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Hyperkalemia associated with ketorolac.

F A Rotenberg¹, V S Giannini

¹Department of Anesthesiology, Rhode Island Hospital, Providence 02903.

The Annals of Pharmacotherapy

|June 1, 1992

Summary

This summary is machine-generated.

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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.

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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.