Botox 58

shevyatiwari's version from 2015-10-17 07:20

Section 1

Question Answer
Botox type A most potent in humans T . C and D have little effect on humans
Botox A-G can all be effective in humans F. C and D have little effect on humans
Pregnancy category D F. C
Contraindicated with use of aminoglycosides T
Contraindicated with use of cholinesterase inhibitors T
Contraindicated with use of succinylcholine T
Contraindicated with use of curare-like depolarising agents T
Contraindicated with use of magnesium sulphate T
Contraindicated with use of polymyxins, lincosamides, calcium channel blockers T
Contraindicated with use of quinidine T

Section 2

Question Answer
Side effects of Botox inc. pain,swelling, bruising , ptosis, hand weakness, dysphagiaT
Side effects commonly inc. headacheF. Uncommon
Rare side effects inc. anaphylaxis , flu-like symptoms and metallic taste T
Non -Derm botox side effects inc MI, diplopia and ectropion T and Dysphagia. xeropthalmia , headache, ectropion, diplopia, hypertension, arrythmia, MI
Contraindications inc. known neuromuscular disease eg. Lambert eaton or myaesthenia gravis T. Botox could exacerabate neuromuscular disease but risk is v. low in cosmetic doses
Calcium channel blockers are an absolute contraindication F. Relative contraindication
Infection and inflammation at injection site - absolute contraindications F. Infection at injection site = absolute contraindication. Inflammation = relative c/i
Comorbid psychiatric condition is a contraindicationT body dysmorhic disorder and unrealistic expectations are relative c/i
BoNT serotypes ACE catalyse synaptobrevin (VAMP) F. BDFG catalyse the cleavage of synaptobrevin aaka - vesicle assoc protien VAMP
BoNT serotypes A, B E catalyse SNARE 25F. Serotypes A,C & E catalyse cleavage of SNARE protein SNAP -25
All botox serotypes induce ACH release from NMJF. All 7 serotypes (a-g) INHIBIT realease of ACH from NMJ - lead to flaccid muscle paralysis
All have a large neurotoxin protein attached to a larger non-toxic protein and free fatty acidF. all have small 150kda neurotoxin proetin surrounded by a large protective non-toxic non-hemaglutinin and a hemaglutatinin attached to a zinc atom
Botox structure contains a zinc atom which stabilises it. T does contain zinc atom but does not stabilise it - that is the HA and non-hemaglutiin
50kda light chain is coupled to the 100kda heavy chain by covalent bonds F. by heat-labile disulfide bonds
Complex is stable in the gut but dissociates in the blood stream releasing toxin T
Heavy chain binds to pre-synaptic membrane and allows light chain to enter cytosol and cleave proteins for ACh releaseF. HC binds to presynaptic nerve terminal and allows light chain to enter cytosol and cleave protein
BoNT is an extremely potent molecule T
Actual dose measures 5ng per 100u of neurotoxinT
Botox is a 900kda complexT
After 3 months a functional reconnection is reestablisedT
subtypes A and B are derived from the same strain of clostridium botulinumT . All 7 known serotypes derive from the same strain of C. botulinum A-G (REAL q)
Subtypes C and D are almost as toxic as A in humans F. C and D have little effect on humans (real q )
only one subtype acts on SNARE F
maximal paralysis occurs at 3 weeks after injection F. . Weakness seen in 2-4 days. max paralysis in 7-10 days
Clsotridium botulinum produces 7 known serologically distinct neurotoxinsT
Botulism has been associated with the cosmetic use of Botox F. No cases of reported with cosmetic use of botox
Toxin diffusion ranges from 1-3cm T
brusing can occur immediately T

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