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Intramuscular Toradol, gastrointestinal bleeding, and peptic ulcer perforation: a case report
Journal of the National Medical Association
|March 1, 1995
Summary
Intramuscular ketorolac tromethamine, a parenteral nonsteroidal anti-inflammatory drug, has not been linked to gastrointestinal issues. However, a patient developed a perforated gastric ulcer after prolonged use for chronic pancreatitis pain.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Parenteral nonsteroidal anti-inflammatory drugs (NSAIDs) offer analgesic benefits.
- Ketorolac tromethamine is the first parenteral NSAID approved for pain management.
- Previous reports indicated no gastrointestinal complications with intramuscular ketorolac.
Observation:
- A case study involved a 39-year-old female patient.
- The patient received multiple intramuscular doses of ketorolac tromethamine.
- Treatment was administered over 2.5 months for chronic pancreatitis pain.
Findings:
- The patient required surgical repair for a perforated gastric ulcer.
- This case suggests a potential risk of gastrointestinal perforation with prolonged intramuscular ketorolac use.
- This contradicts previous findings of safety.
Implications:
- Clinicians should exercise caution when prescribing prolonged courses of intramuscular ketorolac.
- Further research is warranted to investigate the gastrointestinal safety profile of parenteral ketorolac.
- This case highlights the importance of monitoring for serious adverse events in patients receiving long-term NSAID therapy.