An accident victim who presented to the Emergency Department 8 hours earlier begins having seizures. Toxicology reports indicate an abnormally high blood alcohol level. Based on this information, what drug does the nurse expect to administer?
1. Valproic acid (Depakote)
2. Gabapentin (Neurontin)
3. Lorazepam (Ativan)
4. Phenytoin (Dilantin)
Correct Answer: 3
Rationale 1: Valproic acid (Depakote) is incorrect because valproic acid is used for absence and mixed generalized types of seizures.
Rationale 2: Gabapentin (Neurontin) is incorrect because gabapentin is used for partial seizures or generalized seizures.
Rationale 3: Lorazepam (Ativan), a benzodiazepine, intensifies the effect of GABA in the brain. It binds directly to the GABA receptor, suppressing abnormal neuronal foci. Benzodiazepines also treat anxiety, skeletal muscle spasms, and alcohol withdrawal symptoms (which begin six hours after withdrawal of alcohol), all of which might be occurring with this accident victim.
Rationale 4: Phenytoin (Dilantin) is incorrect because phenytoin is used to control tonic-clonic and psychomotor seizures, and seizures that occur after head trauma.
Global Rationale: Lorazepam (Ativan), a benzodiazepine, intensifies the effect of GABA in the brain. It binds directly to the GABA receptor, suppressing abnormal neuronal foci. Benzodiazepines also treat anxiety, skeletal muscle spasms, and alcohol withdrawal symptoms (which begin six hours after withdrawal of alcohol), all which might be occurring with this accident victim. Valproic acid (Depakote) is incorrect because valproic acid is used for absence and mixed generalized types of seizures. Gabapentin (Neurontin) is incorrect because gabapentin is used for partial seizures or generalized seizures. Phenytoin (Dilantin) is incorrect because phenytoin is used to control tonic-clonic and psychomotor seizures, and seizures that occur after head trauma.
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