>Date: Fri, 03 May 1996 11:38:34
>To: [log in to unmask]
>From: MickorPam Koehler <[log in to unmask]>
>Subject: Toradol,Intro
>
>I have been a lurker for several months now (Hello to Johanna and Marty!)
and thought it was time to post. Every time I sit down at the computer to
get my daily e-mail I consider myself a lucky person to have found you all.
Thank you. I am an RN, IBCLC working part-time in a community hospital. I've
followed with interest the discussions a few weeks ago about
Toradol(Ketorolac) because it is a med we use routinely in our postpartum
moms. It is extremely effective for post surgical breakthrough pain IM or IV
in combination with a continuous epidural drip or a morphine PCA (patient
controlled analgesia). We also use it routinely after vaginal deliveries 4
doses 10 mg PO(by mouth) Q6h(every 6 hours). Recently, the anesthesiologist
said no breastfeeding with Toradol, the hospital pharmacy agrees. The Drs
originally accepted my information from the 1990 USPDI when we first started
using the drug several years ago. Dr. Hales book says AAP compatible. The
current USPDI says pretty much the same thing, that neonatal exposure is
minimal. When I called the UCSD drug line they said because the product info
says containdicated and the PDR has the warning in a black box, the liabilty
is prohibitive. The concern is that because it is a potent prostaglandin
inhibitor there is a risk of bleeding in the neonate. My concern is that
because we see great results with this med (more than with any substitute
we've tried) the Drs. will choose the medication over breastfeeding. Now,
for my question. Dr. Hale's book says AAP compatible. I have the AAP
reference. The references are for the 10 mg PO dose and not the 30-60 mg IM
or IV doses. Any info concerning the change in dosages would be appreciated.
>
>Pam Koehler wife to Mick(24 years), mother to Brian(20), Angela(18),
Emily(14) LLLL, IBCLC, BSN and soon to be grad student (in that order).
Wishing this program had spell check.
>