Name of the Procedure:

Prochlorperazine Maleate, 5 mg, Oral Administration (HCPCS Code: Q0164)

Summary

Prochlorperazine maleate, a 5 mg oral medication, is an FDA-approved prescription anti-emetic. It is used as a complete therapeutic substitute for intravenous (IV) anti-emetic treatments at the time of chemotherapy. This regimen should not exceed 48 hours.

Purpose

Medical Conditions:

• Nausea and vomiting associated with chemotherapy.
• To prevent and control severe nausea and vomiting.

Goals:

• Provide relief from nausea and vomiting.
• Allow patients to tolerate and complete chemotherapy sessions more comfortably.
• Offer a non-IV alternative that can be taken orally, enhancing patient convenience.

Indications

Symptoms or Conditions:

• Chemotherapy-induced nausea and vomiting (CINV).

Patient Criteria:

• Patients undergoing chemotherapy treatment.
• Patients who need an anti-emetic alternative to IV medications.
• Patients without contraindications to prochlorperazine.

Preparation

Pre-Procedure Instructions:

• No specific fasting or dietary restrictions.
• Continue other medications as prescribed unless otherwise advised by a healthcare provider.

Preliminary Assessments:

• Detailed medical history evaluation.
• Assessment of allergies, especially to prochlorperazine or other phenothiazines.
• Monitoring renal and hepatic functions where necessary.

Procedure Description

The administration of Prochlorperazine Maleate involves the following steps:

1. Prescription by a Physician: A healthcare provider prescribes Prochlorperazine maleate 5 mg for the patient.
2. Dispensing: The medication is dispensed by a pharmacy.
3. Oral Administration: The patient takes the medication orally as instructed, usually on a regular schedule (every 6-8 hours).
4. Monitoring: Health professionals monitor the patient’s response to the medication during the initial doses.

Tools and Equipment:

• Standard prescription pills or tablets.

Anesthesia or Sedation:

• Not applicable. This is an oral medication not requiring anesthesia or sedation.

Duration

• The total duration of taking Prochlorperazine maleate should not exceed 48 hours as per the prescribed regimen. Individual doses typically offer relief within 30-60 minutes and last for several hours.

Setting

• This procedure is typically conducted in outpatient settings such as a patient’s home, with monitoring by medical personnel as needed.

Personnel

• Prescribing Physician
• Pharmacist
• Oncology Nurse or care coordinator for follow-up

Risks and Complications

Common Risks:

• Drowsiness
• Dizziness
• Dry mouth
• Constipation

Rare Risks:

• Severe allergic reactions
• Neuroleptic malignant syndrome
• Extrapyramidal symptoms

Management of Complications:

• Immediate medical intervention for severe reactions.
• Adjusting dosages or discontinuing the use based on the physician’s evaluation.

Benefits

• Effective management of nausea and vomiting.
• Improvement in patient comfort during chemotherapy.
• Oral administration offers more convenience compared to IV.

Recovery

Post-Procedure Care:

• Patients are advised to rest and avoid operating heavy machinery if drowsiness occurs.
• Maintain regular follow-ups with healthcare providers.

Expected Recovery Time:

• Relief from symptoms often experienced within an hour of dosing.
• Patients can usually resume normal activities soon after, depending on side effects.

Alternatives

Other Treatment Options:

• IV anti-emetics (e.g., Ondansetron, Metoclopramide)
• Other oral anti-emetic medications (e.g., Domperidone, Granisetron)
• Adjunctive therapies such as acupuncture or dietary adjustments.

Pros and Cons:

• Pros of Prochlorperazine: Non-invasive, easy to administer, effective in symptom management.
• Cons: Possible side effects, limited use to 48 hours, not suitable for all patients.

Patient Experience

During the Procedure:

• The patient will take oral medication with or without food as instructed.
• They may need to stay hydrated and rest if drowsiness occurs.

After the Procedure:

• Experience relief from nausea and vomiting.
• Possibly feel drowsy or dizzy, which should be communicated to healthcare providers.
• Follow any specific dietary or activity restrictions advised by the provider until the medication course is completed.