In a patient actively seizing, which is the first-line parenteral medication to administer?

In a patient actively seizing, which is the first-line parenteral medication to administer?

• A. Carbamazepine
• B. Gabapentin
• C. Lorazepam
• D. Phenytoin

Answer: (C)

Rapid control of an active seizure hinges on quickly enhancing inhibitory GABA signaling in the brain. Benzodiazepines do this fast and are the first-line parenteral option for terminating seizures. Lorazepam is preferred for IV use because it acts rapidly and, unlike other benzodiazepines such as diazepam, has a longer duration of action. That longer duration helps prevent early seizure return and reduces the need for repeated dosing, while still being well tolerated. Phenytoin can be used if seizures persist, but it has a slower onset when given IV and carries risks like hypotension and arrhythmias, so it isn’t the initial choice. Carbamazepine and gabapentin aren’t suitable for acute, parenteral seizure control and are generally used for longer-term management rather than immediate termination. So, giving lorazepam first best achieves rapid seizure cessation.

Rapid control of an active seizure hinges on quickly enhancing inhibitory GABA signaling in the brain. Benzodiazepines do this fast and are the first-line parenteral option for terminating seizures. Lorazepam is preferred for IV use because it acts rapidly and, unlike other benzodiazepines such as diazepam, has a longer duration of action. That longer duration helps prevent early seizure return and reduces the need for repeated dosing, while still being well tolerated. Phenytoin can be used if seizures persist, but it has a slower onset when given IV and carries risks like hypotension and arrhythmias, so it isn’t the initial choice. Carbamazepine and gabapentin aren’t suitable for acute, parenteral seizure control and are generally used for longer-term management rather than immediate termination. So, giving lorazepam first best achieves rapid seizure cessation.