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Encyclopedia > Botulinum toxin
Botulinum toxin
Systematic (IUPAC) name
 ?
Identifiers
CAS number 93384-43-1
ATC code M03AX01
PubChem  ?
DrugBank BTD00092
Chemical data
Formula C6760H10447N1743O2010S32 
Mol. mass 149320.83328 g/mol
Pharmacokinetic data
Bioavailability  ?
Metabolism  ?
Half life  ?
Excretion  ?
Therapeutic considerations
Pregnancy cat.

? Image File history File links No higher resolution available. ... IUPAC nomenclature is a system of naming chemical compounds and of describing the science of chemistry in general. ... CAS registry numbers are unique numerical identifiers for chemical compounds, polymers, biological sequences, mixtures and alloys. ... The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... A section of the Anatomical Therapeutic Chemical Classification System. ... PubChem is a database of chemical molecules. ... The DrugBank database available at the University of Alberta is a unique bioinformatics and cheminformatics resource that combines detailed drug (i. ... A chemical formula is an easy way of expressing information about the atoms that constitute a particular chemical compound. ... For other uses, see Carbon (disambiguation). ... This article is about the chemistry of hydrogen. ... General Name, symbol, number nitrogen, N, 7 Chemical series nonmetals Group, period, block 15, 2, p Appearance colorless gas Standard atomic weight 14. ... This article is about the chemical element and its most stable form, or dioxygen. ... This article is about the chemical element. ... The molecular mass (abbreviated Mr) of a substance, formerly also called molecular weight and abbreviated as MW, is the mass of one molecule of that substance, relative to the unified atomic mass unit u (equal to 1/12 the mass of one atom of carbon-12). ... In pharmacology, bioavailability is used to describe the fraction of an administered dose of unchanged drug that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... Drug metabolism is the metabolism of drugs, their biochemical modification or degradation, usually through specialized enzymatic systems. ... The biological half-life of a substance is the time required for half of that substance to be removed from an organism by either a physical or a chemical process. ... The kidneys are important excretory organs in vertebrates. ... The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. ...

Legal status

?(US) The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction. ... For other uses of terms redirecting here, see US (disambiguation), USA (disambiguation), and United States (disambiguation) Motto In God We Trust(since 1956) (From Many, One; Latin, traditional) Anthem The Star-Spangled Banner Capital Washington, D.C. Largest city New York City National language English (de facto)1 Demonym American...

Routes IM (approved),SC, intradermal, into glands

Botulinum toxin is a neurotoxin protein produced by the bacterium Clostridium botulinum. It is one of the most poisonous naturally occurring substances in the world, and it is the most toxic protein.[1] Though it is highly toxic, it is used in minute doses both to treat painful muscle spasms, and as a cosmetic treatment in some parts of the world. It is sold commercially under the brand names Botox, Dysport, and Myobloc for this purpose. The terms Botox, Dysport, and Myobloc are trade names and are not used generically to describe the neurotoxins produced by C. botulinum. In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body. ... A neurotoxin is a toxin that acts specifically on nerve cells – neurons – usually by interacting with membrane proteins such as ion channels. ... A representation of the 3D structure of myoglobin showing coloured alpha helices. ... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... Binomial name van Ermengem, 1896 Clostridium botulinum is a bacterium that produces the toxin botulin, the causative agent in botulism. ...

Contents

History

Between 1817 and 1822 the German physician and poet Justinus Kerner described botulinium toxin, using the terms "sausage poison" and "fatty poison"[2], as this bacterium often causes poisoning by growing in badly handled or prepared meat products. He first conceived a possible therapeutic use of botulinium toxin. In 1870, Muller (another German physician) coined the name botulism, from Latin botulus = "sausage". In 1895, Emile van Ermengem first isolated the bacterium Clostridium botulinum. In 1944, Edward Schantz cultured Clostridium botulinum and isolated the toxin, and, in 1949, Burgen's group discovered that botulinum toxin blocks neuromuscular transmission. Justinus Kerner in old age Justinus Andreas Christian Kerner (September 18, 1786 - February 21, 1862), was a German poet and medical writer. ... Botulism (Latin, botulus, sausage) is a rare, but serious paralytic illness caused by a nerve toxin, botulin, that is produced by the bacterium Clostridium botulinum. ... For other uses, see Latins and Latin (disambiguation). ...


