Ketorolac ophthalmic

Ketorolac, Ophthalmic (Acular, Acular LS, Auclair PF) Ketotifen (Zaditor) Levocabastine (Livostin) Lodoxamide (Alomide)... 

Ketorolac is given as the trometamol salt intramuscularly, intravenously, or orally. The maximal daily dose is 90 mg for the parenteral and the oral route. The duration of treatment is restricted due to side-effects. Ketorolac is also used as a 0.5% ophthalmic solution. 

J. S. Fleitman, I. W. Partridge, and D. A. Neu, Thimerosal analysis in ketorolac tromethamine ophthalmic solutions comparing HPLC and colorimetric techniques, Drug Dev. Ind. Pharm., 17 519(1991). 

Perry HD, Donnemeld ED. An update on the use of ophthalmic ketorolac tromethamine 0.4%. Expert Opin Pharmacother 2006 7 99-10. 

The most frequent adverse event reported with ketorolac use is transient stinging and burning after instillation of the ophthalmic solution. Rarely, allergic reactions and superficial keratitis have occurred. Although inconsistent cases of corneal toxicity have been reported with NSAIDs, prolonged use of NSAIDs in a select group of patients showed the potential for corneal melt. Because other treatment options exist for allergic eye disease, NSAIDs do not need to be used in patients with compromised corneas or those at risk for potentially serious adverse corneal reactions. 

Tinkehnan DG, Rupp G, Kaufman H, et al. Double-masked, paired-comparison clinical study of ketorolac tromethamine 0.5% ophthalmic solution compared with placebo eyedrops in the treatment of seasonal allergic conjunctivitis. Surv Ophthalmol 1993 38 133-140. 

Fleitman JS, Partridge IW, Neu DA. Thimerosal analysis In ketorolac tromethamine ophthalmic solution. Drug Dev Ind Pharm 1991 17 519-530. 

Example Diclofenac sodium (Voltaren) and Ketorolac (Toradol) Route PO/ IM/IV Ophthalmic Pregnancy category B Pharmacokinetic Absorbed from the GI tract, metabolized in the liver, and primarily excreted in urine PB 99% not removed by hemodialysis... 

Chloramphenicol (Chloromycetin Ophthalmic) Ciprofloxacin (Cipro) Erythromycin Gentamicin sulfate (Garamycin Ophthalmic) Norfloxacin (Chibroxin) Tobramycin (Nebcin, Tobrex) Natamycin (Natacyn Ophthalmic Idoxuridine (IDU) Trifluridine (Viroptic) Vidarabine monohydrate (Vira-A) Dexamethasone Diclofenac Na (Voltaren) Suprofen Profenal) Ketorolac tromethamine (Acular) Olopatadine HCL Ophthalmic solution Medrysone (HMS Liquifilm) Prednisolone acetate Prednisolone Na phosphate Combination TobraDex... 

Ketorolac (administered as the tromethamine salt Toradol, Ultram) has been used as a short-term alternative (less than 5 days) to opioids for the treatment of moderate to severe pain and is administered intramnscnlarly, intravenously, or orally. Unlike opioids, tolerance, withdrawal, and respiratory depression do not occur. Like other NSAIDs, aspirin sensitivity is a contraindication to the nse of ketorolac. Typical doses are 30 to 60 mg (intramnscnlar), 15 to 30 mg (intravenous), and 5 to 30 mg (oral). Ketorolac is used widely in postoperative patients, but it should not be used for routine obstetric analgesia. Topical (ophthalmic) ketorolac is FDA approved for the treatment of seasonal allergic conjunctivitis and postoperative ocular inflammation after cataract extraction. 

Kumar, T.R.S Shedbalkar, V.P. Bhalla, H.L. High-performance liquid-chromatographic determination of ketorolac tromethamine in ophthalmic formulations. Indian Drugs 1997, 34 (9), 532-535. 

A recent invention is directed to an aqueous ophthalmic solution comprising an effective amount of ketorolac, consisting of carboxymethyl cellulose, which promotes epitheHal wound healing in a patienfs cornea [148]. The degree of polymerization and the length of the polymer chain affect the properties of the cellulose polymers [149]. 

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