High dose of morphine is used without much danger in -
Ans. is 'c' i.e., Myocardial infarction o Morphine should be given promptly in myocardial infarction to allay apprehension and reflex sympathetic stimulation.About other optionso Morphine should be used cautiously in gall bladder and biliary tract dysfunction as it causes spasm of sphincter of oddi and can cause acute rise of intrabiliary pressure,o Used during labour, morphine can cause neonatal respiratory distress,o Head injury is a contraindication for morphine use.Precautions and contraindications of Morphine:Head injury: morphine is contraindicated in patients with head injury (KDT). Reasons are -By retaining C02 it increases intracranial tension which will add to that caused by head injury itself.Even therapeutic doses can cause marked respiratory depression in these patients.Vomiting, miosis, and altered mentation produce by morphine interfere with assessment of progress in head injury cases.Branchial asthma: Morphine can precipitate an attack by its histamine releasing action.Hypothyroidism, liver and kidney disease patients are more sensitive to morphineInfants and elderly are more susceptible to the respiratory depressant action of morphine.It is dangerous in patients with respiratory insufficiency (Emphysema, pulmonary fibrosis, corpulmonale), sudden deaths have occurred.Hypotensive states and hypovolemia exagerate fall in BP due to morphine.Undiagnosed acute abdominal pain - morphine can aggravate certain conditions e.g., diverticulitis, biliary colic, pancreatitis.Elderly male - chances of urinary retention are high.Unstable personalities - are liable to continue its use and become addicted.
Gall bladdersurgery
Labour
Myocardial infarction
Head injury
C.N.S