Difference between revisions of "Ketorolac"
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{{Infobox drug reference | {{Infobox drug reference | ||
| trade_names = | | trade_names = Toradol | ||
| drug_class = | | drug_class = NSAID | ||
| drug_class_color = | | drug_class_color = | ||
| uses = | | uses = Post-op pain | ||
| contraindications = | | contraindications = Renal disease or injury, peptic ulcer disease, GI bleeding | ||
| routes = | | routes = IV, IM, oral | ||
| dosage = | | dosage = IV or IM: 30mg once, if needed can repeat q6h up to 120mg daily | ||
| dosage_calculation = ketorolac | | dosage_calculation = ketorolac | ||
| mechanism = Inhibition of COX (COX-1 > COX-2) | |||
| time_onset = 10-15 minutes | |||
| duration = 2-4 hours | |||
}} | }} | ||
Ketorolac is a Non-Steroidal Anti-Inflammatory Drug (NSAID) that is frequently used intra-op for management of post-op pain. | |||
== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> == | == Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> == | ||
* Post-op pain management | |||
== Contraindications<!-- List contraindications and precautions for use of the drug. --> == | == Contraindications<!-- List contraindications and precautions for use of the drug. --> == | ||
=== Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. --> === | === Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. --> === | ||
* GFR < 30mL/min | |||
=== Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> === | === Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> === | ||
* Chronic renal disease | |||
* AKI | |||
* GI bleeding | |||
* Peptic ulcer disease | |||
== Pharmacology == | == Pharmacology == | ||
| Line 25: | Line 37: | ||
==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ==== | ==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ==== | ||
* NSAID that inhibits COX | |||
* Of the NSAIDs, most selective for COX-1 inhibition over COX-2 | |||
==== Adverse effects<!-- Describe any potential adverse effects of the drug. --> ==== | ==== Adverse effects<!-- Describe any potential adverse effects of the drug. --> ==== | ||
* COX-1 selectivity increases risk for GI tract irritation and bleeding | |||
* Thromboembolic disease is always a consideration when using NSAIDs, although ketorolac has lower risk for exacerbating thromboembolic disease compared to more COX-2 selective agents like celecoxib | |||
=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> === | === Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> === | ||
* Highly protein bound | |||
* Almost completely renally eliminated | |||
== Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> == | == Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> == | ||
| Line 35: | Line 56: | ||
== References == | == References == | ||
<ref>Toda C, Naguib M. Peripherally acting analgesics. In: Flood P, Rathmell JP, and Urman RD (eds). Stoelting’s Pharmacology & Physiology in Anesthetic Practice. Sixth edition. Philadelphia, Pennsylvania; Wolters Kluwer; 2022: 257-65.</ref><ref>{{Cite web|title=Nonsteroidal Anti-inflammatory Drugs|url=https://www.openanesthesia.org/keywords/nonsteroidal-anti-inflammatory-drugs/|url-status=live}}</ref><ref>Colvin L. Physiology and pharmacology of pain. In: Thompson, JP, Moppett IK, and Wiles M (eds). Smith and Aitkenhead’s Textbook of Anaesthesia. 7th ed. Edinburgh; Elsevier; 2019: 99-120.</ref><ref>Aronson JK. Non-steroidal anti-inflammatory drugs. In: Aronson, JK. Meyler’s Side Effects of Drugs: the International Encyclopedia of Adverse Drug Reactions and Interactions. Sixteenth edition. Amsterdam, Netherlands; Elsevier; 2016: 236-72.</ref><ref>Hurley R, Elkassabany NM, Wu CL. Acute postoperative pain. In: Miller’s Anesthesia. 9th ed. Philadelphia; Elsevier; 2020:2620-22.</ref><ref>{{Citation|last=Mahmoodi|first=Ahmad N.|title=Ketorolac|date=2024|url=http://www.ncbi.nlm.nih.gov/books/NBK545172/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=31424756|access-date=2024-02-14|last2=Kim|first2=Peggy Y.}}</ref><ref>{{Cite journal|last=Buckley|first=Micaela M.-T.|last2=Brogden|first2=Rex N.|date=1990-01-01|title=Ketorolac|url=https://doi.org/10.2165/00003495-199039010-00008|journal=Drugs|language=en|volume=39|issue=1|pages=86–109|doi=10.2165/00003495-199039010-00008|issn=1179-1950}}</ref> | |||
[[Category:Drug reference]] | [[Category:Drug reference]] | ||
Revision as of 12:16, 14 February 2024
Ketorolac
| Trade names |
Toradol |
|---|---|
| Clinical data | |
| Drug class |
NSAID |
| Uses |
Post-op pain |
| Contraindications |
Renal disease or injury, peptic ulcer disease, GI bleeding |
| Routes of administration |
IV, IM, oral |
| Dosage |
IV or IM: 30mg once, if needed can repeat q6h up to 120mg daily |
| Dosage | |
| Pharmacodynamics | |
| Mechanism of action |
Inhibition of COX (COX-1 > COX-2) |
| Pharmacokinetics | |
| Onset of action |
10-15 minutes |
| Duration of action |
2-4 hours |
| Physical and chemical data | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Ketorolac is a Non-Steroidal Anti-Inflammatory Drug (NSAID) that is frequently used intra-op for management of post-op pain.
Uses
- Post-op pain management
Contraindications
Absolute contraindications
- GFR < 30mL/min
Precautions
- Chronic renal disease
- AKI
- GI bleeding
- Peptic ulcer disease
Pharmacology
Pharmacodynamics
Mechanism of action
- NSAID that inhibits COX
- Of the NSAIDs, most selective for COX-1 inhibition over COX-2
Adverse effects
- COX-1 selectivity increases risk for GI tract irritation and bleeding
- Thromboembolic disease is always a consideration when using NSAIDs, although ketorolac has lower risk for exacerbating thromboembolic disease compared to more COX-2 selective agents like celecoxib
Pharmacokinetics
- Highly protein bound
- Almost completely renally eliminated
Chemistry and formulation
History
References
- ↑ Toda C, Naguib M. Peripherally acting analgesics. In: Flood P, Rathmell JP, and Urman RD (eds). Stoelting’s Pharmacology & Physiology in Anesthetic Practice. Sixth edition. Philadelphia, Pennsylvania; Wolters Kluwer; 2022: 257-65.
- ↑ "Nonsteroidal Anti-inflammatory Drugs".
- ↑ Colvin L. Physiology and pharmacology of pain. In: Thompson, JP, Moppett IK, and Wiles M (eds). Smith and Aitkenhead’s Textbook of Anaesthesia. 7th ed. Edinburgh; Elsevier; 2019: 99-120.
- ↑ Aronson JK. Non-steroidal anti-inflammatory drugs. In: Aronson, JK. Meyler’s Side Effects of Drugs: the International Encyclopedia of Adverse Drug Reactions and Interactions. Sixteenth edition. Amsterdam, Netherlands; Elsevier; 2016: 236-72.
- ↑ Hurley R, Elkassabany NM, Wu CL. Acute postoperative pain. In: Miller’s Anesthesia. 9th ed. Philadelphia; Elsevier; 2020:2620-22.
- ↑ Mahmoodi, Ahmad N.; Kim, Peggy Y. (2024), "Ketorolac", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 31424756, retrieved 2024-02-14
- ↑ Buckley, Micaela M.-T.; Brogden, Rex N. (1990-01-01). "Ketorolac". Drugs. 39 (1): 86–109. doi:10.2165/00003495-199039010-00008. ISSN 1179-1950.
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