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Hyperkalemia associated with ketorolac
1Department of Anesthesiology, Rhode Island Hospital, Providence 02903.
The Annals of Pharmacotherapy
|June 1, 1992
Summary
This case study reports hyperkalemia after intramuscular ketorolac, a nonsteroidal anti-inflammatory drug (NSAID). Prostaglandin synthesis suppression is the suspected cause, highlighting the need for careful patient monitoring.
Area of Science:
- Pharmacology
- Nephrology
- Clinical Medicine
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain management.
- Hyperkalemia is a known potential adverse effect of some NSAIDs.
- Ketorolac is a potent NSAID often administered intramuscularly for moderate to severe pain.
Observation:
- A 59-year-old male patient developed hyperkalemia after receiving a 30 mg intramuscular injection of ketorolac for postoperative incisional pain.
- Other potential causes of hyperkalemia, including concurrent medications and perioperative events, were systematically excluded.
Findings:
- This case represents the apparent first report of hyperkalemia specifically linked to intramuscular ketorolac administration.
- The proposed mechanism involves NSAID-induced suppression of prostaglandin synthesis, which can impair potassium excretion.
- Similar hyperkalemic effects have been documented with other NSAIDs.
Implications:
- Parenteral ketorolac may precipitate hyperkalemia, necessitating vigilant monitoring of serum electrolytes in patients receiving this medication.
- Clinicians should consider ketorolac as a potential cause of hyperkalemia in the postoperative setting.
- Further research may be warranted to fully elucidate the risk and incidence of ketorolac-induced hyperkalemia.