Showing papers on "Ketorolac published in 1988"

Effects of ketorolac tromethamine on hemostasis in volunteers.

Abstract: Ketorolac tromethamine, an analgesic agent with prostaglandin synthetase–inhibiting activity, is more active than aspirin in vitro in inhibiting collagen– or arachidonic acid–induced platelet aggregation In this randomized, double-blind study, 26 volunteers received ketorolac, 30 mg intramuscularly four times a day for 5 days, and placebo, two capsules orally four times a day for at the last 2 study days The effects of this treatment were compared with those of intramuscular placebo and oral aspirin, two 325 mg capsules, given on the same schedule to eight volunteers Aspirin at a mean serum concentration of 84 μg/ml did not affect prothrombin time, partial thromboplastin time, platelet count, or bleeding time Ketorolac produced a modest prolongation of the bleeding time, from 49 ±11 minutes (mean ± SD) to 78 ± 40 minutes (p < 0005) Ketorolac did not affect the prothrombin time or partial thromboplastin time but was associated with clinically insignificant change in the platelet count from 303 ± 57 × 103/m3 to 277 ± 56 × 103/mm3 Clinical Pharmacology and Therapeutics (1988) 43, 542–546; doi:101038/clpt198870

Pharmacokinetics of ketorolac tromethamine in humans after intravenous, intramuscular and oral administration

Abstract: The pharmacokinetics of ketorolac tromethamine, a potent non-narcotic analgesic agent used for relief of moderate to severe pain, has been studied in 15 healthy volunteers who received single 10 mg doses intravenously (i.v.), intramuscularly (i.m.) and orally (p.o.) in a three-way cross-over design.

The Quantitative Effect of 0.5% Ketorolac Tromethamine Solution and 0.1% Dexamethasone Sodium Phosphate Solution on Postsurgical Blood-Aqueous Barrier

Abstract: • Anterior chamber fluorophotometry was performed after the oral administration of fluorescein sodium in patients undergoing extracapsular cataract extraction and posterior chamber intraocular lens insertion before and after surgery. The administration of 0.5% ketorolac tromethamine solution (ketorolac solution) eye drops before and after surgery decreased the breakdown of the blood-aqueous barrier as compared with 0.1% dexamethasone sodium phosphate solution (dexamethasone solution) eye drops at each period, as measured by fluorophotometry. A single injection below Tenon's capsule of a short-acting corticosteroid had been given to each patient at the end of each surgical procedure. Slit-lamp observations of postoperative ocular inflammation were not different between treatment groups. Both ketorolac and dexamethasone solutions were well tolerated by patients. Ketorolac solution was more effective than dexamethasone solution in facilitating reestablishment of the blood-aqueous barrier after surgery, as measured by fluorophotometry, and was equal to dexamethasone solution as observed by slit-lamp observations. This study suggests that ketorolac ophthalmic solution may be effective and safe as a nonsteroidal anti-inflammatory agent for topical use after cataract surgery and intraocular lens implantation in place of topically administered corticosteroids.

Haemostatic effects of ketorolac with and without concomitant heparin in normal volunteers.

Abstract: Ketorolac is a potent cyclo-oxygenase inhibitor used for the treatment of postoperative pain. It is known to have anti-platelet properties. The aim of this study was to determine the effect of ketorolac on haemostasis both alone and in combination with low dose heparin in 12 healthy male volunteers. Each volunteer received the following drug combinations in a double blind, placebo controlled, cross over manner: ketorolac placebo/heparin placebo, ketorolac active/heparin placebo, ketorolac active/heparin active and ketorolac placebo/heparin active. Ketorolac significantly prolonged bleeding time, inhibited platelet aggregation to arachidonic acid and collagen and platelet thromboxane production. Heparin had no effect on bleeding time or platelet function, but significantly prolonged the kaolin cephalin clotting time and increased anti-Xa levels. Ketorolac had no effect on the kaolin cephalin clotting time or anti-Xa levels and no interaction was found between ketorolac and heparin in any of the investigations. The prolongation of bleeding time seen with ketorolac is unlikely, to be of any major clinical significance as almost all subjects remained within the normal range; however, it should be used with caution in subjects with haemostatic problems.

