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Other notable derivatives then result from further modification of this template, with saturation of the 7,8-double bond of etorphine resulting in the even more potent dihydroetorphine (up to 12,000× potency of morphine) and acetylation of the 3-hydroxy group of etorphine resulting in acetorphine (8700× morphine)—although while the isopentyl homologue of etorphine is nearly three times more potent, its 7,8-dihydro and 3-acetyl derivatives are less potent than the corresponding derivatives of etorphine at 11000× and 1300× morphine respectively. Replacing the N-methyl group with cyclopropylmethyl results in opioid antagonists such as diprenorphine (M5050, which is used as an antidote to reverse the effects of etorphine, M99), and partial agonists such as buprenorphine , which is widely used in the treatment of opioid addiction.

Loss of appetite; stomach irritation; stomach cramps; constipation; jaundice (yellowing of the skin and/or whites of the eyes); inflammation of the pancreas characterised by severe upper stomach pain, often with nausea and vomiting; sleep disorders; depression; blurred vision; lack of white blood cells, which can result in frequent infections, fever; decrease in the number of platelets (a blood cell essential for the clotting of the blood), decreased number of red blood cells (anaemia) characterised by tiredness, headaches, being short of breath when exercising, dizziness and looking pale; kidney disease; lung problems including pneumonia or build-up of fluid in the lungs; increased sensitivity of the skin to the sun; inflammation of blood vessels; a skin disease characterized by the peeling of the skin all over the body; cutaneous lupus erythematosus, which is identified by a rash that may appear on the face, neck, and scalp; allergic reactions; weakness and muscles spasm; altered heart rate; reduced blood pressure after a change in body position; swelling of the salivary glands; high sugar levels in the blood; sugar in the urine; increases in some kinds of blood fat; high uric acid levels in the blood, which may cause gout.

Thank you so much for posting your blog. I’ve been throat clearing and coughing for 11-12 years I can recall the episode that started it. I used to perform in amateur theatre. During rehearsals for a show I developed a respiratory infection and laryngitis. I continued to try and sing (against the suggestion of a fellow cast member and doctor). When the respiratory infection had cleared up I noticed that my voice continued to sound lower and ‘flu like’. It never went back to normal. I’ve had the throat clearing and cough ever since. A year ago I had my thyroid disabled with radioactive iodine due to Graves Disease and developed radioactive thyroiditis. I also have GERD, IBS and Barrett’s Syndrome. I have coughed violently since then. I can’t work as the cough is so debilitating. I’m currently taking 50mg of Amiltryptaline at night to treat chronic insomnia and general anxiety. The cough is alleviated to a certain extent at night. I feel sick and tired constantly. You have shed some well needed light at the end of a very dark tunnel. I have a Dr appointment tomorrow to start the next series of testing. I won’t stop now until I get some relief from this nightmare. My thoughts are with everyone who suffers this horrid ailment.

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