Name of the Procedure:

Common Name(s): Treprostinil inhalation therapy
Medical Term: Treprostinil, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, 1.74 mg (J7686)

Summary

Treprostinil inhalation therapy involves breathing in a specially-formulated medication through a nebulizer. This treatment helps open the blood vessels in the lungs and improve the flow of blood and oxygen throughout the body.

Purpose

Medical Conditions:
Primarily used to manage pulmonary arterial hypertension (PAH).

Goals:

• Reduce symptoms and complications of PAH.
• Improve exercise capacity and quality of life.
• Delay disease progression.

Indications

Symptoms and Conditions:

• Diagnosed with pulmonary arterial hypertension (PAH).
• Experiencing symptoms such as shortness of breath, fatigue, chest pain, and dizziness.

Patient Criteria:

• Patients who are suitable candidates for inhalation therapy.
• Confirmed diagnosis of PAH through medical examinations.

Preparation

Pre-Procedure Instructions:

• No specific fasting requirements.

• Patients should inform their healthcare providers about all medications and supplements they are currently taking.

  Diagnostic Tests/ Assessments:

• Baseline pulmonary function tests.
• Other relevant cardiovascular assessments.

Procedure Description

1. Setup: A nebulizer device, which turns the liquid medication into an aerosol, is set up.
2. Dosing: The prescribed 1.74 mg dose of Treprostinil is loaded into the device.

3. Administration: The patient breathes in the aerosolized medication through a mouthpiece or mask over a period of a few minutes.

   Tools/Equipment:

   • Nebulizer device (DME: Durable Medical Equipment).
   • Mask or mouthpiece.

Sedation/Anesthesia:

• Not typically required for this procedure.

Duration

Procedure Time:

• Each inhalation session usually takes around 3-5 minutes.
• Multiple sessions may be needed throughout the day, as prescribed.

Setting

Location:

• Can be performed at home with appropriate DME equipment.
• Initial training may be done in a clinic setting.

Personnel

Involved Healthcare Professionals:

• Pulmonologists.
• Registered Nurses or Respiratory Therapists (for initial setup and training).

Risks and Complications

Common Risks:

• Coughing, throat irritation, headaches.

Rare Risks:

• Serious allergic reactions.
• Worsening of respiratory symptoms.

Management:

• Immediate cessation and medical consultation if severe reactions occur.

Benefits

Expected Benefits:

• Improved lung function and exercise capacity.
• Symptom reduction often seen within weeks of regular use.

Recovery

Post-Procedure Care:

• Patients should follow up regularly with their healthcare provider.

• Maintain adherence to the prescribed inhalation schedule.

  Recovery Time:

• No significant recovery time needed beyond the duration of the inhalation sessions.
• Patients can resume normal activities immediately.

Alternatives

Other Treatments:

• Oral, intravenous, or subcutaneous medications for PAH.
• Lifestyle modifications (e.g., diet, exercise).

Pros and Cons:

• Inhalation therapy directly targets the lungs for faster relief.
• Other treatments might be less effective in immediate symptom control but offer convenience in administration.

Patient Experience

During the Procedure:

• Patients may feel a mild sensation as the aerosol is inhaled.
• Comfort measures include sitting in a relaxed position.

After the Procedure:

• Some throat irritation or coughing might occur.
• Pain management is usually not necessary, but over-the-counter remedies can be used if needed.