Estimated Enrollment:	20
Study Start Date:	February 2007
Estimated Study Completion Date:	February 2011
Estimated Primary Completion Date:	February 2011 (Final data collection date for primary outcome measure)

Detailed Description:

Inclusion Criteria:

1. Incomplete or complete SCI
2. Tetraplegia or paraplegia
3. Males or females
4. Age 18 (no upper age limit)
5. Excess time for bowel evacuation (> 60 minutes per bowel training session)

Exclusion Criteria:

1. Persons with SCI who do not require do not require additional bowel care or have "normal bowel function"
2. Known hypersensitivity to neostigmine or glycopyrrolate
3. History of mechanical obstruction of the intestine or urinary tract.
4. Myocardial infarction within less than 6 months of trial.
5. Hemodynamic instability
6. Potential for pregnancy. (Women who are sexually active and of childbearing potential (i.e. not surgically sterile or at least 2 year postmenopausal) must be have a negative serum pregnancy test and to have utilized one of the following methods of contraception prior to screening: barrier (condom, diaphragm with spermacide) intrauterine device, or tubal ligation beginning at least 30 days prior; hormonal (oral, injectable, transdermal, or implanted) beginning at least 3 months prior; or vasectomized partner for at least the prior 6 months. Subjects must agree to maintain these contraceptive methods through the completion of the study.)
7. Lactating/nursing females
8. Patients who develop significant bradycardia (HR<42 bpm) or other significant anticholinergic symptoms (e.g., severe cramps, dry mouth, etc.) any time during the study will be discontinued.
9. Concurrent participation in other clinical trials (within 30 days).
10. Use of concurrent medications that affect cardiac output (e.g. tricyclics, beta blockers, etc.)
11. Fluctuating use of concurrent medications (should be stable for 3-4 weeks before and no changes anticipated throughout the study).
12. History of reduced cardiac output (via history and ECG) in addition to myocardial infarction and hemodynamic instability.
13. Concurrent history of peripheral vascular disease, kidney disease, etc.
14. Asthma or other broncho-constrictive disorders.
15. Hemoglobin level < 12 g/dL

Muscarinic Antagonists Cholinesterase Inhibitors Oxymetazoline Neurotransmitter Agents Neostigmine Cholinergic Antagonists

Phenylephrine Glycopyrrolate Adjuvants, Immunologic Anesthetics Peripheral Nervous System Agents Cholinergic Agents

Parasympathomimetics Neurotransmitter Agents Neostigmine Cholinergic Antagonists Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs Enzyme Inhibitors Cholinergic Agents Pharmacologic Actions

Adjuvants, Anesthesia Muscarinic Antagonists Cholinesterase Inhibitors Autonomic Agents Glycopyrrolate Therapeutic Uses Peripheral Nervous System Agents Central Nervous System Agents