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ModerateCardiovascularAcute pulmonary oedemauk-plab-1

A 78-year-old man with known heart failure presents with acute severe breathlessness. He is orthopnoeic, tachypnoeic and has widespread bilateral crackles to the upper lung zones with frothy sputum. BP is 170/100 mmHg and oxygen saturation 88% on air. What is the most appropriate immediate pharmacological management in addition to high-flow oxygen and sitting him up?

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