The pentose phosphate pathway generates NADPH and pentoses through oxidative and non-oxidative phases. It occurs prominently in tissues that require NADPH for fatty acid synthesis, cholesterol synthesis, steroid synthesis, and glutathione-mediated antioxidant defenses. A deficiency in glucose-6-phosphate dehydrogenase, which catalyzes the first step in the oxidative phase, can lead to hemolytic anemia upon exposure to oxidative drugs or foods like primaquine or fava beans due to the inability to generate sufficient NADPH for antioxidant defenses in red blood cells.