A 40-year-old woman with severe musculoskeletal pain after spinal instrumentation is prescribed ketorolac intramuscularly. Which statement about ketorolac is correct?

• A It may be continued safely for up to one month for chronic pain
• B It has significant opioid-like sedation and dependence liability
• C Use should be limited to about five days because of gastrointestinal and renal toxicity ✓
• D It is safer than ibuprofen in patients with peptic ulcer disease

Explanation

Ketorolac is one of the most potent NSAID analgesics, comparable to low-dose morphine without sedation or dependence, but its high incidence of gastrointestinal bleeding and renal impairment restricts use to short courses, conventionally no more than five days. It is contraindicated in active peptic ulcer disease and is among the NSAIDs with the highest GI risk, so option D is wrong. It is intended for acute pain only, never chronic therapy, and it produces no opioid-type CNS effects.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.