Integration of Metabolism

Organic Chemistry and Medicine

Organic chemistry plays a central role in medicine because most drugs, biomolecules, and therapeutic agents are organic compounds (carbon-based molecules).

1. Drug Design and Development

Organic chemistry provides the foundation for designing, synthesizing, and modifying drugs.
Medicinal chemists use organic synthesis to create molecules with specific biological activity.
Examples: Aspirin, antibiotics (penicillin), statins, and anticancer drugs are all products of organic synthesis.

2. Understanding Biomolecules

Proteins, carbohydrates, lipids, and nucleic acids—the building blocks of life—are all organic molecules.
Organic chemistry helps explain their structure, reactivity, and interactions, which is key to understanding disease mechanisms.

3. Mechanism of Drug Action

Drugs work by interacting with biological targets (enzymes, receptors, DNA).
Organic chemistry explains how functional groups and molecular structures determine these interactions.
Example: Beta-blockers interact with adrenergic receptors because of their specific organic structures.

4. Diagnostics and Imaging

Many imaging agents used in MRI, PET, and CT scans are organic compounds or contain organic ligands.
Fluorescent dyes and contrast agents rely on organic chemistry for their design.

5. Pharmacokinetics and Metabolism

The absorption, distribution, metabolism, and excretion (ADME) of drugs are governed by organic chemistry.
Understanding how drugs are metabolized in the liver (e.g., via oxidation, reduction, conjugation reactions) is crucial for safety.

6. Production of Pharmaceuticals

Industrial organic synthesis enables the large-scale manufacture of drugs.
Knowledge of reaction mechanisms, stereochemistry, and catalysts ensures efficient and cost-effective production.

7. Natural Products as Medicines

Many drugs are derived from natural organic compounds:
- Morphine (analgesic) from opium poppy
- Paclitaxel (anticancer) from yew tree
- Artemisinin (antimalarial) from sweet wormwood
Organic chemistry helps modify these molecules to improve efficacy and reduce toxicity.

Organic chemistry is the backbone of medicine. It enables the discovery, design, and production of drugs, explains how they interact with the human body, and helps develop new therapies and diagnostics.

Biochemical reactions involve the functional groups of molecules.

Functional groups in biochemistry

Types of groups: Alcohols, aldehydes, ketones, carboxylic acids, anhydrides, sulfhydryl groups, amines, esters, and amides are all important components of biochemical compounds
Biochemical reactions
1. Reactions are classified according to the functional groups that react (eg, esterifications, hydroxylations, carboxylations, and decarboxylations).
2. Oxidations of sulfhydryl groups to disulfides, of alcohols to aldehydes and ketones, and of aldehydes to carboxylic acids frequently occur.
  1. Many of these oxidations are reversed by reductions.
  2. In oxidation reactions, electrons are lost. In reduction reactions, electrons are gained.
  3. As foods are oxidized, electrons are released and passed through the electron transport chain. Adenosine triphosphate (ATP) is generated, and it supplies the energy to drive various functions of the body.
    
    Clinical Pearls
    
    Mutations in proteins of the electron transport chain, or the protein subunits required to synthesize ATP in the mitochondria, lead to diseases known as mitochondrial disorders. The reduced ability to generate energy in the form of ATP leads primarily to muscle and nervous system dysfunctions. Examples of such disorders include MERRF (myoclonic epilepsy with ragged red fibers) and MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes), which are discussed in more detail in .