In normal “ extensive metabolizers ” (EMs) ( S )-
mephenytoin is extensively hydroxylated by CYP2C19 at
the 4 position of the phenyl ring before its glucuronidation
and rapid excretion in the urine whereas ( R )-
mephenytoin is slowly (blank) to (blank), an
active metabolite.
N -demethylated, nirvanol