شاب عمره ٢٨ سنة جاء بألم صدري بعد تعاطي الكوكايين، ونبضه ١٢٤ وضغطه ١٧٨/١٠٤ ومتوتر جداً. أي دواء يتوقعه الممرض أولاً لتهدئة الحالة؟

A 28-year-old presents with chest pain after cocaine use, HR 124, BP 178/104 and marked agitation. Which drug does the nurse expect first to settle him?

1. An IV beta-blocker such as metoprolol
2. Rapid adenosine
3. Intramuscular haloperidol
4. A benzodiazepine such as lorazepam

Answer: D) A benzodiazepine such as lorazepam. In cocaine chest pain, benzodiazepines come first to reduce sympathetic drive, with aspirin and nitrates. Beta-blockers are usually avoided acutely because unopposed alpha stimulation can worsen coronary spasm.