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Cocaine-associated chest pain — DIPIMC MCQ

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HardPharmacology (Pre-Hospital)Cocaine-associated chest painDIPIMCDipIMC

A young man who has used cocaine presents with chest pain. He is hypertensive, tachycardic and agitated.

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Give a benzodiazepine, with GTN and aspirin as indicated, and avoid beta-blockers

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · C = shown as D · B = shown as E

Cocaine-associated chest pain is managed with a benzodiazepine first-line, along with GTN and aspirin as appropriate, while beta-blockers are avoided because they can cause unopposed alpha-adrenergic stimulation with coronary vasoconstriction and worsening hypertension. Giving a beta-blocker (A) is therefore the key mistake to avoid. Treat the sympathetic drive with a benzodiazepine and steer clear of beta-blockade.

Reference: JRCALC Clinical Guidelines; TOXBASE