Ketorolac tromethamine provides opioid-level analgesia after surgery. Which prescribing restriction reflects the reason it must never be used for chronic pain?

• A It loses analgesic efficacy beyond 72 hours due to tolerance
• B Duration of use is limited to about 5 days because of rising risk of gastrointestinal bleeding and renal injury ✓
• C It causes cumulative cardiac valve fibrosis with prolonged use
• D It produces physical dependence identical to opioids

Explanation

Ketorolac is the most potent NSAID for pain, comparable to moderate doses of morphine, but its toxicity profile mandates a strict limit of roughly five days of use. With prolonged administration the risks of peptic ulceration, GI haemorrhage and acute renal failure rise steeply, especially in the elderly and postoperative states. Tolerance and dependence do not occur with NSAIDs, and ketorolac has no association with valvular fibrosis.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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