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Patterns of ketorolac dosing by emergency physicians

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World Journal of Emergency Medicine 2017年第1期8卷 43-46页

作者： Emil Soleyman-Zomalan Sergey Motov Antonios Likourezos Victor Cohen Illya Pushkar Christian Fromm Department of Emergency Medicine Texas Health Arlington Memorial HospitalArlingtonTX76012USA Department of Emergency Medicine Maimonides Medical CenterBrooklynNY 11219USA Corporate Clinical Director of Pharmacy services New York City Health+HospitalsNYNY 10013USA

BACKGROUND: ketorolac tromethamine is a non-steroidal anti-inflammatory drug(NSAIDs) that is widely used in the emergency department(ED) for the treatment of moderate-to-severe pain. ketorolac, like other NSAIDs, exhibits an analgesic ceiling effect and previous research suggests that 10 mg is possibly the ceiling dose. Do the patterns of ketorolac dosing by emergency physicians follow its analgesic ceiling dose?METHODS: This was a single center retrospective, descriptive study to characterize patterns of ketorolac administration in ED patients. Data for all patients who received ketorolac during the ten year study period from January 1, 2003 to January 1, 2013 were collected from the electronic medical record of an urban community ED with an annual volume of 116 935 ***: There were 49 605 ketorolac administrations during the study period; 38 687(78%) were given intravenously, 9 916(20%) intramuscularly, and 1 002(2%) orally. Through the intravenous route, 5 288(13.7%) were 15 mg, 32 715(84.6%) were 30 mg, 15(0.03%) were 60 mg, and 669(1.7%) were other varying doses. Through the intramuscular route, 102(1.0%) were 15 mg, 4 916(49.6%) were 30 mg, 4 553(45.9%) were 60 mg, and 345(3.5%) were other varying doses. The most common diagnoses at discharge were renal colic(21%), low back pain(17%) and abdominal pain(11%).CONCLUSION: The data show that ketorolac was prescribed above its ceiling dose of 10 mg in 97% of patients who received intravenous doses and in 96% of patients receiving intramuscular doses.

关键词： ketorolac NSAID Analgesic ceiling Acute pain Prescription pattern

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Renal function after laparoscopic cholecystectomy and analgesia with tramadol and dipyrone or ketorolac

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Health 2013年第11期5卷 35-41页

作者： Tiago Pechutti Medeiros Pedro Thadeu Galvao Vianna Leopoldo Muniz da Silva Lidia Raquel de Carvalho Gilberto Elias Wady Leandro Gobbo Braz Yara Marcondes Machado Castiglia Graduate Program in Anesthesiology Botucatu Medical SchoolUNESP-Universidade Estadual PaulistaBotucatuBrazil Department of Anesthesiology Botucatu Medical SchoolUNESP-Universidade Estadual PaulistaBotucatuBrazil Sao Luiz Hospital Sao PauloBrazil Department of Biostatics Institute of BiosciencesUNESP-Universidade Estadual PaulistaBotucatuBrazil Mercy Hospital Sao CarlosBrazil

Background: Laparoscopic cholecystectomy (LC) reduces surgical trauma and hospital stay, but requires effective and safe postoperative analgesia. This prospective and double-blind study investigated the effects of analgesia with tramadol combined with either dipyrone or ketorolac on the postoperative renal function of patients submitted to LC. Methods: Pre-and post-operatively (PO), estimated glomerular filtration rates (GFR), obtained by two formulas dependent on blood Cr and one on blood cystatin C values, and tubular enzymuria—alkaline phosphatase (AP), γ-glutamiltransferase (γ-GT)— were determined in well hydrated patients who underwent LC and analgesia with tramadol combined with either dipyrone (Dipyrone, n = 63) or ketorolac (ketorolac, n = 63). Upon discharge from the post-anesthetic care unit (PACU), pain (through Verbal Numerical Scale—VNS) and need for rescue analgesia with morphine were evaluated. Results: There was hemodilution PO, which made GFR profile analysis more difficult—those dependent on Cr increased and statistically correlated, but those dependent on cystatin C did not change. There was a significant PO increase in AP in the Dipyrone and ketorolac groups, and in the product of the both enzymes in the ketorolac group. Upon PACU discharge, the Dipyrone group showed signifi cantly higher VNS scores than the ketorolac group. All patients received morphine PO, and the total dose needed for pain control differed between groups, but without statistical significance. Conclusions: The association of tramadol with dipyrone or ketorolac in well hydrated patients submitted to LC had similar analgesic effectiveness in the PACU. Postoperatively, the effect on GFR may have been masked by hemodilution, and enzymuria was discreetly enhanced when ketorolac was used.

