USMLE Step 2 Antibiotics and Treatments Practice Exam

In cases of cocaine-induced chest pain, the preferred management focuses on controlling hypertension and alleviating coronary vasoconstriction caused by cocaine use. Calcium channel blockers, such as Verapamil or Diltiazem, are especially effective in this scenario because they do not exacerbate catecholamine-induced effects, which is important given that cocaine leads to increased sympathetic outflow.

Cocaine can cause tachycardia and increased blood pressure, and using beta-blockers like Propranolol or Atenolol can be problematic. These medications could potentially lead to unopposed alpha-adrenergic receptor stimulation, exacerbating hypertension and increasing the risk of coronary vasospasm.

Calcium channel blockers help reduce heart contractility and induce vasodilation, allowing for better oxygen delivery to the myocardial tissues, which is crucial in alleviating chest pain associated with cocaine use. Additionally, they do not interact negatively with the adrenergic effects of cocaine, making them the safer choice in this acute setting.