What is the drug of choice for managing hypoxic-ischemic encephalopathy (HIE)?

The drug of choice for managing hypoxic-ischemic encephalopathy (HIE) is phenobarbital. This medication is particularly used for its anticonvulsant properties, which can help control seizures that are common in infants experiencing HIE.

Phenobarbital works by depressing the central nervous system and enhancing the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). This decreases neuronal excitability and seizure activity, providing a vital therapeutic benefit in the setting of HIE where brain function is compromised due to lack of oxygen and blood flow.

In addition to its role in seizure management, phenobarbital has been used in neonatal care for its sedative effects, which can be beneficial in the context of mitigating further brain injury associated with hypoxic events.

Choosing phenobarbital effectively addresses the acute neurological complications resulting from HIE, making it a preferred treatment option in managing this serious condition. Other medications listed, while useful in different contexts, do not specifically address the immediate needs presented by hypoxic-ischemic encephalopathy.