Progressive Care Nursing Certification (PCCN) Practice Exam

What is the most appropriate first-line drug for the treatment of a seizure?

1. Lorazepam (Ativan)

2. Midazolam (Versed)

3. Phenytoin (Dilantin)

4. Phenobarbital

The correct answer is: Lorazepam (Ativan)

The most appropriate first-line drug for the treatment of a seizure is lorazepam (Ativan). Lorazepam belongs to the benzodiazepine class of medications, which act quickly to provide sedation and anticonvulsant effects. This rapid action makes it particularly effective for the immediate control of seizures, especially in emergency situations, such as status epilepticus. Benzodiazepines like lorazepam enhance the activity of the neurotransmitter gamma-aminobutyric acid (GABA), resulting in a calming effect on the brain and, consequently, a reduction in seizure activity. Lorazepam's long half-life compared to other benzodiazepines allows for effective seizure management without the need for frequent dosing. Other options have their uses in seizure management but are typically not first-line treatments for acute seizure control. For instance, midazolam is also a benzodiazepine with a rapid onset but is often used in specific situations or settings (like prehospital care) rather than as a first-line choice in a hospital environment. Phenytoin and phenobarbital are more frequently utilized for the long-term management of seizures rather than the urgent control required in acute settings. Phenytoin, for instance, takes longer to achieve