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Stimulant intoxication — MCCQE Part 1 MCQ

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ModerateSubstance UseStimulant intoxicationMCCQE Part 1

A 25-year-old man presents agitated after cocaine use with chest pain, hypertension and tachycardia. ECG shows sinus tachycardia without STEMI. Which of the following is the most appropriate initial management?

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Correct answer: C — Benzodiazepines, supportive care and cardiac evaluation

Cocaine intoxication with agitation and sympathetic excess is initially managed with benzodiazepines, cooling if needed and evaluation for myocardial ischaemia. Restraints alone can worsen hyperthermia and rhabdomyolysis. Discharge without cardiac assessment is unsafe when chest pain is present.

Reference: Canadian emergency medicine toxicology practice; CAMH stimulant use resources