Glossary

An allergen is a usually harmless substance capable of triggering a response that starts in the immune system and results in an allergic reaction.

Word for word from Allergen (AAAAI glossary) Review

Underlined in: Food allergy: the basics, Reading food labels, Cross-reactivity, Pollen, dust mite, pets and mold, Anaphylaxis and epinephrine, Early introduction of peanut and egg, Immunotherapy for allergies, Eczema and the atopic march

Alpha-gal syndrome (AGS) is a serious, potentially life-threatening allergy to alpha-gal that can develop after a tick bite.

Alpha-gal is a molecule found in most mammals, such as cows and pigs, but not in people.

Word for word from About Alpha-gal Syndrome (CDC web page) Review

Underlined in: Cross-reactivity, Alpha-gal syndrome, Allergic reactions during anesthesia

Anaphylaxis is defined as a serious allergic reaction that is rapid in onset and may cause death.

Word for word from Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel (full text) E2Good

Underlined in: Reading food labels, Allergy tests, and why IgG panels do not diagnose allergy, Anaphylaxis and epinephrine, Hives, mast cells and MCAS, Immunotherapy for allergies, Alpha-gal syndrome, TIVA or inhaled anesthesia, The drugs you may hear about

Antihistamines block cells from seeing histamine and can treat common allergies. Medicines like steroids can calm the inflammatory effects of allergies. And anaphylaxis needs to be treated with a shot of epinephrine, which opens up airways, and increases blood pressure.

Word for word from Histamine: The Stuff Allergies are Made of (MedlinePlus video transcript) Review

Underlined in: Pollen, dust mite, pets and mold, Anaphylaxis and epinephrine

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease, with a lifetime prevalence of up to 20% and substantial effects on quality of life. AD is characterized by intense itch, recurrent eczematous lesions and a fluctuating course.

Word for word from Atopic dermatitis Review

Underlined in: Pollen, dust mite, pets and mold, Early introduction of peanut and egg, Eczema and the atopic march

The ability to tolerate baked milk or egg, such as in a cake or muffin, has been associated with an increased chance of tolerance development. Studies report that about 70% of CM- and egg-allergic children can tolerate baked milk or egg and that incorporating baked milk or egg into the diet is well tolerated.

Word for word from Baked milk- and egg-containing diet in the management of milk and egg allergy Review

Underlined in: Food allergy: the basics, Early introduction of peanut and egg

Cross-reactivity in allergic reactions occurs when the proteins in one substance (typically pollen) are similar to the proteins found in another substance (typically a food). For example, if you are allergic to birch tree pollen, you may also find that eating apples causes a reaction for you.

Word for word from Cross-Reactivity (AAAAI glossary) Review

Underlined in: Cross-reactivity

Eosinophilic esophagitis, or EoE, is a chronic disease that can be associated with food allergies. It is increasingly being diagnosed in children and adults. EoE is characterized by immune cells called eosinophils building up in the esophagus.

Word for word from Characterizing Food Allergy & Addressing Related Disorders (NIAID web page) Review

Underlined in: Eosinophilic esophagitis (EoE)

In epicutaneous immunotherapy, a wearable patch delivers an allergen to the skin’s surface.

Word for word from Food Allergy Treatment Research (NIAID web page) Review

Underlined in: Immunotherapy for allergies

Epinephrine is a medicine administered as an injection or in the form of a nasal spray that is used to treat life-threatening allergic reactions called anaphylaxis (an-a-fi-LAK-sis). These very serious reactions are most commonly caused by foods, drugs and stinging insects.

Word for word from Epinephrine (AAAAI glossary) Review

Underlined in: Food allergy: the basics, Anaphylaxis and epinephrine, Hives, mast cells and MCAS, Immunotherapy for allergies

Epinephrine, a medicine to treat anaphylaxis. Your provider may give you a prescription for an epinephrine auto-injector. It is a device used to inject epinephrine when someone is having symptoms of anaphylaxis.

