Name of the Procedure:

Injection of fosnetupitant and palonosetron (J1454).

Summary

This procedure involves the administration of a combined injection containing fosnetupitant (235 mg) and palonosetron (0.25 mg). It is typically given to prevent nausea and vomiting caused by chemotherapy.

Purpose

The injection is used to:

• Prevent acute and delayed nausea and vomiting caused by cancer treatments such as chemotherapy.
• Improve patient comfort and adherence to treatment by controlling one of the most distressing side effects of chemotherapy.

Indications

• Patients undergoing moderately to highly emetogenic (nausea and vomiting inducing) chemotherapy.
• Patients who have experienced nausea and vomiting with previous chemotherapy cycles.

Preparation

• Patients may be advised to fast for 6-8 hours prior to the procedure.
• It is important to review and possibly adjust concurrent medications to avoid interactions.
• Baseline blood tests might be required to ensure the patient is fit for treatment.

Procedure Description

1. Pre-administration: The healthcare provider will confirm the patient’s identity, review medical history, and explain the procedure.
2. Injection Site Preparation: The injection site, typically the upper arm or thigh, will be cleaned with an antiseptic.
3. Injection: Using a sterile technique, the combined fosnetupitant and palonosetron solution is administered intraveneously.
4. Post-administration: The site is monitored for any immediate adverse reactions, and dressing may be applied if necessary.

Duration

The injection process typically takes about 15-30 minutes, including preparation and post-administration observation.

Setting

The procedure is usually performed in an outpatient clinic, hospital, or chemotherapy center.

Personnel

• The injection is administered by a registered nurse or a healthcare professional trained in chemotherapy administration.
• A physician or oncologist oversees the process and is available for any complications.

Risks and Complications

• Common risks: Mild pain or swelling at the injection site, headache, fatigue, or constipation.
• Rare risks: Allergic reactions, significant dizziness, or anaphylactic shock.
• Management: Most side effects are managed with over-the-counter medication or supportive care. Severe reactions require immediate medical intervention.

Benefits

• Effective control of nausea and vomiting associated with chemotherapy, allowing patients to maintain better nutrition and fluid intake.
• Improved quality of life and ability to continue with scheduled chemotherapy treatments.

Recovery

• Patients can usually go home shortly after the injection if no complications arise.
• It’s recommended to stay hydrated and avoid heavy meals for a few hours.
• Follow-up appointments may be scheduled to monitor the patient's response to the treatment.

Alternatives

• Alternative medications include ondansetron, granisetron, and dexamethasone, which can also prevent chemotherapy-induced nausea and vomiting.
• Pros: Different drugs may be more suitable for certain patients based on their medical history and specific side-effect profiles.
• Cons: Alternatives might not be as effective in controlling delayed nausea and vomiting, and some have their own side effects.

Patient Experience

• During the procedure, patients may feel a brief sting or mild discomfort at the injection site.
• Post-procedure, patients may experience minor side effects such as headache or fatigue, which typically resolve within 24-48 hours.
• Pain management might include over-the-counter pain relievers if necessary, and comfort measures such as rest and hydration are encouraged.

By adhering to this structured approach, patients can expect a reliable and effective prevention of chemotherapy-induced nausea and vomiting, enhancing their overall treatment experience.