Pharmacological action of Toradol.
Toradol has a pronounced analgesic effect, has also an anti-inflammatory and moderate antipyretic effect. The mechanism of action is associated with nonselective inhibition of the activity of COX1 and COX2 catalyzing the formation of Pg from arachidonic acid, which play an important role in the pathogenesis of pain, inflammation and fever. By the strength of the analgesic effect comparable to morphine, it significantly exceeds other NSAIDs. After intravenous administration and oral administration, the onset of analgesic action is observed respectively in 0.5 and 1 hour, the maximum effect is achieved after 1-2 hours and 2-3 hours.
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Indications for Toradol.
Pain syndrome of strong and moderate severity: trauma, dental pain, postpartum pain and postoperative, cancer, myalgia, arthralgia, neuralgia, lumbago, sprains, strains, rheumatic disease.
Contraindications for Toradol.
Hypersensitivity, “Aspirin” triad (combination of asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to ASA and PM pyrazolone series), hypovolemia (regardless of its cause), erosive and ulcerated gastrointestinal lesions in the acute stage, hypocoagulation (incl . hemophilia), bleeding or a high risk of their development, severe renal failure (plasma creatinine greater than 50 mg / l), hepatic failure, childbirth, lactation, children’s age (up to 16 years – the safety and efficacy are not tired) with cautious. Hypersensitivity to other NSAIDs, bronchial asthma, the presence of factors that increase gastrointestinal toxicity: alcoholism, tobacco smoking and cholecystitis; postoperative period, heart failure, edema syndrome, hypertension, renal failure (plasma creatinine below 50 mg / l), cholestasis, active hepatitis, sepsis, SLE, simultaneous with other NSAIDs, advanced age (over 65 years), pregnancy.
Side effects of Toradol.
Often – more than 3%, less often – 1-3%, rarely – less than 1%. From the digestive system: often – gastralgia, diarrhea; less often – stomatitis, flatulence, constipation, vomiting, sensation of stomach overflow; rare – loss of appetite, nausea, erosive and ulcerative lesions of the gastrointestinal tract (including with perforation and / or bleeding – abdominal pain, spasm or burning in the epic region, blood in feces or melena, vomiting with blood or by type ” coffee grounds, “nausea, heartburn, etc.), cholus static jaundice, hepatitis, hepatomegaly, acute pancreatitis. From the urinary system: rarely – acute renal failure, back pain, hematuria, azotemia, hemolytic-uremic syndrome (hemolytic anemia, renal failure, thrombocytopenia, purpura), increased urination, increased or decreased amount of urine, nephritis, edema of renal origin. From the senses: rarely: hearing loss, ringing in the ears, visual impairment (including blurred vision). On the part of the respiratory system: rarely – bronchospasm or dyspnoea, rhinitis, pulmonary edema, laryngeal edema (shortness of breath, difficulty breathing). CNS: often – headache, dizziness, drowsiness, rarely – aseptic meningitis (fever, severe headache, cramps, stiffness in the neck muscles and / or back), hyper-responsiveness (mood changes, anxiety), hallucinations, depression, psychosis, fainting state. On the part of the CAS: less often – an increase in blood pressure. Symptoms (with a single administration): abdominal pain, nausea, vomiting, erosive-ulcerative gastrointestinal lesion, impaired renal function, metabolic acidosis. Treatment: symptomatic (maintenance of vital body functions). Dialysis is ineffective.
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Dosing and Administration.
In / m, in / v and inside. For intravenous administration, the dose should be administered at least 15 seconds (for dosage forms containing ethanol). When administered orally to patients aged 16 to 64 years with a body weight exceeding 50 kg, the recommended dose is 20 mg for the first time, then 10 mg 4 times a day, but not more than 40 mg / day. Adult patients with a body weight of less than 50 kg or with kidney failure – 10 mg in the first dose and then 10 mg 4 times a day. The maximum daily dose for oral administration is 40 mg. For parenteral administration, patients between 16 and 64 years of age with a body weight exceeding 50 kg in / m for 1 administration are administered no more than 60 mg (including oral dose); usually 30 mg every 6 hours; in / v – 30 mg (not more than 15 doses for 5 days). In / m adult patients with a body weight of less than 50 kg or with CRF for 1 administration is administered no more than 30 mg (including oral dose); usually – 15 mg (no more than 20 doses in 5 days); in / v- no more than 15 mg every 6 hours (no more than 20 doses in 5 days). The maximum daily doses for in/m and in/v administration are for patients from 16 to 64 years with a body weight exceeding 50 kg, 90 mg / day; adult patients with a body weight of less than 50 kg or with CRF, as well as elderly patients (over 65 years of age) for intravenous and / or 60 mg injections. The duration of treatment should not exceed 5 days.