US20130012872A1 - Drug delivery device - Google Patents

Abstract

A drug delivery device having a housing containing a gas generator controlled by an electronic controller. The gas generator generates gas into a reciprocable chamber, whereby reciprocation of the chamber causes a lever to reciprocate a pawl, and this action causes a ratchet to The device may also be provided with manually control for delivering a bolus dose of drug when necessary.

Description

• This invention relates to drug delivery devices, and in particular to portable devices designed to be carried by a patient during normal activities.
BACKGROUND OF THE INVENTION
• A number of drug delivery devices are known in which medicament is driven from a reservoir, under the action of a driving mechanism, through a needle and into the skin of a patient. A problem with known devices is that the delivery rate accuracy suffers when the volume of drug is small. Such inaccuracies arise in many cases from the driving mechanisms employed which give rise to variations in delivery rates. For example, where a gas is generated to drive a plunger in a cartridge or vial, the volume of gas depends in part on the temperature of the environment. The variation in volume will also depend on the total amount of gas already present in the chamber.
• The reason that gas generation is preferred over mechanical driving mechanisms is that the design of gas generating cells, such as electrolytic cells' is extremely simple when compared to mechanical equivalents, and this provides significant advantages in terms of reliability and cost-effectiveness. Systems are known in which a mechanically driven ratchet is used to incrementally deliver fixed amounts of medicament, but such systems can be expensive to manufacture. In particular, the accuracy of delivery of small amounts of drug depends on the manufacturing tolerances of the ratchet mechanism. For mass-produced, moulded, cut or pressed ratchets, the tolerances may not be sufficiently accurate to deliver the required small volumes, which means that more expensive manufacturing techniques are required to obtain the necessary tolerances. Such considerations are particularly important if the devices are intended to be disposable, in which case a low unit cost is required without compromising accuracy or reliability or system performance.
• A problem with gas driven mechanisms, however, is that it is extremely difficult to ensure that a gas chamber is leakproof without taking elaborate manufacturing and quality control precautions. Even if a leak is minor and relatively slow, this poses a real problem when the mechanism is supposed to accurately deliver small volumes over extended timespans. Thus, for gas generation systems, it is preferred to design a system that is leak free (which is costly and typically more complex) or provide a system that functions accurately in spite of minor or relatively slow leaks. In the alternative, gas generation may not be suitable for lower delivery rates. As mentioned above, mechanical equivalents having the required precision (e.g. clockwork mechanisms) are overly expensive and complex for incorporation into inexpensive devices which may be disposable.
• For many drug delivery regimes, it is desirable to provide both steady state delivery (“basal delivery”) and instantaneous bursts of drug (“bolus delivery”) as required. In particular, in patient controlled analgesia or PCA, it may be advantageous to provide a continuous basal infusion of drug for chronic pain treatment, supplemented to a certain extent by bolus delivery. The bolus delivery would be activated by the patient to deal with increased temporary pain levels (“break-through pain”), with safeguards being incorporated to prevent overdosing.
• Another area in which precisely controlled dosing can be particularly indicated is in chronotherapeutic drug delivery, in which the drug delivery rate varies over time. Most notably, diurnal or circadian rhythms cause variations in the amounts of certain drugs required by a patient during a 24-hour period. This is most notably required to combat variations in disease and/or condition effects throughout a 24-hour cycle.
• For example, hypertension crises, angina, and sudden cardiac death are most likely to occur in the morning, whereas sickle cell crises and perforated ulcer crises are most likely to occur in the afternoon. The concept of chronotherapeutics is discussed in more detail in an article by Smolensky & Labrecque,Pharmaceutical News4, No. 2, 1997, pp. 10-16. The discussion in this article is principally in terms of conventional oral dosing of drugs to take account of chronotherapeutic variations in drug uptake, effects, and requirements, but many of the principles are applicable to other delivery routes. Circadian rhythm applications would also apply to hormonal therapies.
