Toradol

I agree that toradol must be used with caution, but monitoring platelet levels has little meaning. Toradol doesn't decrease the platelet count (it affects the arachodonic acid cycle and inhibits cyclo-oxygenase), it renders the platelet dysfunctional for a period of time (just like the other NSAIDS). A bleeding time can be used but is an unreliable test. INR could also be used. A TEG would be great, but these tests all costs money.

Mike

1) the only useful test is TEG (INR and platelets and bleeding time are useless).

2) it does NOT need to be administered with a narcotic in order to relieve pain. 30mg IV toradol is equi-analgesic to 10mg Morphine!!!

3) and who came up with those limits to IV and PO use??? the recommendations are not to exceed 5 days and that can be applied to IV as well.

Wow, I have learned a lot about phenergan in the last posts. Thanks, However I do have a question. What would happen if someone is given IV phenergan too much? Does it make them have weird symptoms? Tolerance? I mean if they are getting it everyday for about a week or so. Thanks, Curleysue

I agree with Tenesma, TEG is the test to use. If anyone has questions about toradol, Sota Omogui's Anesthesia Drug Handbook has more than enough info (MOA, morphine equivalency, etc)

Mike

I think that other countries have some other NSAIDs and salicylates for parenteral admin. in their formularies.

I like Toradol, and I think it works, but numerous studies have indicated that it is no better than oral ibuprofen for most types of pain.

define "no better"

Doesn't work any better than regular Ibuprofen and other anti inflammatories.

Let me rephrase:

A review of the relevant literature will indicate that oral ibuprofen is equally effective as Toradol injection for relieving most types of pain.

true but you are comparing something that can be given IV vs something that can only be given PO...

I am not sure how that is relevant to efficacy, but I am aware of the practical implications.