Nasal administration of agents for the treatment of gastroparesis

Abstract

The present invention is directed to a method for the treatment of gastroparesis by the use of metoclopramide nasal formulation.

Description

1. FIELD OF THE INVENTION[0001] The present invention is directed to a method for treating gastroparesis. More particularly, the present invention is directed to a method for treating gastroparesis typically caused by diabetes mellitus (including type 1 and type 2 diabetes), postviral syndromes, anorexia nervosa, malnutrition, alcoholism, surgery on the stomach or vagus nerve, medications, particularly anticholinergics and narcotics which slow contractions in the intestine, gastroesophageal reflux disease, smooth muscle disorders such as amyloidosis and scleroderma, nervous system diseases (including abdominal migraine and Parkinson's disease), or metabolic disorders (including hypothyroidism) with the nasal administration of metoclopramide.2. BACKGROUND OF THE INVENTION[0002] The vagus nerve controls the movement of food through the digestive tract. Normally, stomach muscles contract about three times a minute and the stomach empties within 90-120 minutes after eating. When the vag...

AI Technical Summary

Problems solved by technology

When the vagus nerve is damaged or dysfunctional, stomach muscles do not work properly and the stomach contraction becomes sluggish and / or less frequent.

In addition, since food lingers too long in the stomach, gastroparesis can lead to complications such as bacterial overgrowth from the fermentation of food, hardening of food into solid masses which are called bezoars that may cause nausea, vomiting, and obstruction in the stomach.

Bezoars can be dangerous if they block the passage of food into the small intestine.

Blood glucose levels of diabetic patients often remain high over a long period of time.

High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the vagus nerves.

However, injections, particularly daily multiple injections, are often very painful and inconvenient.

As a result, compliance (compliance=following dosage regimen prescribed) is often very poor.

However, for patients with gastroparesis, metoclopramide absorption through the GI tract is unpredictable and far less effective, with predictability and effectiveness having an inverse relationship to the severity of the symptom, i.e., the more severe the symptoms, the less likely that oral administration is an option.

Further complicating the matter of oral administration of metoclopramide is the fact that patients with gastroparesis often have symptoms such as vomiting and nausea.

If vomiting takes place, the amount of metoclopramide that remains in the stomach is unknown, and the result of treatment is even less predictable.

Side effects of metoclopramide include fatigue, sleepiness, depression, anxiety, and difficulty with physical movement.

These side effects may interfere with patient compliance with the drug regimen prescribed, as well as interfere with the patient's ability to effectively communicate the nature and severity of this and other side effects.

Poor compliance or non-compliance is observed in about 25% of patients with an oral medication regimen.

Due to nausea and vomiting associated with gastroparesis, patients are even more reluctant to comply with the oral regimen.

Furthermore, Wenig did not disclose using any forms of MCP, or any particular regimen for the purpose of treating gastroparesis.

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