Other
Flaccid paralysis can be associated with a lower motor neuron lesion. This is in contrast to an upper motor neuron lesion, which often presents with spasticity, although early on this may present with flaccid paralysis.Included in AFPs list are poliomyelitis (polio), transverse myelitis, Guillain–Barré syndrome, enteroviral encephalopathy, traumatic neuritis, Reyes syndrome, etc. An AFP surveillance programme is conducted to increase case yield of poliomyelitis. This includes collection of two stool samples within fourteen days of onset of paralysis and identification of virus, and control of the outbreak and strengthening immunization in that area.Historical records from the 1950s, modern CDC reports, and recent analysis of patterns in India suggest that flaccid paralysis may be caused in some cases by oral polio vaccinations.Venomous snakes that contain neurotoxic venom such as kraits, mambas, and cobras can also cause complete flaccid paralysis. Some chemical warfare nerve agents such as VX can also cause complete flaccid paralysis.In some situations, prominently in those of oriental descent hyperthyroidism can affect the consumption and restoration equilibrium of potassium ions in neurons resulting in hypokalaemic paralysis. References
Further reading
External links
WHO Programme for Immunization Preventable Diseases (IPD) A Collaboration between World Health Organization and Government of Nepal
It was developed by NeXstar Pharmaceuticals (acquired by Gilead Sciences in 1999). It was approved by the FDA in 1997. It is marketed by Gilead in Europe and licensed to Astellas Pharma (formerly Fujisawa Pharmaceuticals) for marketing in the US, and Sumitomo Pharmaceuticals in Japan. Lipid complex formulations
A number of lipid complex preparations are also available. Abelcet was approved by the FDA in 1995. It consists of amphotericin B and two lipids in a 1:1 ratio that form large ribbon-like structures. Amphotec is a complex of amphotericin and sodium cholesteryl sulfate in a 1:1 ratio. Two molecules of each form a tetramer that aggregate into spiral arms on a disk-like complex. It was approved by the FDA in 1996. By mouth
An oral preparation exists but is not widely available. The amphipathic nature of amphotericin along with its low solubility and permeability has posed major hurdles for oral administration given its low bioavailability. In the past it had been used for fungal infections of the surface of the GI tract such as thrush, but has been replaced by other antifungals such as nystatin and fluconazole.However, recently novel nanoparticulate drug delivery systems such as AmbiOnp, nanosuspensions, lipid-based drug delivery systems including cochleates, self-emulsifying drug delivery systems, solid lipid nanoparticles and polymeric nanoparticles—such as Amphotericin B in pegylated polylactide coglycolide copolymer nanoparticles—have demonstrated potential for oral formulation of amphotericin B. Side effects
Amphotericin B is well known for its severe and potentially lethal side effects.