This change is actually misleading, it’s simply that beta blockage leads to unopposed alpha stimulation which could lead to severe HTN; the remark regarding the use of non selective a/b blocker is another distinct idea
I would revert the “text” back to beta blocker and change “extra” to:
"- AMBOSS confirms that nonselective α/β antagonists such as labetalol can be used for acute cocain intoxication (Jul 2023)
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Cocaine is a sympathomimetic that leads to vasoconstriction; don’t want unopposed α constriction of coronary vessels
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Cocaine prevents the reuptake of serotonin, dopamine, and norepinephrine having many adrenergic agonist effects
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Vessels expresses α1 and β2 receptors and as norepinephrine has an affinity α>β cocaine causes hypertension
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By giving β-blockers, vasodilatory effect of β2 agonists is inhibited on the vessels thus leaving unopposed α1 agonism → vasoconstriction → HTN urgency/emergency"