The pharmacokinetics of intravenous ketorolac in children aged 2 months to 16 years: A population analysis

McLay, James S.; Engelhardt, Thomas; Mohammed, Baba Sulemana; Cameron, Gary; Cohen, Mindy; Galinkin, Jeffrey L.; Christians, Uwe; Avram, Michael J.; Henthorn, Thomas K.; Dsida, Richard M.; Hawwa, Ahmed F.; Anderson, Brian J.

doi:10.1111/pan.13302

Cited by 11 publications

(7 citation statements)

References 38 publications

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“…Ketorolac is recovered in the urine mainly in its metabolite form. When intravenous ketorolac PK were studied in children aged 2 months to 16 years, it was found that from infancy CL decreased with age [ 50 ]. This study concluded that a dose of 0.5 mg/kg every 6 h was sufficient to keep trough concentrations above 0.37 mg/L, which produced sufficient analgesia postoperatively.…”

Section: Pharmacokinetics Of Non-steroidal Anti-inflammatory Drugs (N...mentioning

confidence: 99%

Efficacy and Safety of NSAIDs in Infants: A Comprehensive Review of the Literature of the Past 20 Years

Ziesenitz

Welzel²,

Dyk³

et al. 2022

Pediatr Drugs

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Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in infants, children, and adolescents worldwide; however, despite sufficient evidence of the beneficial effects of NSAIDs in children and adolescents, there is a lack of comprehensive data in infants. The present review summarizes the current knowledge on the safety and efficacy of various NSAIDs used in infants for which data are available, and includes ibuprofen, dexibuprofen, ketoprofen, flurbiprofen, naproxen, diclofenac, ketorolac, indomethacin, niflumic acid, meloxicam, celecoxib, parecoxib, rofecoxib, acetylsalicylic acid, and nimesulide. The efficacy of NSAIDs has been documented for a variety of conditions, such as fever and pain. NSAIDs are also the main pillars of anti-inflammatory treatment, such as in pediatric inflammatory rheumatic diseases. Limited data are available on the safety of most NSAIDs in infants. Adverse drug reactions may be renal, gastrointestinal, hematological, or immunologic. Since NSAIDs are among the most frequently used drugs in the pediatric population, safety and efficacy studies can be performed as part of normal clinical routine, even in young infants. Available data sources, such as (electronic) medical records, should be used for safety and efficacy analyses. On a larger scale, existing data sources, e.g. adverse drug reaction programs/networks, spontaneous national reporting systems, and electronic medical records should be assessed with childspecific methods in order to detect safety signals pertinent to certain pediatric age groups or disease entities. To improve the safety of NSAIDs in infants, treatment needs to be initiated with the lowest age-appropriate or weight-based dose. Duration of treatment and amount of drug used should be regularly evaluated and maximum dose limits and other recommendations by the manufacturer or expert committees should be followed. Treatment for non-chronic conditions such as fever and acute (postoperative) pain should be kept as short as possible. Patients with chronic conditions should be regularly monitored for possible adverse effects of NSAIDs.

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Section: Pharmacokinetics Of Non-steroidal Anti-inflammatory Drugs (N...mentioning

confidence: 99%

Efficacy and Safety of NSAIDs in Infants: A Comprehensive Review of the Literature of the Past 20 Years

Ziesenitz

Welzel²,

Dyk³

et al. 2022

Pediatr Drugs

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show abstract

“…Esto es discutible ya que, al menos con el uso de paracetamol, las presentaciones endovenosas no son más efectivas que las orales y el costo es más elevado [2]. Con respecto a ketorolaco, éste es ampliamente usado en niños (0,5 mg/Kg/dosis) [10] sin embargo, no está aprobado por la FDA. Una revisión sistemática Cochrane 2018, muestra que no hay evidencia suficiente para recomendar su uso, ni tampoco para evaluar su seguridad [11].…”

Section: Dolor Posoperatorio En Cirugía Ambulatoria Pediátricaunclassified

Analgesia para cirugía pediátrica ambulatoria

Cárdenas¹,

Flores²

2021

Rev. chil. anest.

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“…In the article by McLay et al in Volume 28 Issue 2 of Pediatric Anesthesia, the penultimate author Ahmed F. Hawwa was inadvertently omitted.…”

Section: The Pharmacokinetics Of Intravenous Ketorolac In Children Agmentioning

confidence: 99%

Corrigendum

2018

Pediatric Anesthesia

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The pharmacokinetics of intravenous ketorolac in children aged 2 months to 16 years: A population analysis

Abstract: Clearance, expressed as L h kg , decreased with age from infancy. A dosing regimen of 0.5 mg kg every 6 hours maintains a trough concentration larger than 0.37 mg L in children 9 months to 16 years of age. This dosing regimen is consistent with current recommendations.

Cited by 11 publications

References 38 publications

Efficacy and Safety of NSAIDs in Infants: A Comprehensive Review of the Literature of the Past 20 Years

Efficacy and Safety of NSAIDs in Infants: A Comprehensive Review of the Literature of the Past 20 Years

Analgesia para cirugía pediátrica ambulatoria

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