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Injection, amphotericin b liposome, 10 mg

HCPCS code

Name of the Procedure:

Common Name(s): Amphotericin B Injection
Technical/Medical Terms: Injection, amphotericin b liposome, 10 mg (J0289)

Summary

Amphotericin B Liposome Injection is a treatment where a medication is injected into a patient's vein to treat fungal infections. The medication is encapsulated in liposomes to reduce toxicity and enhance effectiveness.

Purpose

Conditions Addressed:

  • Severe fungal infections such as cryptococcal meningitis in HIV patients, or systemic fungal infections in immunocompromised patients.

    Goals/Expected Outcomes:

  • To eradicate fungal infections.
  • To alleviate symptoms associated with these infections.
  • To improve the patient's overall prognosis with minimal side effects.

Indications

  • Persistent and severe fungal infections unresponsive to other treatments.
  • Patients diagnosed with conditions like cryptococcosis, histoplasmosis, or aspergillosis.
  • Patients with compromised immune systems (e.g., HIV/AIDS, chemotherapy patients).

Preparation

Pre-procedure Instructions:

  • Patients may need to fast for a few hours before the procedure.
  • Inform your healthcare provider about all the medications you are taking as some may need to be paused.

    Diagnostic Tests/Assessments:

  • Blood tests to check kidney and liver function.
  • Fungal cultures or biopsies to identify the specific fungal infection.

Procedure Description

  1. Preparation: The healthcare provider prepares the Amphotericin B liposome solution.
  2. Administration:

    • The area where the intravenous (IV) line will be inserted is cleaned.
    • An IV line is inserted into a vein, usually in the arm.
    • The medication is slowly injected via IV over a specified period.

    Tools/Equipment Used:

    • IV line, syringes, Amphotericin B liposome solution, infusion pump.

Anesthesia or Sedation:

  • Typically, no anesthesia or sedation is required.

    Duration

    The injection typically takes about 1 to 2 hours to administer.

Setting

Location:

  • Hospital inpatient wards, outpatient clinics, or specialized infusion centers.

Personnel

  • Physicians (e.g., infectious disease specialists)
  • Nurses
  • Pharmacists (for preparing the medication)

Risks and Complications

Common Risks:

  • Infusion-related reactions such as fever, chills, or headache.
  • Kidney function impairment.

    Rare Risks:

  • Severe allergic reactions.
  • Anemia or electrolyte imbalances.

Management of Complications:

  • Monitoring kidney function and adjusting doses.
  • Managing infusion reactions with medications such as antipyretics or antihistamines.

Benefits

Expected Benefits:

  • Effective eradication of fungal infections.
  • Symptomatic relief, often noticeable within a few days to weeks depending on the infection.

Recovery

Post-procedure Care:

  • Monitor for any delayed allergic reactions or side effects.
  • Regular blood tests to check kidney function and drug levels.

    Recovery Time:

  • Varies depending on the severity of the infection but often includes ongoing treatments over several weeks.

Restrictions/Follow-Ups:

  • Avoid other nephrotoxic medications.
  • Regular follow-up visits to the healthcare provider for monitoring.

Alternatives

Other Treatment Options:

  • Other antifungal medications such as fluconazole or itraconazole.

    Pros and Cons of Alternatives:

  • Alternatives may have different side effect profiles or efficacy rates. Amphotericin B is often chosen when other treatments are not effective.

Patient Experience

During the Procedure:

  • A sensation of coolness or mild discomfort at the IV site.
  • Possible transient symptoms like chills or fever during the infusion.

After the Procedure:

  • Tiredness or mild flu-like symptoms can occur but are typically managed and temporary.

    Pain Management:

  • Pre-medications (like acetaminophen) may be given to manage infusion-related symptoms.
  • Hydration and electrolyte management to reduce kidney-related side effects.

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