DENTAL USE OF KETOROLAC TROMETHAMINE: STATUS AND FUTURE PERSPECTIVES
DOI:
https://doi.org/10.22159/ijap.2023v15i2.46862Keywords:
Nonsteroidal anti-inflammatory drug, Dentistry, In situ implant, Postoperative analgesia, KetorolacAbstract
The history of evidence-based use of non-steroidal anti-inflammatory drugs (NSAIDs) goes back at least two hundred and fifty years. Over the past period, the path has been passed from the use of willow bark decoctions to the synthesis and introduction of selective cyclooxygenase inhibitors into clinical practice. To date, the research direction has shifted from the search for new substances to the search for new routes of administration. The wide range of existing drug substances, however, has only in a few dosage forms. Thus, ketorolac tromethamine is known only as a solution for parenteral and intranasal administration, as well as oral tablets. This drug belongs to NSAIDs, particularly non-selective cyclooxygenase inhibitors, and shows a pronounced analgesic activity. Due to this property, ketorolac can serve as an alternative to opioid analgesics or can reduce the dosage of the latter when used in combination. However, a number of systemic side effects (ulcerogenic properties, negative effect on the blood), unfortunately, impose their limitations. A possible solution to this situation may be the creation of local delivery systems, in particular, in situ implants. This review highlights the problem of developing local systems for the delivery of ketorolac tromethamine for the relief of acute pain. Special attention is paid to in situ implants based on bioadhesive polymers.
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References
Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249-60. doi: 10.1016/S0140-6736(19)31146-8, PMID 31327369.
Petermann H, Goerig M. History of anesthesia: ”From narcosis to perioperative homeostasis”. Anaesthesist. 2016;65(10):787-808. doi: 10.1007/s00101-016-0223-y, PMID 27654500.
Rao P, Knaus EE. Evolution of nonsteroidal anti-inflammatory drugs (NSAIDs): cyclooxygenase (COX) inhibition and beyond. J Pharm Pharm Sci. 2008;11(2):81s-110s. doi: 10.18433/j3t886, PMID 19203472.
Kakariqi L, Xhaxho S, Deda L, Vyshka G. Consumption trend of opioids in ambulatory patients in Albania 2014-2019. Asian J Pharm Clin Res. 2021;14(11):124-8. doi: 10.22159/ajpcr.2021.v14i11.42988.
Pergolizzi JV, Magnusson P, LeQuang JA, Breve F, Taylor R, Wollmuth C. Can NSAIDs and acetaminophen effectively replace opioid treatment options for acute pain? Expert Opin Pharmacother. 2021;22(9):1119-26. doi: 10.1080/ 14656566.2021.1901885, PMID 33689517.
Hersh EV, Moore PA, Grosser T, Polomano RC, Farrar JT, Saraghi M. Nonsteroidal anti-inflammatory drugs and opioids in postsurgical dental pain. J Dent Res. 2020;99(7):777-86. doi: 10.1177/0022034520914254, PMID 32286125.
Bresalier RS, Sandler RS, Quan H, Bolognese JA, Oxenius B, Horgan K. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med. 2005;352(11):1092-102. doi: 10.1056/NEJMoa050493. PMID 15713943.
Drugs and lactation database (LactMed). Bethesda: National Institute of Child Health and Human Development. Valdecoxib; 2006. Avaliable from: https://www.ncbi.nlm.nih.gov/ books/NBK501133. [Last accessed on 25 Dec 2022]
Department of Scientific Information, ADA Science Institute. Oral Health topics: oral analgesics for acute dental pain; 2022. Avaliable from: https://www.ada.org/en/member-center/OralHealth-topics/oral-analgesics-for-acute-dental-pain. [Last accessed on 26 Dec 2022]
Yee J, Brown CR, Sevelius H, Wild V. The analgesic efficacy of(±)‐5‐benzoyI‐1,2‐dihydro‐3H‐pyrrolo‐(1.2a)pyrrole‐1‐carboxylic acid tromethamine salt (B) in post-operative pain. Clin Pharmacol Ther. 1984;35:285.
Gillies GW, Kenny GN, Bullingham RE, McArdle CS. The morphine-sparing effect of ketorolac tromethamine. A study of a new, parenteral non-steroidal anti-inflammatory agent after abdominal surgery. Anaesthesia. 1987;42(7):727-31. doi: 10.1111/j.1365-2044.1987.tb05317.x. PMID 3307518.
