Surgeon in Ophthalmology, Massachusetts Eye and Ear Infirmary,

Assistant Clinical Professor, Harvard Medical School

Medical Director Associate Eye Physicians and Surgeons, Inc

Issues in the Science and Chemistry of Products

Issues Governing the Medicine, Science and Chemistry of botulinum toxin.

Botulinum toxin products (eg BOTOX and others) work by blocking neurotransmission. The unique pharmacology relates to two fundamental principles:

  1.  Regional effect which can be controlled by dose
  2.  Long duration of action
  3.  Multiple influences of blocked neurotransmission
  4.  Small mass dosing (because it’s toxin!) which allows for repeated dose without an immune appreciable response in most cases

The most obvious effect is weakening of muscles which produce a desirable effect on age dependent line and face wrinkles, modulation of involuntary muscular activity from cerebral palsy, dystopias, torticollis, blepharospasm, and hemifacial spasm. Additionally the drug has effect on non motor (non muscular) nerves which control body secretions, modulate certain inflammatory mediators (link), and may play a role in central nervous system processing.

Treatment of pain including migraine, sinus and tension headache is an example of extra muscular effects of the toxin.

Current issues governing drug selection relate to controlled administration, potency of dose, long term effectiveness, cost, duration of action, antigenicty of materials and selective effects.

Dr. Borodic’s publications will go into much more detail on each of these points. (link to publications)

Gary E. Borodic. MD

P: 617.770.0011
F: 617.770.0030 

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