No

Barbiturate

Induction and maintenance of general anesthesia for short procedures

C-IV

C

Porphyria, hypersensitivity to methohexital or any component

Use with extreme caution in patients with liver impairment, asthma, cardiovascular instability

>10%: Local: Pain on I.M. injection

1% to 10%: Gastrointestinal: Cramping, diarrhea, rectal bleeding

<1%: Hypotension, peripheral vascular collapse, seizures, headache, nausea, vomiting, hemolytic anemia, thrombophlebitis, tremor, twitching, rigidity, involuntary muscle movement, radial nerve palsy, apnea, respiratory depression, laryngospasm, coughing, hiccups

Symptoms of overdose include apnea, tachycardia, hypotension

Treatment is primarily supportive with mechanical ventilation if needed

CNS depressants worsen CNS depression

Do not dilute with solutions containing bacteriostatic agents; solutions are alkaline (pH 9.5-11) and incompatible with acids (eg, atropine sulfate, succinylcholine, silicone), also incompatible with phenol-containing solutions and silicone

Ultra short-acting I.V. barbiturate anesthetic

Onset of effect: Immediately after I.V. injection

Duration: 10-20 minutes after a single dose

Doses must be titrated to effect

I.M.: Preop: 5-10 mg/kg/dose

I.V.: Induction: 1-2 mg/kg/dose

Rectal: Preop/induction: 20-35 mg/kg/dose; usual 25 mg/kg/dose; administer as 10% aqueous solution

Adults: I.V.: Induction: 50-120 mg to start; 20-40 mg every 4-7 minutes

Dosing adjustment/comments in hepatic impairment: Lower dosage and monitor closely

Should not be given to patients with food in stomach because of danger of vomiting during anesthesia

Dilute to a maximum concentration of 1% for I.V. use

Drowsiness is common

Used as induction anesthesia for electroconvulsive therapy (ECT); concurrent use with psychotropics may produce additive CNS depression

No information available to require special precautions

No effects or complications reported

May cause drowsiness

Avoid extravasation or intra-arterial administration

Injection, as sodium: 500 mg, 2.5 g, 5 g

Cote' CJ, "Sedation for the Pediatric Patient," Pediatr Clin North Am, 1994, 41(1):31-58.

Folkerts H, "Spontaneous Seizure After Concurrent Use of Methohexital Anesthesia For Electroconvulsive Therapy and Paroxetine: A Case Report," J Nerv Ment Dis, 1995, 183(2):115-6.

Forbes RB, Murray DJ, Dillman JB, et al, "Pharmacokinetics of Two Percent Rectal Methohexitone in Children," Can J Anaesth, 1989, 36(2):160-4.

Wells D, Davies G, and Wagner D, "Accidental Injection of Epidural Methohexital," Anesthesiology, 1987, 67(5):846-8.