A 17-year-old male presents to the emergency department with 1 hour of central chest pressure, diaphoresis, and palpitations that began after he used a large amount of cocaine at a party tonight. Two weeks ago he was seen for left upper chest pain at rest; an ECG and troponin were normal, and he was sent home on ibuprofen with reassurance. He has no other medical history, takes no regular medications, and has no known allergies. On examination he is anxious and diaphoretic with dilated pupils; heart sounds are normal with no rub or murmur, and the chest is clear. The ECG shows sinus tachycardia with ST-segment elevation in leads V2 to V5 and reciprocal ST depression in leads III and aVF. A troponin has been sent and the result is pending. An IV line is in place and he is on a cardiac monitor.
| Heart rate | 124/min |
| Respiratory rate | 20/min |
| Temperature | 37.4 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 170/110 mm Hg |
Question 1 of 30
Which of the following are the most appropriate initial medications?
Select 3. (0 / 3 selected)
Tip: right-click an answer (or press and hold on a phone) to strike it out. Drag over the question text to highlight it.