Antiepileptics: neonatal seizures: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Antiepileptics: neonatal seizures

Sample item

A term neonate with hypoxic-ischaemic encephalopathy has repeated seizures on day 2. Blood glucose, calcium and magnesium are normal. Which drug is recommended as the first-line anticonvulsant?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Intravenous phenobarbitone

After correcting treatable metabolic causes, intravenous phenobarbitone is the recommended first-line agent for neonatal seizures. Phenytoin and levetiracetam are used as second-line drugs, and benzodiazepines are reserved for refractory cases because of respiratory depression and a short effect. Valproate is avoided in neonates because of hepatotoxicity risk.

Option by option

  • A. Intravenous phenobarbitone (correct)

    Phenobarbitone is the established first-line anticonvulsant in neonates.

  • B. Intravenous diazepam as a long-term maintenance drug

    Diazepam has a short anticonvulsant effect and causes respiratory depression, so it is not first-line maintenance.

  • C. Oral sodium valproate

    Valproate is avoided in neonates because of hepatotoxicity risk and absence of a role in first-line care.

  • D. Oral carbamazepine

    Carbamazepine has no intravenous form and is not used for neonatal seizures.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Intravenous phenobarbitone. After correcting treatable metabolic causes, intravenous phenobarbitone is the recommended first-line agent for neonatal seizures.

Why is "Intravenous diazepam as a long-term maintenance drug" not the answer?

Diazepam has a short anticonvulsant effect and causes respiratory depression, so it is not first-line maintenance.

Why is "Oral sodium valproate" not the answer?

Valproate is avoided in neonates because of hepatotoxicity risk and absence of a role in first-line care.

Why is "Oral carbamazepine" not the answer?

Carbamazepine has no intravenous form and is not used for neonatal seizures.

What concept does this question test?

It tests Antiepileptics: neonatal seizures in Pharmacology. Phenytoin and levetiracetam are used as second-line drugs, and benzodiazepines are reserved for refractory cases because of respiratory depression and a short effect. Valproate is avoided in neonates because of hepatotoxicity risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antiepileptics: neonatal seizures?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.