Word for word from Food Allergy (MedlinePlus health topic) Review

Underlined in: Food allergy: the basics, Anaphylaxis and epinephrine

A food allergy is defined as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food.

Word for word from Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel (full text) E2Good

Underlined in: Food allergy: the basics, Reading food labels, Cross-reactivity, Allergy tests, and why IgG panels do not diagnose allergy, Pollen, dust mite, pets and mold, Anaphylaxis and epinephrine, Early introduction of peanut and egg, Immunotherapy for allergies

A problem often confused with food allergy is food intolerance, which is also an abnormal response to a food product, but differs from an allergy. A common example is an intolerance to lactose, a sugar found in many milk products that can cause an uncomfortable buildup of gas in the gastrointestinal tract.

Word for word from Characterizing Food Allergy & Addressing Related Disorders (NIAID web page) Review

Underlined in: Food allergy: the basics, Allergy tests, and why IgG panels do not diagnose allergy

Food protein-induced enterocolitis syndrome (FPIES) is another non-IgE-mediated disorder that usually occurs in young infants and manifests as chronic emesis, diarrhea, and failure to thrive. Upon re-exposure to the offending food after a period of elimination, a subacute syndrome can present with repetitive emesis and dehydration.

Word for word from Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel (full text) E2Good

Underlined in: FPIES

Histamine is a chemical released by mast cells in the immune system when the body encounters an allergen. This causes an allergic reaction.

Word for word from Histamine (AAAAI glossary) Review

Underlined in: Food allergy: the basics

The terms allergy and allergic disease are broadly encompassing and include clinical conditions associated with altered immunologic reactivity that may be either IgE mediated or non-IgE mediated. IgE is a unique class of immunoglobulin that mediates an immediate allergic reaction.

Word for word from Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel (full text) E2Good

Underlined in: Food allergy: the basics, Cross-reactivity, Allergy tests, and why IgG panels do not diagnose allergy, Pollen, dust mite, pets and mold, FPIES, Alpha-gal syndrome

The first approach, called immunotherapy, involves exposing a person to a food allergen in a controlled way to reduce their immune response to the allergen.

Word for word from Food Allergy Treatment Research (NIAID web page) Review

Underlined in: Pollen, dust mite, pets and mold, Anaphylaxis and epinephrine, Immunotherapy for allergies

Mast cells play an important role in the immune system, and the cells are directly related to allergic reactions. If you have allergies and are exposed to an allergen, your immune system senses a foreign invader. This triggers mast cells to release an inflammatory substance called histamine, causing an allergic reaction.

Word for word from Mast Cells (AAAAI glossary) Review

Underlined in: Allergy tests, and why IgG panels do not diagnose allergy, Hives, mast cells and MCAS

The diagnosis of non-IgE-mediated FA is based on signs and symptoms occurring reproducibly on exposure to food, resolution of those signs and symptoms with specific food avoidance, and, most often, histologic evidence of an immunologically mediated process, such as eosinophilic inflammation of the GI tract.

Word for word from Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel (full text) E2Good

Underlined in: Food allergy: the basics, FPIES

Oral allergy syndrome (OAS), also referred to as pollen-associated FA syndrome, is a form of localized IgE-mediated allergy, usually to raw fruits or vegetables, with symptoms confined to the lips, mouth, and throat. OAS most commonly affects patients who are allergic to pollens.

Pollen food syndrome is a distinct disorder, usually mild, with oral/pharyngeal symptoms, in the context of hay fever or pollen sensitisation, which can be triggered by nuts. It can usually be distinguish clinically from primary nut allergy.

Word for word from Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel (full text) E2Good and BSACI guideline for the diagnosis and management of peanut and tree nut allergy E2Good

Underlined in: Cross-reactivity

The gold standard for diagnosing food allergy is an oral food challenge. In this procedure, a food is eaten slowly, in gradually increasing amounts, under medical supervision to accurately diagnose or rule out a true food allergy.

Word for word from Diagnosing Food Allergy (NIAID web page) Review

Underlined in: Food allergy: the basics, Reading food labels, Cross-reactivity, Allergy tests, and why IgG panels do not diagnose allergy

Oral immunotherapy involves eating small doses of a food that causes an allergy and gradually increasing the size of those doses.