By 1973, Alan B Scott, MD, of Smith-Kettlewell Institute used botulinium toxin type A (BTX-A) in monkey experiments, and, in 1980, he officially used BTX-A for the first time in humans to treat strabismus. In December 1989, BTX-A (BOTOX) was approved by the US Food and Drug Administration (FDA) for the treatment of strabismus, blepharospasm, and hemifacial spasm in patients over 12 years old. The cosmetic effect of BTX-A was initially described by ophthalmologist Jean Carruthers and dermatologist Alastair Carruthers, a husband-and-wife team working in Vancouver, Canada, although the effect had been observed by a number of independent groups. On April 15, 2002, the FDA announced the approval of botulinum toxin type A (BOTOX Cosmetic) to temporarily improve the appearance of moderate-to-severe frown lines between the eyebrows (glabellar lines). BTX-A has also been approved for the treatment of excessive underarm sweating. The acceptance of BTX-A use for the treatment of spasticity and muscle pain disorders is growing, with approvals pending in many European countries and studies on headaches (including migraine), prostatic symptoms, asthma, obesity and many other possible indications are ongoing. The Smith-Kettlewell Institute of Visual Sciences in San Francisco was formed in 1962 by Dr. Arthur Jampolsky as the Eye Research Institute on the former campus of the Stanford Medical School. ... Strabismus (from Greek: στραβισμός strabismos, from στραβίζειν strabizein to squint, from στραβός strabos squinting, squint-eyed[1]) is a condition in which the eyes are not properly aligned with each other. ... FDA redirects here. ... A blepharospasm (from blepharo (eyelid) and spasm (uncontrolled muscle contraction)) is any abnormal tic or twitch of the eyelid. ... This article refers to the city in British Columbia, Canada. ... Spasticity is a disorder of the bodys motor system,and especially the Central Nervous Systems (CNS), in which certain muscles are continuously contracted. ... On either side of the urethral crest is a slightly depressed fossa, the prostatic sinus, the floor of which is perforated by numerous apertures, the orifices of the prostatic ducts from the lateral lobes of the prostate. ...


Botox is manufactured by Allergan Inc (U.S.) for both therapeutic as well as cosmetic use. The formulation is best stored at cold temperature of 2-8 degrees Celsius. Dysport is a therapeutic formulation of the type A toxin developed and manufactured in Ireland and which is licenced for the treatment of focal dystonias and certain cosmetic uses in many territories world wide. Neuronox is a new type A toxin manufactured by Medy-Tox Inc (South Korea). Categories: Possible copyright violations ...


Botulinium Toxin Type B (BTX-B) received FDA approval for treatment of cervical dystonia on December 21, 2000. Trade names for BTX-B are Myobloc in the United States, and Neurobloc in the European Union. Dystonia is a neurological movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. ...


Chemical overview & lethality

There are seven serologically distinct toxin types, designated A through G; 3 subtypes of A have been described. The toxin is a two-chain polypeptide with a 100-kDa heavy chain joined by a disulfide bond to a 50-kDa light chain. This light chain is an enzyme (a protease) that attacks one of the fusion proteins (SNAP-25, syntaxin or synaptobrevin) at a neuromuscular junction, preventing vesicles from anchoring to the membrane to release acetylcholine. By inhibiting acetylcholine release, the toxin interferes with nerve impulses and causes flaccid (sagging) paralysis of muscles in botulism as opposite to the spastic paralysis seen in tetanus. Peptides are the family of molecules formed from the linking, in a defined order, of various amino acids. ... The unified atomic mass unit (u), or dalton (Da), is a small unit of mass used to express atomic masses and molecular masses. ... In chemistry, a disulfide bond is a single covalent bond derived from the coupling of thiol groups. ... Proteases (proteinases, peptidases, or proteolytic enzymes) are enzymes that break peptide bonds between amino acids of proteins. ... A neuromuscular junction is the junction of the axon terminal of a motoneuron with the motor end plate, the highly-excitable region of muscle fiber plasma membrane responsible for initiation of action potentials across the muscles surface. ... In cell biology, a vesicle is a relatively small and enclosed compartment, separated from the cytosol by at least one lipid bilayer. ... The cell membrane (also called the plasma membrane, plasmalemma or phospholipid bilayer) is a selectively permeable lipid bilayer found in all cells. ... The chemical compound acetylcholine (often abbreviated ACh) is a neurotransmitter in both the peripheral nervous system (PNS) and central nervous system (CNS) in many organisms including humans. ... Botulism (Latin, botulus, sausage) is a rare, but serious paralytic illness caused by a nerve toxin, botulin, that is produced by the bacterium Clostridium botulinum. ... Tetanus is a medical condition that is characterized by a prolonged contraction of skeletal muscle fibers. ...


