Diacetyldihydromorphine
Encyclopedia
Diacetyldihydromorphine (paralaudin, dihydroheroin, acetylmorphinol) is a potent opiate derivative developed in Germany
in 1929 which is rarely used in some countries for the treatment of severe pain such as that caused by terminal cancer, as a more potent form of diamorphine (also commonly known as Heroin). Diacetyldihydromorphine is fast acting and longer lasting than diamorphine, with a duration of action of around 4-7 hours.
Diacetyldihydromorphine is quickly metabolized by plasma esterase
enzymes into dihydromorphine
, in the same way that diacetylmorphine is metabolized into morphine; however unlike dihydromorphine, which is more potent than morphine
on a mg to mg basis, diacetyldihydromorphine is actually less potent than diamorphine, perhaps because it is metabolized more slowly. Diacetyldihydromorphine is approximately equipotent to morphine whereas diamorphine is 1.50-1.80 times the potency of morphine. It shares with other opioids the risk of overdose or (potentially life-threatening) respiratory depression. When strong narcotics are required, and morphine and diamorphine are not an option, it is more common to use better known drugs such as nicomorphine
, hydromorphone
, levorphanol
, oxymorphone
or fentanyl which doctors will be more familiar with, and which do not share the stigma associated with either heroin or morphine. Side effects are similar to those of other semi-synthetic opiates and fully synthetic opioids, and the most commonly reported side effects include drowsiness, nausea, and constipation. Compared to morphine, diacetyldihydromorphine produces far fewer side effects which are also often lower in intensity. Though the two drugs are very similar in effects, morphine often produces more intense side effects, including euphoria
, constipation
, miosis
, physical dependence
, psychological dependence
, potentially life-threatening respiratory depression, and a severe addiction
.
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
in 1929 which is rarely used in some countries for the treatment of severe pain such as that caused by terminal cancer, as a more potent form of diamorphine (also commonly known as Heroin). Diacetyldihydromorphine is fast acting and longer lasting than diamorphine, with a duration of action of around 4-7 hours.
Diacetyldihydromorphine is quickly metabolized by plasma esterase
Esterase
An esterase is a hydrolase enzyme that splits esters into an acid and an alcohol in a chemical reaction with water called hydrolysis.A wide range of different esterases exist that differ in their substrate specificity, their protein structure, and their biological function.- EC classification/list...
enzymes into dihydromorphine
Dihydromorphine
Dihydromorphine is a semi-synthetic opioid invented in Germany in 1900. In structure, it is very similar to morphine, the only difference being the reduction of the double bond between positions 7 and 8 in morphine to a single bond...
, in the same way that diacetylmorphine is metabolized into morphine; however unlike dihydromorphine, which is more potent than morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...
on a mg to mg basis, diacetyldihydromorphine is actually less potent than diamorphine, perhaps because it is metabolized more slowly. Diacetyldihydromorphine is approximately equipotent to morphine whereas diamorphine is 1.50-1.80 times the potency of morphine. It shares with other opioids the risk of overdose or (potentially life-threatening) respiratory depression. When strong narcotics are required, and morphine and diamorphine are not an option, it is more common to use better known drugs such as nicomorphine
Nicomorphine
Nicomorphine is the 3,6-dinicotinate ester of morphine. It is a strong opioid agonist analgesic two to three times as potent as morphine with a side effect profile similar to that of dihydromorphine, morphine, and diamorphine. Nicomorphine was patented as Vilan by Lannacher Heilmittel Ges. m.b.H...
, hydromorphone
Hydromorphone
Hydromorphone, a more common synonym for dihydromorphinone, commonly a hydrochloride is a very potent centrally-acting analgesic drug of the opioid class. It is a derivative of morphine, to be specific, a hydrogenated ketone thereof and, therefore, a semi-synthetic drug...
, levorphanol
Levorphanol
Levorphanol is an opioid medication used to treat severe pain. It is the levorotatory stereoisomer of the synthetic morphinan and a pure opioid agonist, first described in Germany in 1948 as an orally active morphine-like analgesic...
, oxymorphone
Oxymorphone
Oxymorphone or 14-Hydroxydihydromorphinone is a powerful semi-synthetic opioid analgesic first developed in Germany circa 1914, patented in the USA by Endo Pharmaceuticals in 1955 and introduced to the United States market in January 1959 and other countries around the same time...
or fentanyl which doctors will be more familiar with, and which do not share the stigma associated with either heroin or morphine. Side effects are similar to those of other semi-synthetic opiates and fully synthetic opioids, and the most commonly reported side effects include drowsiness, nausea, and constipation. Compared to morphine, diacetyldihydromorphine produces far fewer side effects which are also often lower in intensity. Though the two drugs are very similar in effects, morphine often produces more intense side effects, including euphoria
Euphoria
Euphoria is an emotional and mental state defined as a sense of great elation and well being.Euphoria may also refer to:* Euphoria , a genus of scarab beetles* Euphoria, a genus name previously used for the longan and other trees...
, constipation
Constipation
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...
, miosis
Miosis
Miosis is the constriction of the pupil of the eye to two millimeters or less...
, physical dependence
Physical dependence
Physical dependence refers to a state resulting from chronic use of a drug that has produced tolerance and where negative physical symptoms of withdrawal result from abrupt discontinuation or dosage reduction...
, psychological dependence
Substance dependence
The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...
, potentially life-threatening respiratory depression, and a severe addiction
Substance dependence
The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...
.