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Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin

Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...

Direct-Acting Cholinergic Agonists: Therapeutic Uses

Direct-Acting Cholinergic Agonists: Therapeutic Uses

Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren syndrome.

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...

Cholinergic Antagonists: Therapeutic Uses

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Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal secretions in common...

Indirect-Acting Cholinergic Agonists: Pharmacological Actions

Indirect-Acting Cholinergic Agonists: Pharmacological Actions

Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

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Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...

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Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea

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Published on: November 9, 2016

OnabotulinumtoxinA therapy for compensatory hyperhidrosis.

Jessica A Adefusika¹, Jerry D Brewer

¹Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Journal of Cosmetic Dermatology

|September 3, 2013

Summary

Dilute botulinum toxin therapy effectively treats compensatory hyperhidrosis over large areas. This approach, guided by the iodine starch test, offers a safe and stable solution for severe sweating.

Keywords:

compensatory hyperhidrosis onabotulinumtoxinA sympathotomy

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Area of Science:

Dermatology
Neurology

Background:

Compensatory hyperhidrosis is a debilitating side effect of treatments for focal primary hyperhidrosis.
Managing extensive sweating over large body surface areas presents unique challenges.

Observation:

The iodine starch test was utilized to precisely map large areas of the trunk affected by compensatory hyperhidrosis.
Dilute botulinum toxin therapy was administered to these localized regions.

Findings:

The patient experienced a significant reduction in compensatory truncal sweating.
Sweating levels returned to normal and remained stable for several months post-treatment.

Implications:

Dilute botulinum toxin therapy is a viable and safe treatment for extensive compensatory hyperhidrosis.
This method offers a promising therapeutic option for patients suffering from severe, widespread secondary sweating.