Dextrorphan is a pharmacologically active metabolite of Dextromethorphan (DXM). It is the result of O-demethylation of the prodrug by several enzymatic systems, although it is chiefly a product of the Cytochrome P450 IID6 (CYP4502D6) pathway. Being structurally similar to DXM, and it has affinity for the same receptors in the central nervous system but with a slight difference in selectivity. Whereas DXM has the highest binding-affinity for PCP2 and sigma receptors, DXO is more selective for NMDA receptors. DXO is a strong anti-tussive, but is slightly less effective than DXM, and has no metabolites with significant therapeutic activity in such capacity and therefore is not a drug available on the market. A prodrug is a pharmacological substance (drug) which is administered in an inactive (or significantly less active) form. ... The Central Nervous System (CNS) represents the largest part of the Nervous System. ...
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