Saves the questions and what to expect into your notes, next to the visit they belong to.
Keep this study
Lead
Washington University School of Medicine
With
Assertio Holdings, Inc
Age
6–17
Sex
ALL
Healthy volunteers
Accepted
You may be eligible if
A headache that fulfills at least three of the six following criteria: i) moderate to severe episode of impaired daily activities; ii) focal localization of headache (focal meaning unilateral, bifrontal, bitemporal, or biparietal); iii) pulsatile description; iv) nausea or vomiting or abdominal pain; v) photophobia or phonophobia or avoidance of light and noise; and vi) symptoms increasing with activity or resolving by rest
Pain 4/10 on the validated Faces Pain Scale
Headache duration between 1 and 72 hours
You may not be if
Any contraindication to receiving ketorolac (e.g. known allergy, known peptic ulcer disease, gastrointestinal bleeding, hepatic impairment (patients with known aspartate aminotransferase (AST) \> 60 units/L "OR" alanine aminotransferase (ALT) \> 40 units/L "OR" total bilirubin \> 1.2 mg/dl)
Renal impairment (patients with known estimated glomerular filtration rate of \< 90 mL/min/1.73m2)
Known bleeding disorders
Receipt of an NSAID (e.g. ibuprofen, naproxen, naproxen/sumatriptan) within previous six hours
Receipt of oral prochlorperazine or metoclopramide or diphenhydramine within 12 hours prior to presentation
Presence of intranasal obstruction (e.g. mucous or blood) that cannot be readily cleared using suction or nose blowing
Inability to speak English
Patients with a concurrent diagnosis of traumatic brain injury
Unable to complete self-report measures of pain or questionnaires (e.g. developmental delay, neurologic impairment)
Critical illness
Frequent use of drugs for headache (defined as regular intake of analgesics for acute headaches on more than 10 days per month)
Patients refusing to take oral adjuncts or unable to tolerate oral medications will be excluded from the trial.
Patients currently on the following medications will also be excluded from the study as there are contraindications for use of Ketorolac with use of these medications: antiplatelets (i.e. salicylates, aspirin, clopidogrel, ticagrelor), Anticoagulants (i.e. warfarin, rivaroxaban, apixaban, dabigatran, enoxaparin, and heparin), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (losartan, Lisinopril), cyclosporine or tacrolimus, furosemide, bumetanide, spironolactone, hydrochlorothiazide, digoxin, lithium, methotrexate, probenecid, some selective serotonin reuptake inhibitors (including i.e. citalopram, escitalopram, sertraline), antipsychotics (i.e. Quetiapine, risperidone, aripiprazole, haloperidol), tranylcypromine, oxybates, oral potassium citrate, and Anticholinergics (i.e. amantadine).
