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Botulinum antitoxin, also known as botulism antitoxin, is comprised of antibodies or antibody antigen-binding fragments that block the neurotoxin produced by the bacterial species Clostridium botulinum. Botulinum toxin causes botulism, a paralytic syndrome classically characterized by symptoms of descending symmetric muscle weakness. Symptoms can include blurry vision, inability to speak or swallow, and weakness in the bilateral upper extremities with progression to the chest and lower extremities. This activity reviews the mechanism of action, adverse event profile, toxicity, dosing, pharmacodynamics, and monitoring of botulism antitoxin, pertinent for interprofessional team members for the treatment of patients with botulism poisoning. Objectives: Summarize the mechanism of action of botulism antitoxin. Describe the potential adverse effects of botulism antitoxin. Review the indication(s) for the therapeutic use of botulism antitoxin. Discuss interprofessional team strategies for improving care coordination and communication to advance the treatment of botulism poisoning and improve outcomes when using botulinum antitoxin. Access free multiple choice questions on this topic.

An interprofessional approach to the use of botulinum anti-toxin is recommended. Treatment of botulism is time-sensitive, the antitoxin takes time to be dispatched from the CDC, and it can cause serious side effects.[14] Having an interprofessional team of toxicologists, emergency medicine physicians, other clinicians, nurses, and pharmacists is important for decreasing the time to diagnosis and ensuring patient safety during drug administration. Poison control should immediately be contacted if a patient has suspected botulism. Poison control and the state health department will help guide the diagnostic workup in cases where the diagnosis of botulism is not clear. Toxicologists can consult at presentation and follow-up numerous times throughout the progression of patient care. Next, the state health department needs to be contacted when botulism is suspected. They assist with mobilizing anti-toxin from the CDC and will investigate potential outbreaks. They may also isolate and test the food source in case of foodborne disease, and if needed, provide help with food recall if a potential commercial source is identified. When administering anti-toxin, as stated before, the patient should be monitored closely for adverse reactions. Nurses and treating clinicians need to understand how they will approach resuscitation and what signs and symptoms may present. Pharmacists are needed for guidance on how to administer the anti-toxin correctly and how to step down treatment if reactions do occur. Treatment with botulinum anti-toxin is time-sensitive and not without major risks. Having effective interprofessional communication affords patients the best chance of correctly diagnosing and treating Botulism while minimizing harm. Finally, the public should be educated about the hazards of consuming improperly or poorly packaged canned or preserved foods. Pregnant mothers should be told not to offer any honey to infants, as this is a risk for the infant form of botulism.[16]