Alpha-gal syndrome and impact on patient safety

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    Subscribe Today!  Apple Podcasts  Spotify  YouTube  RSS Feed