Medical Management of an Active Seizure Beyond the Neonatal Period Benzodiazepines are the initial drug of choice for the treatment of seizures Benzodiazepines work by blocking the GABA receptor, thus increasing the seizure threshold Lorazepam (Ativan) has a rapid onset of action (less than minutes) and should be given intravenously over to minutes to avoid acute respiratory decompensation The dose is 0.1 mg/kg, with a maximal dose of mg Its anticonvulsant effects can last for several hours An equally effective alternative is diazepam 0.2 mg/kg IV (maximum dose mg) Intramuscular midazolam was shown to be at least as effective as intravenous lorazepam in terminating status epilepticus in the prehospital setting Midazolam dosing is 0.2 mg/kg/dose (with MAX 10 mg/dose) IM or 0.1 mg/kg/dose IV (maximum mg/dose) Midazolam is shorter acting than both lorazepam and diazepam If a first dose of benzodiazepines fails, then a second dose should be administered at minutes