Contraindications of NSAIDs
Contraindications of NSAIDs ( 5 Questions)
A nurse is preparing to administer ketorolac (Toradol), a nonselective COX inhibitor, to a client who has moderate to severe pain after surgery. What are some of the nursing considerations for this drug?
Ketorolac can cause gastrointestinal effects such as nausea, vomiting, ulceration, bleeding, and perforation because it inhibits the synthesis of prostaglandins that protect the gastric mucosa .
Ketorolac can cause hypotension by inhibiting the synthesis of prostaglandins that regulate blood pressure and renal blood flow . It can also cause thrombophlebitis by irritating the vein wall and activating platelets.
Ketorolac can cause renal impairment by reducing the glomerular filtration rate and causing sodium and water retention, edema, hypertension, and acute renal failure . It can also cause gastrointestinal bleeding by inhibiting the synthesis of prostaglandins that maintain mucosal blood flow and integrity .
This is because ketorolac (Toradol), a nonselective COX inhibitor, inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes, which are responsible for prostaglandin synthesis in various tissues. Prostaglandins are involved in inflammation, pain, fever, and platelet aggregation. Therefore, ketorolac has anti-inflammatory, analgesic, antipyretic, and antiplatelet effects.
This is because ketorolac (Toradol), a nonselective COX inhibitor, inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes, which are responsible for prostaglandin synthesis in various tissues. Prostaglandins are involved in inflammation, pain, fever, and platelet aggregation. Therefore, ketorolac has anti-inflammatory, analgesic, antipyretic, and antiplatelet effects.
Some of the nursing considerations for ketorolac are:
- It should be given orally with food or milk to minimize gastrointestinal irritation .
Ketorolac can cause gastrointestinal effects such as nausea, vomiting, ulceration, bleeding, and perforation because it inhibits the synthesis of prostaglandins that protect the gastric mucosa .
- It should be given intravenously slowly over 15 seconds to prevent hypotension or thrombophlebitis.
Ketorolac can cause hypotension by inhibiting the synthesis of prostaglandins that regulate blood pressure and renal blood flow . It can also cause thrombophlebitis by irritating the vein wall and activating platelets.
- It should be given for short-term use only (up to 5 days) to avoid renal impairment or gastrointestinal bleeding .
Ketorolac can cause renal impairment by reducing the glomerular filtration rate and causing sodium and water retention, edema, hypertension, and acute renal failure . It can also cause gastrointestinal bleeding by inhibiting the synthesis of prostaglandins that maintain mucosal blood flow and integrity .