It is possibly the most acutely toxic substance known, with a median lethal dose of about 1 ng/kg[3], meaning that a few hundred grams could theoretically kill every human on earth (for perspective, the rat poison strychnine, often described as highly toxic, has an LD50 of 1,000,000 ng/kg, and would thus take about six metric tons to kill every human). An LD50 test being administered In toxicology, the LD50 or colloquially semilethal dose of a particular substance is a measure of how much constitutes a lethal dose. ... The nanogram is an SI unit of mass (symbol ng) defined as: 1 ng = 1 × 10-12 kilogram (1 × 10-9 gram) A nanogram is one billionth (1/1,000,000,000) of a gram. ... KG, kg or Kg can refer to several things: Kilogram, the SI base unit of mass. ... Strychnine (pronounced (British, U.S.), or (U.S.)) is a very toxic (LD50 = 10 mg approx. ... An LD50 test being administered In toxicology, the LD50 or colloquially semilethal dose of a particular substance is a measure of how much constitutes a lethal dose. ... The nanogram is an SI unit of mass (symbol ng) defined as: 1 ng = 1 × 10-12 kilogram (1 × 10-9 gram) A nanogram is one billionth (1/1,000,000,000) of a gram. ... KG, kg or Kg can refer to several things: Kilogram, the SI base unit of mass. ...


It is also remarkably easy to come by: Clostridium spores are found in soil practically all over the earth.


Food-borne botulism usually results from ingestion of food that has become contaminated with spores (such as a perforated can) in an anaerobic environment, allowing the spores to germinate and grow. The growing (vegetative) bacteria produce toxin. It is the ingestion of preformed toxin that causes botulism, not ingestion of the spores or vegetative organism. It has been suggested that Anoxic sea water, Oxygen minimum zone, and Hypoxic zone be merged into this article or section. ... Botulism (Latin, botulus, sausage) is a rare, but serious paralytic illness caused by a nerve toxin, botulin, that is produced by the bacterium Clostridium botulinum. ...


Infant (intestinal) and wound botulism both result from infection with spores which subsequently germinate, resulting in production of toxin and the symptoms of botulism.


The toxin itself is rapidly destroyed by heat, such as in thorough cooking.[4] However, the spores which produce the toxin are heat-tolerant and will survive boiling at 100 degrees Celsius for an extended period of time. [5]


Medical uses

Researchers discovered in the 1950s that injecting overactive muscles with minute quantities of botulinum toxin type A decreased muscle activity by blocking the release of acetylcholine at the neuromuscular junction, thereby rendering the muscle unable to contract for a period 3 to 4 months.[citation needed] The chemical compound acetylcholine (often abbreviated ACh) is a neurotransmitter in both the peripheral nervous system (PNS) and central nervous system (CNS) in many organisms including humans. ... A neuromuscular junction is the junction of the axon terminal of a motoneuron with the motor end plate, the highly-excitable region of muscle fiber plasma membrane responsible for initiation of action potentials across the muscles surface. ...


Alan Scott, a San Francisco ophthalmologist, first applied tiny doses of the toxin in a medicinal sense to treat 'crossed eyes' (strabismus) and 'uncontrollable blinking' (blepharospasm), but needed a partner to gain regulatory approval to market his discovery as a drug. Allergan, Inc., a pharmaceutical company that focused on prescription eye therapies and contact lens products, bought the rights to the drug in 1988 and received FDA approval in 1989.[citation needed] Allergan renamed the drug Botox. This page is a candidate for speedy deletion. ... Ophthalmology is the branch of medicine which deals with the diseases of the eye and their treatment. ... Strabismus (from Greek: στραβισμός strabismos, from στραβίζειν strabizein to squint, from στραβός strabos squinting, squint-eyed[1]) is a condition in which the eyes are not properly aligned with each other. ... A blepharospasm (from blepharo (eyelid) and spasm (uncontrolled muscle contraction)) is any abnormal tic or twitch of the eyelid. ... Allergan, Inc. ...


