Assuntos
Toxinas Botulínicas Tipo A/efeitos adversos , Técnicas Cosméticas/efeitos adversos , Doenças Labiais/induzido quimicamente , Fármacos Neuromusculares/efeitos adversos , Idoso , Blefaroptose/induzido quimicamente , Abrasão Química/efeitos adversos , Dermatite de Contato/complicações , Dermatoses Faciais/complicações , Feminino , Humanos , Inflamação/etiologia , Lasers de Estado Sólido/efeitos adversos , Pessoa de Meia-Idade , Fotoquimioterapia/efeitos adversos , Distúrbios da Fala/induzido quimicamenteRESUMO
BACKGROUND: Ptosis after botulinum toxin injection is a disturbing complication. Decongestant and antiglaucoma eyedrops are frequently prescribed for temporary improvement of eyelid ptosis. Although frequently cited on informal communications, the effect of these drugs on eyelid position has never been compared in a formal study. OBJECTIVE: To measure the effect of low-concentration, nonmydriatic selective alpha agonist eyedrops on upper eyelid position. METHODS AND MATERIALS: This nonrandomized clinical trial enrolled 20 healthy subjects aged 18 to 50 years. The upper margin-reflex distance (MRD1) was measured before, 30, 60, and 120 minutes after administration of 1 drop of brimonidine 0.2%, phenylephrine 0.12%, or naphazoline 0.05% to the left eye. RESULTS: There was no statistically significant difference in mean MRD1 between the brimonidine and phenylephrine groups when comparing baseline to all other study time points. After administration of naphazoline 0.05%, MRD1 had a mean increase of 0.56 ± 0.11 mm (p < 0.001) after 30 minutes, 0.47 ± 0.12 mm (p = 0.001) after 60 minutes, and 0.26 ± 0.09 mm (p = 0.028) after 120 minutes when compared with baseline. CONCLUSION: Brimonidine 0.2% and phenylephrine 0.12% have no effect on eyelid aperture, but naphazoline 0.05% eyedrops could be useful for temporary relief of upper eyelid ptosis in selected patients.
Assuntos
Agonistas alfa-Adrenérgicos/administração & dosagem , Pálpebras/efeitos dos fármacos , Adolescente , Adulto , Blefaroptose/induzido quimicamente , Blefaroptose/tratamento farmacológico , Toxinas Botulínicas/efeitos adversos , Tartarato de Brimonidina/administração & dosagem , Humanos , Pessoa de Meia-Idade , Nafazolina/administração & dosagem , Soluções Oftálmicas , Fenilefrina/administração & dosagem , Adulto JovemRESUMO
PURPOSE: To verify the safety and efficacy of botulinum toxin type A (BoNT/A) to promote protective ptosis in dogs. METHODS: In this prospective interventional study, a total of 10 dogs underwent transcutaneous anterior chemodenervation of levator palpebral superioris with 15 U of BoNT/A. The systemic changes, ocular mobility, visual function, intraocular pressure (IOP), tear production, and the onset, degree, and duration of ptosis were evaluated on a daily basis during the first 7 days and on days 14, 21, and 28 after application. RESULTS: The onset of the clinical effect was observed between 2 and 3 days after application of the toxin; the time taken for maximum ptosis to develop varied from 4 to 7 days (mean 5 days) and the average duration of the toxin effect was 21 days. The mean percentage reduction in palpebral fissure height was 42.859% (SD±35.714%-59.821%). There was not a statistically significant difference in IOP before and after the BoNT/A application (P=0.974), or lacrimal production evaluation (P=0.276). There was no change in ocular mobility and no other adverse effect was observed in association with the administration of the study drug. CONCLUSION: The application of BoNT/A into the levator palpebral superioris muscle in dogs was effective and safe to promote protective ptosis with a temporary covering of the cornea.
Assuntos
Blefaroptose/induzido quimicamente , Toxinas Botulínicas Tipo A/farmacologia , Fármacos Neuromusculares/farmacologia , Animais , Toxinas Botulínicas Tipo A/toxicidade , Cães , Movimentos Oculares/efeitos dos fármacos , Feminino , Pressão Intraocular/efeitos dos fármacos , Masculino , Fármacos Neuromusculares/toxicidade , Estudos Prospectivos , Lágrimas/efeitos dos fármacos , Lágrimas/metabolismo , Fatores de TempoRESUMO
Thirteen subjects with trigeminal neuralgia were treated with botulinum-A neurotoxin (BoNT/A) in an open-label pilot study. After BoNT/A, visual analog scale score, surface area of pain, and therapeutic coefficient were reduced in all patients and for all branch trigeminal nerves studied. Therefore, BoNT/A is an efficient treatment. There were no major side effects. A placebo-controlled clinical trial is needed to confirm these findings.
Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Nervo Trigêmeo/efeitos dos fármacos , Neuralgia do Trigêmeo/tratamento farmacológico , Idoso , Analgésicos/uso terapêutico , Anticonvulsivantes/uso terapêutico , Blefaroptose/induzido quimicamente , Toxinas Botulínicas Tipo A/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuropeptídeos/antagonistas & inibidores , Neuropeptídeos/metabolismo , Neurotoxinas/administração & dosagem , Neurotoxinas/efeitos adversos , Nociceptores/efeitos dos fármacos , Nociceptores/fisiologia , Medição da Dor/efeitos dos fármacos , Limiar da Dor/efeitos dos fármacos , Limiar da Dor/fisiologia , Projetos Piloto , Células Receptoras Sensoriais/efeitos dos fármacos , Células Receptoras Sensoriais/fisiologia , Transmissão Sináptica/efeitos dos fármacos , Transmissão Sináptica/fisiologia , Resultado do Tratamento , Nervo Trigêmeo/fisiopatologia , Neuralgia do Trigêmeo/fisiopatologiaRESUMO
An ethanolic extract of the leaves of Cissampelos sympodialis Eichl. (Menispermaceae) was found to potentiate the toxicity of pentylenetetrazol in mice. Similar to imipramine, the extract also reduced the immobility period in the forced swimming test in mice and reversed the degree of ptosis and catalepsy induced by reserpine in rats. These results suggest that the extract possesses antidepressant activity and the reported phosphodiesterase inhibitory activity of the plant may account for the observed antidepressant effect.
Assuntos
Antidepressivos/farmacologia , Plantas Medicinais/química , Animais , Antidepressivos Tricíclicos/farmacologia , Comportamento Animal/efeitos dos fármacos , Blefaroptose/induzido quimicamente , Catalepsia/induzido quimicamente , Sinergismo Farmacológico , Etanol , Imipramina/farmacologia , Masculino , Camundongos , Pentilenotetrazol/toxicidade , Extratos Vegetais/farmacologia , Folhas de Planta/química , Ratos , Ratos Wistar , Reserpina/toxicidade , Convulsões/induzido quimicamente , SolventesRESUMO
The effects of cannabidiol (CBD) were compared to those produced by haloperidol in rats submitted to experimental models predictive of antipsychotic activity. Several doses of CBD (15-480 mg/kg) and haloperidol (0.062-1.0 mg/kg) were tested in each model. First, CBD increased the effective doses 50% (or) ED50 of apomorphine for induction of the sniffing and biting stereotyped behaviors. In addition, both CBD and haloperidol reduced the occurrence of stereotyped biting induced by apomorphine (6.4 mg/kg), increased plasma prolactin levels and produced palpebral ptosis, as compared to control solutions. However, CBD did not induce catalepsy even at the highest doses, in contrast to haloperidol. Such a pharmacological profile is compatible with that of an "atypical" antipsychotic agent, though the mechanism of action is uncertain and may not be identical to that of the dopamine antagonists.
Assuntos
Antipsicóticos , Canabidiol/farmacologia , Animais , Apomorfina/farmacologia , Blefaroptose/induzido quimicamente , Catalepsia/induzido quimicamente , Masculino , Modelos Psicológicos , Prolactina/metabolismo , Ratos , Ratos Endogâmicos , Comportamento Estereotipado/efeitos dos fármacosRESUMO
Blepharospasm is a relatively frequent cranial dystonia which may be seen either alone or related to orofacial-mandibular dystonia (Meige's syndrome). In its maximum degree it can cause functional blindness.Twelve patients with blepharospasm (4 essential and 8 Meige's syndrome) who had been previously treated unsuccessfully with drugs (trihexyphenidyl, biperiden, carbamazepine, lithium, baclofen, lisuride, imipramine, clonazepam and butyrophenones) were treated for 12 months with periocular injections of botulinum toxin (BOTOX). A "low" dose of 12,5 U per eye was employed. With this dose, eleven out of twelve patients experienced significant improvement which lasted from five to fifteen weeks. The only nonresponder obtained complete relief upon duplicating the dose. The only side effect was uni or bilateral ptosis in six patients which improved completely in seven to twenty one days. One patient developed a peripheral facial palsy with complete remission in nineteen days. No systemic side effects were noted. There was only one desertion from this study due to depression enhanced by prolonged (21 days) ptosis. All patients (including the deserter) agreed that treatment with BOTOX provided more relief than any other previous therapeutic method. Our results confirm those obtained by others but a more prolonged study is needed to better evaluate long term effects.