Henry DA, Johnston A, Dobson A, Duggan J. Fatal peptic ulcer complications and the use of non-steroidal anti-inflammatory drugs, aspirin, and corticosteroids. Br Med J (Clin Res Ed). 1987;295(6608):1227-9. doi: 10.1136/bmj.295.6608.1227, PMID 3120956.
Poveda Roda R, Bagan JV, Jimenez Soriano Y, Gallud Romero L. Use of nonsteroidal anti-inflammatory drugs in dental practice. A review. Med Oral Patol Oral Cir Bucal. 2007;12(1):E10-8. PMID 17195821.
Phillips Reed LD, Austin PN, Rodriguez RE. Pediatric tonsillectomy and ketorolac. J Perianesth Nurs. 2016;31(6):485-94. doi: 10.1016/j.jopan.2015.02.005. PMID 27931700.
Maslin B, Lipana L, Roth B, Kodumudi G, Vadivelu N. Safety considerations in the use of ketorolac for postoperative pain. Curr Drug Saf. 2017;12(1):67-73. doi: 10.2174/1574886311666160719154420, PMID 27440142.
Gobble RM, Hoang HLT, Kachniarz B, Orgill DP. Ketorolac does not increase perioperative bleeding: a meta-analysis of randomized controlled trials. Plast Reconstr Surg. 2014;133(3):741-55. doi: 10.1097/01.prs.0000438459.60474.b5, PMID 24572864.
Vadivelu N, Gowda AM, Urman RD, Jolly S, Kodumudi V, Maria M. Ketorolac tromethamine–routes and clinical implications. Pain Pract. 2015;15(2):175-93. doi: 10.1111/papr.12198, PMID 24738596.
Meta IF, Bermolen M, Macchi R, Aguilar J. Randomized controlled trial comparing the effects of 2 analgesic drug protocols in patients who received 5 dental implants. Implant Dent. 2017;26(3):412-6. doi: 10.1097/ID.0000000000000544, PMID 28114265.
Martins-de-Barros AV, Barros AM, Siqueira AK, Lucena EE, Sette de Souza PH, Araújo FA. Is dexamethasone superior to ketorolac in reducing pain, swelling and trismus following mandibular third molar removal? A split-mouth triple-blind randomized clinical trial. Med Oral Patol Oral Cir Bucal. 2021;26(2):e141-50. doi: 10.4317/medoral.24088, PMID 33247572.
Evangelin J, Sherwood IA, Abbott PV, Uthandakalaipandian R, Velu V. Influence of different irrigants on substance P and IL-8 expression for single visit root canal treatment in acute irreversible pulpitis. Aust Endod J. 2020;46(1):17-25. doi: 10.1111/aej.12340, PMID 31270902.
Praveen R, Thakur S, Kirthiga M. Comparative evaluation of premedication with ketorolac and prednisolone on post endodontic pain: A double-blind, randomized controlled trial. J Endod. 2017;43(5):667-73. doi: 10.1016/j.joen.2016.12.012. PMID 28320541.
Degala S, Nehal A. Comparison of intravenous tramadol versus ketorolac in the management of postoperative pain after oral and maxillofacial surgery. Oral Maxillofac Surg. 2018;22(3):275-80. doi: 10.1007/s10006-018-0700-3, PMID 29845481.
Mishra H, Khan FA. A double-blind, placebo-controlled randomized comparison of pre and postoperative administration of ketorolac and tramadol for dental extraction pain. J Anaesthesiol Clin Pharmacol. 2012;28(2):221-5. doi: 10.4103/0970-9185.94892, PMID 22557747.
Hungund S, Thakkar R. Effect of pretreatment with ketorolac tromethamine on operative pain during periodontal surgery: A case-control study. J Indian Soc Periodontol. 2011;15(1):55-8. doi: 10.4103/0972-124X.82274, PMID 21772723.
Aggarwal V, Singla M, Rizvi A, Miglani S. Comparative evaluation of local infiltration of articaine, articaine plus ketorolac, and dexamethasone on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis. J Endod. 2011;37(4):445-9. doi: 10.1016/j.joen.2011.01.016. PMID 21419287.
Akhlaghi NM, Hormozi B, Abbott PV, Khalilak Z. Efficacy of ketorolac buccal infiltrations and inferior alveolar nerve blocks in patients with irreversible pulpitis: A prospective, double-blind, randomized clinical trial. J Endod. 2016;42(5):691-5. doi: 10.1016/j.joen.2016.02.003. PMID 26964901.
Nagendrababu V, Pulikkotil SJ, Veettil SK, Teerawattanapong N, Setzer FC. Effect of nonsteroidal anti-inflammatory drug as an oral premedication on the anesthetic success of inferior alveolar nerve block in treatment of irreversible pulpitis: A systematic review with meta-analysis and sequential trial analysis. J Endod. 2018;44(6):914-922.e2. doi: 10.1016/j.joen.2018.02.017. PMID 29709297.
