A 50-year-old patient receives botulinum toxin type A (Botox) injections for the first time on her forehead and around her eyes. One week later, she calls the clinic to report that she is experiencing droopy eyelids
The nurse will tell the patient that this effect:
a. is normal and will resolve in a few days.
b. may persist for 3 to 6 months but will resolve.
c. may progress to cause drooling and dysphagia.
d. represents an adverse effect that may be permanent.
ANS: B
Botox is a neurotoxin that acts on cholinergic neurons to block the release of acetylcholine. Injection into the wrong site or diffusion from the correct site into surrounding tissues can weaken muscles not intended as targets. This patient's droopy eyelids are an example of the wrong site being affected. Weakening of muscles can last 3 to 6 months but will resolve. It is incorrect to tell the patient that it is a normal effect or that it will resolve in a matter of days. Drooling and dysphagia are likely when injections are around the mouth. It is not a permanent effect.
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