Name of the Procedure:

Common Name: Oral Diphenhydramine Hydrochloride Technical/Medical Term: Diphenhydramine HCl, 50 mg, oral, FDA-approved prescription anti-emetic

Summary

Oral Diphenhydramine Hydrochloride is an FDA-approved prescription medication used to prevent nausea and vomiting associated with chemotherapy. It serves as a complete therapeutic substitute for intravenous anti-emetics and is administered orally.

Purpose

Conditions Addressed:

• Nausea and vomiting induced by chemotherapy treatments.

Goals/Outcomes:

• To effectively control and prevent nausea and vomiting, thereby increasing patient comfort and compliance with chemotherapy regimens.

Indications

Symptoms/Conditions:

• Chemotherapy-induced nausea and vomiting (CINV).

Patient Criteria:

• Patients undergoing chemotherapy who cannot tolerate or do not have access to intravenous anti-emetics.
• Patients requiring anti-emetic therapy for up to 48 hours.

Preparation

Pre-Procedure Instructions:

• Follow the oncologist's instructions regarding food and fluid intake before taking the medication.
• Inform your healthcare provider of all current medications and supplements to avoid potential drug interactions.

Diagnostic Assessments:

• No specific diagnostic tests required; however, a medical history review will be conducted.

Procedure Description

Step-by-Step Explanation:

1. Administration: The patient receives Diphenhydramine Hydrochloride orally, typically in a 50 mg dose.
2. Schedule: Follow the prescribed dosing regimen, not exceeding a 48-hour administration period.
3. Monitoring: Patients may be monitored for effectiveness and side effects.

Tools/Equipment:

• Oral tablets or capsules of Diphenhydramine Hydrochloride.

Anesthesia/Sedation:

• None required.

Duration

• The medication regimen is usually not to exceed 48 hours.

Setting

• Typically administered at home, but can be supervised in a clinical setting if required.

Personnel

• Prescribing Oncologist or healthcare provider.
• Pharmacist for dispensing medication.
• Nurses or medical assistants may provide initial administration instructions.

Risks and Complications

Common Risks:

• Drowsiness
• Dry mouth
• Dizziness
• Constipation

Rare Risks:

• Severe allergic reactions
• Cardiovascular issues such as palpitations

Complications Management:

• Adverse effects should be reported to the healthcare provider immediately for potential adjustments in therapy.

Benefits

• Effective management of chemotherapy-induced nausea and vomiting.
• Oral administration offers convenience and ease of use compared to intravenous options.
• Improved patient comfort and ability to continue with chemotherapy.

Recovery

Post-Procedure Care:

• Patients should stay hydrated and follow dietary recommendations to mitigate side effects.
• Monitor for any adverse effects and report them to the healthcare provider.

Recovery Time:

• Immediate effect upon absorption, with benefits experienced within hours. Full effects last as per the active duration of each dose (typically 4-6 hours).

Follow-Up:

• Scheduled follow-ups with the oncologist to assess overall effectiveness and make any necessary adjustments.

Alternatives

Other Treatment Options:

• Intravenous anti-emetics like ondansetron.
• Other oral anti-emetics such as prochlorperazine or metoclopramide.

Pros and Cons:

Intravenous Anti-Emetics

• Pros: Immediate action, higher bioavailability.
• Cons: Require clinical setting, more invasive.

Other Oral Anti-Emetics

• Pros: Variety in mechanisms of action, can be tailored to patient response.
• Cons: May have different side effect profiles.

Patient Experience

During Procedure:

• Easy to swallow tablet or capsule.
• Instructions regarding dosage and timing to be followed.

After Procedure:

• May experience drowsiness or mild side effects.
• Comfort measures include rest and hydration. Pain management usually not required given the nature of the drug.

Pain management and comfort measures include staying hydrated, rest, and sticking to a light diet if experiencing mild gastrointestinal side effects.