Methods and compositions for decreasing gastric emptying

1. A method of decreasing gastric emptying comprising:

administering to a subject an effective amount of a sodium-channel blocker to decrease gastric emptying,

wherein the sodium-channel blocker is a compound of Formula I:

or a pharmaceutically acceptable salt, solvate, or prodrug thereof,

wherein two of W 1 , W 2 , or W 3 are N and the remaining one is CR 3 ; wherein R 3 selected from the group consisting of: hydrogen; halo; nitro; cyano; hydroxy; amino; alkylamino; dialkylamino; haloalkyl; hydroxyalkyl; alkoxy; haloalkoxy; and alkoxyalkyl;

A 1 is selected from the group consisting of optionally substituted aryl; optionally substituted heteroaryl; optionally substituted cycloalkyl; optionally substituted heterocyclo; and aralkyl;

X is selected from the group consisting of —O—; —S—; —SO—; —SO 2 —; —(CR 7a R 7b ) m —; —NR 8 —; —SO 2 NR 9 —; and —NR 9 SO 2 —;

Each R 7a and R 7b , independently, is selected from the group consisting of hydrogen; halo; and alkyl; or Each R 7a and R 7b taken together with the carbon atom to which they are attached form a 3- to 8-membered optionally substituted cycloalkyl or a 3- to 8-membered optionally substituted heterocyclo; m is 0, 1, 2, or 3; R 8 and R 9 are independently selected from the group consisting of hydrogen and alkyl; A 2 is selected from the group consisting of optionally substituted aryl;

optionally substituted heteroaryl; optionally substituted heterocyclo; and optionally substituted cycloalkyl; or A 2 is absent;

E is selected from the group consisting of hydroxy; alkoxy; and —NR 1 R 2 ; wherein R 1 is selected from the group consisting of: hydrogen; alkyl; aralkyl; (heterocyclo)alkyl; (heteroaryl)alkyl; (amino)alkyl; (alkylamino)alkyl; (dialkylamino)alkyl; (carboxamido)alkyl; (cyano)alkyl; alkoxyalkyl; hydroxyalkyl; and heteroalkyl; R 2 is selected from the group consisting of hydrogen and alkyl; or R 1 and R 2 taken together with the nitrogen atom to which they are attached form a 3- to 8-membered optionally substituted heterocyclo;

Z is selected from the group consisting of —NR 5 — and —O—; wherein R 5 is selected from the group consisting of: hydrogen; alkyl; hydroxyalkyl; and alkylsulfonyl; and

R 4 is selected from the group consisting of

hydroxyalkyl; hydroxy(cycloalkyl)alkyl; and (heterocyclo)alkyl; or

wherein R 4 and R 5 taken together with the nitrogen atom to which they are attached form a 3- to 8-membered optionally substituted heterocyclo;

Each R 10a , R 10b , R 10c , and R 10d is independently selected from the group consisting of: hydrogen; hydroxy; optionally substituted alkyl; aralkyl; (heterocyclo)alkyl; (heteroaryl)alkyl; (amino)alkyl; (alkylamino)alkyl; (dialkylamino)alkyl; (carboxamido)alkyl; (cyano)alkyl; alkoxyalkyl; hydroxyalkyl; heteroalkyl; optionally substituted cycloalkyl; optionally substituted aryl; optionally substituted heterocyclo; and optionally substituted heteroaryl; or R 10a and R 10b taken together with the carbon atom to which they are attached form a 3- to 8-membered optionally substituted cycloalkyl or a 3- to 8-membered optionally substituted heterocyclo;

r and s are independently 1, 2, or 3;

R 11 is selected from the group consisting of: hydroxy; alkoxy; and —NR 1a R 2a ;

R 1a is selected from the group consisting of: hydrogen; alkyl; aralkyl; (heterocyclo)alkyl; (heteroaryl)alkyl; (amino)alkyl; (alkylamino)alkyl; (dialkylamino)alkyl; (carboxamido)alkyl; (cyano)alkyl; alkoxyalkyl; hydroxyalkyl; and heteroalkyl;

R 2a is selected from the group consisting of hydrogen and alkyl; or

R 1a and R 2a taken together with the nitrogen atom to which they are attached form a 3- to 8-membered optionally substituted heterocyclo;

R 12 is selected from the group consisting of hydrogen; optionally substituted alkyl; (amino)alkyl; (alkylamino)alkyl; (dialkylamino)alkyl; (carboxamido)alkyl; (cyano)alkyl; alkoxyalkyl; hydroxyalkyl; and heteroalkyl.

2. The method of claim 1 , wherein the subject is treated for an indication selected from the group consisting of rapid gastric emptying, early rapid gastric emptying, late rapid gastric emptying, weight gain, increased food intake, metabolic syndrome, obesity, diabetes mellitus (type 1 and type 2), sclerodoma, migraine episodes, post-prandial rise in blood glucose, nerve damage, Zollinger-Ellison syndrome, cyclic vomiting syndrome, short bowl syndrome, impaired gastric accommodation, pouch emptying in Roux-en-Y Gastric Bypass (RYGB), and functional dyspepsia.

3. The method of claim 1 , wherein the subject is treated for a symptom selected from the group consisting of cramping, pain, abdominal pain, nausea, vomiting, diarrhea, sweating, flushing, light-headedness, rapid or irregular heartbeat, bloating, dizziness, fatigue, concentration difficulties, anxiety, sitophobia, weight gain, malnutrition, shortness of breath, low blood pressure, weakness, reduced food intake, increased food intake and hypoglycemia.

