title: [Botulinum toxin and the hospital pharmacy].
abstract: Botulinum toxin is a neurotoxic protein synthesized by Clostridium botulinum. Among approved indications for type A pharmaceutical formulations is the treatment of upper limb spasticity in post-stroke patients. Neurologists and rehabilitator physicians have extended their use to treat other types of muscles spasticity. In 2002, most of prescriptions in France were off-label. The activity of the R. Poincaré hospital is dedicated to treating handicapped patients. Working in close collaboration, prescribing physicians and hospital pharmacists elaborated a set of guidelines for the use of botulinum toxin type A. The protocol includes a specific order form, pharmaceutical validation of prescriptions and distribution follow-up. The numbers of prescriptions and treated patients have greatly increased from 2003 to 2005. As a consequence to the extension of marketing authorization for indications for the use of botulinum toxin type A in 2005, 77% of treated therapeutic indications are now compliant to marketing authorization specifications. Through prescription analysis, in-hospital pharmacists participate in the implementation of guidelines for follow-up and management of medical expenditures.
authors.affiliation: Pharmacie à usage intérieur, Hôpital Raymond-Poincaré (Assistance Publique des Hôpitaux de Paris), 104, boulevard Raymond-Poincaré, F 92380 Garches. maryvonne.villart@rpc.aphp.fr
authors.forename: M
authors.initials: M
authors.lastname: Villart
mesh_terms: D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D011307:Drug Prescriptions; D006801:Humans; D009128:Muscle Spasticity / Q000188:drug therapy*
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A