At a Busy Community Hospital, a Medical Intern Works on the Inpatient

At a busy community hospital, a medical intern works on the inpatient wards. The team analyzes a new patient hospitalized for increasing congestive heart failure during rounds. Past medical history of the patient includes atherosclerotic coronary artery disease, diabetes mellitus, and pulmonary hypertension. Metformin, aspirin, and enalapril are among the current drugs. The patient previously acknowledged to taking cocaine recreationally with pals and admits to the intern that his most recent usage was today. The attending physician instructs the intern to begin the patient on propranolol for his heart issue; he will be expected to maintain this medication after being discharged from the hospital. After rounds, the intern recalls learning in medical school that beta adrenergic antagonists had a bad interaction with cocaine.

A) Administer the drug as the attending physician has likely considered the risks and benefits of a beta blocker in combination with cocaine. Which of the following actions by the intern is most appropriate?
B) Discuss concerns with the nurses, ask for their input, and have them monitor the patient's vital signs when starting the medication
C) Discuss the risks and benefits of the medication with the patient and let him decide whether to take it
D) Do not order the medication as the most important principle in medicine is to "do no harm"
E) Do not order the medication until discussing concerns with the attending physician and asking how to proceed