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KetorolacAka: Toradol

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  1. Class
    1. NSAID in the Acetic acid class (Pyrrolo-pyrrole)
  2. Precautions
    1. Do not use longer than 5 days
  3. Indications
    1. Analgesia for moderate to severe acute pain
    2. Alternative to Narcotic Analgesic
  4. Contraindications
    1. Peptic Ulcer Disease
    2. Renal insufficiency
    3. Acute or chronic bleeding risk
    4. Hypersensitivity to Aspirin or other NSAID
  5. Dosing: Indications for using lower dose
    1. Age over 65 years
    2. Renal Impairment
    3. Weight under 50 kg (110 pounds)
  6. Dosing: Intramuscular dose
    1. Regular dose
      1. Single dose: 60 mg IM
      2. Repeated dose: 30 mg IM every 6 hours prn (<5 days)
      3. Maximum: 120 mg per day
    2. Low dose
      1. Single dose: 30 mg IM
      2. Repeated dose: 15 mg IM every 6 hours prn (<5 days)
      3. Maximum: 60 mg per day
  7. Dosing: Intravenous dose
    1. Regular dose: 30 mg IV every 6 hours prn (<5 days)
    2. Low dose: 15 mg IV every 6 hours prn <(5 days)
  8. Dosing: Oral dose (continuation of parenteral dosing)
    1. Maximum: 40 mg per day
    2. Regular dose
      1. First dose: 20 mg PO (two 10 mg tablets)
      2. Subsequent dosing: 10 mg PO q4-6 hours prn
    3. Low dose
      1. Dose: 10 mg PO q4-6 hours prn
  9. Adverse Effects
    1. Gastrointestinal Bleeding (Peptic Ulcer Disease)
      1. See NSAID Gastrointestinal Adverse Effects
    2. Exacerbation of renal insufficiency
      1. See NSAID Renal Adverse Effects
    3. Bleeding risk
  10. Efficacy
    1. Equivalents to Toradol 60 mg IM
      1. Morphine 12 mg IM
      2. Ibuprofen 800 mg PO (See Turturro 1995)
    2. Advantages over Morphine in ER with blunt limb trauma
      1. Toradol has longer duration
      2. Toradol less adverse effects
      3. Toradol IV more effective than Morphine IV
    3. References
      1. Rainer (2000) BMJ 321:1247
  11. References
    1. Turturro (1995) Ann Emerg Med 26:117
    2. (2000) Med Lett Drugs Ther 42(1085):73

Ketorolac (C0073631)

Definition (MSH)A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)
Definition (PDQ)A synthetic pyrrolizine carboxylic acid derivative with anti-inflammatory, analgesic and antipyretic properties. Ketorolac, a non-selective inhibitor of the cyclo-oxygenase (COX) enzyme, prevents the synthesis of prostaglandins and thromboxanes from arachidonic acid. COX enzymes exist in two isoforms; inhibition of the COX-2 enzyme produces the anti-inflammatory and analgesic whereas, inhibition of the COX-1 enzyme is associated with gastrointestinal side effects, nephrotoxicity and platelet de-aggregatory effects. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40569&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40569&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1219" NCI Thesaurus)
Definition (NCI)A synthetic pyrrolizine carboxylic acid derivative with anti-inflammatory, analgesic and antipyretic properties. Ketorolac, a non-selective inhibitor of the cyclo-oxygenase (COX) enzyme, prevents the synthesis of prostaglandins and thromboxanes from arachidonic acid. COX enzymes exist in two isoforms; inhibition of the COX-2 enzyme produces the anti-inflammatory and analgesic whereas, inhibition of the COX-1 enzyme is associated with gastrointestinal side effects, nephrotoxicity and platelet de-aggregatory effects.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishKetorolac, KETOROLAC PREPARATION, Ketorolac product
Spanishcetorolaco, ketorolac, ketorolaco
Parent ConceptsIndomethacin (C0021246), Cyclooxygenase Inhibitors (C0085387), Analgesics, Non-Narcotic (C0242937), [OP300] ANTI-INFLAMMATORIES, TOPICAL OPHTHALMIC (C0993170), Anti-Inflammatory Agents, Non-Steroidal (C0003211), Heteroaryl acetic acid (C1635031), Duplicate concept (C1274013), Nonsteroidal Anti-inflammatory Drugs, Nonspecific (C1579332), Ophthalmic Anti-inflammatories (C1579384)
SourcesLNC, MSH, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG
Derived from the NIH UMLS (Unified Medical Language System)


Toradol (C0146226)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishToradol
SourcesMSH, MTH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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