NHIA Reimbursement Training Center

Therapies 

Antiemetic Therapy
Anti-infective, Antifungal, Antiviral Therapy
Anti-Spasmotic Therapy
Anti-Tumor Necrosis Factor Therapy
Catheter Care Therapy
Chemotherapy
Enteral Therapy
Hydration Therapy
Immunotherapy
Inotropic
Pain Management
Pulmonary Arterial Hypertension
Total Parenteral Nutrition (TPN)

Antiemetic Therapy

Antiemetic therapy is to prevent nausea and vomiting.  Antiemetics are typically used to treat motion sickness and the side effects of chemotherapy.

  • Common Diagnosis
    • Nausea and vomiting
  • Common Drugs
    • Ondansetron
    • Granisetron
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • In conjunction with the primary therapy

 

Anti-infective, Antifungal, Antiviral Therapy

Antibiotics are widely used in the prevention and treatment of infectious diseases.  Antibiotics are produced by various microorganisms and fungi which inhibit the growth of or destroy bacteria and other microorganisms.

  • Common Diagnosis
    • Cellulitis/Bacteremia/Osteomyelitis
  • Common Drugs
    • Vancomycin, Daptomycin, Caspofungin, Ceftriaxone
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • 2 – 6 weeks

 

Anti-Spasmotic Therapy

Therapy that decreases gut contraction and spasm.  These drugs work by blocking the effects of the parasympathetic branch of the autonomic nervous system.

  • Common Diagnosis
    • Spasticity
    • Spastic cerebral palsy
  • Common Drugs
    • Baclofen
  • Method of Administration (IV, subq, etc).
    • Drug is filled into an implantable pump
  • Average length of therapy
    • Long term, > one year

 

Enteral

Enteral nutrition generally refers to any method of feeding that uses the gastrointestinal (GI) tract to deliver part or all of a person’s caloric requirementsThe feeding is delivered directly into the gut via a tube.

  • Common Diagnosis
    • Dysphagia
    • Failure to thrive
    • Malnutrition
  • Common Formulas
    • Osmolite, Peptamen, Nutren
  • Method of Administration
    • Nasogastric tube
    • Jejunostomy tube
    • Gastrostomy tube
  • Average length of therapy
    • May be short as 3 months, usually lifetime

 

Hydration

Hydration therapy is the infusion of fluids directly into the bloodstream.  By using IV delivery, 100% of the administered dose of nutrients, vitamins, minerals and fluids is absorbed immediately on a cellular level.  Hydration is commonly used in conjunction with chemotherapy therapies or for pregnancies causing prolonged emesis.

  • Common Diagnosis
    • Dehydration
  • Common Drugs
    • Normal saline with additives
  • Method of Administration
    • IV
  • Average length of therapy
    • Few weeks; many times hydration is ordered as needed, one to two times per week.

 

Anti-Tumor Necrosis Factor Therapy

A class of drugs that are used to treat inflammatory conditions such as rheumatoid arthritis (RA), psoriatic arthritis, juvenile arthritis, inflammatory bowel disease (Crohn’s and ulcerative colitis), ankylosing spondylitis and psoriasis. These drugs are able to reduce inflammation and stop disease progression.

  • Common Diagnosis
    • Regional enteritis
  • Common Drugs
    • Remicade
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • 6 months

 

Catheter Care Therapy

Tunneled catheters and implanted ports are the other types of central venous catheters, which are tubes threaded through veins to a spot near the heart for the purposes of giving medications. Tunneled catheters and implanted ports are typically left under the skin to keep them in place and require flushing periodically with saline solution or clot-inhibiting medication.

  • Common Diagnosis
    • The patient’s primary dx for their primary therapy
  • Common Drugs
    • Heparin/Saline
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • Up to 4 weeks

 

Chemotherapy

Chemo is a type of treatment that includes a drug or combination of drugs to treat cancer. The goal of chemo is to stop or slow the growth of cancer cells.  Chemotherapy is used most often to describe drugs that kill cancer cells directly. These are sometimes referred to as “anti-cancer” drugs or “antineoplastics.”

  • Common Diagnosis
    • Malignant neoplasms
  • Common Drugs
    • Fluorouracil (5FU)
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • Up to one year

 

Immunotherapy

Human immune globulin therapy is used for the treatment of immunodeficiency, prophylaxis of infectious diseases, and in the management of a variety of other inflammatory and autoimmune disorders.

  • Common Diagnosis
    • Common variable immunodeficiency
    • Chronic inflammatory demyelinating polyneuritis
    • Hypogammaglobulinemia
  • Common Drugs
    • Gammagard, Gamunex, Cytogam, Octagam, Hizentra, HyQvia
  • Method of Administration (IV, subq, etc).
    • SQ, IV
  • Average length of therapy
    • Usually long term, > 1 year

 

Inotropic

Inotropic therapy makes an injured or weakened heart pump harder. It’s used to make the heart muscle’s contractions stronger. It may also speed the heart’s rhythm.

  • Common Diagnosis
    • Cardiomyopathies
    • Heart failure
  • Common Drugs
    • Dobutamine, Milrinone
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • Maybe short term while waiting for heart transplant
    • Maybe long term if surgery is not an option

 

Pain Management

Pain Management therapy is the treatment of intractable or chronic pain.

  • Common Diagnosis
    • Intractable pain
    • Malignant neoplasm
    • Myalgia
  • Common Drugs
    • Morphine, Dilaudid, Hydromorphone
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • Mainly used in Hospice situations until end of life.

 

Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is a rare, progressive disorder characterized by high blood pressure (hypertension) in the arteries of the lungs (pulmonary artery) for no apparent reason. The pulmonary arteries are the blood vessels that carry blood from the right side of the heart through the lungs.

  • Common Diagnosis
    • Pulmonary Hypertension
  • Common Drugs
    • Treprostinil, Epoprostenol
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • Usually long term, > 1 year


Total Parenteral Nutrition (TPN)

TPN is receiving nutrients intravenously.  TPN bypasses the digestive system entirely and goes directly into the bloodstream, where the nutrients are absorbed.

  • Common Diagnosis
    • Malabsorption
    • Dysphagia
  • Common Drugs
    • Amino Acids, Travasol
  • Method of Administration (IV, subq, etc).
    • IV
  • Average length of therapy
    • Maybe short term, i.e., 6 weeks, but most often it is for lifetime