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it depletes GSH indirectly through oxidation, and enzyme activity may decline secondarily (~35% in some studies), but this is not the primary cause. Option (D): Primaquine decreases reduced glutathione levels by promoting its oxidation to combat ROS, not increases them. Introduction: Unraveling Primaquine Hemolytic Anemia and NADPH Demand Primaquine hemolytic anemia strikes G6PD-deficient patients when the drugs metabolites spike NADPH demand for antioxidant protection