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Received Jun 8, 2017; Revised Nov 20, 2017; Accepted Nov 23, 2017
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1. Introduction
Ketorolac is a drug that has analgesic, anti-inflammatory, and antipyretic properties and is indicated in the short-term treatment of mild to moderate pain postoperatively and in musculoskeletal trauma, in addition to pain caused by nephritic colic. This drug is contraindicated when the patient has active gastroduodenal ulcer, gastrointestinal bleeding, in patients with moderate or severe renal impairment [1].
The analgesic activity of ketorolac is due to the elimination of formation of prostaglandins, through the inhibition of the enzyme prostaglandin system [1]. The chemical structure of ketorolac is shown in Figure 1.
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Ketorolac is metabolized by hydroxylation and conjugation with glucuronic acid. The renal route is the primary route of excretion of both the drug and its metabolites, which is approximately 92% of the dose, about 40% as metabolites and 60% as ketorolac. Approximately 6% of the dose is excreted in feces [2].
Data obtained in a study to determine the toxic effects of ketorolac on
Different authors indicate that the wastewater treatment plants do not remove the drugs in their entirety, because they do not have unitary operations that devote their process to the removal or elimination of drugs, since they depend on the physicochemical properties of each substance for which, in some cases, a decrease in the quantity of drugs after treatment barely persists [3–5].
Several studies have determined the presence of ketorolac in different matrices. For example, Gómez et al. in 2006 determined that the amount of ketorolac in the...