• Accordingly there is a need to provide a drug delivery device capable of regulating drug delivery dosages to provide increased dosages at the times when such dosages are more likely to be required. This gives rise to a need for a device in which the delivery rate is accurately controllable over a wide range of delivery rates. In general, devices which are designed to deliver small amounts of drug are not particularly suitable for high drug delivery rates without being specifically adapted in this regard, and vice versa. Moreover there is a need to provide such a device that is relatively compact so that it is fixed to the user during use and disposed of when the treatment is finished. Such a device must be also relatively inexpensive to manufacture yet maintain accurate and reliable delivery rates
• The present invention aims to provide improved drug delivery devices in which smaller volumes of liquid can be delivered more accurately than in prior art devices, thereby giving rise to overall more controlled delivery rates. The invention also aims to provide such devices which additionally allow higher delivery rates to be provided on demand, up to and including bolus delivery. Moreover, the present invention provides for a drug delivery device wherein the technology used to provide for accurate delivery rates is relatively easy and inexpensive to manufacture. Further, the present invention employs designs for the gas generating system and delivery system so that space within the device is minimised and parts used within the device are easy and inexpensive to manufacture while maintaining high tolerances. In addition, the present invention provides for a certain amount of gas leakage while delivering accurate dosages. This eliminates the need for costly sealing devices and systems which increase cost and decrease reliability in the event of gas leakage.
SUMMARY OF THE INVENTION
• The invention provides a drug delivery device having a housing containing a drug reservoir, and means for facilitating the expulsion of drug from the drug reservoir. The device also includes a mechanism in communication with the facilitation means, that incrementally advances and thereby drives the drug from the reservoir, and a member associated with the mechanism to cause the incremental advancement of the mechanism as the member moves in a first direction. The device also includes a gas generator located within the housing and operable to expand in a chamber. The member is in transmission relation to the chamber. In operation, the member is driven by the movement of the chamber to advance the mechanism and thereby drive the drug from the reservoir in incremental fashion.
• Preferably, the mechanism in communication with the facilitation means comprises a ratchet.
• Further, preferably, the member moves in a reciprocable fashion.
• Further, preferably, the movement of the reciprocable member causes the stepwise advancement of the mechanism.
• Further, preferably, the reciprocable member is connected to a wall of the chamber, whereby the reciprocation of the reciprocable member is driven by the expansion and contraction of the chamber.
• The preferred devices according to the invention take advantage of the reciprocation of a gas generation chamber to effect a stepwise advancement of a ratchet mechanism. Gas generation chambers which expand and contract repeatedly are advantageous over known chambers which simply expand over time. For example, a ratchet which has 100 teeth and is driven by a continuously expanding gas chamber will advance one step for every 1% increase in the chamber volume. According to basic gas laws, a temperature rise of only 3° C. will increase the volume of a gas at room temperature by 1%. Thus, towards the end of the chamber expansion, a temperature rise of 3° C. will drive the ratchet one step forward independently of the gas generation rate. In contrast, a chamber which reciprocates will undergo a full expansion for each stepwise advance of the ratchet mechanism, and a 1% variation in the volume of this chamber will have no material effect on the fact that the chamber will expand fully and advance the ratchet correctly.
• For example, a ratchet mechanism which undergoes 100 stepwise advances throughout the emptying of a reservoir. If this ratchet is driven by a continuously expanding gas chamber, a 1% increase in the volume of gas towards the end of the delivery period will advance the ratchet by an (undesired) extra step. Such a 1% expansion occurs with a temperature change of only 3° C. (which is approximately 1% of the room temperature when expressed in kelvins). The situation is worse for devices which require several hundred ratchet advances to ensure the necessary sensitivity for accurate delivery over an extended time period.
• In contrast, devices according to the present invention employ a reciprocating chamber which continually expands and contracts. This enables small-volume chambers to be employed such that the difference in volume between the contracted and expanded states is orders of magnitude greater than the change in volume arising from environmental temperature changes. Moreover, by employing a reciprocating chamber, less space is needed for the chamber as the volume at maximum expansion is considerably less that what would be required for a continuously expanding chamber at the maximum volume of expansion.
