Now you can help

1
Now you can help!
BOTOX Injector Training
2
Overview of Injector Training

• Patient preparation
• Supplies needed
• Iodine starch test
• BOTOX reconstitution
• BOTOX injection

Please see important safety information on slide
12.
3
Patient Preparation

• Shave underarms
• Abstain from use of over-the-counter deodorants
  or antiperspirants for 24 hours prior to
  treatment
• Rest comfortably without exercise, hot beverages,
  etc., for approximately30 minutes prior to
  treatment

Please see Important Safety Information on slide
12.
4
Supplies Needed
Please see Important Safety Information on slide
12.
5
Perform the Iodine Starch Test

• Dry affected axilla
• Paint area with iodine swab
• Be sure to cover excess area around axilla

• Let dry
• Brush area with starch powder
• Wait 10 minutes

Please see Important Safety Information on slide
12.
6
Perform the Iodine Starch Test

• Blue-black mark will identify affected area

• Circle affected area with surgical marker,
  thenclean area inside circle with alcohol

Please see Important Safety Information on slide
12.
7
Perform the Iodine Starch Test

• Use a surgical pen and standard ruler to mark
  injection points
• 1½ to 2 cm apart
• Staggered to allow for ring effect of intradermal
  injections

• Count injection points and allocate recommended
  dosage of BOTOX solution per injection, based
  on
• 50 Units per axilla

Please see Important Safety Information on slide
12.
8
BOTOX Reconstitution

• Be certain youve received actual BOTOX product
  from Allergan
• Look for holographic film on vial Allergan
  should appear within rainbow lines
• If you do not see rainbow lines or Allergan
  does not appear, do not use product and please
  contact Allergan, Inc., directly at (800)
  890-4345 from 800 a.m. to 400 p.m. Pacific
  time.

Please see Important Safety Information on slide
12.
9
BOTOX Reconstitution
BOTOX Must Be Properly Reconstituted With Only
0.9 Nonpreserved Saline Solution Prior to
Injecting

• Using a 21-gauge, 1½ - inch length needle, draw
  up 4 mL of 0.9 nonpreserved sterile saline into
  syringe
• Insert needle at a 45? angle and slowly inject
  saline into BOTOX vial
• Ensure vacuum is present in vial, which means
  sterility of vial is intact
• Do not use vial if there is no vacuum present
• Release vacuum by disconnecting syringe from
  reconstitution needle (with needle remaining
  attached to bottle) and allowing air to flow into
  vial and neutralize pressure
• Gently mix BOTOX with saline by rotating vial
  do notinvert vial
• Attach a new sterile syringe to remaining needle
  and draw fluid from bottom corner of vial for
  full extraction do not invert vial
• Remove reconstitution needle from syringe and
  attach a 30-gauge injection needle, which is
  recommended needle for axillary injections

Please see Important Safety Information on slide
12.
10
BOTOX Injection

• Inject at a 45 angle to skin surface
• Bevel side up to minimize leakage and ensure
  injections remain intradermal
• A depth of approximately 2 mm

• Be sure not to inject directly on ink mark to
  avoida permanent tattoo effect

Please see Important Safety Information on slide
12.
11
BOTOX Injection

• Clean treated area with alcohol
• Treatment complete

Please see Important Safety Information on slide
12.
12
Important Safety Information

• BOTOX treatment is contraindicated in the
  presence of infection at the proposed injection
  site(s) and in individuals with known
  hypersensitivity to any ingredient in the
  formulation. Serious and/or immediate
  hypersensitivity reactions have been rarely
  reported. These reactions include anaphylaxis,
  urticaria, soft tissue edema, and dyspnea. If
  such a reaction occurs, further BOTOX injection
  should be discontinued and appropriate medical
  therapy immediately instituted. BOTOX should
  only be diluted with 0.9 nonpreserved sodium
  chloride. Other diluents, including lidocaine,
  should not be used for reconstitution.
  Individuals with peripheral motor neuropathic
  diseases (eg, amyotrophic lateral sclerosis or
  motor neuropathy) or neuromuscular junctional
  disorders (eg, myasthenia gravis or Lambert-Eaton
  syndrome) should only receive BOTOX treatment
  with caution. Individuals with neuromuscular
  disorders may be at increased risk of clinically
  significant systemic effects including severe
  dysphagia and respiratory compromise from typical
  doses of BOTOX. The most frequently reported
  adverse events (3-10 of patients) were
  injection-site pain and hemorrhage, non-axillary
  sweating, infection, pharyngitis, flu syndrome,
  headache, fever, neck or back pain, pruritus, and
  anxiety.

Please see accompanying full prescribing
information or visit www.botox.com.
13
Back Up
14
Hyperhidrosis Disease Severity Scale (HDSS)

• HDSS is a 4-point scale designed to assess
  severity of hyperhidrosis in everyday clinical
  practice or in clinical research and
  effectiveness of hyperhidrosis treatment
• HDSS can be administered by an interviewer or
  self-completed by patient
• HDSS assesses disease severity based on extent of
  excessive-sweating-related impairment of daily
  activities

Please see Important Safety Information on slide
12.
15
HyperhidrosisDiseaseSeverity Scale
Please see Important Safety Information on slide
12.