Question

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Patient TS is a former alcoholic who has suffered from PTSD. TS has been taking Paroxetine/Paxel (A) for the treatment of panic attacks. The medication did not seem to be effective at first, but after about a week TS noticed fewer panic attacks and improved quality of life. Paroxetine is serotonin reuptake inhibitor used in the treatment of depression, panic disorders, and OCD. It's metabolism is shown above. The metabolites are active, however their concentration is very low and they are not considered to impact the efficacy of the drug. Intermediate B is a strong electrophile - and can react with Heme molecules. The PK exposure of paroxetine is unusual. 1) What enzymes are involved in the metabolism? 2) What is unusual about the PK of this molecule? 3) What are the implications of B being a reactive intermediate? 4) What might be causing the unusual PK? 0 Adole -- 10 mg - 20 mg 30 mg Paroxetine Plasma Concentration (ng/ml) Geometric mean weight 0 normalized CLIF (V) 16 20 24 12 Time (hours) Dose img)

Answer 1

Answer : a) addition of -OH From A to B dehydrogenase .

b) the unusual is OH OH bond .

c) Diester bond and presence of aromatic rings.

d) hydrolysis of the molecule by the activity of enzyme dehydrogenase.