• Induction of general anesthesia.
• Sole anesthesia in short (<15 min), minimally painful procedures.
• Supplement to other anesthetic agents.
• To produce unconsciousness during balanced anesthesia.

Contraindicated in:

• Hypersensitivity
• Intra-arterial injection
• Porphyria

Use Cautiously in:

• Addison’s disease
• Severe anemia
• Severe CV or hepatic disease
• Myxedema
• Shock or hypotension
• Pulmonary disease
• Debilitated patients
• Pedi: Children <3 yr (may affect brain development)
• Geri: Appears on Beers list. Geriatric patients are at ↑ risk for side effects (dose ↓ recommended).

CNS: SEIZURES, anxiety, emergence delirium, headache, restlessness.

EENT: rhinitis.

Resp: APNEA, LARYNGOSPASM, bronchospasm, coughing, dyspnea, respiratory depression.

CV: CARDIORESPIRATORY ARREST, hypotension.

GI: abdominal pain, hiccups, nausea, salivation, vomiting.

Derm: erythema, pruritus, urticaria.

Local: pain at IM site, phlebitis at IV site.

MS: muscle twitching.

Misc: shivering, allergic reactions.

Drug-Drug:

• Additive CNS depression with alcohol, antihistamines, opioid analgesics, and sedative/hypnotics.

Drug-Natural Products:

• See sedative interactions.
• St. John's wort may affect methohexital levels and effectiveness; avoid use.
• Concomitant use of kava, valerian, skullcap, chamomile, or hops can ↑ CNS depression.

• Powder for injection: 500 mg;

• IV (Adults): Induction — 1–1.5 mg/kg. Maintenance — 20–40 mg every 4–7 min as intermittent doses or 3 mL of a 0.2% solution/min.
• IM (Children >1 mo): Induction — 6.6–10 mg/kg of a 5% solution.
• Rect (Children >1 mo): Induction — 25 mg/kg using a 1% solution.

Brevital

• Produces anesthesia by depressing the CNS, probably by potentiating GABA, an inhibitory neurotransmitter.

• Unconsciousness and general anesthesia.

Therapeutic Classification: general anesthetics

Pharmacologic Classification: barbiturates

Absorption: IV administration results in complete bioavailability.

Distribution: Accumulates and may be slowly re-released from lipoid tissues; rapidly crosses the blood-brain barrier. Crosses the placenta.

Metabolism/Excretion: Mostly metabolized by the liver; some metabolism in kidneys and brain.

Half-life: 1.5–5 hr (↑ in geriatric patients).

Schedule IV (C-IV)

(anesthesia)

†In pediatric patients.

• Methohexital may cause psychomotor impairment for 24 hr after administration. Caution patient to avoid driving or other activities requiring alertness for 24 hr.
• Advise patient to avoid use of alcohol or other CNS depressants, including opioids, for 24 hr after anesthesia, unless directed by health care professional.
• Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. May cause dose-related fetal heart rate slowing and newborn sedation. These effects can be minimized by using low doses (0.5–1.0 mg/kg).

meth-o-HEX-i-tal

NDC Code^*

• 42023- Par Pharmaceutical, Inc.
  • 42023-105- Brevital Sodium
    • 42023-105-01- 1 VIAL in 1 CARTON (42023-105-01) > 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

• 42023- Par Pharmaceutical, Inc.
  • 42023-106- Brevital Sodium
    • 42023-106-01- 1 VIAL in 1 CARTON (42023-106-01) > 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL