Which of the following medications has a higher risk of causing renal function compromise in excessive doses?

The medication that poses a higher risk of causing renal function compromise when taken in excessive doses is ketorolac. Ketorolac is a potent nonsteroidal anti-inflammatory drug (NSAID) often used for its analgesic properties. Its mechanism of action involves inhibition of cyclooxygenase (COX) enzymes, which can affect renal blood flow and consequently impact kidney function, particularly in patients who already have a risk of renal impairment or those who are dehydrated.

While aspirin and ibuprofen, which are also NSAIDs, share similar risks related to renal function, ketorolac is known for being more potent and is often used for short-term management of moderate to severe pain, which can lead to a higher risk of renal side effects if used excessively or inappropriately. Acetaminophen, while it can be harmful to the liver in excessive doses, does not have the same direct renal risks associated with high doses as ketorolac does.

In summary, ketorolac's stronger analgesic potency and its specific pharmacological properties make it more likely to compromise renal function when used excessively compared to the other medications listed.