Nonsteroidal anti-inflammatory drugs in ophthalmology

Oral:
Diclofenac potassium liquid-filled capsules: 25 mg orally 4 times a day
Diclofenac free acid capsules: 18 mg or 35 mg orally 3 times a day
Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day; an initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief in some patients.

Comment: Neither the potassium base liquid filled capsules nor the free acid capsules are interchangeable with each other or with other diclofenac products containing the sodium or potassium salt.

Parenteral:
mg IV bolus over 15 seconds every 6 hours as needed for pain
Maximum Dose: 150 mg per day

Comment: Patients should be well hydrated prior to IV administration of this drug in order to reduce the risk of adverse renal reactions.

Uses: For the management of mild to moderate acute pain (oral, IV) and moderate to severe pain alone or in combination with opioid analgesics (IV).

SOURCES: Byron Cryer, MD, spokesman, American Gastroenterological Association; associate professor of medicine, University of Texas Southwestern Medical Center, Dallas. Nieca Goldberg, MD, spokeswoman for the American Heart Association; chief of women's cardiac care, Lennox Hill Hospital, New York; author, Women Are Not Small Men: Lifesaving Strategies For Preventing And Healing Heart Disease In Women . John Klippel, MD, president and CEO, Arthritis Foundation, Atlanta. Scott Zashin, clinical assistant professor, University of Texas Southwestern Medical Center; author of Arthritis Without Pain . American College of Rheumatology web site. Arthritis Foundation web site. American Heart Association web site. American College of Gastroenterology web site. American Gastroenterological Association web site. American Academy of Family Physicians web site. American Academy of Allergy, Asthma, and Immunology web site.

Meloxicam use can result in gastrointestinal toxicity and bleeding, headaches, rash, and very dark or black stool (a sign of intestinal bleeding). Like other NSAIDs , its use is associated with an increased risk of cardiovascular events such as heart attack and stroke . [5] It has fewer gastrointestinal side effects than diclofenac , [6] piroxicam , [7] naproxen , [8] and perhaps all other NSAIDs which are not COX-2 selective. [6] Although meloxicam inhibits formation of thromboxane A, it does not appear to do so at levels that would interfere with platelet function.

Limited data suggest a possible role of ketorolac in the management of other forms of acute pain, such as renal colic, biliary colic, sickle cell crisis or migraine headaches. Ketorolac is also useful in patients with a history of opiate dependency. It can be combined with opiate analgesia to achieve a sparing effect, although it will not prevent opiate withdrawal symptoms. If a patient receiving a low dose of ketorolac (., 15 mg every six hours) experiences a return of pain before the next dose, the dose may be increased to 30 mg before a narcotic analgesic is added or substituted.

Nonsteroidal anti-inflammatory drugs in ophthalmology

nonsteroidal anti-inflammatory drugs in ophthalmology

Limited data suggest a possible role of ketorolac in the management of other forms of acute pain, such as renal colic, biliary colic, sickle cell crisis or migraine headaches. Ketorolac is also useful in patients with a history of opiate dependency. It can be combined with opiate analgesia to achieve a sparing effect, although it will not prevent opiate withdrawal symptoms. If a patient receiving a low dose of ketorolac (., 15 mg every six hours) experiences a return of pain before the next dose, the dose may be increased to 30 mg before a narcotic analgesic is added or substituted.

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