RECENT ARTICLES in Emergency Medicine & Critical Care Pharmacotherapy



Tenecteplase Versus Alteplase for Acute Stroke: Mortality and Bleeding Complications
May 2023

Abstract (Murphy 2023)

Comparison of IV acetaminophen to IV or IM administered NSAIDs or opioids for patients presenting with moderate to severe acute pain conditions to the ED: systematic review and meta-analysis

Abstract (Qureshi 2023)

Etomidate as an induction agent for endotracheal intubation in critically ill patients

April 2023

Abstract (Kotani 2023)

Intravenous Magnesium As An Adjunct To Standard Of Care For Treatment Of Atrial Fibrillation 

April 2023

Comparing the Safety and Effectiveness of Ketamine Versus Benzodiazepine/Opioid Combination for Procedural Sedation in Emergency Medicine
March 2023

Adverse events reported in the current study included vomiting and nausea, visual hallucination, laryngospasm, apnea, and oxygen desaturation requiring intervention (Figure 6).

Abstract (Zaki 2023)

Hydrocortisone in Severe Community-Acquired Pneumonia

March 2023

Abstract (Dequin 2023)

European Stroke Organisation recommendation on tenecteplase for acute ischemic stroke

March 2023

Abstract (Alamowitch 2023)

Webinar presentation of ESO Expedited Recommendation on Tenecteplase for Acute Ischaemic Stroke by S. Alamowitch. 2023. 

Emergency Department management of patients with alcohol intoxication

March 2023

(Open access table)

Introduction (Strayer 2023)

High dose TXA for hemorrhage

March 2023

Abstract (Hmidan 2023)

Standard dose (≤ 1 g) tranexamic acid (TXA) has established mortality benefit in trauma patients. The role of high dose IV TXA (≥2 g or ≥30 mg/kg as a single bolus) has been evaluated in the surgical setting, however, it has not been studied in trauma. We reviewed the available evidence of high dose IV TXA in any setting with the goal of informing its use in the adult trauma population.

We searched MEDLINE, EMBASE and unpublished sources from inception until July 27, 2022 for studies that compared standard dose with high dose IV TXA in adults (≥ 16 years of age) with hemorrhage. Screening and data abstraction was done independently and in duplicate. We pooled trial data using a random effects model and considered randomized controlled trials (RCTs) and observational cohort studies separately. We assessed the individual study risk of bias using the Cochrane Risk of Bias for RCTs and the Newcastle-Ottawa Scale for observational cohort studies. The overall certainty of evidence was assessed using the GRADE approach (Grading of Recommendations Assessment, Development and Evaluation).

We included 20 studies with a combined total of 12,523 patients. Based on pooled RCT data, and as compared to standard dose TXA, high dose IV TXA probably decreases transfusion requirements (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.76 to 0.97, moderate certainty) but with possibly no effect on blood loss (mean difference [MD] 43.31 ml less, 95% CI 135.53 to 48.90 ml less, low certainty), and an uncertain effect on thromboembolic events (OR 1.33, 95% CI 0.86 to 2.04, very low certainty) and mortality (OR 0.70, 95% CI 0.37 to 1.32, very low certainty).

When compared to standard dose, high dose IV TXA probably reduces transfusion requirements with an uncertain effect on thromboembolic events and mortality.

Level of evidence: Systematic review and meta-analysis, level IV.

Keywords: Hemorrhage; High dose; Mortality; Surgery; Thrombo-embolism; Tranexamic acid; Transfusion requirements; Trauma.

Pharmacotherapy in ventricular arrhythmias
March 2023

Pharmacokinetic alterations in the critically ill
February 2023

Acute management of migraine
January 2023

Epinephrine in OHCA - Network Meta-Analysis, shockable and non-shockable rythms
January 2023


IV Potassium and Magnesium in atrial fibrillation and atrial flutter in the ED

October 2022

IV MgSO4 for Acute Exacerbations of COPD Systematic Review

August 2022

Antihistamines vs benzodiazepines for acute vertigo

July 2022


FAKT: Fentanyl vs placebo with ketamine and rocuronium for RSI in the ED
June 2022

NORT-TEST 2 part A: Tenecteplase versus alteplase for the management of acute ischaemic stroke in Norway

June 2022

Andexanet alfa vs four-factor prothrombin complex concentrate for the reversal of apixaban or rivaroxaban associated intracranial hemorrhage
June 2022

PLUS: Balanced versus normal saline solutions in the critically ill
March 2022

Droperidol Emergency Medicine updates (narrative review)

March 2022


DOREMI: Milrinone vs Dobutamine in Cardiogenic Shock
August 2021

Abstract (Mathew 2021)

CDC Sexually Transmited Infections Treatment Guidelines
July 2021

Abstract (Workowski 2021)

These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11–14, 2019. The information in this report updates the 2015 guidelines. These guidelines discuss 1) updated recommendations for treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; 2) addition of metronidazole to the recommended treatment regimen for pelvic inflammatory disease; 3) alternative treatment options for bacterial vaginosis; 4) management of Mycoplasma genitalium; 5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testing among pregnant women; 7) one-time testing for hepatitis C infection; 8) evaluation of men who have sex with men after sexual assault; and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. Physicians and other health care providers can use these guidelines to assist in prevention and treatment of STIs.

