58-year-old Man in Medicine / Internal Medicine — 58yo Man | Cardiology | SMLE Q#4352

A 58-year-old man presents to a rural emergency department 1 hour after onset of severe, crushing substernal chest pain radiating to his left arm. He is diaphoretic and nauseated. ECG shows 3 mm ST-segment elevations in leads V2–V5. The facility does not have percutaneous coronary intervention capability, and transfer to a PCI center would take more than 2 hours. Vital signs: T 36.8 °C, BP 178/99 mmHg, HR 92/min, RR 18/min, SpO2 97% on room air. He has no history of prior stroke or bleeding and no contraindications to thrombolytic therapy. Which of the following medication combinations is most appropriate at this time?