Pain killer medications come with clear instructions on use, including the duration of use. Due to the mechanism of action of certain categories of pain killers, extended use can cause severe harm. Toradol is regarded as an effective pain killer medication belonging to the category of nonsteroidal anti-inflammatory drugs for moderate to severe pain. A common question of patients and caregivers regarding the drug is – how and where is the Toradol injection given? Following sub sections offer a detailed look at the drug including the mechanism of action and recommended actions or instructions for patients. This will help proper use of the medication and mitigate the possibility of undesirable effects.

Overview of Ketorolac tromethamine

Toradol is the branded version of ketorolac tromethamine and presently is available only as a generic version. Available in several forms, including oral tablets, injections, and eye drops, the injection is typically used for short-term pain relief after surgery or injury. This is administered in a clinic or hospital setting by trained healthcare specialists. It is not recommended for use in patients with a history of stomach ulcers or bleeding, severe kidney disease, or allergy to aspirin or other NSAIDs.

Mechanism of action of Toradol (ketorolac tromethamine)

The drug works by inhibiting the production of prostaglandins, substances in the body that cause pain and inflammation and are involved in inflammatory response and pain signaling. It inhibits both cyclooxygenase (COX) 1 and COX-2 enzymes, responsible for producing prostaglandins from arachidonic acid. COX-1 is involved in the production of prostaglandins that have a role in homeostatic functions, including maintaining gastrointestinal mucosal integrity and regulation of renal blood flow. COX-2 is a response to inflammation and injury, and produces prostaglandins that cause pain, fever, and inflammation.

By inhibiting both COX-1 and COX-2, the medication reduces inflammation and relieves pain. However, as COX-1 has a role in maintaining normal physiological functions, the medication exposes patients to certain risks. For instance, gastrointestinal bleeding and kidney damage are a possibility when the drug is used for an extensive period or when taken in high doses.

What are the different forms of Toradol?

The drug is presently available as a generic version in in different forms, including oral tablets, injection, nasal spray, and eye drops. The tablets are typically used for short-term pain relief, such as after surgery or injury. Injections are generally used for short-term pain relief, post-surgery or after an injury. The nasal spray is a new form used to treat migraines and is sprayed into the nostrils to provide quick relief of headache pain. Eye drops are used to treat pain and inflammation experienced by patients after certain types of eye surgery.

The choice of the form of Ketorolac tromethamine depends on location of the pain, the type of pain, and the severity of the pain, apart from other medications in use.

Side effects of Toradol

All medications expose patients to risk of possible undesirable effects, and medications that are of NSAIDs category have distinct effects. Some of the commonly reported effects include:

In addition to the above, other infrequently reported, yet serious side effects of the medication include the following:

It is important to note that the above effects are not necessarily experienced by all patients. The risk of is elevated when the drug is used for an extended period of time or when taken in high doses. Additionally, patients with a history of certain medical conditions – bleeding disorders, stomach ulcers, kidney problems, or heart disease are likely to be exposed to aggravation of symptoms.

Drug interactions of Toradol

The NSAID may interact with other medications, including prescription drugs and OTC products. This could affect the effectiveness of either of the medications and could increase the risk of side effects. Some of the common drug interactions include the following:

#1 When taken along with other NSAIDS, including aspirin/ibuprofen, as this could increase the risk of stomach ulcers and bleeding.

#2 When taken along with blood thinners, including warfarin/heparin, as this could increase the risk of bleeding.

#3 When the drug is taken along with antiplatelet drugs, including clopidogrel or ticlopidine, as this could also increase the risk of bleeding.

#4 When the drug is taken along with SSRIs and SNRIs, used to treat depression and anxiety, as this can increase the risk of bleeding.

#5 When the drug is taken along with Lithium, used to treat bipolar disorder, as this can increase the levels of the NSAID in the blood, resulting in increased risk of side effects.

#6 When Toradol is taken with methotrexate, prescribed to treat cancer and autoimmune diseases, the patient may be exposed to risk of kidney damage.

How and where is the Toradol injection given?

The injection is usually given in the muscle (intramuscular) or in the vein (intravenous). When given intramuscularly, the injection is typically administered in the large muscle of the buttock or in the upper arm. When administered intravenously, the medication is administered directly into a vein, typically through an IV line in the arm.

Toradol is typically used for short-term pain relief, and is not intended for long-term use. The ideal maximum period of use of the medication depends on the individual patient’s medical condition, and is usually up to a maximum of 5 days for pain management. This could be moderate to severe pain, including post-operative pain or pain due to injuries. The reason for restricting use of the drug to a short period is the possibility of increased risk of side effects, including stomach ulcers, bleeding, and kidney damage. Patients and caregivers are to diligently follow instructions and use Toradol only as directed by the healthcare provider.  Under no circumstances, should its use exceed the recommended duration.

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