What is the initial dose of diazepam IV to be used if seizures continue after magnesium?

• A. 5 mg IV; may repeat q5min
• B. 2 mg IV
• C. 10 mg IV
• D. 1 mg IV

Answer: (A)

Diazepam is used for rapid seizure control by enhancing GABA-A–mediated inhibition in the brain. When seizures continue after magnesium, a fast-acting benzodiazepine is needed as an adjunct. The best starting move is a 5 mg intravenous push, with the option to repeat every 5 minutes if seizures persist. This dose provides quick anticonvulsant effect while allowing you to reassess and avoid excessive sedation or respiratory depression. Lower amounts are unlikely to halt ongoing seizures, while a higher single dose isn’t the standard initial bolus and carries more risk. Always monitor airway, breathing, and circulation and be prepared to escalate or switch agents if seizures continue.