol as an ether inhibits such inactivation without diminishing biologic activity. Acetylation of p-ethoxyaniline iffords the widely used peripheral analgesic, phenacetin (25). ... 

J. Huwyler, S. Rufer, E. Kusters and J. Drewe, Rapid and highly automated determination of moipliine and moipliine glucuronides in plasma by on-line solid-phase extraction and column liquid cliromatography , 7. Chromatogr. B 674 51-63 (1995). 

MRP1 (ABCC1) Glucuronides and sulfate conjugates of steroid hormones and bile salts, colchicine, doxorubicin, daunorubicin, epirubicin, folate, irinotecan, methotrexate, pacitaxel, vinblastine, vincristine, and others... 

MRP2 (ABCC2) LTC4, bilirubin-glucuronide, estradiol 17 3-glucuronide, dianionic bile salts, anionic conjugates, glutathione disulfide, and others... 

The active metabolite of this drug is mycophenolic acid (MPA), which inhibits IMPDH, too. MPA is metabolized in vivo by glucuronidation. It has to be noted that its acyl glucuronide inhibits EVDPDH with similar potency compared to the parent compound. 

Ibuprofen is the most thoroughly researched 2-ary lpropionic acid. It is a relatively weak, non-selective inhibitor of COX. In epidemiological studies, ibuprofen compared to all other conventional NSAIDs, has the lowest relative risk of causing severe gastrointestinal side effects. Because of this, ibuprofen is the most frequently used OTC ( over the counter , sale available without prescription) analgesic. Ibuprofen is highly bound to plasma proteins and has a relatively short elimination half-life ( 2 h). It is mainly glucuronidated to inactive metabolites that are eliminated via the kidney. 

Phenyl p-D-glucopyranosiduronic acid not phenyl p-D-glucuronoside or phenyl glucuronide H... 

Many authors reported poor elimination of antiepileptic drug carbamazepine [6,13,17,49, 54]. Pharmacokinetic data indicate that only 1-2% of carbamazepine is excreted unmetabolized. However, glucuronide conjugates of carbamazepine can presumably be cleaved in the sewage, and thus increase its environmental concentrations [51]. This is confirmed by its high ubiquity in the enviromnent at concentration levels of several hundred nanograms per liter in different surface waters. Due to its recalcitrant nature, it can be used as anthropogeiuc marker for the contamination of aquatic environment. 

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