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Nortriptyline is an active metabolite of Amitriptyline. Therapeutic drug levels are monitored to assist the physician assessing therapeutic response and to avoid toxicity.ortriptyline is an active metabolite of Amitriptyline. Therapeutic drug levels are monitored to assist the physician assessing therapeutic response and to avoid toxicity.
Both COX1 and COX2 (also termed prostaglandin-endoperoxide synthase-1 and PTGS2, respectively) metabolize arachidonic acid by adding molecular O 2 between carbons 9 and 11 to form an endoperoxide bridge between these two carbons, adding molecular O 2 to carbon 15 to yield a 15-hydroperoxy product, creating a carbon-carbon bond between carbons 8 and 12 to create a cyclopentane ring in the middle of the fatty acid, and in the process making PGG2, a product that has two fewer double bonds than ...