Methohexital

Question 1

Brand Name

Answer 1

Brevital

Question 2

Broad Category

Answer 2

Rapid, Ultrashort-acting IV anesthetic

Question 3

Pharmacological class

Answer 3

Oxybarbiturate

Question 4

MOA

Answer 4

Primary: GABA-A agonist activating cortical and brainstem GABA inhibitory pathways

Secondary: Ingibition of central excitatory pathways (NMDA / Nicotinic Acetylcholine)

Question 5

Indications

Answer 5

• ECT
• ENDO
• very short procedures

Question 6

Volume of distribution

Answer 6

High (2-3 L/kg)
Highly lipid soluble

Question 7

CV effects

Answer 7

CV depression

Question 8

Respiratory effects

Answer 8

Dose-dependent Respiratory depression/apnea

Question 9

CNS

Answer 9

Proconvulsant
Myoclonus
Skeletal muscle hyperactivity

Question 10

Pain on injection

Answer 10

yes

Question 11

Absolute Contraindications

Answer 11

Acute Intermittent Porphyria

Question 12

Induction Dosing

Answer 12

1-1.5 mg/kg

Question 13

Onset

Answer 13

< 1 min

Question 14

Duration

Answer 14

5-7 mins

Question 15

Reduction of dose with

Answer 15

Opioids and other CNS depressants

Question 16

Metabolism

Answer 16

Hepatic

Question 17

Excretion

Answer 17

Renal

Question 18

Reconsititution?

Answer 18

reconstituted into a 1% (10mg/mL) solution for intermittent IV use

Question 19

Elimination Half-life

Answer 19

4 hours