Ketocetz Overdosage

Overdose: Overdose of NSAIDs, including ketorolac, may cause gastrointestinal irritation directly, and by inhibiting cyclooxygenase-1 which is necessary for the formation of the prostaglandins PG12 and PGE2. The acidosis associated with severe NSAIDs overdose is the result of the formation of acidic metabolites and mild hypotension. Overdose of NSAIDs also causes renal arteriolar constriction, reduced renal blood flow and subsequently renal insufficiency. In addition, platelet aggregation is inhibited, predisposing patients to bleeding.
Treatment: Most toxicity associated with NSAIDs overdose resolves with supportive care, decontamination with activated charcoal, and fluid and electrolyte replacement. There is no known specific antidote for NSAIDs overdose. In patients with CNS depression or recurrent seizures, benzodiazepines and airway management by intubation and mechanical ventilation should be considered. Hemodialysis is unlikely to be effective since NSAIDs are highly protein bound. However, renal replacement therapy may be necessary for acid-base and electrolyte correction.