Name of the Procedure:

Injection, cidofovir, 375 mg (HCPCS Code: J0740)

Summary

The injection of cidofovir is a medical procedure that involves administering a medication known as cidofovir directly into the bloodstream. This antiviral drug is used to treat certain viral infections, particularly in patients with weakened immune systems.

Purpose

The primary purpose of cidofovir injection is to combat serious viral infections caused by cytomegalovirus (CMV) in patients with compromised immune systems, such as those with AIDS or who have undergone organ transplants. The goal is to reduce the viral load in the body, alleviate symptoms, and prevent the progression of the infection.

Indications

• CMV retinitis in AIDS patients
• Other severe CMV infections in immunocompromised individuals
• Patients who have not responded to or cannot tolerate other antiviral treatments

Preparation

• The patient may need to undergo blood tests to assess kidney function before the procedure.
• Patients should stay well hydrated; an intravenous saline solution may be administered before and after cidofovir injection.
• Patients will be advised to avoid taking nephrotoxic drugs (medications that could harm the kidneys) before and after the procedure.

Procedure Description

1. The healthcare provider checks the patient's vital signs and renal function.
2. An intravenous line is established in the patient's arm.
3. Hydration with saline solution is initiated to prevent kidney damage.
4. Cidofovir is slowly injected into the bloodstream via the intravenous line.
5. The procedure may be followed up with additional hydration.

Duration

The injection of cidofovir usually takes about 1 to 2 hours, including the time for pre- and post-hydration.

Setting

This procedure is typically performed in a hospital or an outpatient clinic with close monitoring by healthcare professionals.

Personnel

• Physician or infectious disease specialist
• Nurse or medical assistant
• Pharmacist (for medication preparation)
• Anesthesiologist or nurse anesthetist (if sedation is needed, though it is usually not required)

Risks and Complications

• Kidney damage or nephrotoxicity
• Decreased white blood cell count (neutropenia)
• Eye inflammation (uveitis)
• Nausea, vomiting, or diarrhea
• Allergic reactions

Benefits

• Reduction in CMV viral load
• Improvement in symptoms related to the viral infection
• Prevention of further complications from CMV

Recovery

• Patients need to stay hydrated following the procedure.
• They should rest and monitor for any signs of kidney issues or other side effects.
• Follow-up appointments will be necessary to monitor kidney function and efficacy of the treatment.

Alternatives

• Other antiviral medications like ganciclovir or foscarnet
• Each alternative has its own risk profile and efficacy, which should be discussed with the healthcare provider.

Patient Experience

• During the procedure, the patient may feel a slight prick from the IV insertion.
• They might experience mild discomfort during the injection.
• Post-procedure, patients may feel tired and should follow hydration recommendations.
• Pain management is typically not needed, but any discomfort should be reported to the healthcare provider.