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Indications:

•For short-term management (? 7 days) of different painful conditions that requires analgesia at opioid level e.g.: Major abdominal operations-Orthopaedic operations-Dental operations -Gynecological operations; Therapy should be initiated with IV or IM and continuation of treatment with oral Ketorolac, if necessary. •For management of severe painful conditions e.g.: Cancer pain, Renal colic,........etc. N.B.: The total combined duration of use of Ketorolac tromethamine is not to exceed ? 7 days because of potential increase of severity of adverse reactions associated with therapeutic doses. Patients should be switched to alternative analgesics as soon as possible. - As an eye drops: indicated to patients suffering from: The temporarily relief of ocular itching due to seasonal allergic conjunctivitis. Postoperative inflammation due to cataract extraction.

Contraindications:

Known hypersensitivity to ketorolac or other NSAIDs, history of asthma, severe heart failure, peptic ulcer, coagulation disorders, and during pregnancy and lactation.

Adverse reactions:

Side effects may include: GIT upsets, Dizziness, Vertigo, Rash, Pruritus, Sweating, Tinnitus, Headache, Dyspnea, Oliguria, Insomnia, Flushing, Bradycardia, and Weight Gain. Ophtlamic Adverse effects: Transient stinging & burning sensation on instillation are most frequent. Ocular irritation, allergic reactions, superficial infections, superficial keratitis are very few reported, eye dryness, corneal infiltrates, corneal ulcer, & visual disturbance are rare.

Interactions:

Ketorelac should not be used with other NSAIDs and Probenecid because of the potential for additive side-effects. *Ketorolac reduces the diuretic response to frusemide by approximately 20%, in renal impairment. *Caution is advised when: Methotrexate or Lithium is administered concurrently with ketorolac.

Warnings:

•In elderly: Longer dosing interval is advisable. •History of asthma: Bronchspasm may be precipitated. •NSAIDs can cause: GIT irritation, ulcers or bleeding with or without a history of previous symptoms. •Renal patients: patients with moderate to severe impairment of renal function should not receive ketorolac. •Appropriate monitoring is required for patients with history of hypertension and/or congestive heart failure. •Caution should be used where strict haemostasis is critical, e.g. in cosmetic or day-case surgery.

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Consultants Corner

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

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