Compositions and methods for bowel care in individuals with...

Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Having -c- – wherein x is chalcogen – bonded directly to...

Reexamination Certificate

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C514S304000, C514S423000, C514S642000

Reexamination Certificate

active

07635709

ABSTRACT:
The present disclosure provides compositions and methods for on-going bowel care for persons with chronic intestinal pseudo-obstruction. The compositions and methods can be administered in a non-clinical setting. The compositions comprise acetylcholinesterase inhibitors for stimulating motility of the bowel in combination with anti-cholinergic agents to counteract the potentially dangerous cardiac side effects of the acetylcholinesterase inhibitor. In some examples, the acetylcholinesterase inhibitor, neostigmine, and the anti-cholinergic agent, glycopyrrolate, are combined in a pharmaceutical composition. Certain examples also provide the frequency and duration of administration of the disclosed drug combinations.

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patent: 6469030 (2002-10-01), Farrar et al.
patent: 0140434 (1985-05-01), None
Vavilala et al. Neostigmine for acute colonic pseudo-obstruction. New England Journal of Medicine, 1999 vol. 341, No. 21, pp. 1622-1623.
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Child, “Glycopyrrolate and the Bowel,”Anaesthesia, vol. 39, No. 5, pp. 495-496, 1984.
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Fajardo, et al., “Decreased Colonic Motility in Persons With Chronic Spinal Cord Injury.”The American Journal of Gastroenterology, vol. 98, No. 1, pp. 128-134, 2003.
Mehan et al., “Comparison of Recovery in Patients Receiving Atropine-Neostigmine or Glycopyrrolate-Neostigmine for Reversal of Neuromuscular Block,”Ind. J. Anaesth., vol. 38, pp. 234-238, 1990.
Ponec et al., “Neostigmine for the Treatment of Acute Colonic Pseudo-Obstruction,”The New England Journal of Medicine, vol. 341, No. 3, pp. 137-141, 1999.
Korsten et al., “Infusion of Neostigmine-Glycopyrrolate for Bowel Evacuation in Persons with Spinal Cord Injury,”Am. J. Gastroenterology, 100:1560-1565, 2005.
Nelson and Fine, “Bowel Elimination and Continence,” Nursing Practice Related to Spinal Cord Injury and Disorders: A Core Curriculum, A. Nelson (Ed.), Eastern Paralyzed Veterans Association, Palo Alto, CA, pp. 203-223, 2001.
Stiens et al., “Neurogenic Bowel Dysfunction After Spinal Cord Injury: Clinical Evaluation and Rehabilitative Management,”Arch. Phys. Med. Rehabil., 78:S86-S104, 1997.
Stiens et al., “The Gastrointestinal System after Spinal Cord Injury,” Spinal Cord Medicine Principles and Practice, V.W. Lin (Ed.), New York, NY, pp. 321-348, 2003.
“Neurogenic Bowel Management in Adults with Spinal Cord Injury,” Clinical Practice Guidelines, Spinal Cord Medicine, Consortium for Spinal Cord Medicine, Paralyzed Veterans of America, pp. 1-39, Mar. 1998.

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