Quantitative Assessment of Postsurgical Breakdown of the Blood-Aqueous Barrier Following Administration of 0.5% Ketorolac Tromethamine Solution: A Double-Masked, Paired Comparison With Vehicle-Placebo Solution Study

Abstract: • Preoperative and serial postoperative anterior chamber fluorophotometry were performed after oral administration of fluorescein sodium in patients undergoing extracapsular cataract extraction and posterior chamber intraocular lens insertion. The administration of topical 0.5% ketorolac tromethamine solution before and after surgery markedly decreased the breakdown of the blood-aqueous barrier compared with vehicle-placebo solution administration at each time period, as measured by fluorophotometry. Corticosteroids were not given to any patients throughout the duration of the study. These fluorophotometric results correlated well with slit-lamp observations of postoperative ocular inflammation. Both ketorolac and vehicle were well tolerated by patients. No effects on intraocular pressure were seen with ketorolac administration. This study suggests that ketorolac ophthalmic solution is effective and safe as a nonsteroidal anti-inflammatory agent for topical use following cataract surgery and intraocular lens implantation.

The effects on ventilation of ketorolac in comparison with morphine.

Abstract: We have compared the effect on ventilation of ketorolac, an injectable non-steroidal analgesic, with that of morphine in a randomized, double-blind, cross-over study, using two doses of ketorolac (10 and 90 mg i.m.) and one of morphine (10 mg i.m.). The effect on ventilation was measured with a CO2 rebreathing technique. As a measure of the effect we studied the increase in PETCO2 (CO2 shift) that caused a respiratory minute volume (RMV) equal to the RMV in the control period at 8 kPa PETCO2. Ketorolac caused insignificant CO2 shifts of about 0.10 kPa, while morphine caused a significant CO2 shift of 0.86 kPa. We conclude that ketorolac in analgesic and supra-analgesic doses has no effect on the ventilatory response to CO2 under circumstances in which significant effects are seen with morphine.

Percutaneous absorption of nicardipine and ketorolac in rhesus monkeys.

Abstract: Vehicle effects on the percutaneous absorption of nicardipine base, nicardipine hydrochloride, ketorolac acid, and ketorolac tromethamine were determined using the rhesus monkey as an in vivo model for human skin penetration. Vehicles investigated included blends of propylene glycol, trimethylene glycol, ethanol, Azone, Tween 20, water, and long-chain fatty acids. Formulations were prepared such that the compound dose, application area, and percentage saturation of the compound in the vehicle were held constant. Variations in absorption of the compounds were therefore attributable to vehicle effects. Each formulation was applied to three monkeys for a period of 24 hr using 10 Hill Top Chambers. Plasma samples were taken at appropriate intervals for 36 to 48 hr. The results indicated that trimethylene glycol and Tween 20 did not enhance absorption of the test compounds despite claims by other investigators. Azone and ethanol provided moderate enhancement of both the rate and the extent of absorption, while long-chain fatty acids in combination with propylene glycol significantly enhanced penetration. In general, higher fluxes were observed with the more lipophilic compounds nicardipine base and ketorolac acid as compared to the hydrochloride and tromethamine salts.

Effect of Ketorolac on Pseudomonas aeruginosa Ocular Infection in Rabbits

Abstract: Corticosteroids can exacerbate bacterial ocular infections, even in the presence of antibiotics. Ketorolac tromethamine is a new non-steroidal compound being considered as an anti-inflammatory ophthalmic drug. In this study, rabbits ocularly infected with Pseudomonas aeruginosa were treated topically with 0.4 percent tobramycin sulfate 4 times daily for 7 days to control infection. At the same times, either 0.5 percent ketorolac, 0.1 percent dexamethasone or vehicle was also given topically. Animals were scored for severity of both conjunctivitis (maximum severity rates score of 10) and corneal opacity (maximum of 4) using the Draize scale. Severity of the infection was determined by counting the number of punctate lesions which developed on the cornea. Nine days after treatment ended, the number of these lesions was the same for ketorolac as for the vehicle (respectively, 16.7 +/- 3 and 13.8 +/- 3, mean +/- SE, n = 24), indicating no exacerbation of the infection, whereas with dexamethasone these parameters increased (30.2 +/- 4, n = 24). During treatment, ketorolac reduced conjunctivitis (1.8 +/- 0.2, n = 120) when compared with the vehicle (2.9 +/- 0.2, n = 120), whereas dexamethasone did not (3.8 +/- 0.2, n V 120); neither ketorolac nor dexamethasone reduced corneal opacity (respectively, 2.3 +/- 0.05 and 2.6 +/- 0.1, n = 24) compared with vehicle (2.2 +/- 0.05, n = 24). After treatment, both conjunctivitis and corneal opacity became more severe only in dexamethasone treated eyes (respectively, 4.4 +/- 0.2, n = 120 and 3.0 +/- 0.02, n = 24). Thus, ketorolac appears to be an anti-inflammatory agent that does not worsen bacterial ocular infection.

