Question about Seizures.

[BSN 2 B]

Hello everybody, I have a quick question. I am in my last semester of nursing school and ran across a test question that I was puzzled with. If a person is having a breakthrough seizure, what medication would you use?

Phenytoin (Dilatin)?

Ativan?

Phenobarbitol?

I tried to look for the answer in the book and even on the internet, but the question is giving multiple answers. I chose Dilantin on the test....What do you guys thing?

[ErinS, BSN, RN]

Ativan is used for breakthrough seizures. It comes in a liquid and tiny tablet that both can be used SL. In hospice we will use ativan instead of other seizure medication on a routine basis to prevent seizures as well. Hope this helps.

[Nascar nurse, ASN, RN]

First...I appreciate your wording of your question. Nice to see a student give it the ole college try before wanting answers.

Unfortunately, I'm not sure of the correct answer, but here is my thinking process. Dilantin requires a therapuetic level therefore it doesn't make sense to give this in an acute situation. I haven't seen anyone give phenobarbital in years so therefore I wouldn't pick this answer either.

I have seen many a MD order Ativan for an acute seizure.

Good luck, maybe someone will come along that knows for sure.

[Meriwhen, ASN, BSN, MSN, RN]

Ativan: fast acting and can be given in a multiple of ways. Then follow with Dilantin once stabilized.

We use phenobarbital to prevent seizures in some of our patients with seizure d/o. But when we've had patients have such a severe seizure that medication is required stat, we've gone with a benzodiazepine first every time.

[BSN 2 B]

Thanks a lot. I really could not think about which one to pick. My mother is pounding it in my hand right now!! Lol...rationale while at home...Thanks alot!!

[LouisVRN, RN]

Yeah, I would definitely say Ativan, as it can provide more immediate treatment/management.

[wooh, BSN, RN]

Agree with above, dilantin and phenobarbital for maintenance, ativan or valium for breakthrough.