Substance use: cocaine intoxication management: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: cocaine intoxication management

Sample item

A young man with cocaine intoxication has chest pain, agitation, a heart rate of 130 and a blood pressure of 180/110. Which drug is the first-line choice?

ABenzodiazepineBPropranolol aloneCHaloperidolDNaloxone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Benzodiazepine

Benzodiazepines reduce agitation, tachycardia, hypertension and seizure risk in cocaine toxicity and are first-line. Unopposed beta blockade is avoided as it may worsen coronary vasospasm. Haloperidol can lower the seizure threshold and cause arrhythmia.

Option by option

A. Benzodiazepine (correct)
Correct. Benzodiazepines are first-line for cocaine-related toxicity.
B. Propranolol alone
Propranolol alone risks unopposed alpha stimulation and coronary spasm.
C. Haloperidol
Haloperidol lowers the seizure threshold and prolongs QT.
D. Naloxone
Naloxone reverses opioids and has no role.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Benzodiazepine. Benzodiazepines reduce agitation, tachycardia, hypertension and seizure risk in cocaine toxicity and are first-line.

Why is "Propranolol alone" not the answer?

Propranolol alone risks unopposed alpha stimulation and coronary spasm.

Why is "Haloperidol" not the answer?

Haloperidol lowers the seizure threshold and prolongs QT.

Why is "Naloxone" not the answer?

Naloxone reverses opioids and has no role.

What concept does this question test?

It tests Substance use: cocaine intoxication management in Psychiatry. Unopposed beta blockade is avoided as it may worsen coronary vasospasm. Haloperidol can lower the seizure threshold and cause arrhythmia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: cocaine intoxication management?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.