Word for word from Food Allergy Treatment Research (NIAID web page) Review

Underlined in: Food allergy: the basics, Immunotherapy for allergies

Food sensitization means a person has a positive IgE test to a food but can still tolerate that food in their diet.

Word for word from Diagnosing Food Allergy (NIAID web page) Review

Underlined in: Allergy tests, and why IgG panels do not diagnose allergy, Alpha-gal syndrome

In a skin-prick test, a lancet is used to prick the skin under a drop of allergen extract. If a person is allergic to the allergen, a raised red bump will appear at the site of the prick after about 15 minutes.

Word for word from Diagnosing Food Allergy (NIAID web page) Review

Underlined in: Allergy tests, and why IgG panels do not diagnose allergy

A specific IgE test measures how much IgE your body makes in response to a single allergen. A separate test is done for each allergen that may be causing your allergies.

Word for word from Allergy Blood Test (MedlinePlus medical test page) Review

Underlined in: Allergy tests, and why IgG panels do not diagnose allergy

Sublingual immunotherapy involves placing small amounts of an allergen under the tongue. This approach has been successful for treating allergic rhinitis, also known as hay fever. Researchers are now studying it to treat food allergy.

Word for word from Food Allergy Treatment Research (NIAID web page) Review

Underlined in: Immunotherapy for allergies

Individuals may tolerate food only for a short term, perhaps because they have been desensitized by exposure to the food. Alternatively, they may develop long-term tolerance. The specific term tolerance is used in these Guidelines to mean that an individual is symptom free after consumption of the food or upon oral food challenge weeks, months, or even years after the cessation of treatment.

Word for word from Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel (full text) E2Good

Underlined in: Food allergy: the basics, Eczema and the atopic march

A total IgE test measures the total amount of IgE antibodies in your blood.

Word for word from Allergy Blood Test (MedlinePlus medical test page) Review

Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%.

Word for word from The International Guideline for the Definition, Classification, Diagnosis and Management of Urticaria E2Good

Underlined in: Food allergy: the basics, Anaphylaxis and epinephrine, Hives, mast cells and MCAS, Alpha-gal syndrome

The American Society of Anesthesiologists (ASA) physical status is a tool commonly used to classify a patient's physical fitness before surgery. Since its introduction in 1941 it has undergone very few modifications to improve its reliability and to eliminate subjectivity, despite vast changes in both surgical and anaesthetic technique.

Word for word from A review of ASA physical status - historical perspectives and modern developments Review

Why would having food in your stomach make you less safe? Because your stomach contents could flow backward into your esophagus and get into your airway or lungs. This is called “regurgitation” and “aspiration.”

Aspiration of stomach contents into the lungs is dangerous and can be life-threatening.

Word for word from Diabetes and Weight Loss Drugs and Surgery (ASA patient education page) Review

Underlined in: Fasting before surgery, Medicines to discuss before surgery, Colonoscopy and endoscopy sedation

Deep Sedation/Analgesia is a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully** following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate.

Word for word from Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia E2Good

Underlined in: Types of anesthesia and sedation, Medicines to discuss before surgery, Colonoscopy and endoscopy sedation, Dental sedation

Emergence delirium (postoperative confusional states or agitation) has occurred in approximately 12% of patients during the recovery period, and the duration is generally a few hours. The neuropsychological manifestations vary in severity between pleasant dream-like states, vivid imagery, hallucinations, and emergence delirium.

Word for word from KETALAR (ketamine hydrochloride) injection, Prescribing Information Official text

Underlined in: TIVA or inhaled anesthesia, The drugs you may hear about

If you choose to have an epidural, an anesthesiologist will insert a needle and a tiny tube, called a catheter, in the lower part of your back. The needle is removed and the catheter left in place for delivery of the medication through the tube as needed.

An epidural provides anesthesia that creates a band of numbness from your bellybutton to your upper legs. It allows you to be awake and alert throughout labor, as well as to feel pressure.

