What is the drug of choice for a patient having a seizure that does not respond to multiple doses of lorazepam?

In the scenario where a patient is experiencing a seizure that does not respond to multiple doses of lorazepam, phenytoin is typically considered the drug of choice for several reasons.

Phenytoin is an antiepileptic medication that stabilizes neuronal membranes and is effective in controlling seizures. It is particularly useful in the management of status epilepticus, a condition where seizures are prolonged or recurrent without full recovery between them.

Fosphenytoin is a prodrug that is converted to phenytoin in the body and can be administered more rapidly, which makes it an effective alternative, but in many clinical settings, traditional phenytoin remains widely used.

Phenobarbital is also an option for seizure control but is generally considered a second-line treatment after phenytoin in the context of acute seizure management, especially if the patient has ongoing seizures after lorazepam.

Carbamazepine is primarily used for the management of certain types of seizures and is not typically used for acute seizure management but rather for long-term control and prevention of seizure recurrence.

Thus, given the specific need for rapid seizure control in a patient who has not responded to lorazepam, phenytoin is favored due