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Related Concept Videos

Phase II Reactions: Glucuronidation01:24

Phase II Reactions: Glucuronidation

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Glucuronidation, a pivotal phase II biotransformation process, involves the coupling of glucuronic acid to a drug or xenobiotic. Given its widespread occurrence and critical role in drug metabolism, it's considered the most crucial phase II reaction. It enhances the water solubility of substances, aiding their expulsion from the body. The driving force behind these reactions is a group of enzymes known as UDP-glucuronosyltransferases (UGTs). UGTs facilitate the transfer of a glucuronic acid...
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Drug Excretion: Miscellaneous Routes01:10

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Drug excretion involves various organs, including the liver, intestines, skin, and eyes. In the case of drugs or toxins, they can be actively secreted into bile by transporters in the hepatocyte's canalicular membrane. These substances enter the GI tract during digestion and may be reabsorbed into the body from the intestine. This process, known as enterohepatic recycling, can significantly prolong the presence and effects of a substance in the body. To interrupt this cycle, specific...
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Drug Elimination: Overview01:18

Drug Elimination: Overview

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Drug elimination involves many complex processes and does not necessarily differentiate between distribution and elimination. It is divided into two primary components: excretion and biotransformation.
Excretion refers to removing a drug from the body, either in its unchanged form or as its metabolites. Nonvolatile and polar drugs are primarily excreted through the kidneys, with other pathways including bile, sweat, saliva, and milk. Volatile drugs such as anesthetic gases are excreted via the...
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Drug Metabolism: Phase II Reactions01:14

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Phase II reactions are essential for the detoxification and elimination of drugs from the body. These reactions involve the conjugation of parent drugs or their phase I metabolites with endogenous molecules, resulting in more hydrophilic drug conjugates. The primary conjugation reactions in this phase are sulfation and glucuronidation. Both sulfation and glucuronidation typically produce biologically inactive metabolites. However, in some cases involving prodrugs, active metabolites may be...
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Toxicokinetics: Overview01:21

Toxicokinetics: Overview

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Studies that assess how a drug is absorbed, distributed, metabolized, and excreted (ADME) at toxic doses are termed toxicokinetics. Understanding toxicokinetics helps predict adverse drug reactions (ADRs) and manage toxicity in humans.Toxicokinetics differs from pharmacokinetics mainly in the dose levels studied, with toxicokinetics focusing on higher toxic doses. The kinetics at these levels can be non-linear due to altered physiological processes. Toxicodynamics examines the relationship...
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Phase II Reactions: Glutathione Conjugation and Mercapturic Acid Formation01:22

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Glutathione, a tripeptide made up of glutamate, cysteine, and glycine, is a critical player in the detoxification of drugs and xenobiotics via a process known as glutathione conjugation or mercapturic acid formation. This phase II biotransformation reaction involves the covalent binding of glutathione to a drug or its metabolite, enhancing the compound's water solubility and enabling its excretion.
Several distinctive characteristics distinguish glutathione conjugation from other phase II...
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Ethyl Glucuronide in Hair: A 10-Year Overview.

Sara Casati1,2, Alessandro Ravelli1, Roberta F Bergamaschi1

  • 1Laboratorio di Tossicologia Forense, Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, Milan, Italy.

Drug Testing and Analysis
|February 19, 2026
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Summary

This study analyzed hair ethyl glucuronide (EtG) in over 68,000 samples to assess long-term alcohol consumption trends. Results show EtG levels vary by demographics and season, confirming hair EtG testing

Keywords:
EtGLC‐MS/MSaddictionalcoholhair analysis

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Area of Science:

  • Forensic Toxicology
  • Analytical Chemistry
  • Addiction Medicine

Background:

  • Hair ethyl glucuronide (EtG) analysis offers a reliable method for assessing long-term alcohol consumption.
  • Understanding EtG distribution patterns is crucial for interpreting abstinence and consumption levels.
  • Previous studies have explored EtG but lacked large-scale, decade-long data from diverse populations.

Purpose of the Study:

  • To evaluate long-term alcohol consumption patterns using hair EtG analysis over a 10-year period.
  • To investigate the influence of demographic factors (age, gender), seasonality, and the COVID-19 pandemic on EtG levels.
  • To assess the reliability and comparability of hair EtG testing using established cut-offs.

Main Methods:

  • Retrospective analysis of 68,221 hair samples collected between 2013 and 2022 from a Northern Italian cohort.
  • Quantification of hair EtG using High-Performance Liquid Chromatography-Mass Spectrometry/Mass Spectrometry (HPLC-MS/MS).
  • Classification of EtG levels based on Society of Hair Testing (SoHT) cut-offs for abstinence, repeated, and chronic excessive alcohol consumption.

Main Results:

  • 13.6% of samples indicated repeated alcohol consumption (5 < EtG < 30 pg/mg) and 5.6% indicated chronic excessive consumption (EtG ≥ 30 pg/mg).
  • EtG levels showed significant variations based on gender, age, hair type (head, chest, axillary, pubic), hair segment length, and season (higher in colder months).
  • While no short-term COVID-19 impact was observed, a significant long-term influence of the pandemic on alcohol consumption was detected via hair EtG.

Conclusions:

  • Hair EtG testing is a reliable method for monitoring long-term alcohol consumption, despite inherent variability in concentrations.
  • Demographic factors, seasonality, and long-term societal events like the COVID-19 pandemic significantly influence alcohol consumption patterns.
  • This study provides valuable insights into alcohol consumption trends within a large, monitored population, aiding clinical and forensic interpretations.