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Xenobiotic metabolism is divided into three phases. In phase I, enzymes such as cytochrome P450 oxidases introduce reactive or polar groups into xenobiotics. These modified compounds are then conjugated to polar compounds in phase II reactions. These reactions are catalysed by transferase enzymes such as glutathione S-transferases.
Drug metabolism is the metabolic breakdown of drugs by living organisms, usually through specialized enzymatic systems. More generally, xenobiotic metabolism (from the Greek xenos "stranger" and biotic "related to living beings") is the set of metabolic pathways that modify the chemical structure of xenobiotics, which are compounds foreign to an organism's normal biochemistry, such as any drug ...
[2] [3] In medicine, detoxification can be achieved by decontamination of poison ingestion and the use of antidotes as well as techniques such as dialysis and (in a limited number of cases) chelation therapy. [4] Many alternative medicine practitioners promote various types of detoxification such as detoxification diets.
Some addiction medicine practitioners use the term withdrawal management instead of detoxification. [ 1 ] [ 2 ] A detoxification program for physical dependence does not necessarily address the precedents of addiction , social factors, psychological addiction, or the often-complex behavioral issues that intermingle with addiction.
It is a phase II detoxification enzyme which can carry out two or four electron reductions of quinones. Its mechanism of reduction is through a ping-pong mechanism involving its FAD cofactor. Initially in a reductive phase NQO2 binds to reduced dihydronicotinamide riboside (NRH) electron donor, and mediates a hydride transfer from NRH to FAD.
Laura Duke, who was recently the detox unit’s supervisor, said the cost put the medication out of reach for all but 1 to 2 percent of the addicts she saw. Detoxing is a first step towards sobriety. To overcome the inevitable pain of withdrawal from opiates without medication—going “cold turkey”—is excruciating.