To Ann Calandro:
Re : oxybutynin(Ditropan)  and Flavoxate(Urispas)

        Both of these compounds produce a spasmolytic or relaxation of the
smooth muscle of the bladder.  They are used to reduce urinary urgency and
frequency.  They are both anticholinergic(atropine-like),  and have direct
effects on smooth muscle similar to papaverine.  They are primarily used
for neurogenic bladder problems.

        Onset 30-60 min, peak 3-6 hrs, effects last for 6-10 hrs.  Both are
well absorbed orally.   These products are so seldom used that there are no
reports in the literature on their breast milk concentrations or their
effects on infants.  They are not generally used in the pediatric
population.

        Because these products belong to the anticholinergic family, I
would be hesitant to use them in breastfeeding mothers. Infants are
exceedingly sensitive to this family of drugs(atropine-like) and could have
significant side effects including CNS disturbances, tremor, irritability,
seizures, delirium, nausea/vomiting, respiratory failure.


-----------------------------


To :    Judy Eastburn
Re :    Colyte, Fleet Phospho-soda

        Both of these products are osmotic laxative products that work by
pulling water into the gut. By design, they are not absorbed orally so they
should have minimal or no effect on a breastfeeding infant.  Colyte can be
used in infants for clinical purposes down to 3 weeks of age.  They are
generally eliminated within 4-6 hours anyway,  so I seriously doubt any
would be transferred via breastmilk.  Mom could wait for 12 hours just to
be safe,  but I'm not sure even that is required.  Perhaps others who may
have a more personal experience with these products could provide their
insite.


------------------------------

To      : Nancy Sherwood
Re      : Dornase(Pulmozyme)

        Pulmozyme is a large protein enzyme that selectively digests DNA.
When DNA is destroyed in large quantities, it produces a thick mucoid-like
substance.  When in the lung of a CF patient, this sticky mucoid prevents
adequate clearing of the pulmonary tract, hence infection.  When inhaled
directly into the lung, dornase digests DNA polymers and reduces the thick
mucous plugs, enhancing normal ciliary clearing of the lungs.

        Dornase is a large peptide(260 amino acids, 37,000 daltons WM) and
is poorly absorbed by the human lung.  Serum levels are undetectible.  It
is very, very unlikely that any would be secreted into human milk,
although we have no studies yet available.

        I would think it extremely remote that any dornase would be present
in breast milk.  Even if present,  the GI tract acidity and proteases would
rapidly destroy this product.


Tom Hale, Ph.D.