Response to Mazer-Amirshahi et al, Intravenous Acetaminophen and Hydromorphone: the Bad and the Ugly of Emergency Department Pain Management.

Intravenous administration of opioid analgesics is the mainstay of treatment of severe pain in the ED. The search for adjunctive analgesics is due to the desire to limit exposure to opioids, reduce side effects at the same time as increasing pain relief. While agreeing with the premise of combining analgesics from different therapeutic classes, Mazer-Amirshahi et al. question the choice of intravenous (IV) acetaminophen and IV hydromorphone.