Injectable Nonsteroidal Anti-Inflammatory Drugs in Sport

Abstract

Nonsteroidal anti-inflammatory drug medications are currently used at every level of competition. Injectable ketorolac is an effective analgesic and anti-inflammatory drug. However, its potential effectiveness must be weighed against the risk of potential complications in all athletes, especially those who participate in contact/collision sports. The team physician must balance the goal of treating pain and inflammation with the ethical implications and medical considerations inherent in the administration of injectable medications solely to prevent pain and/or return the athlete to competition.

Effects of repeated treatment with monoamine-transporter-inhibitor antidepressants on pain-related depression of intracranial self-stimulation in rats

“…Ketorolac also blocked IP acidinduced weight loss. These findings are consistent with the analgesic effectiveness of ketorolac in human and veterinary medicine (Litvak and McEvoy 1990;Matava 2018;Mathews et al not certified by peer review) is the author/funder. All rights reserved.…”

“…morphine) and nonsteroidal anti-inflammatory drugs (NSAIDs, e.g. ketorolac) are among the most widely used analgesics for treatment of moderate to severe pain, but they are not always effective, and their use is often constrained by side effects (Litvak and McEvoy 1990;Matava 2018;Yaksh and Wallace 2018). Drugs that inhibit the norepinephrine transporter (NET), serotonin transporter (SERT), and/or dopamine transporter (DAT) represent another class of drugs that is sometimes used to treat pain (Obata 2017;Sutherland et al 2018).…”

Effects of Repeated Treatment with Monoamine-Transporter-Inhibitor Antidepressants on Pain-Related Depression of Intracranial Self-Stimulation in Rats

“…Ketorolac also blocked IP acidinduced weight loss. These findings are consistent with the analgesic effectiveness of ketorolac in human and veterinary medicine (Litvak and McEvoy 1990;Matava 2018;Mathews et al 1996) and also agree with our previous report that acute ketorolac treatment blocked acute IP acid-induced ICSS depression (Moerke et al 2019). Ketorolac and other NSAIDs can produce gastric ulceration upon repeated exposure, and this in turn has the potential to reduce body weight; however, the dosing regimen used here in the absence or presence of repeated IP acid was not sufficient to alter body weight.…”

Injectable Ketorolac and Corticosteroid Use in Athletes: A Systematic Review

“…24 Additionally, increasing the dose of ketorolac beyond a daily maximum of 40 mg in adults does not provide improved efficacy, but will increase the risk of developing serious adverse events. 14…”

“…24 Additionally, increasing the dose of ketorolac beyond a daily maximum of 40 mg in adults does not provide improved efficacy, but will increase the risk of developing serious adverse events. 14 NSAIDs should also be avoided in athletes with a history of baseline renal disease. Healthy adults experience transient decreases in renal blood flow and glomerular filtration rate while on a salt-restricted diet.…”