ketorolac
Table of Contents
ketorolac
introduction:
- Structurally & pharmacologically related to tolmetin & indomethacin, however, unlike these pyrolle acetic acid derivatives, it is a cyclic propionic derivative.
- It is the most potent analgesic of the NSAID's & can be used in adults instead of narcotics to avoid the associated dependence problems of the narcotics.
- if unavailable, consider 40mg parecoxib IM as an alternative parenteral NSAID analgesic
post-op. analgesia:
- 30mg IM has onset of action & peak analgesic efficacy comparable to 12mg IM morphine or 100mg IM pethidine but has a longer duration of action.
- 10mg IM is as efficacious as 6mg IM morphine
- doses above 10mg IM or IV do not appear to have additional analgesic benefit but may increase risks1)
- 10mg orally is superior to:
- paracetamol (acetaminophen) 1000mg + codeine 60mg
- ibuprofen 400mg
P/K:
- Rapidly absorbed orally, peak [ ] @ 30min, T1/2 4-6hrs;
- 99% plasma protein bound; Linear P/K after single dose;
- Steady state after 6hrly doses for 1 day;
- Mainly excreted in urine; poorly crosses BBB;
indications:
- IM: Short term analgesia Rx (up to 2days) post-op
- Oral: Short term analgesia Rx (up to 7days) post-op
C/I:
- Obstetric use as PG inhib. effects on uterine contraction & fetal circulation;
- Dehydration or hypovolaemia
- Renal impairment (CRN > 180umol/L)
- Coagulopathy
- Post-op for ops. with high risk of bleeding
- HS to NSAIDs
- Pts with PH nasal polyps, angiooedema or bronchospasm/asthma
- PH Stevens-Johnson synd. or vesicular bullous rash
- Suspected or confirmed intracranial bleeding
- GIT bleeding / PH peptic ulcer
- Concurrent other NSAIDs
- Pregnancy, labour, lactation, children < 16yrs.
ketorolac.txt · Last modified: 2025/05/31 03:42 by wh