Sivaramakrishnan G, Sridharan K. Oral ketorolac with inferior alveolar nerve block for irreversible pulpitis: A systematic review and meta-analysis. Open Dent J. 2018;12:340-6. doi: 10.2174/1874210601812010340, PMID 29875886.
Nivedha V, Sherwood IA, Abbott PV, Ramaprabha B, Bhargavi PV. Pre-operative ketorolac efficacy with different anesthetics, irrigants during single visit root canal treatment of mandibular molars with acute irreversible pulpitis. Aust Endod J. 2020;46(3):343-50. doi: 10.1111/aej.12407, PMID 32243716.
Niebler G, Dayno J. Effect size comparison of ketorolac nasal spray and commonly prescribed oral combination opioids for pain relief after third molar extraction surgery. Postgrad Med. 2016;128(1):12-7. doi: 10.1080/00325481.2016.1126185, PMID 26616001.
Paderni C, Compilato D, Giannola LI, Campisi G. Oral local drug delivery and new perspectives in oral drug formulation. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(3):e25-34. doi: 10.1016/j.oooo.2012.02.016. PMID 22771408.
H RR, Dhamecha D, Jagwani S, Rao M, Jadhav K, Shaikh S. Local drug delivery systems in the management of periodontitis: a scientific review. J Control Release. 2019;307:393-409. doi: 10.1016/j.jconrel.2019.06.038. PMID 31255689.
Garala K, Joshi P, Shah M, Ramkishan A, Patel J. Formulation and evaluation of periodontal in situ gel. Int J Pharm Investig. 2013;3(1):29-41. doi: 10.4103/2230-973X.108961, PMID 23799203.
Craciunescu O, Seciu A, Manoiu VS, Trif M, Moisei M, Nicu AI. Biosynthesis of silver nanoparticles in collagen gel improves their medical use in periodontitis treatment. Part Sci Technol. 2019;37(6):757-63. doi: 10.1080/02726351.2018.1455780.
Phaechamud T, Jantadee T, Mahadlek J, Charoensuksai P, Pichayakorn W. Characterization of antimicrobial agent loaded Eudragit RS solvent exchange-induced in situ forming gels for periodontitis treatment. AAPS PharmSciTech. 2017;18(2):494-508. doi: 10.1208/s12249-016-0534-y, PMID 27116203.
Dabhi MR, Nagori SA, Gohel MC, Parikh RK, Sheth NR. Formulation development of smart gel periodontal drug delivery system for local delivery of chemotherapeutic agents with an application of experimental design. Drug Deliv. 2010;17(7):520-31. doi: 10.3109/10717544.2010.490247, PMID 20553104.
Reise M, Wyrwa R, Muller U, Zylinski M, Volpel A, Schnabelrauch M, Berg A, Jandt KD, Watts DC, Sigusch BW. Release of metronidazole from electrospun poly(L-lactide-co-D/L-lactide) fibers for local periodontitis treatment. Dent Mater. 2012;28(2):179-88. doi: 10.1016/j.dental.2011.12.006. PMID 22226009.
Pichayakorn W, Boonme P. Evaluation of cross-linked chitosan microparticles containing metronidazole for periodontitis treatment. Mater Sci Eng C Mater Biol Appl. 2013;33(3):1197-202. doi: 10.1016/j.msec.2012.12.010. PMID 23827560.
Saboktakin MR, Tabatabaie RM, Maharramov A, Ramazanov MA. Development and in vitro evaluation of thiolated chitosan-poly(methacrylic acid) nanoparticles as a local mucoadhesive delivery system. Int J Biol Macromol. 2011;48(3):403-7. doi: 10.1016/j.ijbiomac.2010.12.014. PMID 21215774.
Ruan H, Yu Y, Liu Y, Ding X, Guo X, Jiang Q. Preparation and characteristics of thermoresponsive gel of minocycline hydrochloride and evaluation of its effect on experimental periodontitis models. Drug Deliv. 2016;23(2):525-31. doi: 10.3109/10717544.2014.929195, PMID 24963751.
Madhumathi K, Jeevana Rekha L, Sampath Kumar TS. Tailoring antibiotic release for the treatment of periodontal infrabony defects using bioactive gelatin-alginate/apatite nanocomposite films. J Drug Deliv Sci Technol. 2018;43:57-64. doi: 10.1016/j.jddst.2017.09.015.