• Preferably, the chamber is elastically biased to revert to a contracted state, and wherein a venting means is provided to enable contraction of the chamber after gas generation has expanded the chamber.
• One advantage of using a reciprocity chamber to drive a reciprocating mechanism linked to a ratchet is that there is sufficient amplitude of movement in the reciprocation to advance the ratchet by the required number of steps (in many cases only one step), to ensure that venting is sufficiently thorough to relax the system completely, in order to arrive at a device in which the delivery rate is controlled to a high degree of accuracy.
• For example, if the delivery volume is low (equivalent to a single stepwise ratchet advance) every five minutes, then the gas generator can be designed to deliver a sufficient amount of gas within one minute, and then switch off automatically for four minutes. In the first minute, the ratchet will be caused to advance by the required “tooth” (or equivalent), and then the venting means is actuated to relax the system. By the end of four minutes the system will be fully relaxed and the cycle can begin again.
• This design automatically compensates for any inaccuracies in the performance of its driving mechanism. Thus, the gas generator can be designed to deliver e.g. 20%±10% more than the required volume of gas (i.e. not a particularly expensive or accurate system), and still to have an extremely accurate delivery for the following reason. If the gas generator generates between 10% and 30% too much gas on each cycle, the ratchet will advance by a single “tooth”, but it is equally certain that it will not be pushed to advance by a second tooth. Thus, when the gas generation ceases, a certain amount of controlled overpressure or stress will be present in the system, but the amount of drug delivered will be precisely known. Then when the gas is vented, the overpressure is released and the system returns to equilibrium. Thus, the accuracy of delivery at the end of the five minute cycle is independent of whether the generator generated 10% or 30% too much gas.
• It should be noted that the accuracy of the system is controlled by the tolerances of the ratchet mechanism, the timer, the reciprocity chamber, the venting system and the gas generator.
• In some embodiments, the venting means is passive and allows escape of gas therethrough when the chamber is pressurised relative to atmospheric pressure. In other embodiments, there is designed to be venting means within the gas generator. Such venting means may connect sub-chambers within the gas generating means. The venting means enables the sub-chambers to increase and decrease pressure therein more efficiently.
• In some embodiments, the gas generator is adapted to generate gas at a rate higher than the venting rate. When the gas generator is active, the chamber becomes pressurised and expands, and when the gas generator is inactive, the venting means causes depressurisation and contraction of the chamber. Minor leaks in the system, provided that they are not so serious as to prevent the chamber from fully pressurising, do not have any significant effect on the operation or accuracy of the device. This enables a gas generating system to deliver extremely small volumes of drug in a highly controlled, accurate manner, without employing any elaborate gas generation system, or any special leakproofing of the gas chamber. Also, the gas generation rate should exceed the venting rate so that the error of movement of the reciprocator member errs to the side of excessive pressure rather than too little pressure. If there is insufficient pressure (i.e. caused by the leakage rate exceeding the pressurisation rate, the force needed to move the reciprocating member will be insufficient and the pawl on the ratchet will not move. Thus, the volume of drug wilt not be advanced through the cartridge and delivered to the user.
• In alternative embodiments, the gas pressure of the gas generator is divided between at least two cells. A first cell has a more permeable member and is designed for minimum gas leakage. The first cell also has a controllable vent associated therewith. The vent allows excess gas to escape from the first cell but prevents the escape of gas at a stage in the cycle when the member of the first cell is needed to deflect so as to cause forward movement of the ratchet. The alternative embodiment is also designed so that the latter part of the cycle allows the re-opening of the first cell vent to enable gas therein to quickly escape and cause the member to return to its initial resting position.
• In some preferred embodiments, the venting means comprises a permeable or semi-permeable member. Currently one of the most preferred member is a silicone membrane. In another embodiment, there are at least two members with varying permeability. The less permeable material is preferably bromo-butyl, ethylene propylene or EPDM, and the more permeable member is preferably silicone rubber.
