ケトロラク

動物種別の用量

用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。

投与経路

禁忌

• Active GI ulcers
• History of hypersensitivity to ketorolac
• Pre-existing hematologic, renal, or hepatic disease (relative contraindication)
• Known hypersensitivity to NSAIDs
• Use with extreme caution in patients with deep or progressive corneal ulcers

有害事象

• Gastrointestinal ulceration and erosion
• Gastrointestinal perforation
• Renal toxicity
• Hepatic toxicity
• Platelet inhibition (increased bleeding risk)
• Local ocular irritation
• Delayed corneal epithelial healing
• Increased intraocular pressure (IOP)
• Corneal 'melting' (keratomalacia) - reported in humans, theoretical risk in animals

薬物相互作用

• ACE INHIBITORS · Increased risk for nephrotoxicity
• ALPRAZOLAM · Hallucinations reported in some human patients taking with ketorolac
• AMINOGLYCOSIDES (gentamicin, amikacin, etc.) · Increased risk for nephrotoxicity
• ANTICOAGULANTS (heparin, LMWH, warfarin) · Increased risk for bleeding possible
• ASPIRIN · Increased likelihood of GI adverse effects (blood loss)
• BISPHOSPHONATES (alendronate, etc.) · May increase risk for GI ulceration
• CORTICOSTEROIDS · Concomitant administration with NSAIDs may significantly increase the risks for GI adverse effects
• CYCLOSPORINE · May increase risk for nephrotoxicity
• FLUCONAZOLE · May increase NSAID levels
• FLUOXETINE · Hallucinations reported in some human patients taking with ketorolac
• FUROSEMIDE · Ketorolac may reduce the saluretic and diuretic effects of furosemide
• METHOTREXATE · Serious toxicity has occurred when NSAIDs have been used concomitantly; use together with extreme caution
• MUSCLE RELAXANTS, NONDEPOLARIZING · Ketorolac may potentiate effects

モニタリング

• Analgesic and anti-inflammatory efficacy
• Gastrointestinal signs (appetite, vomiting, diarrhea, occult blood in feces)
• Renal function parameters (BUN, creatinine, urinalysis) with repeated use
• Intraocular pressure (IOP), especially in predisposed breeds
• Corneal healing via fluorescein staining
• Signs of corneal melting or worsening ulceration

過量投与

Ketorolac has a narrow margin of safety in small animals. - **Cats**: Have developed renal toxicity at doses as low as 0.7 mg/kg. - **Mice**: The oral LD50 is 200 mg/kg. - **Clinical Signs**: GI effects, including severe GI ulceration and bleeding, are highly likely in overdoses in small animals. Metabolic acidosis has been reported in humans. - **Treatment**: Consider GI emptying for large, recent overdoses. Patients must be closely monitored for GI bleeding and renal impairment. Treat aggressively with GI protectants (sucralfate) and consider giving misoprostol early.