What is the first-line medication administered immediately for a child experiencing an acute generalized convulsive status epilepticus lasting longer than 5 minutes?
Answer and explanation
Correct answer: B. Intravenous lorazepam (or rectal/buccal midazolam)
- Step 1: Status epilepticus is defined as a seizure lasting minutes or recurrent seizures without regaining consciousness.
- Step 2: First-line abortive therapy is a fast-acting benzodiazepine: IV lorazepam (0.1 mg/kg) or IV diazepam, or buccal/IM midazolam if IV access is not yet established.
Answer
Intravenous lorazepam (or rectal/buccal midazolam).
Why not the others: 'Oral levetiracetam' cannot be administered during an active convulsion and takes hours to absorb; 'Phenytoin' is second-line therapy given after benzodiazepine failure; 'Propofol' is third-line therapy for refractory status epilepticus requiring intubation.
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