A 22-year-old man presents with a 15-minute episode of continuous generalized tonic-clonic seizure that does not stop. IV access is established. What is the first-line immediate pharmacological treatment?
- A IV phenytoin loading
- B IV lorazepam ✓
- C IV levetiracetam
- D IV phenobarbital
Correct answer: B. IV lorazepam
Explanation
Convulsive status epilepticus is a seizure lasting more than 5 minutes or recurrent seizures without recovery. First-line treatment is a benzodiazepine: IV lorazepam (or IM midazolam, or rectal diazepam). Benzodiazepines act rapidly via GABA-A receptors. Phenytoin or levetiracetam are second-line agents if benzodiazepines fail.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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