• Suitably, the mechanism is caused to advance as the chamber undergoes expansion. Alternatively, the mechanism may be caused to advance as the chamber undergoes contraction. While it is possible to employ a mechanism which drives the ratchet forward during both expansion and contraction strokes, it is preferred to employ a single driving stroke (either contraction or expansion) during a reciprocation cycle for lower delivery rates.
• Suitably, the member comprises a lever extending between the chamber and the mechanism.
• The use of a lever mechanism enables the amplitude of movement of the expanding chamber to be accurately converted to the correct amplitude of movement to drive the ratchet.
• In certain preferred embodiments, the mechanism comprises a rigid ratchet element having spaced formations on a surface thereof.
• Preferably, the formations have a sawtooth cross section, although the formations may be in the form of grooves on a surface of the rigid ratchet element.
• Preferably, the mechanism includes a pawl carried on the member, the pawl being adapted to make ratcheting engagement with the formations on the rigid ratchet element.
• Further, preferably, the pawl is resiliently biased against the formations on the rigid ratchet element.
• Suitably, the pawl is in the form of a substantially flat spring an end of which bears against the formations on the rigid ratchet element.
• Such a pawl is adapted to allow the ratchet element to slide with little resistance in one direction but to prevent any movement in the opposite direction.
• In preferred embodiments, the formations are regularly spaced along the rigid ratchet element, and the pawl comprises a pair of pawl members resiliently biased against the rigid ratchet element at different points along the length of the rigid ratchet element, the axial distance between the pair of pawl members being different to the axial distance between successive formations.
• The advantage of this arrangement is that by locating the ratcheting linkage between the pawl and the ratchet teeth, the teeth make alternating contact with either pawl member. The ratcheting member advances by increments which are less than the actual difference between successive formations on the ratchet.
• In particularly preferred embodiments, the distance between successive formations is twice the distance between the pawl members. This means that then the ratchet advances in half steps and enables accurate delivery of even smaller incremental volumes of drug (if a full step is counted as equating to the distance between successive ratchet teeth formations.)
• The definitions of “half steps” and “full steps” is not as arbitrary as it may appear, since one of the main constraints on the accuracy of delivery of small volumes, as explained above, is the manufacturing tolerances of the ratcheting teeth.
• It is envisaged that one of the least expensive ratcheting mechanisms, and therefore one of the most suitable for large scale production, is a stamped plastics ratchet bar having a sawtooth surface, against which a pawl in the form of a leaf spring may be biased. The main limitation on accuracy in this system is likely to arise from the spacing of adjacent sawtooth formations which may not be able to be made accurately with the required spacing. In such cases the minimum delivery volume, all other things being equal, will be limited by this component. However, by employing a specially designed pawl or leaf spring (which can be made to much higher tolerances from metal materials at relatively low cost), accuracy is doubled, and the minimum deliverable volume may be halved.
• In alternative embodiments, the ratchet teeth are regularly spaced along the rigid ratchet element, and the pawl comprises three or more members resiliently biased against the rigid ratchet element at regular intervals along its length. The axial distance between each successive pair of pawl members is chosen to be different to the axial distance between successive ratchet teeth.
• Suitably, in such cases, the distance between successive ratchet teeth is given by the number of pawl members multiplied by the distance between each successive pair of pawl members.
• Thus, by analogy with the two pawl members spaced at half of the distance between successive ratchet teeth, three or four pawl members would preferably be spaced at intervals of a third and a quarter, respectively, of the distance between successive ratchet teeth on the ratchet element.
• Suitably, the pawl is in the form of a resilient member which terminates in a plurality of fingers biased against the ratchet element.
• A preferred embodiment in this regard is a pawl which comprises a flat spring which is partly split to define fingers of different lengths.
• In another preferred embodiment, the ratchet element comprises a helical spring and the pawl comprises one or more fingers which engage with the coils of the spring. The coils of a helical spring easily engage with the pawl fingers, and the regular spacing of the coils of a helical spring enable it to be used as a ratchet element.
• A further advantage of this embodiment is that the size of the device can be minimised by taking advantage of the flexibility of the spring. Thus, whereas a rigid ratchet bar protruding from a drug cartridge before use might provide an unacceptably long device for certain applications (after use, the ratchet element might be partly or totally accommodated within the empty cartridge interior), a helical spring can be bent to be parallel with the cartridge to reduce the overall length.