Word for word from Epidurals (ASA patient education page) Review

Underlined in: Types of anesthesia and sedation, Medicines to discuss before surgery, Hip and knee replacement, Labor epidurals and cesarean birth

Prevention of regurgitation and aspiration is why all patients are told to fast before any procedure that requires general anesthesia or sedation.

Word for word from Diabetes and Weight Loss Drugs and Surgery (ASA patient education page) Review

Underlined in: Fasting before surgery, Medicines to discuss before surgery, Children and anesthesia, Recovery and pain plans, Dental sedation

With general anesthesia, you will be unconscious and unaware of anything that happens during your procedure.

While the anesthesia is working and you are unconscious, many of your body’s functions will slow down or need help to work effectively. A tube may be placed in your throat to help you breathe.

Word for word from General Anesthesia (ASA patient education page) Review

Underlined in: Types of anesthesia and sedation, TIVA or inhaled anesthesia, The drugs you may hear about, Fasting before surgery, Delirium and thinking after surgery, Malignant hyperthermia, Children and anesthesia, Colonoscopy and endoscopy sedation

Local anesthesia, also called local anesthetic, is usually a one-time injection of medicine that numbs a small area of the body. It is used for procedures such as performing a skin biopsy or breast biopsy, repairing a broken bone, or stitching a deep cut. You will be awake and alert, and you may feel some pressure, but you won’t feel pain in the area being treated.

Word for word from Local Anesthesia (ASA patient education page) Review

Underlined in: Types of anesthesia and sedation, The drugs you may hear about, Allergic reactions during anesthesia, Labor epidurals and cesarean birth, Dental sedation, Cosmetic surgery

Malignant hyperthermia is a severe reaction to particular anesthetic drugs that are often used during surgery and other invasive procedures. Specifically, this reaction occurs in response to some anesthetic gases, which are used to block the sensation of pain, either given alone or in combination with a muscle relaxant that is used to temporarily paralyze a person during a surgical procedure.

People at increased risk of this disorder are said to have malignant hyperthermia susceptibility. Affected individuals may never know they have the condition unless they have a severe reaction to anesthesia during a surgical procedure or they undergo testing (for instance, if susceptibility is suspected because a family member had a severe reaction).

Word for word from Malignant hyperthermia (MedlinePlus Genetics condition page) Review

Underlined in: TIVA or inhaled anesthesia, The drugs you may hear about, Malignant hyperthermia

Minimal Sedation (Anxiolysis) is a drug-induced state during which patients respond normally to verbal commands. Although cognitive function and physical coordination may be impaired, airway reflexes, and ventilatory and cardiovascular functions are unaffected.

Word for word from Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia E2Good

Underlined in: Types of anesthesia and sedation, Cataract surgery, Dental sedation

Moderate Sedation/Analgesia (“Conscious Sedation”) is a drug-induced depression of consciousness during which patients respond purposefully** to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.

Word for word from Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia E2Good

Underlined in: Types of anesthesia and sedation, Colonoscopy and endoscopy sedation, Dental sedation

Monitored Anesthesia Care (“MAC”) does not describe the continuum of depth of sedation, rather it describes “a specific anesthesia service performed by a qualified anesthesia provider, for a diagnostic or therapeutic procedure.”

Word for word from Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia E2Good

Underlined in: Types of anesthesia and sedation, Cosmetic surgery

Nausea and vomiting – This very common side effect can occur within the first few hours or days after surgery and can be triggered by a number of factors, such as the medication, motion, and the type of surgery.

Word for word from Effects of Anesthesia (ASA patient education page) Review

Underlined in: TIVA or inhaled anesthesia, Nausea and vomiting after surgery

Other types of nerve blocks are used to help control pain after certain orthopedic procedures, such as shoulder, knee, and ankle surgeries. Nerve blocks can also be used to help manage chronic pain. Anesthetic medication is injected near a nerve or group of nerves to numb them for hours, and sometimes days, to reduce pain.

