Difference between revisions of "Ketorolac"

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==General==
 
==General==
 
*Type: [[NSAID]]
 
*Type: [[NSAID]]
*Dosage Forms: 15 mg/mL, 30 mg/mL injection
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*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:  
 
*Acute pain:  
**IM: 30-60 mg x 1 or 30 mg q6h
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**IM: 15mg x 1 or 15mg q6h
**IV: 30 mg x 1, then 15-30 mg q6h
+
**IV: 15mg x 1, then 15mg q6h
**Black box warning against tx for > 5 days
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**Black box warning against treatment for > 5 days
  
 
==Pediatric Dosing==
 
==Pediatric Dosing==
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==Contraindications==
 
==Contraindications==
 
*Allergy to class/drug
 
*Allergy to class/drug
*Active or prior PUD, recent GIB
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*Active or prior [[PUD]], recent [[GI bleed]]
 
*Severe renal disease or HD
 
*Severe renal disease or HD
 
*Bleeding diathesis
 
*Bleeding diathesis
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*Bleeding, MI, CVA, GI bleed/perforation, Hyperkalemia
 
*Bleeding, MI, CVA, GI bleed/perforation, Hyperkalemia
 
===Common===
 
===Common===
*Dispepsia, nausea, HA
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*Dispepsia, nausea, headache
  
 
==Pharmacology==
 
==Pharmacology==
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*Peak: 2-3 hours
 
*Peak: 2-3 hours
 
*Duration: 4-6 hours
 
*Duration: 4-6 hours
*Half-life: 2-6 hours, up to 19 hours in renal dz
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*Half-life: 2-6 hours, up to 19 hours in renal disease
 
*Metabolism: Hepatic
 
*Metabolism: Hepatic
 
*Excretion: Renal
 
*Excretion: Renal
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==See Also==
 
==See Also==
 +
*[[NSAID toxicity]]
  
==Sources==
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==References==
Lexicomp
 
 
<references/>
 
<references/>
[[Category:Drugs]]
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[[Category:Pharmacology]]

Latest revision as of 22:00, 28 November 2018

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

  • Dispepsia, 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

  1. 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