• Preferably, in embodiments which employ a helical spring in lieu of a ratchet element, one or more fixed fingers are mounted in fixed position relative to the housing, and one or more reciprocable fingers are mounted on the mechanism, such that when the one or more reciprocable fingers move in a first direction they engage the coils of the helical spring to drive the helical spring in the first direction, and when the one or more reciprocable fingers move in an opposite direction, the one or more fixed fingers engage with and hold the coils of the helical spring preventing it being driven back in the second direction, whereby the fixed and reciprocable fingers co-operate to drive the helical spring in one direction only.
• The operation of this embodiment will become clearer from the description below. The fingers are generally arranged such that the helical spring is forced to alternately slip past the fixed fingers and the reciprocable fingers, which gives rise to a uni-directional driving movement. Suitably, each finger is inclined in the first direction. This makes it easier for the helical spring coils to slip past the fingers in this direction, and more difficult for the coils to push back in the opposite direction against the fingers.
• Preferably, the position of the one or more fixed fingers relative to the one or more reciprocable fingers is such that the helical spring is driven by the reciprocable fingers towards the fixed fingers.
• This feature helps prevent a situation which may develop in which a flexible helical spring is pulled by the reciprocable fingers away from the fixed fingers, but rather than slipping past the fixed fingers, the helical spring merely stretches, such that when the reciprocating fingers move back towards the fixed fingers the helical spring simply relaxes, without any net movement having taken place. The solution to this problem is achieved in part by pushing the helical spring towards the fixed fingers as the driving step of the delivery action.
• Suitably, the minimum distance between the fixed and reciprocable fingers, respectively, is not greater than ten times the distance between adjacent coils of the helical spring when the helical spring is in a relaxed position. Preferably, this minimum distance between the fixed and reciprocable fingers, respectively, is not greater than five times the distance between adjacent coils of the helical spring when the helical spring is in a relaxed position, most preferably not greater than twice the distance between adjacent coils.
• The reason for this again relates to the problem of using a flexible spring which is likely to stretch rather than be displaced. While the problem could be overcome by using a sufficiently stiff spring, this would defeat the purpose of using this type of spring, which is to allow the ratchet element to be bent within the housing to reduce overall dimensions. While even a stiff spring can be bent under sufficient force, this tends to generate frictional forces which would prevent the spring from sliding past the ratchet fingers.
• Instead, setting the two sets of fingers close together allows even a relatively very flexible spring to be used without much stretching, since for a given overall amount of stretching, a greater stiffness is achieved by concentrating this stretching over just a few coils.
• Thus, in certain preferred embodiments, the minimum distance between the fixed and reciprocable fingers, respectively, is approximately equal to the distance between adjacent coils of the helical spring when the helical spring is in a relaxed position.
• Suitably, the mechanism comprises a flexible ratchet element which is sufficiently stiff to drive medicament from the chamber when driven by the member, and sufficiently flexible to be bent before it meets the member, whereby the overall length of the device is reduced relative to a device in which a rigid ratchet element protrudes linearly from_the mechanism before use. Thus, the flexible member may be, for example, a piece of bendable thermoplastics stamped or molded with a ratchet sawtooth profile.
• In order for this embodiment to be useful, the flexible member should have a degree of flexibility which allows it to be bent sufficiently to reduce the overall dimensions of the device. Furthermore, it must nevertheless be sufficiently stiff to transmit the driving force of the ratcheting mechanism without buckling or distorting to any great extent. This can be achieved by restraining the degree of freedom of movement of the member.
• For example, by driving a flexible member into a conduit in which the flexible member makes a good fit, the flexible member is prevented by the conduit walls from bowing or buckling sideways. Thus, when driven by the ratchet mechanism the flexible member is constrained to transmit the driving force to the piston, and despite its flexibility it acts as a drivable piston rod. Other mechanisms not requiring a restraining conduit are also possible, as described below.