4. The method of claim 1 , wherein the subject has undergone gastric surgery, esophageal surgery, gastrectomy, gastroenterostomy, vagotomy, fundoplication, esophagectomy, gastric bypass or bariatric surgery.

5. The method of claim 1 , wherein the subject is prophylactically treated for rapid gastric emptying.

6. The method of claim 1 , wherein the administration is selected from a route selected from the group consisting of oral, parenteral, subcutaneous, intravenous, intramuscular, intraperitoneal, transdermal, sublingual, buccal, gingival, rectal, subcutaneous, transpulmonary and topical.

7. The method of claim 1 , wherein the sodium-channel blocker is contained in a dosage form selected from the group consisting of a tablet, troche, lozenge, powder, granule, hard or soft capsule, microparticle, buccal tablet, transdermal patch, liquid, solution, suspension and suppository.

8. The method of claim 1 , wherein the subject exhibits an increase in stomach acidity after the administration.

9. The method of claim 1 , wherein the sodium-channel blocker is a 4-N substituted pyrimidine amide compound.

10. The method of claim 1 , wherein the sodium-channel blocker is:

or a pharmaceutically acceptable salt, solvate, or prodrug thereof.

11. A method of weight management comprising:

administering to a subject an effective amount of a sodium-channel blocker to increase weight loss,

wherein the sodium-channel blocker is a compound of Formula I:

or a pharmaceutically acceptable salt, solvate, or prodrug thereof,

wherein two of W 1 , W 2 , or W 3 are N and the remaining one is CR 3 ; wherein R 3 selected from the group consisting of: hydrogen; halo; nitro; cyano; hydroxy; amino; alkylamino; dialkylamino; haloalkyl; hydroxyalkyl; alkoxy; haloalkoxy; and alkoxyalkyl;

A 1 is selected from the group consisting of optionally substituted aryl; optionally substituted heteroaryl; optionally substituted cycloalkyl; optionally substituted heterocyclo; and aralkyl;

X is selected from the group consisting of —O—; —S—; —SO—; —SO 2 —; —(CR 7a R 7b ) m —; —NR 8 —; —SO 2 NR 9 —; and —NR 9 SO 2 —;

Each R 7a and R 7b , independently, is selected from the group consisting of hydrogen; halo; and alkyl; or Each R 7a and R 7b taken together with the carbon atom to which they are attached form a 3- to 8-membered optionally substituted cycloalkyl or a 3- to 8-membered optionally substituted heterocyclo; m is 0, 1, 2, or 3; R 8 and R 9 are independently selected from the group consisting of hydrogen and alkyl; A 2 is selected from the group consisting of optionally substituted aryl; optionally substituted heteroaryl; optionally substituted heterocyclo; and optionally substituted cycloalkyl; or A 2 is absent;

E is selected from the group consisting of hydroxy; alkoxy; and —NR 1 R 2 ; wherein R 1 is selected from the group consisting of: hydrogen; alkyl; aralkyl; (heterocyclo)alkyl; (heteroaryl)alkyl; (amino)alkyl; (alkylamino)alkyl; (dialkylamino)alkyl; (carboxamido)alkyl; (cyano)alkyl; alkoxyalkyl; hydroxyalkyl; and heteroalkyl; R 2 is selected from the group consisting of hydrogen and alkyl; or R 1 and R 2 taken together with the nitrogen atom to which they are attached form a 3- to 8-membered optionally substituted heterocyclo;

Z is selected from the group consisting of —NR 5 — and —O—; wherein R 5 is selected from the group consisting of: hydrogen; alkyl; hydroxyalkyl; and alkylsulfonyl; and

R 4 is selected from the group consisting of

hydroxyalkyl; hydroxy(cycloalkyl)alkyl; and (heterocyclo)alkyl; or

wherein R 4 and R 5 taken together with the nitrogen atom to which they are attached form a 3- to 8-membered optionally substituted heterocyclo;

Each R 10a , R 10b , R 10c , and R 10d is independently selected from the group consisting of: hydrogen; hydroxy; optionally substituted alkyl; aralkyl; (heterocyclo)alkyl; (heteroaryl)alkyl; (amino)alkyl; (alkylamino)alkyl; (dialkylamino)alkyl; (carboxamido)alkyl; (cyano)alkyl; alkoxyalkyl; hydroxyalkyl; heteroalkyl; optionally substituted cycloalkyl; optionally substituted aryl; optionally substituted heterocyclo; and optionally substituted heteroaryl; or R 10a and R 10b taken together with the carbon atom to which they are attached form a 3- to 8-membered optionally substituted cycloalkyl or a 3- to 8-membered optionally substituted heterocyclo;

r and s are independently 1, 2, or 3;

R 11 is selected from the group consisting of: hydroxy; alkoxy; and —NR 1a R 2a ;

R 1a is selected from the group consisting of: hydrogen; alkyl; aralkyl; (heterocyclo)alkyl; (heteroaryl)alkyl; (amino)alkyl; (alkylamino)alkyl; (dialkylamino)alkyl; (carboxamido)alkyl; (cyano)alkyl; alkoxyalkyl; hydroxyalkyl; and heteroalkyl;

R 2a is selected from the group consisting of hydrogen and alkyl; or

R 1a and R 2a taken together with the nitrogen atom to which they are attached form a 3- to 8-membered optionally substituted heterocyclo;

R 12 is selected from the group consisting of hydrogen; optionally substituted alkyl; (amino)alkyl; (alkylamino)alkyl; (dialkylamino)alkyl; (carboxamido)alkyl; (cyano)alkyl; alkoxyalkyl; hydroxyalkyl; and heteroalkyl.