Ketorolac is an effective parenteral NSAID used for postoperative pain, but its use is restricted to five days. The main reason for this restriction is:

• A Rapid development of tolerance to its analgesic effect
• B Induction of hepatic microsomal enzymes
• C Progressive loss of efficacy against opioid-resistant pain
• D Cumulative risk of gastrointestinal bleeding and renal injury ✓

Explanation

Ketorolac is one of the most potent nonselective COX inhibitors available, and its serious dose-related toxicities are peptic ulceration, GI hemorrhage and renal impairment including acute kidney injury in vulnerable patients. Risk rises steeply beyond five days of cumulative exposure, so guidelines cap its duration and avoid it after major surgery with high bleeding risk. Tolerance and enzyme induction are not recognized problems with this drug.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.