{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T20:53:57Z","timestamp":1726433637216},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"24","license":[{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Propofol is an intravenous sedative used in many patient populations and care settings. Although generally considered safe and effective, the drug has historically been avoided in patients with reported allergies to egg, soy, and\/or peanut on the basis of the manufacturer\u2019s prescribing information. Concerns exist for potential adverse events, increased medication costs, reduced efficacy, and risk of medication errors when using alternative agents. Here we present a critical examination of the literature concerning cross-reactivity of food allergies with propofol to provide evidence-based recommendations for the evaluation and management of potential allergic reactions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>Literature regarding the history of propofol allergy warnings and clinical trial data were assessed to provide an alternative perspective on avoidance of propofol in patients with food allergies. Suspected trigger molecules are discussed, with evaluation of the antigenic potential of excipient ingredients used in the manufacture of multiple propofol formulations. Evidence-based recommendations are provided for pharmacist-led screening of adult patients with reported food allergies to support selection of propofol or alternative therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>There is a lack of definitive evidence that propofol must be routinely avoided in patients with reported allergies to egg, soy, and\/or peanut products. Data from clinical trials suggest that propofol is safe for patients with nonanaphylactic food allergies. Patients who do experience allergic reactions following administration of propofol should undergo further testing to definitively identify the specific trigger and prevent future unnecessary avoidance of preferred medication regimens. Pharmacists can play an important role in interviewing patients with reported food allergies to better determine the risk vs benefit of propofol avoidance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxab298","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T15:50:36Z","timestamp":1627314636000},"page":"2195-2203","source":"Crossref","is-referenced-by-count":3,"title":["New perspectives on propofol allergy"],"prefix":"10.1093","volume":"78","author":[{"given":"Jessica L","family":"Johnson","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, William Carey University School of Pharmacy, Biloxi, MS, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Hawthorne","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, William Carey University School of Pharmacy, Biloxi, MS, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Bounds","sequence":"additional","affiliation":[{"name":"William Department of Pharmacy Practice, Carey University School of Pharmacy, Biloxi, MS, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Weldon","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, William Carey University School of Pharmacy, Biloxi, MS, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"issue":"1","key":"2021121005423932200_CIT0001","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1213\/ANE.0b013e31821b450f","article-title":"Allergic reactions to propofol in egg-allergic children","volume":"113","author":"Murphy","year":"2011","journal-title":"Anesth Analg"},{"issue":"10","key":"2021121005423932200_CIT0002","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1111\/anae.14693","article-title":"Propofol use in children with allergies to egg, peanut, soybean or other legumes","volume":"74","author":"Sommerfield","year":"2019","journal-title":"Anaesthesia"},{"issue":"1","key":"2021121005423932200_CIT0003","doi-asserted-by":"crossref","first-page":"46","DOI":"10.4168\/aair.2012.4.1.46","article-title":"A case of propofol-induced oropharyngeal angioedema and bronchospasm","volume":"4","author":"You","year":"2012","journal-title":"Allergy Asthma Immunol Res"},{"issue":"14","key":"2021121005423932200_CIT0004","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.2146\/ajhp100437","article-title":"Rapid-sequence intubation and the role of the emergency department pharmacist","volume":"68","author":"Hampton","year":"2011","journal-title":"Am J Health-Syst Pharm"},{"issue":"15","key":"2021121005423932200_CIT0005","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.2146\/ajhp110707","article-title":"Pharmacists\u2019 role in procedural sedation and analgesia in the emergency department","volume":"69","author":"Patanwala","year":"2012","journal-title":"Am J Health-Syst Pharm"},{"author":"Diprivan","key":"2021121005423932200_CIT0006"},{"issue":"2","key":"2021121005423932200_CIT0007","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/CCM.0b013e31823b8fef","article-title":"Bioavailability or just availability? How the national propofol shortage example may transform tenets of critical care