Asthma Caused by Topical Application of Ketorolac

• Published in: Ophthalmology (Rochester, Minn.) Vol. 103; no. 6; pp. 890 - 892
• Main Authors: Sitenga, Garret L., Ing, Edsel B., Van Dellen, Richard G., Younge, Brian R., Leavitt, Jacqueline A.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.1996; Elsevier
• Subjects: Administration, Topical; Adult; Albuterol - therapeutic use; Anti-Inflammatory Agents - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Asthma - chemically induced; Asthma - drug therapy; Asthma - physiopathology; Biological and medical sciences; Bronchodilator Agents - therapeutic use; Chronic Disease; Conjunctivitis, Allergic - drug therapy; Drug Hypersensitivity; Drug toxicity and drugs side effects treatment; Female; Humans; Ketorolac Tromethamine; Medical sciences; Nasal Polyps - complications; Ophthalmic Solutions; Pharmacology. Drug treatments; Respiratory Function Tests; Rhinitis - complications; Sinusitis - complications; Steroids; Tolmetin - adverse effects; Tolmetin - analogs & derivatives; Tolmetin - therapeutic use; Toxicity: respiratory system, ent, stomatology; Tromethamine - adverse effects; Tromethamine - analogs & derivatives; Tromethamine - therapeutic use; Non steroidal antiinflammatory agent; Eye drop; Human; Ophthalmic preparation; Treatment; Respiratory disease; Toxicity; Obstructive pulmonary disease; Asthma
• ISSN: 0161-6420; 1549-4713
• DOI: 10.1016/S0161-6420(96)30591-5

Background: Ketorolac tromethamine 0.5% ophthalmic solution is a widely used nonsteroidal anti-inflammatory drug (NSAID) in ophthalmology. Ketorolac eye drops have not been implicated previously as -a cause of NSAID-induced asthma. Study Design: A patient with severe asthma after topical application of ketorolac is described. The current ophthalmic indications for topical application of ketorolac and reported hypersensitivity reactions with systemic use of ketorolac are reviewed. Results: A 44-year-old woman with chronic asthma, rhinosinusitis, and nasal polyps inadvertently was given ketorolac to be applied topically. After applying the first dose of ketorolac, an exacerbation of her asthma developed, necessitating hospital admission. Conclusions: Topical application of ketorolac is safe in the vast majority of ophthalmology patients. However, NSAID eye drops should not be prescribed for patients with aspirin or NSAID allergy or the combination of asthma and nasal polyps unless the patient is known to tolerate aspirin without trouble.