Methohexital

Methohexital Brand Name– Brevital

What is Methohexital

Methohexital is an ultra-short-acting barbiturate similar to thiopental.

Methohexital has a faster onset of action and recovery time than does thiopental, and it is twice as potent.

Although methohexital is highly lipophilic, it exhibits minimal accumulation in fatty tissues and thus has a shorter duration of action than do most thiobarbiturates.

Methohexital can be used alone as an anesthetic for short procedures that are relatively painless, as an inducing agent, or as an adjunct to regional anesthesia. It does not provide muscle relaxation but can be used concomitantly with muscle relaxants without complication.

Postanesthesia excitatory phenomena occur more frequently with methohexital than with thiopental.

Methohexital received FDA approval in 1960.

Indications

  • general anesthesia induction
  • general anesthesia maintenance

For general anesthesia induction and general anesthesia maintenance

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. anxiety
  4. apnea
  5. bronchospasm
  6. cardiac arrest
  7. cough
  8. delirium
  9. drowsiness
  10. dyspnea
  11. elevated hepatic enzymes
  12. erythema
  13. headache
  14. hiccups
  15. hypersalivation
  16. hypotension
  17. hypoventilation
  18. injection site reaction
  19. laryngospasm
  20. nausea
  21. phlebitis
  22. pruritus
  23. psychomotor impairment
  24. respiratory arrest
  25. respiratory depression
  26. restlessness
  27. rhinitis
  28. seizures
  29. shivering
  30. sinus tachycardia
  31. skin irritation
  32. skin necrosis
  33. skin ulcer
  34. thrombosis
  35. urticaria
  36. vomiting

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • adrenal insufficiency
  • agranulocytosis
  • anemia
  • barbiturate hypersensitivity
  • breast-feeding
  • carbamazepine hypersensitivity
  • cardiac disease
  • children
  • chronic obstructive pulmonary disease (COPD)
  • CNS depression
  • coadministration with other CNS depressants
  • depression
  • driving or operating machinery
  • ethanol ingestion
  • ethanol intoxication
  • exfoliative dermatitis
  • extravasation
  • geriatric
  • heart failure
  • hepatic disease
  • hepatic encephalopathy
  • hydantoin hypersensitivity
  • hypertension
  • hypotension
  • infants
  • intraarterial administration
  • labor
  • mental status changes
  • myxedema
  • neonates
  • neuromuscular disease
  • obesity
  • obstetric delivery
  • peripheral vascular disease
  • porphyria
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • requires a specialized care setting
  • requires an experienced clinician
  • respiratory depression
  • respiratory insufficiency
  • seizure disorder
  • seizures
  • shock
  • sleep apnea
  • status asthmaticus
  • status epilepticus
  • subcutaneous administration
  • suicidal ideation
  • tachycardia
  • uremia

Interactions

  • Abemaciclib
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
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  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
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  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorthalidone
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  • Diltiazem
  • Dimenhydrinate
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