Week 1

Question 1

Ketolorac/Toradol

Answer 1

NSAIDS
MOA= Reduces inflammatory response by inhibiting COX 1 & 2. Also inhibits prostaglandin synthesis causing anti-inflammatory & analgesia effects
Pharmacokinetics: Protein Binding: 99%; Onset - 10 min; peak- 2-3 hrs; Elimination half time (E1/2)- 5 hrs (prolonged to 6-8 hrs in elderly). Duration is 6-8 hours. Metabolized: liver, principally by glucoronic acid conjugation. Elimination: kidneys, 60% excreted unchanged.
SE=GI Bleed (ulcer/perforation), ARF, Bronchospasm, prolonged bleeding time, anaphylaxis (Stephen Johnson Syndrome), sedation, peripheral edema, nausea.
CI= asthma, RF, ASA allergy (cross sensitivity), liver failure, GI bleed, coagulation problems, 3rd trimester (inhibit uterine contractions and affect fetal circulation); Black Box- do not use post CABG, can cause ↑ CV effects like MI & stroke (graft spasm); can inhibit platelet function.
Dose= 30-60 mg IV, then 15-30mg q6 hrs (max daily is 120mg)- do not give longer than 5 days; decrease dose in elderly to 15mg