Soru

A 68-year-old man is brought to the emergency department due to severe, rapidly worsening shortness of breath that began $2$ hours ago. His medical history includes hypertension, coronary artery disease, and heart failure with reduced ejection fraction (left ventricular ejection fraction of $30\%$). On arrival, he appears extremely anxious, diaphoretic, and is using accessory muscles of respiration. Vital signs are temperature $37.1^\circ\text{C}$ ($98.8^\circ\text{F}$), blood pressure $215/115\text{ mmHg}$, heart rate $118/\text{min}$, respiratory rate $32/\text{min}$, and oxygen saturation $86\%$ on room air. Physical examination reveals distended jugular veins and diffuse bilateral crackles halfway up the lung fields. A bedside electrocardiogram shows sinus tachycardia with no acute ischemic changes. Which of the following pharmacologic interventions are most appropriate for the immediate management of this patient's condition? (Select all that apply)