ACEP Task Force Report on Hyperactive Delirium with Severe Agitation

June 2021

Abstract (ACEP 2021)

NoPAC: TXA to reduce the need for nasal packing in epistaxis

June 2021

Abstract (Reuben 2021)

ED-AWARENESS Study: A Prospective, Observational Cohort Study of Awareness With Paralysis in Mechanically Ventilated Patients Admitted From the ED
May 2021

Abstract (Pappal 2021)

Effect of Continuous Infusion of Hypertonic Saline vs Standard Care on 6-Month Neurological Outcomes in Patients With Traumatic Brain Injury
May 2021

Abstract (Roquilly 2021)

Ketamine for Acute Agitation in the ED

April 2021

Abstract (Lin 2021)


Risk of overcorrection in rapid intermittent bolus vs slow continuous infusion of hypertonic saline in symptomatic hyponatremia

January 2021

Abstract (Baek 2021)


NEAR-Registry. Ketamine vs Etomidate and peri-intubation hypotension

November 2020

Abstract (NEAR Registry 2020)

IV alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis

November 2020

Abstract (Thomalla 2020)

HALT-IT: TXA in acute gastrointestinal bleeding

June 2020

Abstract (HALT-IT 2020)

Survival after IV vs IO Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest

 January 2020

Abstract (Daya 2020)


ESETT: Three Anticonvulsants comparison for Status Epilepticus

November 2019

Abstract (Kapur 2019)


LEAP-2: Lefamulin vs Moxifloxacin for Community-Aquired Bacterial Pneumonia
November 2019

Abstract (Alexander 2019)

ROSE: Early neuromuscular blockade in ARDS
May 2019

Abstract (ROSE trial 2019)

Reversal of oral anticoagulation in intracerebral hemorrhage

February 2019

Abstract (Bower 2019)

Introduction: (references removed)

The NACSTOP Trial: A Multicenter, Cluster-Controlled Trial of Early Cessation of Acetylcysteine in Acetaminophen Overdose

February 2019

Abstract (Wong 2019)


PARAMEDIC2: Epinephrine in OHCA

August 2018

NEJM (Open Access)

Abstract (Perkins 2018)

Meta-analysis: tenecteplase versus alteplase for acute ischemic stroke

August 2018

Springer (Open Access)

Abstract (Kheiri 2018)

EXTEND IA TNK: Tenecteplase 0.25mg/kg versus alteplase 0.9mg/kg before thrombectomy for AIS

April 2018

NEJM (Open Access)

Abstract (Campbell 2018)

SALT-ED: balanced crystalloids versus normal saline in the ED

March 2018

NEJM (Open Access)

Abstract (Self 2018)


1. Minor head injury and vitamin K antagonists or direct oral (novel) anticoagulants
September 2017

Abstract (Riccardi 2017)

2. Promotion of drugs for off-label uses and the US-FDA
February 2017

Abstract (Kim 2017)

Since 1962, the US Food and Drug Administration (FDA) has required companies to establish, with adequate and well-controlled clinical trials, a drug’s safety and efficacy for each intended use and has prohibited the “off-label” promotion of drugs. For companies to market an approved medicine for new indications, they must first conduct trials and submit data to establish safety and efficacy, as was the case for the initial approval.

The FDA’s approach to off-label promotion is in jeopardy, however. In response to recent US Supreme Court decisions strengthening First Amendment protection for companies, the pharmaceutical industry has framed off-label marketing as a free speech right. Drug companies have won several important court cases that have weakened the FDA’s authority to regulate off-label marketing. Although the legal issue—whether the FDA’s restrictions on off-label marketing are unconstitutional—remains unresolved, the agency has initiated a comprehensive review of its approach to off-label marketing. On November 9 and 10, 2016, the FDA will convene a public hearing to address “its regulations and policies governing firms’ communications about unapproved uses of approved/cleared medical products.”


1. Adverse events in procedural sedation in the ED (pediatrics)
June 2016

The table shows the incidence of adverse events per 1000 procedural sedations. 

Abstract (Bellolio 2016 - Procedural sedation, pediatrics)

2. Adverse events in procedural sedation in the ED (adults)
January 2016

The table shows the incidence of adverse events per 1,000 sedations.

Abstract (Bellolio 2016 - Procedural sedation, adults)

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