Botulinum Toxin Type A
Botulinum Toxin Type A is an exotoxin produced by germinating spores and growing cells of Clostridium botulinum. There are seven immunologically distinct types (A-G). Type A is one of the most powerful poisons known. It binds to presynaptic terminals of the central nervous system and inhibits the calcium-ion mediated release of acetylcholine at the motor nerve terminals, leading to flaccid paralysis of the affected muscles. Paralysis persists for about 2-3 months (until new nerve terminals form). Botulinum Toxin Type A is used in the treatment of hemifacial spasm, blepharospasm, spasmodic torticollis, and lower limb spasticity in children with cerebral palsy.
Primary Characteristics
It is of Natural origin and belongs to protien.
Molecular Weight: 150000 · Solubility in Water: Readily soluble · Non-proprietary name: Botulinum Toxin Type A.
Pharmacokinetics
None recorded.
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Indications
Botulinum Toxin Type A is primarily indicated in conditions like Anal fissure, Focal or segmental limbdystonia, Hemifacial spasm, Idiopathic blepharospasm, Muscular spasm, Oromandibular dystonia, Spasmotic dysphonia.
Contraindications
Botulinum Toxin Type A is contraindicated in conditions like Myasthenia gravis, Bleeding diathesis, Pregnancy, Immunocompromised patient, Breast feeding.
Dosage
Botulinum Toxin Type A's dosage details are as follows:
| Dose | Single Dose | Frequency | Route | Instructions |
|---|---|---|---|---|
| Adult Dosage | ||||
| 50 units | 50 units | — | ID | Dose for Hyperhidrosis: sual dose should be injected intradermally in 0.1 to 0.2 mL aliquots to each axilla distributed evenly in multiple sites (10 to 15) 1 to 2 cm apart. |
| 1.875 units | 1.875 units | — | IM | Dose for Persistent VI nerve palsy of 1 month or longer duration. |
| 1.875 units | 1.875 units | — | IM | Dose for Blepharospasm: the dose is administered intramuscularly each into the medial and lateral pretarsal orbicularis oculi of the upper lid and into the lateral pretarsal orbicularis oculi of the lower lid. The cumulative dose of botulinum toxin type A in a 30 day period should not exceed 200 units. |
| 1.875 units | 1.875 units | — | IM | Dose for vertical muscles or horizontal strabismus of less than 20 prism diopters |
| 3.75 units | 3.75 units | — | IM | Dose for Horizontal strabismus of 20 to 50 prism diopters. |
| 4 units | 4 units | — | IM | Dose for Glabellar Lines: dose should be injected into each of five sites, two in each corrugator muscle and one in the procerus muscle for a total of 20 units. |
| 236 units | 236 units | — | IM | Dose for Cervical Dystonia |
| Paediatric Dosage (20kg) | ||||
| No data. | ||||
| Neonatal Dosage (3kg) | ||||
| No data. | ||||
Drug Interactions
Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Side Effects
Botulinum Toxin Type A in overdosage may give rise to further complications which include Vertical misalignment of eyes.
Botulinum Toxin Type A produces potentially life-threatening effects which include Laryngeal edema, Aspiration of body fluid. Careful monitoring is needed with proper medical management.
The signs and symptoms that are produced after acute overdosage of Botulinum Toxin Type A are Dysphagia, Focal muscles weakness.
Botulinum Toxin Type A is known to cause more or less tolerable side effects which are usually transient. These include Diplopia, Dysphagia, Ectropion, Lower facial weakness, Neck weakness, Swallowing difficulties.
Warnings / Precautions
Available Brands
None recorded.
Storage Conditions
Drug Classification
- 1.19.2.10 — Botulinum toxin