Pharmacology of Botulinum Toxins: From Poison to Remedy

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2020

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info:eu-repo/semantics/openAccess

Özet

Botulinum toxin (BTX) is produced by autolysis of several strains of Clostridium botulinum,a gram-positive, spore-forming, rod-shaped, strictly anaerobic bacterium. However there arealso non-clostridial microorganisms that are enable to produce the toxin. As some otherbeneficial poison, BTX also fits well the quotations by old scientists and philosophers like“Almost every substance can become a poison but only thing is the dose discriminating thedifference” (Paracelsus, XVI century) or “Poisons can be employed as a means for thedestruction of life or as agents for the treatment of the sick” (Claude Bernard, XIX century) or“Poison is a medicine, medicine is a poison” (Ahi Evran, XIII century). In the 1980's, AlanScott first published articles on the use of BTX for the treatment of strabismus. The Food andDrug Administration of the USA (FDA) first approved botulinum toxin for the treatment ofstrabismus (crossed eye) blepharospasm (uncontrollable eye blinking) in 1989 and for glabellarrhytides in 2002, the first cosmetic indication. Since then BTX has been used for a verity ofindications not only dermatological but also non-dermatological indications including onlabelled as well as off-labelled uses. In this review you will find the pharmacological profileof botulinum toxins, i.e., mode of action, pharmacokinetics, adverse effects, indications andcontrindications, drug interactions, duration and site of action, etc. Furthermore, currentcommercial products and novel dosage forms as well as new perspective of BTX use will alsobe discussed.

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22

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2

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