Toradol, an NSAID used for renal colic, decreases renal perfusion and ureteral pressure in a canine model of unilateral ureteral obstruction.
Toradol is a new parenteral, nonsteroidal anti-inflammatory drug which is efficacious in treating renal coli. In the present experiments, Toradol was administered to both control dogs and dogs with unilateral ureteral obstruction. In control dogs, Toradol had no effect on RBF or GFR, despite inhibition of renal prostaglandin synthesis (measured as urinary prostaglandin release). In contrast, RBF fell acutely by 35% (p < 0.001) within 15 minutes of Toradol administration in the setting of ureteral obstruction; contralateral RBF was unaffected. Ipsilateral ureteral pressure also fell. Changes in RBF and ureteral pressure, together with the known effects of NSAIDs on pain pathways, may contribute to the pain relief observed clinically with Toradol. However, the abrupt changes in renal hemodynamics brought on by Toradol to the obstructed kidney may compromise renal reserve, and Toradol should be used cautiously in treating renal colic.
Perlmutter
A
A
James Buchanan Brady Foundation of The New York Hospital-Cornell Medical Center, Department of Surgery, New York 10021.
Miller
L
L
Trimble
L A
LA
Marion
D N
DN
Vaughan
E D
ED
Felsen
D
D
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003085:Colic / Q000188:drug therapy*; D003864:Depression, Chemical; D015232:Dinoprostone / Q000652:urine; D004285:Dogs; D004338:Drug Combinations; D005919:Glomerular Filtration Rate / Q000187:drug effects; D020911:Ketorolac Tromethamine; D007674:Kidney Diseases / Q000188:drug therapy*; D011312:Pressure; D012079:Renal Circulation / Q000187:drug effects*; D013930:Thromboxane-A Synthase / Q000097:blood; D014046:Tolmetin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014325:Tromethamine / Q000627:therapeutic use*; D014513:Ureter / Q000187:drug effects; D014517:Ureteral Obstruction / Q000188:drug therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D014325:Tromethamine; D020911:Ketorolac Tromethamine; D014046:Tolmetin; D013930:Thromboxane-A Synthase; D015232:Dinoprostone