management","volume":"40","author":"Popovich","year":"2012","journal-title":"Crit Care Med"},{"issue":"1","key":"2021121005423932200_CIT0008","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1093\/bja\/aev401","article-title":"Propofol and food allergy","volume":"116","author":"Harper","year":"2016","journal-title":"Br J Anaesth"},{"issue":"2","key":"2021121005423932200_CIT0009","doi-asserted-by":"crossref","first-page":"124","DOI":"10.4103\/0259-1162.108286","article-title":"Anaphylaxis during the perioperative period","volume":"6","author":"Mali","year":"2012","journal-title":"Anesth Essays Res"},{"issue":"4","key":"2021121005423932200_CIT0010","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1097\/00000542-200510000-00026","article-title":"Propofol: the challenges of formulation","volume":"103","author":"Baker","year":"2005","journal-title":"Anesthesiology"},{"key":"2021121005423932200_CIT0011"},{"year":"2014","author":"Propofol","key":"2021121005423932200_CIT0012"},{"year":"2020","author":"Propofol injectable emulsion, USP 1%. Safety data sheet","key":"2021121005423932200_CIT0013"},{"issue":"6","key":"2021121005423932200_CIT0014","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/j.jaci.2014.03.011","article-title":"Potential food allergens in medications","volume":"133","author":"Kelso","year":"2014","journal-title":"J Allergy Clin Immunol"},{"key":"2021121005423932200_CIT0015","first-page":"79","article-title":"Bet 1: is propofol safe in patients with egg anaphylaxis?","volume":"30","author":"Baombe","year":"2013","journal-title":"Emerg Med J"},{"issue":"4","key":"2021121005423932200_CIT0016","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1007\/s11882-014-0426-8","article-title":"Cross-reactivity of peanut allergens","volume":"14","author":"Bublin","year":"2014","journal-title":"Curr Allergy Asthma Rep"},{"issue":"3","key":"2021121005423932200_CIT0017","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/imj.13362","article-title":"Food allergy: is prevalence increasing?","volume":"47","author":"Tang","year":"2017","journal-title":"Intern Med J"},{"issue":"1","key":"2021121005423932200_CIT0018","doi-asserted-by":"crossref","first-page":"e185630","DOI":"10.1001\/jamanetworkopen.2018.5630","article-title":"Prevalence and severity of food allergies among US adults","volume":"2","author":"Gupta","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"2","key":"2021121005423932200_CIT0019","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.pcl.2011.02.014","article-title":"Current understanding of egg allergy","volume":"58","author":"Caubet","year":"2011","journal-title":"Pediatr Clin North Am"},{"issue":"2","key":"2021121005423932200_CIT0020","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1159\/000503749","article-title":"The natural course of immediate-type cow\u2019s milk and egg allergies in children","volume":"181","author":"Kim","year":"2020","journal-title":"Int Arch Allergy Immunol"},{"issue":"1","key":"2021121005423932200_CIT0021","doi-asserted-by":"crossref","first-page":"72","DOI":"10.18176\/jiaci.0337","article-title":"Recommendations for the use of propofol in egg-allergic patients","volume":"29","author":"Mart\u00ednez","year":"2019","journal-title":"J Investig Allergol Clin Immunol"},{"issue":"4","key":"2021121005423932200_CIT0022","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1097\/MPG.0000000000001291","article-title":"Propofol use in pediatric patients with food allergy and eosinophilic esophagitis","volume":"64","author":"Mehta","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"3","key":"2021121005423932200_CIT0023","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/all.12360","article-title":"Propofol administration is safe in adult eosinophilic esophagitis patients sensitized to egg, soy, or peanut","volume":"69","author":"Molina-Infante","year":"2014","journal-title":"Allergy"},{"issue":"1","key":"2021121005423932200_CIT0024","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1093\/bja\/aev360","article-title":"No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut","volume":"116","author":"Asserh\u00f8j","year":"2016","journal-title":"Br J Anaesth"},{"issue":"10","key":"2021121005423932200_CIT0025","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1111\/anae.14693","article-title":"Propofol use in children with allergies to egg, peanut, soybean or other legumes","volume":"74","author":"Sommerfield","year":"2019","journal-title":"Anaesthesia"},{"issue":"2","key":"2021121005423932200_CIT0026","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/00000542-200302000-00009","article-title":"Effects of EDTA- and sulfite-containing formulations of propofol on respiratory system resistance after tracheal intubation in smokers","volume":"98","author":"Rieschke","year":"2003","journal-title":"Anesthesiology"},{"issue":"2","key":"2021121005423932200_CIT0027","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jaip.2013.12.001","article-title":"Systemic allergy to EDTA in local anesthetic and radiocontrast media","volume":"2","author":"Russo","year":"2014","journal-title":"J