关键词： Kidney Function Tests Pneumoperitoneum Biological Markers Cystatin C ketorolac Analgesia

A randomized controlled trial of ketorolac for prevention of headache related to electroconvulsive therapy

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Pain Studies and Treatment 2013年第2期1卷 5-8页

作者： Keith G. Rasmussen Mayo Clinic Department of Psychiatry and Psychology Rochester USA

Background and Purpose: Headache is one of the most common side effects of electroconvulsive therapy (ECT), with a reported prevalence as high as 45%. Typical pharmacologic measures include aspirin, acetaminophen, or nonsteroidal anti-inflammatory medications. Among the latter, ketorolac may be especially advantageous in that it can be administered intravenously right before a treatment. The primary aim of this study was to measure the efficacy of intravenous ketorolac administration for the prevention of post-ECT headache at the first treatment session. Methods: Sixteen patients were assigned to the control group, while eight patients were assigned to the ketorolac treatment group (8 males, 16 females;mean age ± standard deviation = 46 ± 13.5 years). Statistical analysis consisted of a one-way analysis of variance using the two-sample test. We utilized a post-ECT headache severity scale from zero (no headache) to 3 (severe headache). Results:The mean score for the control group was 1.3 (±1.1), while the mean score for the ketorolac treatment group was 1.2 (±1.1), p = 0.86 (not significant). Conclusions: ketorolac administration does not decrease the incidence of post ECT headache at the first treatment session. It is possible that ketorolac may be effective at subsequent treatments for patients with particularly bothersome headaches after the first treatment. Implications: ketorolac should not be routinely used at the first treatment session to prevent headache associated with ECT.

关键词： Electroconvulsive Therapy ketorolac Headache

ketorolac根尖周注射对牙髓止痛效果的评价

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国际口腔医学杂志 1997年第5期 298-299页

作者：史久成王渝宁

ketorolac tromethamine(KT)是美国用于肌注的一种非固醇类抗炎药。本研究旨在比较此药根尖周注射与肌肉注射对牙髓疼痛的止痛效果。作者选择52例(18～65岁)身体健康的急性牙髓炎患者,每例患者在接受三角肌肌肉注射1ml及邻近痛牙作根... 详细信息

ketorolac tromethamine(KT)是美国用于肌注的一种非固醇类抗炎药。本研究旨在比较此药根尖周注射与肌肉注射对牙髓疼痛的止痛效果。作者选择52例(18～65岁)身体健康的急性牙髓炎患者,每例患者在接受三角肌肌肉注射1ml及邻近痛牙作根尖周注射1.8ml后,作基线痛级测定。随机双盲分4组:①肌注安慰剂,根尖周注射安慰剂;②肌注KT30mg,根尖周注射安慰剂;③肌注安慰剂,根尖周注射KT;④肌注安慰剂,根尖周作2％卡波卡因局麻注射,注射后15,30,45和60min再记录疼痛分值。局麻下行切髓术,嘱回家记录疼痛分值并送回报告。结果显示根尖周注射KT有显著的牙髓止痛效

