Toxina Botulínica A

Toxina Botulínica A Uses, Dosage, Side Effects, Food Interaction and all others data.

In 2002, botulinum toxin A, also known as onabotulinumtoxinA or Botox, was the first type A botulism toxin to be introduced into the market for cosmetic use. With a wide variety of applications and favourable safety profile, Botulinum toxin A injection is a minimally invasive and promising treatment for cosmetic imperfections, muscle spasms, and other conditions. A popular use for Botox is the treatment of facial wrinkles and lines, however, there are many uses for the botulinum toxin A in the treatment of dystonia, incontinence, migraine, blepharospasm, and hyperhidrosis.

Botulinum toxin A inhibits the release of acetylcholine, relieving muscle contraction and spasm associated with many conditions, such as incontinence and dystonia. Cosmetically, botulinum toxin A paralyses muscles in the face to temporarily treat wrinkles. The maximum effects of muscle paralysis occur four to seven days after a dose. When injected at therapeutic doses, botulinum toxin A causes partial chemical denervation of muscle tissue, causing local reduction of muscle activity. Muscle atrophy may result, axonal sprouting may begin, and extrajunctional acetylcholine receptors can be formed. Reinnervation of the muscle may occur, reversing muscle denervation caused by botulinum toxin A.

Toxina Botulínica A
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Toxina Botulínica A
Generic	Botulinum toxin type A
Botulinum toxin type A Other Names	AbobotulinumtoxinA, Botulinum A neurotoxin, Botulinum antitoxin type A, Botulinum toxin A, Botulinum toxin type A, BTX-A, EvabotulinumtoxinA, IncobotulinumtoxinA, OnabotulinumtoxinA, Prabotulinumtoxin A, Toxina botulínica A, Toxine botulinique A
Type
Formula	C₆₇₆₀H₁₀₄₄₇N₁₇₄₃O₂₀₁₀S₃₂
Weight	900000.0 Da
Protein binding	A pharmacokinetic study in mice and rats revealed significant binding to albumin after subcutaneous injection or intranasal administration.
Groups	Approved, Investigational
Therapeutic Class
Manufacturer
Available Country
Last Updated:	September 19, 2023 at 7:00 am

Uses

Toxina Botulínica A is a purified form of botulinum toxin type A used to block acetylcholine release in the treatment of chronic sialorrhea, muscle spasticity, and dystonia, as well as in cosmetic applications.

Botulinum toxin A is indicated for a variety of conditions, depending on the preparations. Cosmetically, it is used for the treatment of facial fine lines and wrinkles, specifically for upper facial rhytides, including forehead, lateral canthus, and glabellar lines.

In addition to the above indications, botulinum toxin A is used for the following conditions: treatment of adults with symptomatic overactive bladder with or without incontinence, treatment of incontinence in adult patients who are not candidates for anticholinergic therapy, treatment of Neurogenic Detrusor Overactivity (NDO) in patients over 5 years who cannot undergo anticholinergic therapy. Botulinum toxin A is indicated for the prevention of chronic migraines, for the treatment of muscle spasms, cervical dystonia, axillary hyperhidrosis, strabismus, and disorders of the 7th cranial nerve.

Off-label, botulinum toxin A is used for a variety of conditions such as temporomandibular joint (TMJ) disorders and myofascial pain, neurogenic thoracic outlet syndrome, epicondylitis, post-stroke pain, post-herpetic neuralgia, diabetic neuropathy, trigeminal neuralgia, neuropathic pain, spinal cord injury, and bladder pain.

Toxina Botulínica A is also used to associated treatment for these conditions: Bladder pain, Blepharospasm, Cervical Dystonia, Chronic Migraine, Diabetic Neuropathies, Epicondylitis, Equinus deformity of foot, acquired, Glabellar Lines, Myofascial Pain Syndrome, Neurogenic Detrusor Overactivity, Neurogenic Thoracic Outlet Syndrome, Post Stroke Pain, Post-Herpetic Neuralgia (PHN), Rhytides, Sialorrhea, Spasticity, Spinal Cord Injuries (SCI), Strabismus, TMJ Disorders, Trigeminal Neuralgia (TN), Upper Limb Spasticity, Urinary Bladder, Overactive, Urinary Incontinence (UI), Detrusor overactivity, neurologic conditions, Hypertonicity disorders of the 7th nerve, Severe axillary hyperhidrosis, Temporary improvement in the appearance of moderate to severe lateral canthal lines associated with orbicularis oculi activity, Temporary improvement in the appearance of moderate to severe glabellar lines associated with procerus and corrugator muscle activity

How Toxina Botulínica A works

Botulinum toxin is a 150-kDa molecular weight protein consisting of a light chain (50 kDa) and heavy chain (100 kDa) linked by a single disulfide bond. The crystal structure reveals 3 lobes - the light chain, the amino-terminal portion of the heavy chain, and the carboxyl-terminal portion of the heavy chain.

Toxina Botulínica A blocks neuromuscular transmission on motor or sympathetic nerve terminals, inhibiting the release of acetylcholine. Botulinum toxins have actions on various regions: the neuromuscular junction, autonomic ganglia, and both postganglionic sympathetic and parasympathetic nerve endings. The heavy chain of the toxin binds selectively at the presynaptic surface of cholinergic neurons in an irreversible fashion. After binding, the toxin-receptor complex is transported into the cell by endocytosis. The disulfide bond between the two chains is cleaved and the botulism toxin enters the cytoplasm. The light chain specifically interacts with SNAP-25 in the nerve terminals to block binding of acetylcholine vesicles with the cell membrane. SNAP-25 is required for successful binding and release of acetylcholine from vesicles in nerve endings.

Toxicity

The intraperitoneal LD50 of botulinum toxin A in mice is 160 ng/kg. An overdose of botulinum toxin A is expected to produce neuromuscular weakness, manifested by a variety of symptoms that may not appear immediately after injection. Dysphagia, dysphonia, weakness, dyspnea or respiratory distress may indicate distant spread of botulinum toxin A effects. If an overdose is suspected or confirmed, patients should be monitored for several weeks closely for local and distant neurologic effects. Hospitalization or further medical evaluation and appropriate intervention should be provided immediately.

Food Interaction

No interactions found.

Volume of Distribution

There are extremely limited data about the pharmacokinetics of botulinum toxin in humans. An animal study demonstrated that botulinum toxin accumulates in the liver and spleen in rats and mice when injected subcutaneously or administered intranasally.

Elimination Route

The chemical complexity of botulinum toxin type A combined with its extreme potency limits the opportunity to study its pharmacokinetic profile in humans. For this reason, human pharmacokinetic studies have not been performed. Animal studies using radio labeled botulinum toxin suggest it is absorbed systemically after subcutaneous and intranasal administration. Clinical relevance is unknown.

Half Life

There is no readily available data about the pharmacokinetics of botulinum toxin in humans. The elimination half-life for non-metabolized botulinum toxin in blood and serum ranged from 230 to 260 min in a pharmacokinetic study of rats and mice.