• Preferably, the mechanism comprises two or more co-operating flexible ratchet elements which are individually sufficiently flexible to be bent before they meet the member but when joined together are together sufficiently stiff to drive medicament from the chamber when driven by the member.
• Further, in a preferable embodiment, the two or more co-operating flexible ratchet elements are bent away from one another before they meet the member.
• Suitably, the device according to the invention further comprises electronic control means for controlling the delivery rate. Preferably, the electronic control means comprises a timing mechanism which alternately energises and de-energises the gas generating mechanism for controlled periods.
• As explained above, by choosing an energized period long enough to always guarantee complete advancement of the ratchet mechanism by a predetermined number of steps, and by providing a de-energised period (e.g. for venting) which allows relaxation of the system, the amount of drug delivered in this overall cycle is accurately controllable independently of variations (within reason) in the gas generation rate.
• Furthermore, the use of a timer allows the overall cycle length to be varied in a controlled manner over time, thereby providing an accurately controllable device which delivers at a time-varying rate. Such devices find a particular application in the field of chronotherapeutics.
• Further, preferably, the electronic control means is programmable for different delivery programs. The control means may be user-programmable or a single unit may be factory-programmable for different delivery regimes (e.g. for different drugs. Preferably, the device according to the invention further comprises means for manually adjusting the delivery rate. This allows for a certain degree of flexibility which might be desirable where the user can safely have an amount of control over the treatment. Alternatively, it can be set by the physician or pharmacist and disabled to prevent patient interference.
• In preferred embodiments, the member reciprocates to cause the incremental advancement of the mechanism and the means for manually adjusting the delivery rate comprises means for limiting the travel of the member, whereby the volume of drug delivered on each reciprocating stroke is controllable. Thus, a simple advancing screw can control a stop against which any reciprocating element ends its travel. If this is used, adjustment of the screw will provide a control mechanism. For example, a device could be designed with three delivery rates, namely low, medium and high, corresponding respectively to one, two and three ratchet advancements per reciprocation. A simple mechanism would determine how far the reciprocating mechanism is allowed to advance on each stroke, to determine the delivery rate. Clearly, more sophisticated embodiments could also be achieved. Devices having the ability to deliver bolus doses of drug are preferred in therapies such as patient controlled analgesia.
• In a preferred embodiment, the means for manually adjusting the delivery rate provides the user with the ability to deliver a bolus dose of drug. It is advantageous if the bolus dose can be delivered without this interfering with the normal basal delivery rate.
• When the reciprocating mechanism comprises a lever arrangement, it is preferred that the means for manually advancing the mechanism comprises means for manually advancing the lever extending between the chamber and the mechanism, operable from the exterior of the housing. Any suitable mechanism, such as a knob, button or lever can be used to operate the lever.
• Preferably, the mechanism comprises a ratchet and wherein the means for manually advancing the mechanism comprises a pawl which is manually reciprocable from the exterior of the housing.
• Further, preferably, the mechanism for manually advancing said lever is provided with gradations corresponding to a number of stepwise advances of the ratchet mechanism.
• For example, in delivering insulin, the advancing means could be marked in units which would be understood by the patient, and the scale would be calibrated to correspond to the delivery of the correct dose.
• In a further aspect, the present invention provides a method of delivering drug to a patient. The method includes affixing a drug delivery device to the surface of the patient's skin. The drug delivery device having a housing containing a drug reservoir, means for facilitating expulsion of drug from the drug reservoir, a mechanism in communication with the facilitation means, operable to undergo incremental advancement and thereby drive the drug from the reservoir, a member operatively associated with the mechanism to cause the incremental advancement of the mechanism as the member moves in a first direction, and a gas generator located within the housing and operable to expand in a chamber, the member being in transmission relation to the chamber. The method further includes activating the device whereby the member is driven by the movement of the chamber to advance the mechanism and thereby drive the drug from the reservoir in incremental fashion.