Cosmetically desirable effects of Botox were first discovered by Vancouver-based cosmetic surgeons Drs. Alastair and Jean Carruthers.[6] The serendipitous discovery occurred when the husband-and-wife team observed the softening of patients' frown lines following treatment for eye muscle disorders, leading to clinical trials and subsequent FDA approval for cosmetic use in April 2002.[citation needed] As of 2007, Botox injection is the most common cosmetic operation, with 4.6 million procedures in the United States, according to the American Society of Plastic Surgeons. For other uses, see Vancouver (disambiguation). ... For the album by The Huntingtons, see Plastic Surgery (album). ... The American Society of Plastic Surgeons (ASPS) is the largest plastic surgery specialty organization in the world. ...


Besides its cosmetic application, Botox is used in the treatment of

  • Achalasia (failure of the lower esophageal sphincter to relax)

Other uses of botulinum toxin type A that are widely known but not specifically approved by FDA include treatment of: Dystonia is a neurological movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. ... Torticollis, or wry neck, is a condition in which the head is tilted toward one side, and the chin is elevated and turned toward the opposite side. ... A blepharospasm (from blepharo (eyelid) and spasm (uncontrolled muscle contraction)) is any abnormal tic or twitch of the eyelid. ... Primary hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature. ... Achalasia, also known as esophageal achalasia, achalasia cardiae, cardiospasm, dyssynergia esophagus, and esophageal aperistalsis, is an esophageal motility disorder. ...

  • TMJ pain disorders
  • diabetic neuropathy
  • wound healing
  • excessive salivation
  • VCD Vocal Cord Dysfunction a spasming of the vocal cords
  • Reduction of the Masseter muscle for decreasing the size of the lower jaw

Treatment and prevention of chronic headache[14] and chronic musculoskeletal pain[15] are emerging uses for botulinum toxin type A. In addition, there is evidence that Botox may aid in weight loss by increasing the gastric emptying time.[16] Dysfunction of the urinary bladder due to disease of the central or peripheral nervous system pathways involved in the control of micturition. ... An anal fissure is an unnatural crack or tear in the anus skin. ... A diagram showing the CNS: 1. ... For other uses, see Stroke (disambiguation). ... Cerebral palsy (CP) is an umbrella term encompassing a group of non-progressive,[1] non-contagious conditions that cause physical disability in human development. ... Dystonia is a neurological movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. ... Laryngoscopic view of the vocal folds. ... The temporomandibular joint (From the Latin for too much jaw) is a diarthrodial joint that connects the condyle of the mandible (lower jaw) to the temporal bone at the side of a skull. ...


Links to deaths

On September 2005, a paper published in the Journal of American Academy of Dermatology reported from the FDA saying that use of Botox has resulted in 28 deaths between 1989 and 2003, though none were attributed to cosmetic use.[17]


On February 8, 2008, the FDA announced that Botox has "been linked in some cases to adverse reactions, including respiratory failure and death, following treatment of a variety of conditions using a wide range of doses," due to its ability to spread to areas distant to the site of the injection.[18]


Several cases of death have been linked to the use of fake Botox.[19]


Side effects

Side effects can be predicted from the mode of action (muscle paralysis) and chemical structure (protein) of the molecule, resulting broadly speaking in two major areas of side effects: paralysis of the wrong muscle group and allergic reaction. Bruising at the site of injection is a side effect not of the toxin, but rather the mode of administration. In cosmetic use, this means that the client will complain of inappropriate facial expression such as drooping eyelid, uneven smile, loss of ability to close the eye. This will wear off in around 6 weeks. Bruising is prevented by the clinician applying pressure to the injection site, but may still occur, and will last around 7 - 10 days. When injecting the masseter muscle of the jaw, loss of muscle function will result in a loss or reduction of power to chew solid foods. All cosmetic treatments are of limited duration, and can be as short a period as six weeks, but usually one reckons with an effective period of between 3 and 8 months. At the extremely low doses used medicinally, botulinum toxin has a very low degree of toxicity.


Reported adverse events from cosmetic use includes headaches, focal facial paralysis, muscle weakness, dysphagia, flu-like syndromes, and allergic reactions[20]. Dysphagia () is a medical term defined as difficulty swallowing. ...


