Ketorolac

Description

Ketorolac Tromethamine is a drug of pyrrolo-pyrrole group of nonsteroidal antiinflammatory drug (NSAID). Chemically it is known as ±5 benzoyle-2,3-dihydro-1H-pyrroligine-1-carboxylic acid, compound with 2 amino-2-(hydroxymethyl)-1,3-propanediol. Ketorolac Tromethamine inhibits synthesis of prostaglandins and may be considered as a peripherally acting analgesic. The biological activity of Ketorolac Tromethamine is associated with the S-form. Pharmacokinetic property of Ketorolac Tromethamine is linear. It is highly protein bound and is largely metabolized in liver. The products of metabolism and some unchanged drugs are excreted in the urine.

 Indications and Uses

Ketorolac Tromethamine is indicated for the short-term (5 days) management of moderate to severe  acute pain that requires analgesia at the opiod level (usually in a postoperative setting).

 Dosage and Administration

By mouth: 10 mg every 4-6 hours (elderly, every 6-8 hours) or 40mg daily; maximum duration of treatment is 7 days.

 Side effects

It is generally well tolerated. However, side effects like dry mouth, excessive thirst, psychotic reactions, convulsion, myalgia, hyponatremia, hyperkalemia, raised blood urea and creatinine, renal failure, hypertension, bradycardia, chest pain, purpura, post operative haemorrhage, haematoma, liver function change etc may occur in some cases.

 Contraindications

Ketorolac Tromethamine is contraindicated in patients with known hypersensitivity to NSAIDs and any of the components of Ketorolac Tromethamine. Moreover, the patient with the history of asthma, nasal polyp, angioedema, peptic ulcer and bleeding, bleeding disorder are contraindicated for this drug.

 Precautions

Precaution should be taken in the following conditions

- Elderly

- Allergic disorder

- Renal, cardiac & hepatic impairment

- Porphyria

- Patient with low body weight (<50kg): reduce dose.

 Use in pregnancy & lactation

Ketorolac Tromethamine is contraindicated in pregnancy and lactation.

 Use in children

Not recommended for children below 16 years of age.

 Drug Interaction

Warfarin, digoxin, heparin and salicylate should be used carefully with Ketorolac Tromethamine. 

 Over dosage

Overdosage of Ketorolac Tromethamine may cause abdominal pain, peptic ulcers which healed after discontinuation of doses. Metabolic acidosis has been reported following intentional overdosage.