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Ketorolac is an nonsteroidal anti-inflammatory drug(NSAID) which is usually prescribed in short-term management of pain. But ketorolac occurs adverse reaction of prolonged bleeding-time and peptic ulcer. This study was conducted through retrospective chart review of eighty nine inpatients who received ketorolac injection to manage pain in Korea university Kuro hospital from March to July 1998. We applied the modification of the ASHP DUE criteria which is composed of justification for use, critical indicators, complications and outcome measures and added to the Korea Medical Insurance Standard. As a result, only 27.0%(24 patients) of the patients met with the criteria for justification for use. In analysis critical indicators, measurement of SCr within 48 hours before initial ketorolac dose was acceptable 52.8%(47 patients). In contraindication including history of peptic ulcer, breast-feeding, pregnant patient, children showed the acceptable levels 92.1%, 98.9%, 84.3%, 95.5%, respectively. In appropriated dosage, 87.6% of the patients received under 120㎎ which is maximum daily dosage in ASHP criteria and 84.3% of the patients received under 90㎎ which is maximum daily dosage in Korea Medical Insurance Standard. In duration for therapy, 82.0% of the patients received within five days in ASHP criteria, but only 33.7% of the patients received within two days in Korea Medical Insurance Standard. The complication occurred fifteen cases(16.8%) including nausea(5 cases), headache(1 case), hematuria(3 cases), edema(2 cases). In the outcome measurements, the case of decrease in pain severity or increase in time until pain recurs and control of pain at tolerable level was 98.9%. In this research, we concluded that justification for use was inadequate and consideration for contraindication was insufficient. And we found that the duration for therapy in Korea Medical Insurance Standard was unacceptable, especially. Therefore Korea Medical Insurance Standard must to be widely and a hospital wide medication use evaluation and education effort is necessary.
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