Diazepam 5-10mg IV OR lorazepam 2mg IV q5min PRN agitation
Avoid haldol if patient has abnormal vital signs (lowers seizure threshold, contributes to dysrhythmias, hyperthermia)
Benzos
Phentolamine 2.5-5mg IV (direct α-adrenergic antagonist, anti-hypertensive of choice)  OR nitroprusside 0.3mcg/kg/min
Beta-blockers contraindicated
May cause paradoxical hypertension
May cause paradoxical hypertension
Tachycardias usually respond to benzodiazepines
Wide complex tachycardia (deviation from ACLS)
Treat with bicarbonate 1-2 mEq/kg IV bolus; titrate to pH 7.45-7.55
Cocaine has sodium-channel blockade effect (similar to TCA toxicity)
Consider lidocaine IV if refractory to NaHCO3 (controversial)
Treat with bicarbonate 1-2 mEq/kg IV bolus; titrate to pH 7.45-7.55
Cocaine has sodium-channel blockade effect (similar to TCA toxicity)
Consider lidocaine IV if refractory to NaHCO3 (controversial)
Cocaine has sodium-channel blockade effect (similar to TCA toxicity)
Cardiac cath is safest option; consult (if possible) before using thrombolytics
Cocaine toxicity
Cocaine
Carbamate toxicity
Amphetamines
Tianeptine toxicity
Synthetic cathinones 
Phencyclidine toxicity
Ketamine