Allergy Clin Immunol Pract"},{"author":"Lusedra","key":"2021121005423932200_CIT0028"},{"author":"Food and Drug Administration","key":"2021121005423932200_CIT0029"},{"issue":"2","key":"2021121005423932200_CIT0030","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/00000542-199208000-00009","article-title":"Life-threatening anaphylactoid reactions to propofol (Diprivan)","volume":"77","author":"Laxenaire","year":"1992","journal-title":"Anesthesiology"},{"issue":"11","key":"2021121005423932200_CIT0031","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1111\/j.1365-2044.2007.05337.x","article-title":"Propofol and peanut allergy","volume":"62","author":"Gangineni","year":"2007","journal-title":"Anaesthesia"},{"issue":"4","key":"2021121005423932200_CIT0032","first-page":"301","article-title":"New drug, fospropofol disodium: a propofol prodrug","volume":"77","author":"Welliver","year":"2009","journal-title":"AANA J"},{"author":"American","key":"2021121005423932200_CIT0033"},{"issue":"3","key":"2021121005423932200_CIT0034","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3390\/pharmacy7030120","article-title":"Penicillin allergy skin testing in the inpatient setting","volume":"7","author":"Justo","year":"2019","journal-title":"Pharmacy"},{"issue":"3","key":"2021121005423932200_CIT0035","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1093\/ajhp\/zxy043","article-title":"A practical guide for pharmacists to successfully implement penicillin allergy skin testing","volume":"76","author":"Bland","year":"2019","journal-title":"Am J Health-Syst Pharm"},{"issue":"3","key":"2021121005423932200_CIT0036","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/ACI.0b013e3283464d1b","article-title":"Molecular diagnosis of egg allergy","volume":"11","author":"Caubet","year":"2011","journal-title":"Curr Opin Allergy Clin Immunol"},{"issue":"6","key":"2021121005423932200_CIT0037","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1111\/all.12142","article-title":"Skin test concentrations for systemically administered drugs\u2014an ENDA\/EAACI Drug Allergy Interest Group position paper","volume":"68","author":"Brockow","year":"2013","journal-title":"Allergy"},{"issue":"8","key":"2021121005423932200_CIT0038","first-page":"480","article-title":"Clarification of drug allergy information using a standardized drug allergy questionnaire and interview","volume":"43","author":"Harig","year":"2018","journal-title":"P&T"},{"issue":"2","key":"2021121005423932200_CIT0039","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3390\/pharmacy7020069","article-title":"Strategies for clarifying penicillin allergies when skin testing is not an option","volume":"7","author":"Covington","year":"2019","journal-title":"Pharmacy"},{"key":"2021121005423932200_CIT0040","doi-asserted-by":"crossref","first-page":"S91","DOI":"10.1177\/03946320110240S313","article-title":"Prevention of allergic reactions in anesthetized patients","volume":"24","author":"Caffarelli","year":"2011","journal-title":"Int J Immunopathol Pharmacol"},{"issue":"4","key":"2021121005423932200_CIT0041","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.aorn.2012.07.009","article-title":"Propofol allergy: assessing for patient risks","volume":"96","author":"Cochico","year":"2012","journal-title":"AORN J"},{"issue":"7","key":"2021121005423932200_CIT0042","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.3390\/ijms18071437","article-title":"Pro and contra: provocation tests in drug hypersensitivity","volume":"18","author":"Soyer","year":"2017","journal-title":"Int J Mol Sci"},{"issue":"4","key":"2021121005423932200_CIT0043","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1007\/s40629-018-0071-1","article-title":"Perioperative drug reactions\u2014practical recommendations for allergy testing and patient management","volume":"27","author":"Pf\u00fctzner","year":"2018","journal-title":"Allergo J Int"},{"issue":"2","key":"2021121005423932200_CIT0044","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/j.1365-2044.2008.05733.x","article-title":"Guidelines suspected anaphylactic reactions associated with anaesthesia","volume":"64","author":"Harper","year":"2009","journal-title":"Anaesthesia"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxab298\/39620623\/zxab298.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/78\/24\/2195\/41710297\/zxab298.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/78\/24\/2195\/41710297\/zxab298.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T05:47:03Z","timestamp":1639115223000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/78\/24\/2195\/6328604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,26]]},"references-count":44,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,7,26]]},"published-print":{"date-parts":[[2021,12,9]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxab298","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"type":"print","value":"1079-2082"},{"type":"electronic","value":"1535-2900"}],"subject":[],"published-other":{"date-parts":[[2021,12,15]]},"published":{"date-parts":[[2021,7,26]]}}}