Ketorolac provides morphine-level analgesia after surgery without sedation or respiratory depression. Despite this profile, its use is restricted to a maximum of five days because of:
- A Rapid development of tolerance and physical dependence
- B Cumulative bone marrow suppression leading to agranulocytosis
- C High incidence of gastrointestinal bleeding, perforation and renal impairment with prolonged use ✓
- D Progressive hepatotoxicity resembling halothane injury
Correct answer: C. High incidence of gastrointestinal bleeding, perforation and renal impairment with prolonged use
Explanation
Ketorolac is the most potent analgesic among NSAIDs and is approved only for short-term management of moderately severe acute pain. Its limiting toxicities are those of potent non-selective COX inhibition: serious upper gastrointestinal bleeding and perforation, acute kidney injury especially in volume-depleted or elderly patients, and increased surgical site bleeding through platelet inhibition. Tolerance and dependence are opioid phenomena, marrow suppression is characteristic of colchicine overdose, and ketorolac is not classically hepatotoxic.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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