Comparative Study of Ketorolac and Paracetamol/Codeine in Alleviating Pain following Gynaecological Surgery

Abstract: In a randomized, double-blind, multiple-dose, parallel study of 107 patients, the safety and analgesic efficacy of single and multiple doses of orally administered ketorolac tromethamine (10–40 mg/...

The transfer of ketorolac tromethamine from maternal to foetal blood

Abstract: Thirty two women who were participating in an efficacy study comparing 10 mg ketorolac with 50 mg or 100 mg of pethidine in the relief of labour pain, underwent sampling of vein blood, for determination of plasma ketorolac concentrations. The sample was withdrawn at delivery and a sample of umbilical cord blood was withdrawn at the same time. The ratio of ketorolac concentrations in the cord blood sample: the maternal venous sample were calculated and plotted against the time elapsed between drug administration and sampling. Samples for one patient, withdrawn 24 min after dosing, had ketorolac concentrations below the quantification limit. The ratios in the remaining patients were all low and showed a tendency to increase with time. The mean ratio was 0.116 with a range of 0.04 in 2 patients, at 43 min and 1 h 6 min, to 0.25 at 6 h 34 min.

Effect of ketorolac on herpes simplex virus type one ocular infection in rabbits.

Abstract: Corticosteroids can exacerbate viral ocular infections. Ketorolac tromethamine is an effective nonsteroidal anti-inflammatory agent that may be a useful substitute for corticosteroids following ocular surgery. In this study, rabbits ocularly infected with herpes simplex virus type 1 (HSV-1) were treated topically four times daily with 0.5 percent ketorolac or 0.1 percent dexamethasone for 7 days after infection. Severity of the infection was determined by scoring corneal opacity and HSV-1 corneal ulcerations with the Draize scale as well as iritis and conjunctivitis. Ten days after treatment ended both the corneal opacity scores (1.5 out of 4) and HSV-1 corneal ulcerations (0.3 to 0.7 out of 4) were similar for ketorolac and the vehicle, indicating no exacerbation of the infection, whereas with dexamethasone these scores were increased (3.6/4 and 3.4/4, respectively). Furthermore, both iritis scores (0.5/2) and conjunctivitis scores (1.3 to 1.4/10) were also similar for ketorolac and the vehicle, while dexamethasone increased both iritis (1.8/2) and conjunctivitis (4.3/10) compared to vehicle. Thus, ketorolac appears to be an anti-inflammatory agent that does not worsen viral ocular infection.

Comparative analgesic efficacy and tolerability of ketorolac tromethamine and glafenine in patients with post-operative pain

Abstract: In a randomized, single-dose, double-blind, parallel comparative trial of analgesic efficacy, 96 adult patients received either 10 mg ketorolac tromethamine or 400 mg glafenine orally the morning after surgery if they requested pain relief medication. Each patient provided a baseline pain assessment and then received the assigned medication. Patients assessed pain intensity and pain relief and reported any adverse events in interviews held 30 minutes after drug administration and then hourly for 6 hours. The demographic characteristics, baseline pain intensity, and surgical categories of the 47 patients who received ketorolac tromethamine and the 49 who received glafenine were similar. Both drugs provided prompt, sustained pain relief throughout the 6-hour observation period, and there were no statistically significant differences between the two groups in any of the efficacy measures analyzed. The global assessment recorded by patients suggested a slight clinical advantage for ketorolac tromethamine (32.6% of 'excellent' responses) as compared to glafenine (12.5% 'excellent'). The differences in overall response were statistically significant (p = 0.017). Fourteen (30%) patients who received ketorolac tromethamine and 17 (35%) who received glafenine reported adverse experiences that began or seemed to worsen after administration of the study drugs. The most prominent were drowsiness and sleeping, both of which are common in post-surgical patients.