5.3 : Phase I Reactions: Oxidation of Aliphatic and Aromatic Carbon-Containing Systems

Phase I biotransformation reactions are integral to drug metabolism, predominantly involving oxidative, reductive, and hydrolytic transformations. Chief among these are oxidative reactions, which enhance the hydrophilicity of xenobiotics and introduce polar functional groups to facilitate their elimination from the body.

Oxidation reactions are fundamental in aromatic carbon-containing systems. An example is the hydroxylation of phenobarbital, a process that transforms it into hydroxyphenobarbital. This reaction exemplifies how aromatic carbon atoms undergo oxidation, and other drugs like phenytoin undergo similar processes.

Aliphatic carbon-containing systems also undergo oxidation reactions; p-hydroxy phenytoin is a product of the hydroxylation of phenytoin. This exemplifies the oxidation of aliphatic carbon atoms, a process also witnessed in drugs such as hexobarbital.

Oxidation reactions also occur in benzylic and allylic carbon atoms and carbon atoms alpha to carbonyl and imines. An illustration of this is the conversion of codeine to morphine, which involves oxidation at the benzylic carbon atom. Other drugs, like diazepam, also undergo comparable reactions. However, it's important to underscore that oxidative reactions can sometimes produce reactive metabolites, potentially leading to the toxicological activation of drugs. A classic example is acetaminophen (paracetamol), whose conversion to reactive metabolites can instigate hepatic necrosis.

Oxidative reactions play a pivotal role in phase I metabolism. They act as a detoxifying mechanism, transforming lipophilic drugs into polar metabolites that the body can readily excrete. The complexity of these reactions underscores their importance in drug metabolism, highlighting the need for continued research and understanding in this field.