Page 1 of 1: paeds-- antiepileptic of choice

candy · Credits: 15282 My Scrapbook

A 2 year old boy is brought to pediatric emergency with history of fever, lethargy and vomiting for the last 4 days. His parents have observed seizures for the last half an hour. The most appropriate antiepileptic drug for him is

a) Phenytoin
b) Phenobarbitone
c) Diazepam
d) Carbamazepine

manpreet108 · Credits: 30682 My Scrapbook

i think diazepam...

i think this cd be febrile seizure if we can rule out that fever is due to meningitis in this case.

febrile seizure s are the most imp cause of seizures in early childhood.
age grp and preceding history favoe febrile seizure as diagonosis.

i hope thats the ans given.
ideally it shd be PCM+diazepam....

candy · Credits: 15282 My Scrapbook

thats correct manu!
but we cant rule out meningitis right? in that case wat wud b the AE of choice
?

manpreet108 · Credits: 30682 My Scrapbook

thats right...

but if its due to meningitis--we have to start with antibiotics first--based on culture sensitivity of organism.

most likely cause in this age grp is --H.inf.
and forthat i think DOC is ampicillin.[PLS CROSS CHECK]

do correct me if i am wrong....

candy · Credits: 15282 My Scrapbook

yup..
in the ques what goes against febrile seizures is
1. onset>24hrs of fever
2.seizures lasting>10mins

so we may consider meningitis as diagnosis.. in this age grp. H.flu is commonest cause...
treatment of choice for H.flu is i.v. ceftriaxone or cefotaxime.. ampi n chloramphenicol can also b used.. As for antiepileptic in meningitis, diazepam 0.3mg/kg foll by phenytoin10mg/kg.

pl correct me if anyone thinks otherwise!!

parin · Credits: 14530 My Scrapbook My Reading List 1 Books

You are correct candy...

Its diazepam..

even seizures last for half an hour, then it's status epilepticus & we still use diazepam for initial management....

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