Well, diphenoxylate also has the prodine/pethidine substructure, but it doesn't produce any euphoria. The structures of prodine and dehalogenated loperamide are too different to make any deductions about receptor responses.
My question about the esterified derivative of loperamide was in relation to the p-glycoprotein pump. The reason that loperamide isn't active centrally active is that it gets thrown out of the brain back into the blood by the transporter. So, some people (you) have noted euphoria upon administration of the esterified derivative. So, either 1) the esterfication prevents the ligand from recognizing the p-glycoprotein transporter or 2) the pharmokinetic properties of the ligand (such as lipophilicity) have increased to the point that the transporter can be overwhelmed and you can achieve a high enough concentration of the drug in the brain. I'm going with number two, but I want your thoughts.
Also, I don't think that loperamide follows the morphine rules, due to 1 & 4 (the N,N-dimethylamido moiety, therefore, doesn't satisfy #1). Does #1 simply require an alkyl spacer between the tertiary nitrogen and bulkier substituents?
1. A tertiary nitrogen with a small alkyl substituent.
2. A quaternary carbon.
3. A phenyl group or its isosteric equivalent directly attached to the quaternary carbon.
4. A 2 carbon spacer between the quaternary carbon and the tertiary nitrogen.
Increased drug delivery to the brain by P-glycoprotein inhibition
Abu J. M. Sadeque, Christoph Wandel, Hauibing He, Selina Shah and Alastair J. J. Wood
Clinical Pharmacology & Therapeutics 68, 231-237 (September 2000)
doi:10.1067/mcp.2000.109156
Background: Although the antidiarrheal loperamide is a potent opiate, it does not produce opioid central nervous system effects at usual doses in patients. On the basis of in vitro studies demonstrating that loperamide is a substrate for the adenosine triphosphate–dependent efflux membrane transporter P-glycoprotein, we postulated that inhibition of P-glycoprotein with quinidine would increase entry of loperamide into the central nervous system with resultant respiratory depression.
Results: Loperamide produced no respiratory depression when administered alone, but respiratory depression occurred when loperamide (16 mg) was given with quinidine at a dose of 600 mg (P < .001). [....]
Conclusion: [...] the lack of respiratory depression produced by loperamide [...] can be reversed by a drug causing P-glycoprotein inhibition, resulting in serious toxic and abuse potential.