Skip to Main Content

++

INTRODUCTION

++

abobotulinum toxin A (ab-oh-bot-yoo-lye-num tox-in aye)

Dysport

Classification

Therapeutic: antispasticity agents cosmetic agents

Pharmacologic: neurotoxins

++
Indications
++

Treatment of cervical dystonia in adults in order to decrease severity of abnormal head position and neck pain Temporary improvement of moderate to severe glabellar (frown) lines in adult patients <65 yr.

++
Action
++

Inhibits release of acetylcholine from peripheral cholinergic nerve endings, resulting chemical denervation of treated muscle. Therapeutic Effects: Localized reduction of muscle activity, with decreased spasticity in cervical dystonia. Decreased appearance of glabellar lines.

++
Adverse Reactions/Side Effects Cervical dystonia
++

CNS: fatigue, headache. EENT: dysphonia, eye disorder. GI: dry mouth, dysphagia. Local: injection site pain. MS: muscular weakness, neck pain. Misc: SPREAD OF TOXIN EFFECT.

++
Glabellar lines
++

CNS: headache. EENT: nasopharyngitis, eyelid edema, eyelid ptosis, sinusitus. Resp: nasopharyngitis, dyspnea. GI: nausea, dysphagia. Local: injection site pain/reaction. Misc: SPREAD OF TOXIN EFFECT.

++

PHYSICAL THERAPY IMPLICATIONS (when treating cervical dystonia or spasticity)

++
Examination and Evaluation
++

  • Assess dystonia, spasticity, ROM, and functional ability as the drug begins to take effect. Document whether changes in spasticity and tone are consistent with rehabilitation goals.

  • Watch for signs that the effects of abotulinum toxin A spread beyond the site of local injection. Signs include generalized muscle weakness, difficulty breathing, vision disturbances, drooping eyelids (ptosis), urinary incontinence, difficulty swallowing, and problems speaking. These signs can occur hours to weeks after injection. Report these signs to the physician immediately.

  • Monitor IM injection site for redness, swelling, and irritation. Report prolonged or excessive skin reactions to the physician.

++
Interventions
++

  • Implement aggressive therapeutic exercises (neuromuscular re-education, postural stabilization, gait training, other task-specific training) to facilitate voluntary motor function and help patient adjust to reduced spasticity and tone.

  • Provide appropriate assistive devices (walker, cane, crutches) while patient adjusts to reduced levels of spasticity. Specifically, make sure patient can ambulate and transfer safely while adjusting to reduced tone in the lower extremities.

  • When indicated, incorporate serial casting and similar techniques to capitalize on drug effects and achieve maximal soft tissue lengthening and help reduce contractures.

++
Patient/Client-related Instruction
++

  • Explain to patient and family/caregivers that treatment effects may only last 2–4 months. Periodic re-injection may be needed to sustain muscle relaxant effects.

  • Instruct patient or family/caregivers to report any untoward responses such as severe or prolonged headache, drooping eyelids, vision problems, difficulty speaking, or GI problems (nausea, dry mouth, difficulty swallowing).

++
Pharmacokinetics
++

Absorption: Minimal but may be significant in selected populations.

++

Distribution: Unknown

++

Metabolism and Excretion: Unknown

++

Half-life: Unknown

++...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.