There has been a petition by Public Citizen to the FDA requesting regulatory action concerning the possible spread of botulinum toxin (Botox, Myobloc) from the site of injection to other parts of the body (HRG Publication #1834): Public Citizen


Biochemical mechanism of toxicity

Target molecules of botulinum (BoNT) and tetanus (TeNT) toxins inside the axon terminal.[1]
Target molecules of botulinum (BoNT) and tetanus (TeNT) toxins inside the axon terminal.[1]

The heavy chain of the toxin is particularly important for targeting the toxin to specific types of axon terminals. The toxin must get inside the axon terminals in order to cause paralysis. Following the attachment of the toxin heavy chain to proteins on the surface of axon terminals, the toxin can be taken into neurons by endocytosis. The light chain is able to leave endocytotic vesicles and reach the cytoplasm. The light chain of the toxin has protease activity. The type A toxin proteolytically degrades the SNAP-25 protein, a type of SNARE protein. The SNAP-25 protein is required for the release of neurotransmitters from the axon endings.[21] Botulinum toxin specifically cleaves these SNAREs, and so prevents neuro-secretory vesicles from docking/fusing with the nerve synapse plasma membrane and releasing their neurotransmitters. Image File history File links This is a lossless scalable vector image. ... Image File history File links This is a lossless scalable vector image. ... An axon or nerve fiber, is a long, slender projection of a nerve cell, or neuron, that conducts electrical impulses away from the neurons cell body or soma. ... Endocytosis (IPA: ) is a process whereby cells absorb material (molecules such as proteins) from the outside by engulfing it with their cell membrane. ... Schematic showing the cytoplasm, with major components of a typical animal cell. ... Molecular machinery driving exocytosis in neuromediator release. ... Paired sets of SNARE proteins (soluble N-ethylmaleimide-sensitive fusion protein attachment protein receptors) mediate fusion of vesicles with target membranes. ... Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ...


Though it affects the nervous system, common nerve agent treatments (namely the injection of atropine and 2-pam-chloride) will increase mortality by enhancing botulin toxin's mechanism of toxicity. Attacks involving botulinum toxin are distinguishable from those involving nerve agent in that NBC detection equipment (such as M-8 paper or the ICAM) will not indicate a "positive" when a sample of the agent is tested. Furthermore, botulism symptoms develop relatively slowly, over several days compared to nerve agent effects, which can be instantaneous. Atropine is a tropane alkaloid extracted from the deadly nightshade (Atropa belladonna) and other plants of the family Solanaceae. ... NBC is an initialism used to indicate nuclear, biological and chemical weapons. ...


Documented outbreaks

Bon Vivant incident Image File history File links This is a lossless scalable vector image. ...


On July 2, 1971 the FDA released a public warning after learning that a New York man had died and his wife had become seriously ill due to botulism after eating a can of Bon Vivant vichyssoise soup. The company began a recall of the 6,444 cans of vichyssoise soup made in the same batch as the can known to be contaminated. The FDA discovered that the company’s processing practices raised questions not only about these lots of the vichyssoise, but also about all other products packed by the company. The effectiveness check of the recall had revealed a number of swollen or otherwise suspect cans among Bon Vivant’s other products, so FDA extended the recall to include all Bon Vivant products. The FDA shut down the company’s Newark, New Jersey plant on July 7, 1971. Only five cans of Bon Vivant soup were found to be contaminated with the botulin toxin, all in the initial batch of vichyssoise recalled and part of the first 324 cans tested. The ordeal destroyed public confidence in the company’s products and the Bon Vivant name. Bon Vivant filed for bankruptcy within a month of the announcement of the recall. [22] is the 183rd day of the year (184th in leap years) in the Gregorian calendar. ... Year 1971 (MCMLXXI) was a common year starting on Friday (link will display full calendar) of the 1971 Gregorian calendar. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ... Vichyssoise ([1], commonly mispronounced ) is a French-style soup made of puréed leeks, onions, potatoes, cream, and chicken stock. ... Nickname: Map of Newark in Essex County Coordinates: , Country State County Essex Founded/Incorporated 1666/1836 Government  - Mayor Cory Booker, term of office 2006–2010 Area [1]  - Total 26. ... is the 188th day of the year (189th in leap years) in the Gregorian calendar. ... Year 1971 (MCMLXXI) was a common year starting on Friday (link will display full calendar) of the 1971 Gregorian calendar. ... Botulin toxin is a neurotoxic protein produced by the bacterium clostridium botulinum. ...


Treatment of botulinum poisoning

The case fatality rate for botulinum poisoning between 1950 and 1996 was 15.5%, down from approximately 60% over the previous 50 years.[23] Death is generally secondary to respiratory failure due to paralysis of the respiratory muscles, so treatment consists of antitoxin administration and artificial ventilation. If initiated on time, these are quite effective. Occasionally, functional recovery may take several weeks to months.


