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Chemotherapy in the Emergency Department? There Is a Role for That: Methotrexate for Ectopic Pregnancy

Weant, Kyle A. PharmD, BCPS, FCCP; Bailey, Abby M. PharmD; Baum, Regan A. PharmD; Justice, Stephanie B. PharmD; Calhoun, Chara D. PharmD

Section Editor(s): Weant, Kyle A. PharmD, BCPS, FCCP; Column Editor

Advanced Emergency Nursing Journal: January/March 2017 - Volume 39 - Issue 1 - p 18–25
doi: 10.1097/TME.0000000000000137
Applied Pharmacology

Approximately 1.6% of all emergency department (ED) visits in the United States are for vaginal bleeding in early pregnancy, translating to around 500,000 ED visits per year. A potentially life-threatening condition, ectopic pregnancy occurs in 1.5%–2% of pregnancies. Many patients will require either surgical or pharmacological intervention following a positive diagnosis. With regard to pharmacological options, methotrexate, largely known for its use in the oncology arena, has emerged as the most effective nonsurgical option and the pharmacological agent of choice. However, this therapy is not without its own unique adverse event profile and patients should be adequately educated on the monitoring parameters of this pharmacotherapy.

Medical University of South Carolina, Charleston (Drs Weant and Calhoun); Departments of Pharmacy Services and Pharmacy Practice and Science, College of Pharmacy, University of Kentucky HealthCare, University of Kentucky, Lexington (Drs Bailey and Baum); and Clinical Pharmacy Services, St. Claire Regional Medical Center, Morehead, Kentucky (Dr Justice).

Corresponding Author: Kyle A. Weant, PharmD, BCPS, FCCP, Pharmacy Services, Medical University of South Carolina, 150 Ashley Ave, PO Box 250584, Charleston, SC 29425 (

Disclosure: The authors report no conflicts of interest.

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