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    DEA Class;  Rx

    Common Brand Names; Brevital

    • General Anesthetics, Systemic; 
    • Barbiturates

    Ultra-short-acting highly lipophilic barbiturate; faster onset of action and recovery time vs thiopental and twice as potent; used alone as an anesthetic for short procedures that are relatively painless, as an inducing agent, or as an adjunct to regional anesthesia.

    Indicated for general anesthesia induction and general anesthesia maintenance.

    Known hypersensitivity to barbiturates

    Patients in whom general anesthesia contraindicated

    Patients with latent or manifest porphyria

    Hiccups, coughing, muscle twitching & laryngospasm, which may impair pulmonary ventilation

    Respiratory depression, apnea, dyspnea, cardiorespiratory arrest (which may occur in association with seizures), or hypotension may occur

    Circulatory depression, peripheral vasculatory collapse, bronchospasm, postanesthetic shivering, salivation, skeletal muscle hyperactivity (twitching to convulsive-like movements), seizures, restlessness, anxiety (especially in the presence of postop pain), headache, nausea, vomiting, abd pain, & emergence delirium may also occur

    Acute allergic reactions including erythema, pruritus, urticaria, rhinitis, hypotension, dyspnea, anxiety, restlessness, abdominal pain & peripheral vascular collapse have been reported

    Thrombophlebitis, injection site pain, & injury to nerves adjacent to injection site

    Extravasation may cause local irritation manifested as pain, swelling, ulceration, & necrosis

    Caution in severe anemia, extreme obesity, debilitated patients

    Rapid bolus doses will increase cardiorespiratory effects including laryngospasm, apnea, hypotension, myocardial depression, cardiovascular collapse

    Mild sedation may persist 8-12 hr

    Patients should be instructed on discharge not to drive or operate heavy machinery

    All routes of administration are often associated with hiccups, coughing, and/or muscle twitching, which may also impair pulmonary ventilation; following induction, temporary hypotension and tachycardia may occur

    Recovery from methohexital anesthesia is rapid and smooth; the incidence of postoperative nausea and vomiting is low if the drug is administered to fasting patients; postanesthetic shivering has occurred in a few instances

    The usual precautions taken with any barbiturate anesthetic should be observed with this drug; the drug should be used with caution in patients with asthma, obstructive pulmonary disease, severe hypertension or hypotension, myocardial disease, congestive heart failure, severe anemia, or extreme obesity

    Use with extreme caution in patients in status asthmatics; caution should be exercised in debilitated patients or in those with impaired function of respiratory, circulatory, renal, hepatic, or endocrine systems

    This drug should be used only in hospital or ambulatory care settings that provide for continuous monitoring of respiratory (eg. Pulse oximetry) and cardiac function; immediate availability of resuscitative drugs and age- and size-appropriate equipment for bag/valve/mask ventilation and intubation and personnel trained in their use and skilled in airway management should be assured

    There are no adequate and well-controlled studies in pregnant women; published studies in pregnant primates demonstrate that administration of anesthetic and sedation drugs that block NMDA receptors and/or potentiate GABA activity during the period of peak brain development increases neuronal apoptosis in the developing brain of the offspring when used for longer than 3 hours

    Excreted in breast milk; use by nursing mothers should be evaluated carefully


    Dose depends on indication and is titrated to effect.


    Dose depends on indication and is titrated to effect.


    Dose depends on indication and is titrated to effect.


    Dose depends on indication and is titrated to effect.


    Dose depends on indication and is titrated to effect.


    Safety and efficacy have not been established.

    Methohexital Sodium

    powder for injection: Schedule IV

    • 500mg
    • 2.5g