Word for word from Regional Anesthesia (ASA patient education page) Review

Underlined in: Types of anesthesia and sedation, Medicines to discuss before surgery, Delirium and thinking after surgery, Recovery and pain plans, Hip and knee replacement, Labor epidurals and cesarean birth

Rocuronium Bromide Injection is a nondepolarizing neuromuscular blocking agent indicated as an adjunct to general anesthesia to facilitate both rapid sequence and routine tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Word for word from Rocuronium Bromide Injection, Prescribing Information Official text

Underlined in: The drugs you may hear about, Awareness under anesthesia, Malignant hyperthermia, Allergic reactions during anesthesia

DIPRIVAN is an intravenous general anesthetic and sedation drug indicated for: (1) • Induction of General Anesthesia for Patients Greater than or Equal to 3 Years of Age • Maintenance of General Anesthesia for Patients Greater than or Equal to 2 Months of Age • Initiation and Maintenance of Monitored Anesthesia Care (MAC) Sedation in Adult Patients • Sedation for Adult Patients in Combination with Regional Anesthesia • Intensive Care Unit (ICU) Sedation of Intubated, Mechanically Ventilated Adult Patients

Word for word from DIPRIVAN (propofol) injectable emulsion, Prescribing Information Official text

Underlined in: Types of anesthesia and sedation, TIVA or inhaled anesthesia, The drugs you may hear about, Nausea and vomiting after surgery, Allergic reactions during anesthesia, Colonoscopy and endoscopy sedation, Cosmetic surgery

Regional anesthesia is a type of pain management for surgery that numbs a large part of the body, such as from the waist down. It is used when a simple injection of local anesthetic is not enough, and when it’s better for the patient to remain awake. Regional anesthesia is delivered through an injection or through a small tube called a catheter that is inserted near the part of the body where the surgery will take place.

Word for word from Regional Anesthesia (ASA patient education page) Review

Underlined in: The drugs you may hear about, Medicines to discuss before surgery, Hip and knee replacement, Labor epidurals and cesarean birth, Cosmetic surgery

Depending on the procedure, the level of sedation may range from minimal (you’ll feel drowsy but able to talk) to deep (you probably won’t remember the procedure). Moderate or deep sedation may slow your breathing, and in some cases, you may be given oxygen.

But even with deep sedation, you won’t be unconscious, as you would be with general anesthesia.

Word for word from Sedation (ASA patient education page) Review

Underlined in: Types of anesthesia and sedation, The drugs you may hear about, Medicines to discuss before surgery, Awareness under anesthesia, Children and anesthesia, Colonoscopy and endoscopy sedation, Cataract surgery, Dental sedation

A spinal block, like an epidural, involves an injection in the lower back. While you sit or lie on your side in bed, a small amount of medication is injected into the spinal fluid to numb the lower half of the body. It brings good relief from pain and starts working quickly, but it lasts only an hour or two and is usually given only once during labor.

Spinal analgesia is stronger and is used during procedures such as cesarean deliveries, also known as C-sections, and knee and hip replacements.

Word for word from Epidurals (ASA patient education page) Review and Regional Anesthesia (ASA patient education page) Review

Underlined in: Types of anesthesia and sedation, Hip and knee replacement

BRIDION is indicated for the reversal of neuromuscular blockade induced by rocuronium bromide and vecuronium bromide in adult and pediatric patients undergoing surgery.

Word for word from BRIDION (sugammadex) injection, Prescribing Information Official text

Underlined in: The drugs you may hear about, Allergic reactions during anesthesia

Guidelines are presented for safe practice in the use of intravenous drug infusions for general anaesthesia. When maintenance of general anaesthesia is by intravenous infusion, this is referred to as total intravenous anaesthesia.

Word for word from Guidelines for the safe practice of total intravenous anaesthesia (TIVA): Joint Guidelines from the Association of Anaesthetists and the Society for Intravenous Anaesthesia E2Good

Underlined in: TIVA or inhaled anesthesia, Nausea and vomiting after surgery