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Ketorolac Tromethamine: Comprehensive Information
Composition and Forms: Ketorolac tromethamine is a potent non-steroidal anti-inflammatory drug (NSAID) primarily used for short-term management of moderate to severe pain. It is available in several forms, including oral tablets (typically 10 mg), intramuscular injection (15 mg/mL and 30 mg/mL), and intravenous injection (15 mg/mL and 30 mg/mL). Some formulations may also include eye drops for ophthalmic use.
Indications: Ketorolac is indicated for the short-term treatment of moderately severe acute pain, particularly when the use of opioid analgesics is undesirable. It is commonly prescribed for postoperative pain, pain associated with fractures, severe musculoskeletal pain, dental pain, and renal colic. It is not intended for chronic pain management or mild pain.
Mechanism of Action: Ketorolac works by inhibiting cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2. These enzymes are crucial for the synthesis of prostaglandins, which are mediators of pain, inflammation, and fever. By blocking prostaglandin production, ketorolac effectively reduces pain perception and inflammatory responses.
Safety Profile:
- Benefits: Provides rapid and effective pain relief, especially for acute and severe pain, often reducing the need for opioid medications.
- Side Effects: Common side effects include gastrointestinal issues (nausea, indigestion, stomach pain, diarrhea), dizziness, drowsiness, and headache. More serious risks include gastrointestinal bleeding, ulceration, perforation, cardiovascular events (heart attack, stroke), kidney problems, and hypersensitivity reactions.
- Contraindications: Ketorolac is contraindicated in patients with a history of hypersensitivity to ketorolac, aspirin, or other NSAIDs. It should not be used in individuals with active peptic ulcer disease, recent gastrointestinal bleeding, moderate to severe renal impairment, or in patients undergoing certain types of surgery (e.g., during and in the period surrounding coronary artery bypass graft surgery). It is also generally avoided in the third trimester of pregnancy.
- Warnings: Use with caution in patients with pre-existing cardiovascular disease, hypertension, or risk factors for cardiovascular events. Elderly patients and those with compromised kidney function are at higher risk of adverse effects. Prolonged use increases the risk of serious gastrointestinal and renal adverse events.
Dosage Table
Note: Dosages are illustrative and should be determined by a healthcare professional based on individual patient factors. Maximum daily dosage and duration of treatment should not be exceeded.
| Condition/Indication | Dosage Form | Recommended Dosage | Maximum Duration |
|---|---|---|---|
| Postoperative Pain (Moderate to Severe Acute) | IM Injection | 30 mg every 6 hours | Maximum 5 days |
| Postoperative Pain (Moderate to Severe Acute) | IV Injection | 15 mg every 6 hours | Maximum 5 days |
| Postoperative Pain (Moderate to Severe Acute) | Oral Tablets | 20 mg initially, then 10 mg every 4-6 hours as needed | Maximum 5 days (total course including parenteral) |
| Renal Colic (Acute Pain) | IM Injection | 30 mg every 6 hours | Maximum 2 days |
| Musculoskeletal Pain (Moderate to Severe Acute) | IM Injection | 30 mg every 6 hours | Maximum 5 days |
Frequently Asked Questions
- What is the primary use of Ketorolac?
Ketorolac tromethamine is primarily used for the short-term management of moderate to severe acute pain. It is particularly effective for postoperative pain and pain associated with conditions like fractures or renal colic, offering a potent alternative to opioids.
- How quickly does Ketorolac work?
Ketorolac provides rapid pain relief. When administered intravenously or intramuscularly, pain relief can begin within minutes to an hour. Oral formulations typically take about an hour to start working. Its effectiveness is generally seen within the first few doses.
- Can Ketorolac be used for chronic pain?
No, Ketorolac is intended for short-term use only, typiclaly not exceeding five consecutive days. It is not suitable for managing chronic pain conditions due to the increased risk of serious side effects with prolonged administration, particularly gastrointestinal and renal complications.
- Are there any serious risks associated with Ketorolac?
Yes, serious risks include gastrointestinal bleeding, ulceration, and perforation; cardiovascular events like heart attack and stroke; and kidney damage. It is crucial to use Ketorolac under medical supervision and adhere strictly to recommended dosages and durations.
