In which patient's condition is the risk associated with morphine administration elevated due to renal function?

In which patient's condition is the risk associated with morphine administration elevated due to renal function?

• A. Pregnancy
• B. Diabetes
• C. End-stage renal disease
• D. Asthma

Answer: (C)

The correct answer is linked to the fact that morphine and its metabolites are primarily eliminated from the body through the kidneys. In patients with end-stage renal disease, renal function is severely compromised, which impedes the clearance of morphine. This can result in increased plasma levels of morphine and its active metabolites, such as morphine-6-glucuronide, potentially leading to toxicity. In individuals with significantly reduced kidney function, even standard doses of morphine may lead to adverse effects such as respiratory depression, sedation, and an overall heightened risk of overdose. Therefore, morphine administration in patients with end-stage renal disease requires careful consideration, often involving dose adjustments or alternative pain management strategies to avoid complications. While pregnancy, diabetes, and asthma present unique considerations for morphine use, they do not inherently elevate the risks associated with renal function to the same extent as in patients with end-stage renal disease. In these other conditions, the primary concerns may relate to the safety of the mother and fetus or managing underlying health conditions, rather than the pharmacokinetics associated with diminished renal function.

The correct answer is linked to the fact that morphine and its metabolites are primarily eliminated from the body through the kidneys. In patients with end-stage renal disease, renal function is severely compromised, which impedes the clearance of morphine. This can result in increased plasma levels of morphine and its active metabolites, such as morphine-6-glucuronide, potentially leading to toxicity.

In individuals with significantly reduced kidney function, even standard doses of morphine may lead to adverse effects such as respiratory depression, sedation, and an overall heightened risk of overdose. Therefore, morphine administration in patients with end-stage renal disease requires careful consideration, often involving dose adjustments or alternative pain management strategies to avoid complications.

While pregnancy, diabetes, and asthma present unique considerations for morphine use, they do not inherently elevate the risks associated with renal function to the same extent as in patients with end-stage renal disease. In these other conditions, the primary concerns may relate to the safety of the mother and fetus or managing underlying health conditions, rather than the pharmacokinetics associated with diminished renal function.