D) Ketorolac (brand name Toradol). The more COX-1 selective the NSAID, the more gastrointestinal side effects (increased stomach acid, decreased protective mucus, ulcers, and even GI bleeding and perforation). Of the commonly used NSAIDs, ketorolac is the most COX-1 selective > infomethacin > ketoprofen > aspirin > naproxen > ibuprofen. There is even higher risk with certain other concomitant drugs used (anti-platelet agents, anticoagulants, corticosteroids, SSRIs), H. pylori infection, alcohol & tobacco use, prior history of peptic ulcer. The more COX-2 selective the NSAID, the more cardiovascular side effects (eg celecoxib, diclofenac).
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February 17, 2021 at 1:20 am
D) Ketorolac (brand name Toradol). The more COX-1 selective the NSAID, the more gastrointestinal side effects (increased stomach acid, decreased protective mucus, ulcers, and even GI bleeding and perforation). Of the commonly used NSAIDs, ketorolac is the most COX-1 selective > infomethacin > ketoprofen > aspirin > naproxen > ibuprofen. There is even higher risk with certain other concomitant drugs used (anti-platelet agents, anticoagulants, corticosteroids, SSRIs), H. pylori infection, alcohol & tobacco use, prior history of peptic ulcer. The more COX-2 selective the NSAID, the more cardiovascular side effects (eg celecoxib, diclofenac).