Which single intervention has the strongest evidence for reducing mortality in convulsive status epilepticus when given as first-line therapy?
- A Intravenous phenytoin loading
- B Intravenous lorazepam ✓
- C Intravenous levetiracetam loading
- D Rectal diazepam after 30 minutes of seizure
Correct answer: B. Intravenous lorazepam
Explanation
Early administration of a benzodiazepine, classically intravenous lorazepam 0.1 mg/kg, is the established first-line treatment for established status epilepticus and outperforms placebo and delayed therapy in terminating seizures. Phenytoin, levetiracetam, or valproate are second-line agents added only if seizures persist. Delaying any treatment until 30 minutes have passed worsens outcome, since benzodiazepines work best when given early.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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