methohexital (Brevital)

Indications

• induction & maintenance of general anesthesia for short procedures

Contraindications

porphyria

Caution:

• hepatic insufficiency
• asthma
• cardiovascular instability

pregnancy category = b

safety in lactation = ?

Dosage

• adults:
  • induction: 1-2 mg/kg IV (50-120 mg)
  • maintenance: 20-40 mg every 4-7 min
• children:
  • preop: 5-10 mg/kg IM, 20-35 mg/kg rectal
  • induction: 1-2 mg/kg

Powder for injection: 500 mg.

Pharmacokinetics

duration of action: 5 minutes

elimination via liver

Adverse effects

• common (> 10%)
  • pain on IM injection
• less common (1-10%)
  • cramping, diarrhea, rectal bleeding
• uncommon (< 1%)
  • radial nerve palsy, hemolytic anemia, thrombophlebitis, hypotension, peripheral vascular collapse, seizures, tremor, headache, nausea/vomiting, involuntary muscle movement, twitching, rigidity, apnea, respiratory depression, laryngospasm, hiccups, coughing

Drug interactions

CNS depressants

More general terms

• dissociative anesthetic

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=9034
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=9391