As a potent opioid analgesic, morphine should be avoided in all of the following clinical situations except____________?
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Answer: D. A & C
Explanation
Morphine provides critical hemodynamic benefits in left ventricular failure by reducing ventricular preload. It also manages severe pain and anxiety without exacerbating acute pulmonary edema symptoms. Therefore, left ventricular failure represents a recognized clinical exception where morphine is beneficial. Left ventricular failure often causes acute pulmonary edema due to elevated pulmonary capillary pressures. Opioids dilate capacitance vessels to reduce venous return and relieve pressure on the heart. Bronchial asthma is typically aggravated by morphine due to histamine release and respiratory depression.
Emergency treatment of acute pulmonary edema historically included intravenous morphine for rapid relief. Asthmatic patients must avoid morphine to prevent life-threatening bronchospasm and respiratory failure. Clinical guidelines carefully weigh the cardiovascular and respiratory effects of potent opioid analgesics. Option A is correct because morphine reduces preload and anxiety during acute heart failure episodes. Option B is incorrect because morphine is strictly avoided in bronchial asthma due to histamine release. Option C is incorrect because opioid-induced constipation is a common adverse effect rather than a use.
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