Name of the Procedure:

Oral Chlorpromazine Hydrochloride, 5 mg (Q0161)

Summary

Oral Chlorpromazine Hydrochloride is a medication previously approved by the FDA used to prevent nausea and vomiting associated with chemotherapy. This oral medication is taken as a complete therapeutic substitute for an intravenous (IV) anti-emetic, providing the same benefits with a simpler administration method. The regimen should not exceed 48 hours in duration.

Purpose

Medical Conditions Addressed

• Chemotherapy-induced nausea and vomiting (CINV).

Goals and Expected Outcomes

• Prevention and management of nausea and vomiting.
• Enhanced patient comfort during chemotherapy.
• Avoidance of dehydration and weight loss associated with vomiting.

Indications

• Patients undergoing chemotherapy who are experiencing or are at high risk for nausea and vomiting.
• Those who prefer an oral medication over an IV administration.
• Patients who have no contraindications to Chlorpromazine.

Preparation

Pre-procedure Instructions

• No specific fasting required before taking oral Chlorpromazine.
• Follow any dietary or medication instructions provided by your healthcare provider.
• Ensure you have contacted your doctor to discuss all medications and medical history.

Diagnostic Tests

• No specific tests required before starting this medication, but a review of medical history and current medications is critical.

Procedure Description

Step-by-Step Explanation

1. The patient receives the prescribed oral dosage of Chlorpromazine (5 mg).
2. The medication can typically be taken at home 1-2 hours before chemotherapy.
3. Additional doses may be taken as prescribed by the healthcare provider, adhering strictly to the 48-hour regimen ceiling.

Tools and Equipment

• Oral medication (Chlorpromazine Hydrochloride, 5 mg).

Anesthesia or Sedation

• Not applicable, as the medication is taken orally.

Duration

• The medication regimen lasts up to 48 hours, encompassing multiple doses as prescribed.

Setting

• This treatment is typically administered at home or in an outpatient clinic setting.

Personnel

• The healthcare team may include oncologists, pharmacists, and nurses for dosing instructions and monitoring.

Risks and Complications

Common Risks

• Drowsiness.
• Dry mouth.
• Blurred vision.

Rare Risks

• Severe allergic reactions.
• Extrapyramidal symptoms (EPS) like tremors or muscle stiffness.
• Cardiovascular effects such as low blood pressure or arrhythmias.

Complications Management

• Immediate medical attention in case of severe reactions or EPS.
• Continuous monitoring of side effects and adjusting the medication regimen if necessary.

Benefits

Expected Benefits

• Effective management of nausea and vomiting linked to chemotherapy.
• Greater convenience and comfort compared to IV anti-emetics.
• Improved patient adherence due to ease of administration.

Realization Timeline

• Relief from nausea typically begins within hours of the initial dose.

Recovery

Post-Procedure Care

• Monitor for any side effects like drowsiness or dizziness.
• Stay hydrated and maintain a balanced diet.
• Report any severe side effects to your healthcare provider immediately.

Recovery Time

• No prolonged recovery period from the medication; side effects, if any, should resolve shortly after the last dose.

Follow-Up

• Regular check-ups with your oncologist to adjust dosages or address any issues.

Alternatives

• IV anti-emetics.
• Other oral anti-emetics such as ondansetron or metoclopramide.
• Behavioral methods like acupuncture or guided relaxation.

Pros and Cons of Alternatives

• IV anti-emetics: Effective but involve hospital visits and potential discomfort.
• Other oral anti-emetics: Similar ease of use but may have different side effects profiles.
• Behavioral methods: No medication side effects but may not be as immediately effective.

Patient Experience

During the Procedure

• The patient will take the medication orally according to the prescribed schedule.

After the Procedure

• There may be mild drowsiness or dry mouth, which can be managed with rest and hydration.
• Patients generally experience significant relief from nausea, leading to a more comfortable chemotherapy experience.

Pain Management and Comfort Measures

• Taking the medication with food to avoid stomach upset.
• Informing the healthcare provider of any severe discomfort for appropriate management.