Methohexital

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Brietal; Finland: Brietal; Germany: Brevimytal; Greece: Brevimytal; Luxembourg: Brietal; Netherlands: Brietal.

North America

USA: Brevital.

Drug combinations

Chemistry

Methohexital: C~14~H~18~N~2~O~3~. Mw: 262.30. (1) 2,4,6(1H,3H,5H)-Pyrimidinetrione, 1-methyl-5-(1-methyl-2-pentynyl)-5-(2-propenyl)-, (±)-; (2)(±)-5-Allyl-1-methyl-5-(1-methyl-2-pentynyl)barbituric acid. CAS-18652-93-2.

Methohexital Sodium: C~14~H~17~N~2~NaO~3~. Mw: 284.29. 2,4,6(1H,3H,5H)-Pyrimidinetrione, 1-methyl-5-(1-methyl-2-pentynyl)-5-(2-propenyl)-, (±)-, monosodium salt. CAS-309-36-4; CAS-60634-69-7 (±).

Pharmacologic Category

General Anesthetics; Barbiturates. Anticonvulsants; Barbiturates. (ATC-Code: N01AF01; N05CA15).

Mechanism of action

Ultra short-acting intravenous barbiturate anesthetic.

Therapeutic use

For induction of anesthesia. As adjunct to subpotent inhalational anesthetic agents for short surgical procedures. For short surgical, diagnostic, or therapeutic procedures associated with minimal painful stimuli. For use with other parenteral agents in adults, to supplement subpotent inhalational anesthetic agents for longer surgical procedures. As agent to induce hypnotic state. Induction and maintenance of general anesthesia for short procedures.

Pregnancy and lactiation implications

Animal studies have not shown fetal or maternal harm. Use only if potential benefit outweighs risk to fetus. Enters breast milk (use caution).

Unlabeled use

Wada test.

Contraindications

Hypersensitivity to barbiturates, methohexital, or any component of the formulation. Porphyria (latent or manifest). Patients in whom general anesthesia is contraindicated.

Warnings and precautions

Use of hypnotic/sedative agents for sleep associated with hypersensitivity reactions including anaphylaxis and also angioedema. Might cause hypotension (use with caution in hemodynamically unstable patients (hypotension or shock) or severe hypertension). Use with caution in severe anemia (respiratory depression might occur leading to further inadequate tissue oxygenation), in cardiovascular disease including heart failure, in hepatic impairment (might prolong or potentiate hypnotic effect), and in extreme obesity. Might cause respiratory depression (use with caution in pulmonary disease). Use with caution in asthma and chronic obstructive pulmonary disease. Use with extreme caution in ongoing status asthmaticus. Use with caution in renal impairment (might prolong or potentiate hypnotic effect), and in history of seizure disorder. Effects with other sedative drugs or ethanol might be potentiated. Use with caution in the elderly and in children. Repeated dosing or continuous infusions might cause cumulative effects. Extravasation or intra-arterial injection causes necrosis.

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