Emergency Medicine

Answer 4 Midazolam IV. First-line interventions for patients presenting with symptoms of myocardial infarction after cocaine use are aspirin, nitrates, and benzodiazepines (eg, midazolam). Propranolol is a nonselective ß-blocker and is not recommended in patients who have ingested cocaine because of the theoretical risk of unopposed α1 stimulation. Haloperidol and ziprasidone are used to treat agitation due to underlying psychiatric pathology. Phenobarbital has sedative effects but is not considered a first-line agent in the treatment of patients with a myocardial infarction due to cocaine use. REFERENCES 1. Thompson T, Frable MA. Drug-induced, life-threatening angioedema revised. Laryngoscope 1993;103(1 Pt 1): 10-2. Click here to return to the questions

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