Generic Name and Formulations:
Methohexital sodium 500mg, 2.5g; per vial; pwd for IV inj, continuous IV drip, IM or rectal use, after reconstitution and dilution.
Indications for BREVITAL:
IV induction of anesthesia prior to use of other general anesthetics. IV induction of anesthesia and as an adjunct to subpotent inhalational anesthetics for short surgical procedures (as infusion or intermittent inj). As an adjunct to other parenterals (eg, narcotic analgesics), to supplement subpotent inhalational anesthetics for longer surgical procedures. IV anesthesia for short, surgical, diagnostic, or therapeutic procedures associated with minimal painful stimuli. As an agent for inducing hypnotic state. In pediatric patients >1month: for rectal or IM induction of anesthesia prior to use of general anesthetics; for rectal or IM induction of anesthesia as an adjunct to subpotent inhalational anesthetics for short surgical procedures; as rectal or IM anesthesia for short surgical, diagnostic, or therapeutic procedures associated with minimal painful stimuli.
Individualize. Induction of anesthesia: Use 1% soln administered at a rate of 1mL/5 seconds. Gaseous anesthetics and/or skeletal muscle relaxants may be given concomitantly. Usual dose: 1–1.5mg/kg; usually provides anesthesia for 5–7 minutes. Maintenance of anesthesia: May use intermittent injections of 1% soln or continuous IV drip of 0.2% soln. Intermittent injections of 20–40mg may be given as required, usually every 4–7 minutes. Continuous drip: Average rate is about 3mL of 0.2% soln/minute. For longer procedures: gradual reduction in rate of administration is recommended.
<1 month: not recommended. ≥1 month: Give 5% concentration for IM administration; 1% soln for rectal administration. Induction of anesthesia: Usual range: 6.6–10mg/kg IM or 25mg/kg rectally.
Latent or manifest porphyria. Barbiturates hypersensitivity.
Should only be administered by persons qualified in the use of IV anesthetics. Keep resuscitative and endotracheal intubation equipment and oxygen readily available; maintain patency of the airway at all times. Avoid intra-arterial inj. Seizure disorders. Status asthmaticus. Severe hepatic dysfunction. Cardiovascular disease. Shock. Asthma. Obstructive pulmonary disease. Severe hyper- or hypotension. CHF. Severe anemia. Extreme obesity. Impaired respiratory, circulatory, renal, hepatic, or endocrine systems. Pediatric neurotoxicity risk with repeated or prolonged use. Elderly. Debilitated. Labor & delivery. Pregnancy. Nursing mothers.
Additive CNS depression with concomitant other CNS depressants. Chronic administration of phenytoin reduces effectiveness of methohexital. Caution with halothane, anticoagulants, corticosteroids, alcohol, propylene-glycol solutions.
Circulatory depression, thrombophlebitis, hypotension, tachycardia, peripheral vascular collapse, convulsions in association with cardiorespiratory arrest, respiratory depression, laryngospasm, bronchospasm, hiccups, dyspnea, skeletal muscle hyperactivity, injury to nerves adjacent to inj site, emergence delirium, restlessness, anxiety, GI upset, abdominal pain, abnormal LFTs, allergic reactions, inj site pain, salivation, headache, rhinitis.
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