Name of the Procedure:

Injection, Metoclopramide HCl, Up to 10 mg (HCPCS Code: J2765)

Summary

Metoclopramide hydrochloride injection is a procedure where a medication called metoclopramide is administered via injection. This medication is used to treat nausea, vomiting, and issues related to gastric motility disorders.

Purpose

This procedure is designed to:

• Alleviate nausea and vomiting, particularly associated with cancer treatments or post-surgery.
• Improve gastric emptying in patients with diabetic gastroparesis.
• Manage gastroesophageal reflux disease (GERD) that isn't responsive to conventional treatment.

Indications

• Chronic nausea or vomiting.
• Gastroparesis, especially in diabetic patients.
• GERD not managed effectively by other medications.
• Prevention of nausea and vomiting associated with chemotherapy or surgery.

Preparation

Patient preparation may include:

• Fasting for a few hours before the injection.
• Informing the healthcare provider of all medications and allergies.
• Possibly undergoing diagnostic tests such as an ECG, especially for patients with cardiac conditions.
• Adjusting current medications as per the doctor’s recommendations.

Procedure Description

1. The healthcare provider will clean the injection site with an antiseptic.
2. Metoclopramide HCl, up to 10 mg, will be drawn into a sterile syringe.
3. The injection is typically administered intramuscularly or intravenously.
4. If given intravenously, the medication is administered slowly over a period to avoid rapid side effects.
5. The area may be massaged gently after the injection to distribute the medication.

Tools & Equipment:

• Sterile syringe and needle
• Antiseptic solution
• Bandages or cotton swabs

Anesthesia or Sedation: Generally not required; however, local anesthesia might be used to minimize pain at the injection site.

Duration

The injection procedure itself usually takes about 5-10 minutes.

Setting

This injection can be administered in various settings, including:

• Hospital
• Outpatient clinic
• Doctor’s office

Personnel

• The procedure is usually performed by a nurse or a physician.
• Supervision by a medical doctor, especially in a hospital or clinic setting.

Risks and Complications

Common risks include:

• Redness or swelling at the injection site.
• Mild pain or burning sensation.

Rare complications:

• Allergic reactions
• Dystonic reactions (muscle spasms or tremors)
• Changes in heart rhythm, particularly in patients with a history of cardiac issues.

Benefits

• Rapid relief from nausea and vomiting.
• Improved gastric motility leading to better digestion and comfort.
• Quick onset of action, usually within hours.

Recovery

• Patients can usually resume normal activities shortly after the injection.
• Follow-up appointments may be scheduled to monitor response to the treatment and adjust dosages if necessary.
• Patients should monitor for side effects and contact their healthcare provider if any adverse symptoms occur.

Alternatives

• Oral antiemetic medications.
• Other injectable antiemetics.
• Non-pharmacological therapies like acupuncture or behavior modification for nausea management.

Pros and Cons:

• Alternatives may offer less immediate relief.
• Some alternatives have a different side effect profile, which may be preferable to some patients.

Patient Experience

During the injection:

• Patients may feel a brief sting or burning sensation.
• Some may experience mild discomfort at the injection site.

After the injection:

• Relief from symptoms is usually quick.
• Mild tenderness or bruising at the injection site may occur, which can be managed with over-the-counter pain relievers and cold packs.