Toradol

[BlueBear]

i have seen many of my post op joints and trauma patients get good relief with toradol. but yesterday i was speaking with one of the sugeons about it and he said it should never be given to a post op ortho patient because almost all are being anticoagulated. apparently, toradol cannot be used with coumadin, lovenox, asa, or fragmin as it can cause an intracranial bleed. anyone else have any thoughts on this?

[OrthoNutter]

Our consultants don't like toradol on post-ops or pre-ops. Only people they give it to really are back pains, arthritis...stuff like that. Like the above, they would really crack up if one of the post-ops or pre-ops got toradol. Drug of choice for pain relief at the moment seems to be oxycodone orally or morphine s/c or im.

[Sleepyeyes]

Thanks so much for the heads-up! Very useful info! :)

[sunnygirl272]

Originally posted by alkat

How many days s/p hip surgery can you use these drugs? If they are three or four days post-op. can you use them?

as a home care nurse, i am also curious..not about toradol, but the other NSAIDs and s/p joint replacements...after discharge from hospital...

[Nurse Jenni]

Hey thanks for the great info everbody..I just stumbled in to this one, and guess what...I just accepted a job on ortho/trauma unit this week! i got lucky!

[groggy]

toradol is classified as an nsaid right? can you give it to a patient with gastric bleed? i know of one md who prescribed it to a patient, whom he does not know has hx of gastric bleed.undefined

[zambezi, BSN, RN]

Toradol is on our standing orders for our post-open heart patients. Some of our exclusion criteria include hx of peptic ulcer disease, creat >1.2, allergy to NSAIDS, and a few others...it is too bad that it can't be used more often as it really works well for most people.

[nursern20]

Wow, I had one pt on our medsurg floor who was in with a hip fx but was his trip to the OR kept getting delayed d/t other acute problems like resp. problems. So they kept him on toradol round the clock for like over two weeks. At the same time they diagnosed him with multiple DVT's so they also had him on scheduled lovenox as well.

[Roy Fokker, BSN, RN]

Toradol is actually on our standing orders for post-op knees and hips!

The only guy I know who doesn't use Toradol is the ortho doc who does backs - but he liberally precribes Lorcets/Vicodin etc. (NSAIDs).

While I did know about the 72 hrs limit d/t kidney/liver - I had NO idea Toradol was a no-no with ortho surgeries and it's conflict with anti-coags!

cheers,

[Diary/Dairy, RN]

Thanks all for the useful med info!!!

[suehp]

We have Toradol on our post op orders and usually it is given in PACU before they come up to the unit. (as a one off dose) BUT I have seen some patients that have had it ordered for about 6 doses...

thanks for the info

[cdm.rn2006]

We have given Toradol to post-op joints in my hospital but it's usually just a one time dose.

[NJNursing, ASN, RN]

None of our ortho docs prescribe toradol post-operatively. It's often a morphine PCA or if they do really well, morphine IV with Percocet for breakthrough. In recent years there has been a study with Toradol and anti-coagulants. All our patients are put on Lovenox BID (or at least daily) post-operatively.