MA Fathalla ZMA, Vangala A, Longman M, Khaled KA, Hussein AK, El-Garhy OH. Poloxamer-based thermoresponsive ketorolac tromethamine in situ gel preparations: design, characterization, toxicity and transcorneal permeation studies. Eur J Pharm Biopharm. 2017;114:119-34. doi: 10.1016/j.ejpb.2017.01.008. PMID 28126392.
Bhowmik M, Das S, Chattopadhyay D, Ghosh LK. Study of thermo-sensitive in-situ gels for ocular delivery. Sci Pharm. 2011;79(2):351-8. doi: 10.3797/scipharm.1010-04, PMID 21773071.
Singh M, Dev D. Acacia catachu gum in situ forming gels with prolonged retention time for ocular drug delivery. Asian J Pharm Clin Res. 2022;15:33-40. doi: 10.22159/ajpcr.2022.v15i9.45269.
Yang JH, Yun MY, Kim DK, Kim MJ, Kim YI, Kim TY, Yang KH, Shin SC. Preparation and evaluation of ketorolac tromethamine gel containing genipin for periodontal diseases. Arch Pharm Res. 2007;30(7):871-5. doi: 10.1007/BF02978839, PMID 17703740.
Alsarra IA, Alanazi FK, Mahrous GM, Abdel Rahman AA, Al Hezaimi KA. Clinical evaluation of novel buccoadhesive film containing ketorolac in dental and post-oral surgery pain management. Pharmazie. 2007;62(10):773-8. PMID: 18236783.
Vigani B, Rossi S, Sandri G, Bonferoni MC, Caramella CM, Ferrari F. Recent advances in the development of in situ gelling drug delivery systems for non-parenteral administration routes. Pharmaceutics. 2020;12(9):859. doi: 10.3390/pharmaceutics12090859, PMID 32927595.
Rossi S, Marciello M, Bonferoni MC, Ferrari F, Sandri G, Dacarro C, Grisoli P, Caramella C. Thermally sensitive gels based on chitosan derivatives for the treatment of oral mucositis. Eur J Pharm Biopharm. 2010;74(2):248-54. doi: 10.1016/j.ejpb.2009.10.003. PMID 19854272.
Vigani B, Faccendini A, Rossi S, Sandri G, Bonferoni MC, Gentile M, Ferrari F. Development of a mucoadhesive and in situ gelling formulation based on κ-carrageenan for application on oral mucosa and esophagus walls. I. A functional in vitro characterization. Mar Drugs. 2019;17(2):112. doi: 10.3390/md17020112, PMID 30759831.
Allam A, El-Mokhtar MA, Elsabahy M. Vancomycin-loaded niosomes integrated within pH-sensitive in situ forming gel for the treatment of ocular infections while minimizing drug irritation. J Pharm Pharmacol. 2019;71(8):1209-21. doi: 10.1111/jphp.13106, PMID 31124593.
Noreen S, Ghumman SA, Batool F, Ijaz B, Basharat M, Noureen S, Kausar T, Iqbal S. Terminalia Arjuna gum/alginate in situ gel system with prolonged retention time for ophthalmic drug delivery. Int J Biol Macromol. 2020;152:1056-67. doi: 10.1016/j.ijbiomac.2019.10.193. PMID 31751751.
Sandri G, Bonferoni MC, Ferrari F, Rossi S, Del Fante C, Perotti C, Gallanti A, Caramella C. An in situ gelling buccal spray containing platelet lysate for the treatment of oral mucositis. Curr Drug Discov Technol. 2011;8(3):277-85. doi: 10.2174/157016311796799017, PMID 21644923.
Kassem AA, Ismail FA, Naggar VF, Aboulmagd E. Comparative study to investigate the effect of meloxicam or minocycline HCl in situ gel system on local treatment of periodontal pockets. AAPS PharmSciTech. 2014;15(4):1021-8. doi: 10.1208/s12249-014-0118-7, PMID 24831089.
Do MP, Neut C, Delcourt E, Sexiixas Certo T, Siepmann J, Siepmann F. In situ forming implants for periodontitis treatment with improved adhesive properties. Eur J Pharm Biopharm. 2014;88(2):342-50. doi: 10.1016/j.ejpb.2014.05.006. PMID 24833006.
Bakhrushina EO, Nikiforova DA, Demina NB. The main aspects of the thermoreversible poly-complexes of poloxamers developing. The Journal of Scientific Articles Health and Education Millenniumzdor Obraz XXI Veke. 2018;20(5):103-6. doi: 10.26787/nydha-2226-7425-2018-20-5-103-106.
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