peraspera
Forum Elite
Topics: 38
Posts: 233
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32 y.o. man in ER, has a continuous, generalized tonic-clonic seizures. The patient appers cyanotic and he is intubated. He weighs 75kg. His pulse is 115/min, BP-140/66 mmHg, t- 98.6 F. The patient is given- lorazepam IV, but continues to have seizures. The patient is given another 3 mg of lorazepam, there is no effect. The patient continues to have seizures. What is next step in management?
A. Additional dose of lorazepam until the seizures stop
B. Phenytoin IV
C. Lumbar puncture
D. A/biotics
E. Fosphenytoin IV
F. Phenobarbital IV
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| GOGETA
Trying to get in PGY1
Topics: 375
Posts: 3,053
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a?
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As a general rule, the better it felt when you said it, the more trouble it's going to get you into.
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| elitoki
Forum Guru
Topics: 54
Posts: 508
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B. phenytoin IV
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| dr.wad
Forum Senior
Topics: 3
Posts: 350
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B_ phenytoin IV ...
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| peraspera
Forum Elite
Topics: 38
Posts: 233
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dr.wad, elitoki- close but not quite close
tricky answer 
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| kpmle2
Forum Guru
Topics: 81
Posts: 464
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E. Fosphenytoin IV
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| elitoki
Forum Guru
Topics: 54
Posts: 508
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Is it Refractory Status Epilepticus??? so the answer should be F ?
 
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| Doc750
transfer:step 3 prison
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F ... (undereducated guesstimate)
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| docfor99
Forum Senior
Topics: 10
Posts: 111
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peraspera,could u explain why its fosphenytoin and not phenytoin?
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| peraspera
Forum Elite
Topics: 38
Posts: 233
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Correct is E.
Phenytoin is standard of care in treating pts with status epilepticus who don't respond to initial therapy with benzo.
But in this qs- we have two right answers, so:
Fosphenytoin has certain advantages when compared with standard phenytoin. Fosphenytoin is less often associated with hypotension or arrhythmias.
Please, We need to remember side effect of drugs & go with better drug with less side eff.
Good luck.
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