Ontario Paramedic Practice Exam

What is the most critical contraindication for using Ketorolac?

1. Allergy or Sensitivity

2. Current Active Bleed

3. Known liver disease

4. Renal Impairment

The correct answer is: Current Active Bleed

The most critical contraindication for using Ketorolac is the presence of a current active bleed. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that works by inhibiting the production of prostaglandins, which play a key role in mediating pain and inflammation. However, prostaglandins also help maintain the integrity of the gastric mucosa and support normal platelet function. In patients with an active bleed, the use of Ketorolac poses significant risks. This medication can impair platelet aggregation, which increases the potential for bleeding complications. In addition, Ketorolac can cause gastrointestinal side effects, including ulcers and bleeding, making it particularly dangerous for individuals with any existing bleeding condition. Therefore, administering Ketorolac in the presence of an active bleed could exacerbate the situation, leading to more severe health risks. While other factors, such as allergies, liver disease, and renal impairment, are important considerations when using Ketorolac, the immediate risk posed by a current active bleed makes it the most critical contraindication.