What is the first-line treatment for methamphetamine-induced tachycardia in this protocol?

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Multiple Choice

What is the first-line treatment for methamphetamine-induced tachycardia in this protocol?

The key idea here is that methamphetamine-induced tachycardia is driven by increased central sympathetic activity. The most effective first step is to calm the patient and dampen that sympathetic surge. A benzodiazepine like diazepam given at 5-10 mg provides rapid sedation and anxiolysis, which lowers CNS outflow of adrenergic signals. This helps reduce heart rate and blood pressure and can prevent progression to hyperthermia or agitation‑related complications, all while avoiding risks associated with other therapies in stimulant toxidromes. Naloxone addresses opioid overdose and wouldn’t treat stimulant-induced tachycardia. Hypertonic saline isn’t related to this scenario. Amiodarone is an antiarrhythmic used for specific rhythm disturbances, not for a nonpathologic sinus tachycardia due to stimulant effect, and isn’t a first-line choice here. If tachycardia persists after sedation or if there are arrhythmias, additional interventions would be considered based on the evolving clinical picture.

The key idea here is that methamphetamine-induced tachycardia is driven by increased central sympathetic activity. The most effective first step is to calm the patient and dampen that sympathetic surge. A benzodiazepine like diazepam given at 5-10 mg provides rapid sedation and anxiolysis, which lowers CNS outflow of adrenergic signals. This helps reduce heart rate and blood pressure and can prevent progression to hyperthermia or agitation‑related complications, all while avoiding risks associated with other therapies in stimulant toxidromes.

Naloxone addresses opioid overdose and wouldn’t treat stimulant-induced tachycardia. Hypertonic saline isn’t related to this scenario. Amiodarone is an antiarrhythmic used for specific rhythm disturbances, not for a nonpathologic sinus tachycardia due to stimulant effect, and isn’t a first-line choice here. If tachycardia persists after sedation or if there are arrhythmias, additional interventions would be considered based on the evolving clinical picture.

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