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Botulism

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Critical Care Toxicology

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Abstract

Botulinum toxin is the ultimate example of the core principle in toxicology that all substances are poisons, and it is only the dose that determines if a substance is therapeutic or toxic. Two forms of pharmaceutical products, onabotulinum toxin A (Botox) and rimabotulinum toxin B (Myobloc), are used as injectable therapeutic agents to induce local muscle paralysis to treat a growing variety of disorders from dystonia to bladder spasm, as well as cosmetic enhancer to flatten facial wrinkles. More botulinum-based products for these, and other, purposes are under development. As a toxin, botulinum, when ingested, is one of the most lethal on a weight per kilogram basis with a LD50 of 0.001 ug/kg [1].

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Authors and Affiliations

  1. Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, USA

    B. Zane Horowitz

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  1. B. Zane Horowitz
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Correspondence to B. Zane Horowitz .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies, and case reports, or reports of expert committees.

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Horowitz, B.Z. (2017). Botulism. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_126-2

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  • DOI: https://doi.org/10.1007/978-3-319-20790-2_126-2

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  1. Latest

    Botulism
    Published:
    22 March 2017

    DOI: https://doi.org/10.1007/978-3-319-20790-2_126-2

  2. Original

    Botulism
    Published:
    01 October 2015

    DOI: https://doi.org/10.1007/978-3-319-20790-2_126-1

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