Name of the Procedure:

Aprepitant, oral, 5 mg (HCPCS Procedure Code: J8501) Commonly referred to as Aprepitant or Emend (brand name), antiemetic therapy.

Summary

Aprepitant is a medication used to prevent nausea and vomiting caused by chemotherapy. It is taken orally, typically in a 5 mg dose, to help manage and alleviate these symptoms, significantly improving the patient's comfort during their treatment regimen.

Purpose

Aprepitant is used to:

• Prevent nausea and vomiting caused by chemotherapy.
• Enhance the patient's quality of life during cancer treatment. The main goal is to reduce the discomfort of chemotherapy-induced nausea and vomiting (CINV).

Indications

• Chemotherapy-induced nausea and vomiting (CINV).
• Patients undergoing moderate to high-emetogenic chemotherapy.
• May be combined with other antiemetics for enhanced effectiveness.

Preparation

• Follow doctor's instructions on medication adjustments.
• No specific fasting required, but follow any dietary restrictions provided by healthcare provider.
• Inform the healthcare provider of any other medications being taken to avoid interactions.

Procedure Description

1. The patient is prescribed Aprepitant by their oncologist or primary physician.
2. The medication is taken orally, typically 1 hour before chemotherapy.
3. It can be taken with or without food.
4. It is commonly part of a comprehensive antiemetic regimen that may include other medications like corticosteroids and 5-HT3 antagonists.

Duration

• The oral intake of the medication itself takes only a few minutes.
• Aprepitant is usually taken on the first day of chemotherapy and may be continued for 2 to 3 days following treatment, depending on the regimen.

Setting

• The medication is taken by the patient, typically at home or in the clinical setting just before the chemotherapy session.

Personnel

• Prescribed and monitored by oncologists or primary care physicians.
• Administration guidance may be provided by nurses or pharmacists.

Risks and Complications

• Common side effects: Fatigue, diarrhea, constipation, hiccups, dizziness.
• Rare side effects: Severe allergic reactions, liver enzyme changes.
• Proper assessment and monitoring can manage and mitigate these risks.

Benefits

• Significant reduction in the frequency and severity of nausea and vomiting.
• Improved comfort and quality of life during chemotherapy.
• Benefits are typically noticeable within hours of administration and can last several days.

Recovery

• No specific recovery needed from taking the medication itself.
• Patients should follow their healthcare provider’s instructions regarding follow-up appointments and overall chemotherapy care plan.
• Encourage hydration and a balanced diet to help manage side effects.

Alternatives

• Other antiemetic medications like ondansetron or granisetron.
• Non-pharmacological approaches include dietary modifications and acupressure.
• Each alternative has its own set of pros and cons, often discussed with a healthcare provider to tailor the best plan for individual patients.

Patient Experience

• The patient should expect minimal disruption when taking the medication.
• It is designed to enhance comfort during chemotherapy.
• Pain management is typically not required, but maintaining regular communication with the healthcare team helps optimize the treatment's effectiveness and manage any discomfort or side effects that occur.