关键词：根尖安慰剂肌肉注射空白剂肌内注射止痛效果 ketorolac 牙髓

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ND-55 酮咯酸(ketorolac)

中国医药工业杂志 1993年第4期 152-152页

作者：周建明武汉制药厂研究所

关键词：酮咯酸 ketorolac ND-55 消炎镇痛药

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扁桃体术后出血与ketorolac

国际耳鼻咽喉头颈外科杂志 1997年第5期 290-290页

ketorolac是外周作用非类固醇类抗炎药物，由于它的高效能和无呼吸抑制作用（与传统的鸦片类镇痛剂相比），近年来在术中得到广泛的应用，但对该药的潜在的严重副作用研究较少，特别是它能抑制血小板聚积和血栓素入的产生，从而延历出... 详细信息

ketorolac是外周作用非类固醇类抗炎药物，由于它的高效能和无呼吸抑制作用（与传统的鸦片类镇痛剂相比），近年来在术中得到广泛的应用，但对该药的潜在的严重副作用研究较少，特别是它能抑制血小板聚积和血栓素入的产生，从而延历出血时；司。该作名回顾自1992年1月至1...

关键词：扁桃体淋巴组织术后出血 ketorolac

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InSite新的眼药传输系统

中国医疗设备 2012年第10期27卷 183-184页

InSite公司最近推出了最新的DuraSite2给药系统，用于眼部疾病的治疗。比如说，该给药系统可以在眼科手术过程中对患者眼部进行持续给药，药物成分包括ketorolac，一种强力消炎止痛药（NSAID）以及一种阳离子高分子药物。

关键词：传输系统 ketorolac 眼药给药系统眼部疾病高分子药物消炎止痛药持续给药

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镇痛＆麻醉药品研发进展

中国新药杂志 2010年第13期19卷 1097-1097页

FDA批准Roxro Pharma公司的Sprix^TM鼻腔喷雾剂用于急性疼痛Roxro Pharma公司的Sprix^TM（酮洛酸氨丁三醇，ketorolac tromethamine）鼻腔喷雾剂，用于短期（〉5d）治疗中度至中重度疼痛。Sprix ^TM鼻腔喷雾剂是一种非麻醉性镇痛剂，给... 详细信息

FDA批准Roxro Pharma公司的Sprix^TM鼻腔喷雾剂用于急性疼痛Roxro Pharma公司的Sprix^TM（酮洛酸氨丁三醇，ketorolac tromethamine）鼻腔喷雾剂，用于短期（〉5d）治疗中度至中重度疼痛。Sprix ^TM鼻腔喷雾剂是一种非麻醉性镇痛剂，给药方便，是常用阿片类处方药的备选药物。

关键词：麻醉性镇痛剂药品研发 Pharma公司 ketorolac 鼻腔喷雾剂酮洛酸氨丁三醇 FDA批准中重度疼痛

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FDA批准眼科手术用药Omidria上市

中国执业药师 2014年第8期11卷 44-44页

美国 FDA 于2014年5月30日批准奥麦罗（Omeros）公司的ketorolac Tromethamine；Phenyle-phrine Hydrochloride（参考译名：酮咯酸氨丁三醇-盐酸去氧肾上腺素，商品名：Omidria ）复方制剂上市。用于在白内障或人工晶体置换手术时加入... 详细信息

美国 FDA 于2014年5月30日批准奥麦罗（Omeros）公司的ketorolac Tromethamine；Phenyle-phrine Hydrochloride（参考译名：酮咯酸氨丁三醇-盐酸去氧肾上腺素，商品名：Omidria ）复方制剂上市。用于在白内障或人工晶体置换手术时加入眼用冲洗液中，通过防止手术中瞳孔缩小以维持瞳孔大小，减少手术后眼部疼痛。

关键词： FDA批准眼科手术上市 ketorolac 盐酸去氧肾上腺素酮咯酸氨丁三醇用药复方制剂

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