There are two primary Botulinum Antitoxins available for treatment of botulism.

  • The second antitoxin is Heptavalent (A,B,C,D,E,F,G) Botulinum Antitoxin which is derived from "despeciated" equine IgG antibodies which have had the Fc portion cleaved off leaving the F(ab')2 portions. This is a less immunogenic antitoxin that is effective against all known strains of botulism where not contraindicated. This is available from the US Army. On June 1, 2006 the US Department of Health and Human Services awarded a $363 million contract with Cangene Corporation for 200,000 doses of Heptavalent Botulinum Antitoxin over five years for delivery into the Strategic National Stockpile beginning in 2007.[24]

For other uses, see Valence. ... An antitoxin is an antibody with the ability to neutralize a specific toxin. ... Wikipedia does not yet have an article with this exact name. ... An antitoxin is an antibody with the ability to neutralize a specific toxin. ... The Centers for Disease Control and Prevention (CDC) in Atlanta is recognized as the lead United States agency for protecting the public health and safety of people by providing credible information to enhance health decisions, and promoting health through strong partnerships with state health departments and other organizations. ... An antitoxin is an antibody with the ability to neutralize a specific toxin. ... An antitoxin is an antibody with the ability to neutralize a specific toxin. ... Wikipedia does not yet have an article with this exact name. ... An antitoxin is an antibody with the ability to neutralize a specific toxin. ... The United States Department of Health and Human Services, often abbreviated HHS, is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. ... An antitoxin is an antibody with the ability to neutralize a specific toxin. ...

References

  1. ^ Montecucco C, Molgó J (2005). "Botulinal neurotoxins: revival of an old killer". Current opinion in pharmacology 5 (3): 274–9. doi:10.1016/j.coph.2004.12.006. PMID 15907915. 
  2. ^ Frank J. Erbguth (2004). "Historical notes on botulism, Clostridium botulinum, botulinum toxin, and the idea of the therapeutic use of the toxin". Movement Disorders 19 (S8): S2–S6. Movement Disorder Society (Wiley). doi:10.1002/mds.20003. 
  3. ^ Ar non, Stephen. "Botulinum Toxin as a Biological Weapon." JAMA. vol 285. pp.1059-1070. 2001.
  4. ^ Thermal inactivation of Botulinum toxin
  5. ^ Setlowa, Peter (April 2007). "I will survive: DNA protection in bacterial spores". Trends in Microbiology 15 (4): 172–180. Elsevier Ltd.. doi:10.1016/j.tim.2007.02.004. 
  6. ^ Carruthers.net. Retrieved on 2008-01-22.
  7. ^ Brin MF, Lew MF, Adler CH, Comella CL, Factor SA, Jankovic J, O'Brien C, Murray JJ, Wallace JD, Willmer-Hulme A, Koller M (1999). "Safety and efficacy of NeuroBloc (botulinum toxin type B) in type A-resistant cervical dystonia". Neurology 53 (7): 1431–8. PMID 10534247. 
  8. ^ Shukla HD, Sharma SK (2005). "Clostridium botulinum: a bug with beauty and weapon". Crit. Rev. Microbiol. 31 (1): 11–8. doi:10.1080/10408410590912952. PMID 15839401. 
  9. ^ Eisenach JH, Atkinson JL, Fealey RD (2005). "Hyperhidrosis: evolving therapies for a well-established phenomenon". Mayo Clin. Proc. 80 (5): 657–66. PMID 15887434. 
