Morphine can cause several side effects including respiratory depression, nausea and vomiting, constipation, itching, bronchoconstriction, hypotension, urine retention, and increased intracranial pressure. It works by stimulating dopamine reward circuits in the brain and can lead to addiction where people forsake other activities. Morphine is contraindicated for people with bronchial asthma, chronic pulmonary disease, convulsions, advanced liver disease, the very old or young, during delivery, biliary colic, prostate hypertrophy, and hypotension.

1. SIDE EFFECTS OF
MORPHINE
Muhammad Nazli Bin Iderus

2. Respiratory depression
 Decrease the respiratory center sensitivity to
CO2
 Thus depress it
 And so decrease the depth and rate of
breathing.

3. Nausea and Vomitting
 Due to stimulation of emetic chemoreceptor
trigger zone.

4. Constipation
 Decerease of gastric secretion
 Decrease of peristaltic activity
 Decrese of defecation reflex
 Increase tone of intestinal smooth muscle
 Spams of sphincters

5. Itching & Bronchoconstriction
& Hypotension
 Due to histamine release.
 Hypotension due to histamine effect-
vasodilatation

6. Urine retention
 Release of antideuretic hormone (ADH) from
the posterior pituitary
 Decrease of micturition reflex
 Increase muscle tone of the urinary bladder
sphincter.

7. Increase intracranial Pressure
 Manifested by headche
 Due to respiratory depression
 Cause increase in CO2
 Vasodilatation of cranial vascular- thus
elevated the C.S.F pressure

8. Addiction
 it stimulates the dopamine reward circuits
 The more stronger it stimulate the dopamine
reward circuits the more the addictiveness.
 Cause people to forsake all other life activities
and obligations.
 As the brain respond after taking the addictive
substance to very pleasurable experiences.

9. CONTRAINDICATION
 1. Bronchial asthma because of
 Bronchoconstriction
 Release of histamine
 Respiratory depression
 2. Chronic pulmonary because of
 Respiratory depression

10. CONTRAINDICATION
 3. Cases of idiosyncrasy of morphine
 Due to euphoric action that excite convulsion
 Thus convulsion patient dangerous to take morphine
 4. Advanced liver disease because of
 Increase morphine toxicity due to malfunction of the
liver to detoxifies morphine

11. CONTRAINDICATION
 5. Extreme age (very old/very young)
 6. During delivery
 Morphine can cross placenta and depress the baby
respiratory system
 7. Biliaric colic
 As it increase the biliary pressure by spasm of biliary
muscles and spasm of sphincter of Oddi.

12. CONTRAINDICATION
 8. Prostate hypertrophy
 Urine retention causing more pressure on the prostate
gland
 9. Hypotension people
 Because histamine release cause vasodilatation that
will lower the blood pressure