The management of myocardial infarction includes complementary pharmacotherapy for pain relief and cardioprotection.

The safety and efficacy of some commonly used treatments have been questioned by recent evidences.

Considering the interaction between opioids and oral P2Y12 inhibitors, morphine administration should be reserved for those patients having persistent severe chest pain despite alternative analgesics which avoid opioids.

Considering the results of therapies for cardioprotection, many drugs should not be part of routine standard care, but they should be wisely and selectively administered.

Future research efforts need to focus on novel therapeutic approaches for improving clinical outcomes.

In the current era of ST elevation myocardial infarction (STEMI) treatment, the “as soon as possible” therapies (“ASAP”) remain Aspirin, Second antiplatelet agent, Anticoagulant and of course Primary percutaneous coronary intervention.