DENTAL USE OF KETOROLAC TROMETHAMINE: STATUS AND FUTURE PERSPECTIVES

Abstract

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.