VerifiedRx

Alpha-gal Syndrome and Impact on Patient Safety

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Alpha-gal syndrome is an emerging and often underrecognized allergy triggered by a tick bite that can cause delayed reactions to red meat and mammalian-derived products. In this episode, host Stacy Lauderdale is joined by clinical experts Zack Stacy and Kyna Henrici to unpack the science behind alpha-gal, its implications in healthcare settings, and the operational challenges providers face in managing this complex condition. 

 

Guest Speakers:  
Zachary Stacy, Pharm.D., MS, FCCP, BCPS 
Clinical Pharmacy Specialist, Surgery 
BJC Health

 

Kyna Henrici, RN 

Medical Evidence Director - Cardiovascular 
Vizient, Inc.


Host:   
Stacy Lauderdale, Pharm.D., BCPS 
AVP, Evidence-Based Medicine 
Vizient, Inc.

 

00:05 – Introduction 

  • Podcast introduction and welcome to VerifiedRx 

    • 00:14 – What is alpha-gal syndrome 

    • Overview of alpha-gal syndrome 
      • Delayed allergic reactions after eating red meat 
        • Often linked to tick bites 

          • 00:48 – Meet the Guests 

          •  Zack Stacy, clinical pharmacy specialist 
            • Kyna Henrici, medical evidence director 

              • 01:10 – Understanding the Allergy 

              • Alpha-gal is a carbohydrate in nonprimate mammals that can trigger an allergy in humans 
                • Key difference is delayed reaction timing 
                  • Symptoms are not always easy to trace  

                    • 01:32 – How It Develops 

                    • Triggered by tick bites 
                      • Immune system produces IgE antibodies  
                        • Oral exposure to alpha-gal leads to delayed reactions 
                          • IV exposure to alpha-gal can cause immediate reactions 

                            • 02:17 – Prevalence and Diagnosis Challenges 

                            • More common in Midwest and southern United States 
                              • Likely underdiagnosed 
                                • Often mistaken for general food allergies 
                                  • Allergy may fade over time 

                                    • 03:07 – Risks in Healthcare Settings 

                                    • Patient safety concerns beyond food 
                                      • Mammalian components in medications and devices 
                                        • Examples include heparin and surgical materials 

                                          • 03:44 – Hidden Medication Risks 

                                          • Inactive ingredients can be animal derived 
                                            • Examples include glycerin, lactose, amino acids, stearates 
                                              • Difficult to identify and track 

                                                • 04:42 – Lack of Transparency 

                                                • No centralized ingredient database 
                                                  • Sourcing can change frequently 
                                                    • Variability across manufacturers and batches 

                                                      • 05:33 – Screening in Surgical Settings 

                                                      • Medication review at NDC level 
                                                        • Identification of active and inactive ingredients 
                                                          • May require contacting manufacturers 

                                                            • 06:45 – Timing Challenges 

                                                            • Urgent procedures limit investigation time 
                                                              • Manufacturer responses may take days 
                                                                • Alternative medications often needed 

                                                                  • 07:14 – Identifying At Risk Patients 

                                                                  • Many patients are unaware they have alpha-gal syndrome 
                                                                    • Screening includes questions about dairy tolerance 
                                                                      • Three patient categories used for evaluation 

                                                                        • 08:32 – Using Dairy as a Screening Tool 

                                                                        •  Dairy tolerance helps guide risk level 
                                                                          • Food exposure typically higher than medication exposure 
                                                                            • Determines need for deeper review 

                                                                              • 09:12 – Managing Emergencies 

                                                                              • Focus shifts from avoidance to risk mitigation 
                                                                                • Use of team communication and clear documentation 
                                                                                  • Preparation for unavoidable exposure 

                                                                                    • 10:03 – Prevention and Preparedness 

                                                                                    • Stock alpha-gal safe medications when possible 
                                                                                      • Prepare for allergic reactions with standard treatments 

                                                                                        • 10:47 – Team Based Care Approach 

                                                                                        • Collaboration across care teams is essential 
                                                                                          • Premedication strategies may be used 
                                                                                            • Close monitoring for reactions 

                                                                                              • 11:11 – Gaps in Care 

                                                                                              • Limited visibility into product ingredients 
                                                                                                • Need for better labeling and transparency 

                                                                                                  • 11:33 – Need for Standardization 

                                                                                                  • Call for clearer guidance and clinician education 
                                                                                                    • Desire for centralized resource for medication ingredients 

                                                                                                      • 12:24 – Monitoring Challenges 

                                                                                                      • CDC tracking decreased after privatization of testing 
                                                                                                        • Cases likely still increasing 

                                                                                                          • 12:53 – Closing Remarks 

                                                                                                           

                                                                                                          Links and Resources: Alpha-gal Syndrome | Alpha-gal Syndrome | CDC 

                                                                                                           

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