Avoiding drugs

According to the product information leaflets, which one of the following statements

is TRUE?

a) Albumin solution should not be used in patients with known egg allergy

b) The use of 20% Intralipid is safe in patients with a known peanut allergy

c) Gelofusine® may be unacceptable for the management of a Hindu patient

d) Propofol should not be used in patients with a known egg allergy

e) The use of hydroxyl ethyl starch solutions in patients with gluten-sensitive

enteropathy should be avoided

Answer: d

Explanation

The aim of this question is to emphasise the point that propofol now explicitly states in its product information that it should be avoided in patients with a known egg allergy. Intralipid, which is very similar to the lipid emulsion used with propofol, is also not recommended in patients with a known soya or peanut allergy. This is despite containing no peanuts. Recommendations in guidelines from the European Commission now require products containing soya to be labelled as unsuitable for peanut allergy sufferers because of the high risk of cross-sensitivity. Albumin solution is sourced from human plasma and is different from the albumen of eggs, which may contain a number of ovalbumins. Gelofusine® is a bovine-sourced gelatin solution. Even though this may prove unacceptable to some members of the Hindu faith, this is not mentioned in Gelofusine’s product information. Currently marketed hydroxyl ethyl starch solutions are made from either maize- or potato-sourced starch and so would be unlikely to create a problem in gluten-sensitive enteropathy, even if swallowed.