Nasal Spray for Control of Dental Pain

Nasal spray

SPRIX (ketorolac tromethamine) Nasal Spray is a nonopiod alternative for managing moderate to moderately severe dental pain.  

Pain management in dentistry has historically and usually relies upon opiod based (narcotic, codeine-type) medications. This group of prescription medications is problematic because of the potential for misuse, abuse, diversion and addiction. Notable central nervous system (CNS) side affects, such as sedation, sleep disturbances, and bladder dysfunction are common. Typical opiod-induced complications are nausea and constipation, followed by sedation or drowsiness, and vomiting. The medications are dispensed with warnings regarding the operation of machinery.  

Ketorola provide pain control without the side effects

Ketorolac is a non-steroidal antiinflammatory that decreases the sensitivity of nerve endings that originate at the sites of injury or inflammation, thus diminishing pain. It has been used in an intramuscular form in the United States since 1990. As an alternative to opiods, it has proven to provide effective pain control without the side effects associated with opiods, such as constipation, CNS effects or respiratory depression. In IM form, it is similar to 6 to 12mg of morphine or 50 to 100mg of demerol for short term (5 days or less) treatment.  It is now available as SPRIX, a nasal spray. As formulated, it avoids the need for IM injections or intravenous access. It avoids the oral route for patients who are nauseated or unable to take oral medications. SPRIX clears from the nose without deposition in the lungs. It lacks CNS activity and does not cause sedation, tolerance or addiction. It is not approved for pediatric use, and adults over the age of 65 require only half of the adult dose. Precautions are the same as for NSAIDS in general and follow those of the IM version but are generally not significant because of the short duration of use. In addition, the method of spraying into the nose is important.  

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309