Home Drug Guide Methohexital Sodium

Drug Guide

Generic Name

Methohexital Sodium

Brand Names Brevital Sodium

Classification

Therapeutic: Anesthetic agent

Pharmacological: Barbiturate

FDA Approved Indications

Induction of anesthesia for short procedures or diagnostic tests

Mechanism of Action

Methohexital enhances the activity of GABA at GABA-A receptors, leading to increased chloride influx and neuronal hyperpolarization, resulting in sedation and anesthesia.

Dosage and Administration

Adult: Dosage varies based on procedure; typically 1 to 2 mg/kg IV for induction.

Pediatric: Dose based on weight and procedure; usually 1-2 mg/kg IV.

Geriatric: Reduced doses recommended due to increased sensitivity.

Renal Impairment: No specific adjustment, but caution advised.

Hepatic Impairment: Dose reduction may be necessary due to altered metabolism.

Pharmacokinetics

Absorption: Administered intravenously; rapid onset.

Distribution: Widely distributed throughout the body, crosses the blood-brain barrier.

Metabolism: Metabolized in the liver.

Excretion: Excreted primarily via the kidneys.

Half Life: Approximately 4-6 hours for context of recovery.

Contraindications

Hypersensitivity to barbiturates.
Porphyria.

Precautions

Use with caution in patients with cardiovascular or respiratory diseases, or history of drug abuse. Monitor for respiratory depression and hypotension. Not recommended for premature infants or during pregnancy unless clearly indicated.

Adverse Reactions - Common

Respiratory depression (Common)
Hypotension (Common)
Nausea and vomiting (Common)
Drowsiness, dizziness (Common)

Adverse Reactions - Serious

Cardiac arrhythmias (Less common)
Anaphylaxis (Rare)
Seizures upon withdrawal (Rare)

Drug-Drug Interactions

Other CNS depressants, anticoagulants, anticonvulsants.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor vital signs continuously, watch for signs of respiratory depression, hypotension.

Diagnoses:

Ineffective airway clearance
Risk for impaired tissue perfusion
Risk for injury from falls or neurological changes.

Implementation: Administer in controlled environment with resuscitative equipment nearby. Use appropriate infusion techniques.

Evaluation: Assess patient for return of consciousness, stability of vital signs, and absence of adverse reactions.

Patient/Family Teaching

Explain the purpose and effects of the medication.
Inform about potential side effects and signs of adverse reactions.
Advise on the importance of monitoring during and after the procedure.

Special Considerations

Black Box Warnings:

Potential for respiratory depression and hypotension; careful monitoring required.

Genetic Factors: Limited data.

Lab Test Interference: May alter liver function tests temporarily.

Overdose Management

Signs/Symptoms: Profound respiratory and cardiovascular depression, coma.

Treatment: Supportive care, maintain airway, oxygen therapy, vasopressors for hypotension, and possible use of intravenous lipid emulsion therapy in resistant cases.

Storage and Handling

Storage: Store in a tightly closed container at controlled room temperature, away from light and moisture.

Stability: Stable under recommended conditions for shelf life indicated by the manufacturer.