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Hemorrhage: Because prostaglandins play an important role in hemostasis, and NSAIDs affect platelet aggregation as well, useof ketorolac tromethamine in patients who have coagulation disorders should be undertaken very cautiously, and those patients should be carefully monitored.
Only short-term therapy (10 d) should be considered for this indication.
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Subsequent comparative studies failed to demonstrate any advantages of meperidine over comparable doses of other analgesics.
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Distal ureteral stones cause pain that tends to radiate into the groin or testicle in the male or labia majora in the female because the pain is referred from the ilioinguinal or genitofemoral nerves.
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Discrepancies were resolved by mutual review and consensus.
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In patients older than 60 years presenting with severe abdominal pain and with no prior history of renal stones, look carefully for physical signs of abdominal aortic aneurysm (AAA) (see Abdominal Aortic Aneurysm).
Nonteratogenic Effects: Because of the known effects of prostaglandin-inhibiting drugs on the fetal cardiovascular system (closure of the ductus arteriosus), the use of ketorolac tromethamine solution during late pregnancy should be avoided.
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