Use of Morphine should be avoided in all of the following patients Except
Contraindications for morphine 1. Use of pure agonists with weak paial agonists: When a weak paial agonist such as pentazocine is given to a patient also receiving a full agonist (eg, morphine), there is a risk of diminishing analgesia or even inducing a state of withdrawal; combining full agonist with paial agonist opioids should be avoided.2. Use in patients with head injuries: risk of elevated intracranial pressure3. Use during pregnancy: In pregnant women who are chronically using opioids, the fetus may become physically dependent in utero and manifest withdrawal symptoms in the early postpaum period. 4. Use in patients with impaired pulmonary function: In patients with borderline respiratory reserve, the depressant propeies of the opioid analgesics may lead to acute respiratory failure. 5. Use in patients with impaired hepatic or renal function: Because morphine is primarily metabolized in the liver, their use in patients in a prehepatic coma may be questioned. Half-life is prolonged in patients with impaired renal function.6. Use in patients with endocrine disease: Patients with adrenal insufficiency (Addison's disease) and those with hypothyroidism (myxedema) may have prolonged and exaggerated responses to opioids. Reference: Katzung Pharmacology; 13th edition; Chapter 31; Opioid Analgesics & Antagonists
IHD
Bronchial asthma
Elderly male
Biliary colic
Anesthesia