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: | *Acute pain: | ||
**IM: | **IM: 15mg x 1 or 15mg q6h | ||
**IV: | **IV: 15mg x 1, then 15mg q6h | ||
**Black box warning against | **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 | *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, | *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 | *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]] | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] |
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
- ↑ 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