  10. ^ Schurch B, Corcos J (2005). "Botulinum toxin injections for paediatric incontinence". Current opinion in urology 15 (4): 264–7. doi:10.1097/01.mou.0000172401.92761.86. PMID 15928517. 
  11. ^ Duthie J, Wilson D, Herbison G, Wilson D (2007). "Botulinum toxin injections for adults with overactive bladder syndrome." 3: CD005493. doi:10.1002/14651858.CD005493.pub2. PMID 17636801. 
  12. ^ Akbar M, Abel R, Seyler TM, Gerner HJ, Möhring K (2007). "Repeated botulinum-A toxin injections in the treatment of myelodysplastic children and patients with spinal cord injuries with neurogenic bladder dysfunction.". BJU Int. 100 (3): 639–45. doi:10.1111/j.1464-410X.2007.06977.x. PMID 17532858. 
  13. ^ Trzciński R, Dziki A, Tchórzewski M (2002). "Injections of botulinum A toxin for the treatment of anal fissures". The European journal of surgery = Acta chirurgica 168 (12): 720–3. PMID 15362583. 
  14. ^ Panicker JN, Muthane UB (2003). "Botulinum toxins: pharmacology and its current therapeutic evidence for use". Neurology India 51 (4): 455–60. PMID 14742921. 
  15. ^ Charles PD (2004). "Botulinum neurotoxin serotype A: a clinical update on non-cosmetic uses". American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists 61 (22 Suppl 6): S11–23. PMID 15598005. 
  16. ^ Coskun H, Duran Y, Dilege E, Mihmanli M, Seymen H, Demirkol MO (2005). "Effect on gastric emptying and weight reduction of botulinum toxin-A injection into the gastric antral layer: an experimental study in the obese rat model". Obesity surgery : the official journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand 15 (8): 1137–43. doi:10.1381/0960892055002275. PMID 16197786. 
  17. ^ http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WM8-4GX157V-F&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=cf848f941c5b6baa959fced0a96af842
  18. ^ FDA Notifies Public of Adverse Reactions Linked to Botox Use
  19. ^ Woman Dies From Fake Botox Injections
  20. ^ http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WM8-4GX157V-F&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=cf848f941c5b6baa959fced0a96af842
  21. ^ Foran PG, Mohammed N, Lisk GO, et al (2003). "Evaluation of the therapeutic usefulness of botulinum neurotoxin B, C1, E, and F compared with the long lasting type A. Basis for distinct durations of inhibition of exocytosis in central neurons". J. Biol. Chem. 278 (2): 1363–71. doi:10.1074/jbc.M209821200. PMID 12381720. 
  22. ^ "An Examination of FDA’s Recall Authority", Harvard Law School. Retrieved on 2007-09-25. "The incident did not take a toll only on the company, however. Bon Vivant did not have adequate records and controls of production lots and distribution in order to trace the products quickly. The company also did not have the finances or manpower necessary to run a successful recall program. As a result, the FDA had to seize all the Bon Vivant soup throughout the country, more than a million cans in all. FDA said the seizure occupied 125 man years of FDA time, enough for 2,000 ordinary factory inspections for preventive purposes." 
  23. ^ Disease Listing, Botulism Manual, Additional Information. Retrieved on 2007-08-14.
  24. ^ FEMA. Retrieved on 2007-08-14.

