Ketorolac: Difference between revisions
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==General== | ==General== | ||
*Type: [[NSAID]] | *Type: [[NSAID]] | ||
*Dosage Forms: | *Dosage Forms: 15mg/mL, 30mg/mL injection | ||
*Common Trade Names: Toradol | *Common Trade Names: Toradol | ||
''Although standard packaging provides 30mg doses current research demonstrates that the analgesic ceiling for ketorolac appears to be 10 mg if given intravenously''<ref> Motov S et al. Comparison of intravenous ketorolac at three single-dose regimens for treating acute pain in the emergency department: a randomized controlled trial. Ann Emerg Med 2016. PMID: 27993418</ref> | |||
==Adult Dosing== | ==Adult Dosing== | ||
*Acute pain: | |||
**IM: 15mg x 1 or 15mg q6h | |||
**IV: 15mg x 1, then 15mg q6h | |||
**Black box warning against treatment for > 5 days | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*N/A | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*Lactation: | *Lactation: Enters breast milk, use caution | ||
*Elderly (> 65 yo): Decrease dose by 50% | |||
*Renal Dosing | *Renal Dosing | ||
** | **Mild-Moderate impairment: Decrease dose by 50% | ||
** | **Severe impairment or HD: Contraindicated | ||
*Hepatic Dosing | *Hepatic Dosing: No dose change, but may increase LFTs | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Active or prior [[PUD]], recent [[GI bleed]] | |||
*Severe renal disease or HD | |||
*Bleeding diathesis | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Bleeding, MI, CVA, GI bleed/perforation, Hyperkalemia | |||
===Common=== | ===Common=== | ||
*Dyspepsia, nausea, headache | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Onset: 20-30 minutes | ||
*Metabolism: | *Peak: 2-3 hours | ||
*Excretion: | *Duration: 4-6 hours | ||
*Mechanism of Action: | *Half-life: 2-6 hours, up to 19 hours in renal disease | ||
*Metabolism: Hepatic | |||
*Excretion: Renal | |||
*Mechanism of Action: NSAID, Reversible COX-1/2 inhibitor | |||
==See Also== | ==See Also== | ||
*[[NSAID toxicity]] | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Pharmacology]] | ||
Latest revision as of 22:50, 7 March 2021
General
- Type: NSAID
- Dosage Forms: 15mg/mL, 30mg/mL injection
- Common Trade Names: Toradol
Although standard packaging provides 30mg doses current research demonstrates that the analgesic ceiling for ketorolac appears to be 10 mg if given intravenously[1]
Adult Dosing
- Acute pain:
- IM: 15mg x 1 or 15mg q6h
- IV: 15mg x 1, then 15mg q6h
- Black box warning against treatment for > 5 days
Pediatric Dosing
- N/A
Special Populations
- Pregnancy Rating: C
- Lactation: Enters breast milk, use caution
- Elderly (> 65 yo): Decrease dose by 50%
- Renal Dosing
- Mild-Moderate impairment: Decrease dose by 50%
- Severe impairment or HD: Contraindicated
- Hepatic Dosing: No dose change, but may increase LFTs
Contraindications
- Allergy to class/drug
- Active or prior PUD, recent GI bleed
- Severe renal disease or HD
- Bleeding diathesis
Adverse Reactions
Serious
- Bleeding, MI, CVA, GI bleed/perforation, Hyperkalemia
Common
- Dyspepsia, nausea, headache
Pharmacology
- Onset: 20-30 minutes
- Peak: 2-3 hours
- Duration: 4-6 hours
- Half-life: 2-6 hours, up to 19 hours in renal disease
- Metabolism: Hepatic
- Excretion: Renal
- Mechanism of Action: NSAID, Reversible COX-1/2 inhibitor
See Also
References
- ↑ Motov S et al. Comparison of intravenous ketorolac at three single-dose regimens for treating acute pain in the emergency department: a randomized controlled trial. Ann Emerg Med 2016. PMID: 27993418