In general, most biochemical reactions are stereoselective, so only one stereoisomer will produce the intended product while the other simply does not participate or can cause side-effects. Of note, the  form of amino acids and the  form of sugars (primarily glucose) are usually the biologically reactive form. This is due to the fact that many biological molecules are chiral and thus the reactions between specific enantiomers produce pure stereoisomers. Also notable is the fact that all amino acid residues exist in the  form. However, bacteria produce -amino acid residues that polymerize into short polypeptides which can be found in bacterial cell walls. These polypeptides are less digestible by peptidases and are synthesized by bacterial enzymes instead of mRNA translation which would normally produce -amino acids.
The stereoselective nature of most biochemical reactions meant that different enantiomers of a chemical may have different properties and effects on a person. Many psychotropic drugs show differing activity or efficacy between isomers, e.g. amphetamine is often dispensed as racemic salts while the more active dextroamphetamine is reserved for refractory cases or more severe indications; another example is methadone, of which one isomer has activity as an opioid agonist and the other as an NMDA antagonist.
Racemization of pharmaceutical drugs can occur in vivo. Thalidomide as the (R) enantiomer is effective against morning sickness, while the (S) enantiomer is teratogenic, causing birth defects when taken in the first trimester of pregnancy. If only one enantiomer is administered to a human subject, both forms may be found later in the blood serum. The drug is therefore not considered safe for use by women of child-bearing age, and while it has other uses, its use is tightly controlled. Thalidomide can be used to treat multiple myeloma.
Another commonly used drug is ibuprofen which is only anti-inflammatory as one enantiomer while the other is biologically inert. Likewise, the (S) stereoisomer is much more reactive than the (R) enantiomer in citalopram (Celexa), an antidepressant which inhibits serotonin reuptake, is active. The configurational stability of a drug is therefore an area of interest in pharmaceutical research. The production and analysis of enantiomers in the pharmaceutical industry is studied in the field of chiral organic synthesis.