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Common Era (or Anno Domini), in accordance with the Gregorian calendar. ... is the 22nd day of the year in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Harvard Law School (colloquially, Harvard Law or HLS) is one of the professional graduate schools of Harvard University. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 268th day of the year (269th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 226th day of the year (227th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 226th day of the year (227th in leap years) in the Gregorian calendar. ...

See also

  • Bon Vivant Soup Company

Bon Vivant was a manufacturer of French soups in Newark, New Jersey. ...

External links

The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ... A muscle relaxant is a drug which decreases the tone of a muscle. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A nicotinic antagonist is a type of anticholinergic which inhibits the action at nicotinic acetylcholine receptors. ... Drugs can block neuromuscular transmission etiher by acting presynaptically, to inhibit ACh synthesis or release, or by acting postsynaptically, the latter being the site of action ofa ll of the clincally important drugs. ... Strychnos toxifera by Koehler 1887 This page is about the plant toxins. ... Alcuronium is a peripherally acting muscle relaxant in the curare alkaloid family. ... Dimethyltubocurarinium (INN) or metocurine (USAN), also known as dimethyltubocurarine, is a non-depolarizing muscle relaxant. ... Tubocurarine chloride is a competitive neuromuscular blocker, used to paralyse patients undergoing anaesthesia. ... Categories: Chemistry stubs ... Atracurium is a neuromuscular-blocking drug or muscle relaxant in the category non-depolarising neuromuscular blocking agents, used in anaesthesia to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. ... Cisatracurium is a muscle relaxant in the quaternary ammonium compound family. ... Doxacurium chloride is a muscle relaxant in the quaternary ammonium compound family. ... Fazadinium bromide is a muscle relaxant. ... Gallamine is a non-depolarising muscle relaxant. ... Hexafluronium (or hexafluorenium) is a muscle relaxant. ... Mivacurium is a bisbenzylisoquinolinium based neuromuscular blocker or muscle relaxant. ... Pancuronium bromide is a chemical compound, used in medicine with the brand name Pavulon® (Organon International). ... Pipecuronium bromide (trade name Raplon) is a muscle relaxant. ... Rocuronium is a non-depolarizing (that is, it does not cause initial stimulation of muscles before weakening them) neuromuscular blocker used in modern anaesthesia, to aid and enable endotracheal intubation, which is often necessary to assist in the controlled ventilation of unconscious patients during surgery and sometimes in intensive care. ... Vecuronium bromide (trade name Norcuron) is a muscle relaxant in the category of non depolarising neuromuscular blocking agents. ... Choline is an organic compound, classified as an essential nutrient and usually grouped within the Vitamin B complex. ... Suxamethonium chloride (also known as succinylcholine, scoline, or SUX) is a white crystalline substance, it is odourless and highly soluble in water. ... Suxamethonium chloride (also known as succinylcholine, or scoline) is a white crystalline substance, it is odourless and highly soluble in water. ... carbamic acid ... Carisoprodol is a centrally-acting skeletal muscle relaxant whose active metabolite is meprobamate. ... Febarbamate is a muscle relaxant. ... Meprobamate (marketed under the brand names Miltown by Wallace Laboratories, Equanil by Wyeth, and Meprospan) is a carbamate derivative which is used as an anxiolytic drug. ... Methocarbamol (chemical formula: ) is a central muscle relaxant for skeletal muscles, used to treat spasms. ... Phenprobamate is a centrally acting skeletal muscle relaxant. ... Styramate is a muscle relaxant. ... Tybamate is an anxiolytic. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ... Bentazepam (also known as Thiadipone) is a drug which is a benzodiazepine derivative. ... Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. ... Lorazepam is a benzodiazepine tranquilizer with short to medium duration of action. ... Nitrazepam (marketed under the trade names Mogadon®, Nitredon®, Nilandron®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Tetrazepam, (Clinoxan, Myolastan, Musaril) is a benzodiazepine derivative with anxiolytic and muscle relaxant properties. ... An anticholinergic agent is a member of a class of pharmaceutical compounds which serve to reduce the effects mediated by acetylcholine in the central nervous system and peripheral nervous system. ... ... Cyclobenzaprine is a skeletal muscle relaxant and a central nervous system (CNS) depressant. ... Orphenadrine (Norflex®, Disipal®, Banflex®, Flexon® and others) is an anticholinergic and NMDA receptor antagonist [1]drug belonging to the ethanolamine class of antihistamines. ... Trazodone (Desyrel®, Trittico®, Thombran®, Trialodine®) is a psychoactive compound with sedative, anxiolytic, and antidepressant properties. ... Baclofen (brand names Kemstro® and Lioresal®) is a derivative of gamma-aminobutyric acid, and is an agonist specific to mammalian but not fruit fly (Drosophila) GABAB receptors[1][2]. It is used for the treatment of spastic movement, especially in instances of spinal cord injury, spastic diplegia and multiple sclerosis. ... Chlormezanone is a centrally acting muscle relaxant. ... This page meets Wikipedias criteria for speedy deletion. ... Donepezil, marketed under the trade name Aricept® (Eisai), is a centrally acting reversible acetyl cholinesterase inhibitor. ... Mephenesin is a centrally acting muscle relaxant. ... Mephenoxalone is an anxiolytic. ... Phenyramidol is a muscle relaxant. ... Pridinol is a muscle relaxant. ... Quinine (IPA: ) is a natural white crystalline alkaloid having antipyretic (fever-reducing), anti-smallpox, analgesic (painkilling), and anti-inflammatory properties and a bitter taste. ... Wikipedia does not have an article with this exact name. ... Tizanidine (Zanaflex, Sirdalud) is a centrally acting α-2 adrenergic agonist. ... Tolperisone. ... Dantrolene sodium is a muscle relaxant that is currently the only specific and effective treatment for malignant hyperthermia. ...

  Results from FactBites:
 
Emergency Medicine (1360 words)
Botulinum toxin, which has been used as a therapeutic agent by neurologists, ophthalmologists, plastic surgeons, and ENT surgeons, is considered the most likely of these toxins to have a significant public health impact and is on the CDC's "A" list.
Botulinum toxin type B (Myobloc) was approved in 2000 for spasmodic torticollis and cervical dystonia.
The toxin is absorbed by gastrointestinal mucosa and respiratory epithelium.
  More results at FactBites »

 
 

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