Assuntos
Blefarospasmo/tratamento farmacológico , Toxinas Botulínicas/uso terapêutico , Idoso , Blefaroptose/induzido quimicamente , Toxinas Botulínicas/efeitos adversos , Paralisia Facial/induzido quimicamente , Feminino , Humanos , Injeções Intramusculares , Pessoa de Meia-IdadeRESUMO
El blefaroespasmo, ya sea aislado o en el contexto de una disquinesia oro-facio-mandibular (síndrome de Meige) es una distonía cranial relativamente frecuente. En su máxima expresión puede dar origen a marcada minusvalía e incluso ceguera funcional. Doce pacientes con respuesta poco satisfactoria a tratamientos medicamentosos (trihexifenidilo, hiperideno, imipramina, carbamazepina, baclofén, litio, lisuride, clonazepam, butirofenonas) fueron tratados con inyecciones perioculares de toxina botulínica (Botox), utilizando una dosis "baja" de 12,5 UI por ojo. Once de los doce pacientes obtuvieron mejoria significativa que duró entre cinco y quince semanas. Una sola paciente no respondió y lo hizo al duplicar la dosis de toxina inyectada. Los únicos efectos secundarios observados fueron ptosis uni o bilateral en 6 pacientes, reversible antes de los 21 días de la inyección y no se observaron efectos secundarios sistemáticos. Una paciente tuvo una parálisis facial periférica de 19 días de duración con remisión completa. Hubo una sola deserción del estudio en una paciente depresiva con ptosis prolongada (21 días). Todos los pacientes (inclusive la desertora) coincidieron en que el tratamiento con Botox fue más eficaz que cualquier ensayo medicamentoso previo. A pesar que estos resultados son similares a comunicaciones previas, creemos aconsejable acumular experiencia para evaluar los resultados a largo plazo
Assuntos
Pessoa de Meia-Idade , Humanos , Feminino , Blefarospasmo/tratamento farmacológico , Toxinas Botulínicas/uso terapêutico , Blefaroptose/induzido quimicamente , Ensaios Clínicos como Assunto , Paralisia Facial/induzido quimicamente , Injeções Intramusculares/métodos , Toxinas Botulínicas/administração & dosagem , Toxinas Botulínicas/efeitos adversosRESUMO
El blefaroespasmo, ya sea aislado o en el contexto de una disquinesia oro-facio-mandibular (síndrome de Meige) es una distonía cranial relativamente frecuente. En su máxima expresión puede dar origen a marcada minusvalía e incluso ceguera funcional. Doce pacientes con respuesta poco satisfactoria a tratamientos medicamentosos (trihexifenidilo, hiperideno, imipramina, carbamazepina, baclofén, litio, lisuride, clonazepam, butirofenonas) fueron tratados con inyecciones perioculares de toxina botulínica (Botox), utilizando una dosis "baja" de 12,5 UI por ojo. Once de los doce pacientes obtuvieron mejoria significativa que duró entre cinco y quince semanas. Una sola paciente no respondió y lo hizo al duplicar la dosis de toxina inyectada. Los únicos efectos secundarios observados fueron ptosis uni o bilateral en 6 pacientes, reversible antes de los 21 días de la inyección y no se observaron efectos secundarios sistemáticos. Una paciente tuvo una parálisis facial periférica de 19 días de duración con remisión completa. Hubo una sola deserción del estudio en una paciente depresiva con ptosis prolongada (21 días). Todos los pacientes (inclusive la desertora) coincidieron en que el tratamiento con Botox fue más eficaz que cualquier ensayo medicamentoso previo. A pesar que estos resultados son similares a comunicaciones previas, creemos aconsejable acumular experiencia para evaluar los resultados a largo plazo (AU)