The first generation of the quinolones began following introduction of the related, but structurally distinct naphthyridine-family nalidixic acid in 1962 for treatment of urinary tract infections in humans.  Nalidixic acid was discovered by George Lesher and coworkers in a chemical distillate during an attempt at synthesis of the chloroquinoline antimalarial agent, chloroquine .  Naphthyridone and quinolone classes of antibiotics prevent bacterial DNA replication by inhibition of DNA unwinding events, and can be both bacteriostatic and bacteriocidal.  (See Mechanism of Action later.) The majority of quinolones in clinical use belong to the second generation class of "fluoroquinolones", which have a true quinoline framework, maintain the C-3 carboxylic acid group, and add a fluorine atom to the all-carbon containing ring, typically at the C-6 or C-7 positions.
The following adverse reactions have been identified during post-approval use of BOTOX. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These reactions include: abdominal pain; alopecia , including madarosis; anorexia ; brachial plexopathy; denervation /muscle atrophy ; diarrhea; hyperhidrosis; hypoacusis; hypoaesthesia; malaise ; paresthesia ; peripheral neuropathy ; radiculopathy ; erythema multiforme , dermatitis psoriasiform, and psoriasiform eruption; strabismus; tinnitus ; and visual disturbances.