FPGEE for National Association of Boards of Pharmacy (NABP) Practice Exam

Which medication would typically be included in a treatment plan for status epilepticus?

1. Phenobarbital

2. Dextrose 10% solution

3. Amiodarone

4. Levothyroxine

The correct answer is: Phenobarbital

In the management of status epilepticus, which is a medical emergency characterized by prolonged seizures, certain medications are prioritized for their effectiveness in rapid seizure cessation. Phenobarbital is a barbiturate that has been used historically to treat seizures, including status epilepticus, due to its ability to enhance GABAergic activity, thereby providing a calming effect on the nervous system. In acute settings, benzodiazepines are often the first line treatment, but when immediate control is needed and benzodiazepines are not effective, phenobarbital can be administered. It acts quickly to halt ongoing seizures and provides a longer duration of action compared to some other antiepileptic medications. The other medications listed have different indications: Dextrose 10% solution is mainly used in cases of hypoglycemia or to provide caloric support, amiodarone is primarily an antiarrhythmic agent used in cardiac conditions, and levothyroxine is a hormone replacement therapy used in hypothyroidism. None of these agents have a direct role in the treatment of seizures. Therefore, the inclusion of phenobarbital in the treatment plan highlights its established role in the management of status epilepticus.