A 34-year-old man presents with generalised tonic-clonic seizures for the last 20 minutes without regaining consciousness between episodes. After securing the airway, the intravenous drug recommended as initial therapy is:
- A Lorazepam ✓
- B Phenobarbital
- C Fosphenytoin
- D Valproate
Correct answer: A. Lorazepam
Explanation
In established status epilepticus, an intravenous benzodiazepine such as lorazepam is the accepted first-line agent to terminate ongoing seizures rapidly. Fosphenytoin, valproate or phenobarbital are second-line agents given after the benzodiazepine to prevent recurrence. Lorazepam has a longer duration of action within the brain than diazepam because of slower redistribution, making it preferred in Indian practice.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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