Stereoselectivity: An Issue of Significant Importance in Clinical Pharmacology

Many drugs have one or more asymmetric centers and are administered as a racemate containing an equal mixture of enantiomers with different pharmacologic properties, routes, and rates of disposition in humans. For example, S-warfarin is more potent than R-warfarin, and is metabolized by different pathways. The S-enantiomer is primarily oxidized, and the R-enantiomer is metabolized by both oxidatio…