• Other objects, features and advantages of the present invention will become apparent upon reading the following detailed description, when taken in conjunction with the drawings and appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
• The invention will be now be described with reference to the accompanying drawings, which illustrate the preferred embodiments of the present invention and in which:
• FIG. 1 is a sectional plan view of a first embodiment of a drug delivery device according to the invention;
• FIGS. 2-5 are schematic views of a detail of the embodiment ofFIG. 1 shown at successive points in the operating cycle;
• FIG. 6 is a sectional plan view of the embodiment ofFIG. 1, in use;
• FIGS. 7-11 are sectional side views of a second embodiment of a device according to the invention, shown at successive points during its use;
• FIG. 12 is a simplified sectional plan view of a third embodiment of a drug delivery device according to the invention;
• FIG. 13 is a cross sectional side view of the embodiment ofFIG. 12, taken along the line XIII-XIII;
• FIG. 14 is a sectional plan view of a fourth embodiment of a drug delivery device according to the invention;
• FIG. 15 is a cross sectional side view of the embodiment ofFIG. 12, taken along the line XV-XV;
• FIG. 16 is a graph showing the test results of an 80 hour test which plots delivery pressure and amount of drug delivered against time;
• FIG. 17 is an enlarged detail of a portion of the graph ofFIG. 16;
• FIG. 18 is a sectional plan view of a fifth embodiment of a drug delivery device according to the invention;
• FIG. 19 is a sectional side view of the embodiment ofFIG. 18;
• FIG. 20 is a sectional plan view of the embodiment ofFIG. 18, as it is being prepared for use;
• FIG. 21 is a sectional side view of the embodiment ofFIG. 18 when ready for use;
• FIG. 22 is a sectional plan view of a sixth embodiment of the drug delivery device according to the invention;
• FIG. 23 is a sectional plan view of the embodiment ofFIG. 22 when ready for use;
• FIG. 24 is a cross-sectional view along line A-A of the embodiment ofFIG. 22;
• FIG. 25 is a cross-sectional view along line B-B of the embodiment ofFIG. 22; and
• FIG. 26 is a schematic drawing representing the various parts of the gas generation sub-assembly of the embodiment ofFIG. 22.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
• Referring now in more detail to the drawings, in which like numerals indicate like parts throughout the several views, inFIG. 1 there is indicated, generally at10, a drug delivery device according to the invention. Thedevice10 comprises ahousing11 containing acartridge12 filled with adrug13. Thecartridge12 is provided with aneedle14 extending from afirst end15 of the cartridge for delivery ofdrug13 to a patient. Apiston16 is slidably received in thecartridge12, such that when thepiston16 is pushed towards thefirst end15, drug is forced from thecartridge12 out through theneedle14.
• Thepiston16 is mounted on aratchet bar17 which is driven by apawl18 mounted on areciprocable lever19.Lever19 is mounted on anaxis20 at oneside21 and is connected to a drivingrod22 at theother side23, whereby reciprocation of the drivingrod22 causes pawl18 to reciprocate with respect to theratchet bar17. As will be explained in greater detail below, this causes theratchet bar17 to advance stepwise towards thefirst end15 ofcartridge12 and thereby drive thedrug13 from the cartridge.
• The drivingrod22 is in connection with aflexible diaphragm24 which defines a wall of agas generation chamber25. Abattery26 is connected via amicroprocessor27 to anelectrolytic cell28 which is operable to generate a gas intochamber25. When gas is generated, the chamber expands and causes thediaphragm24 to move. This movement pushes the drivingrod22 in the direction away from thefirst end15 ofcartridge12. The movement is opposed by areturn spring29 which biases thelever19 towards thefirst end15. After a certain period of time thechamber25 is fully expanded and the supply of current from thebattery26 to theelectrolytic cell28 is switched off by themicroprocessor27.
• Asilicone membrane30 defines a wall of thechamber25. Themembrane30 is slightly permeable and thus allows a controlled leakage of gas from thechamber25. When thechamber25 is in its expanded state, the force ofreturn spring29 will act to decompress thechamber25 by gas leaking throughmembrane30. After thechamber25 has fully decompressed in this manner, thelever19 and hence thepawl18 will have made one complete reciprocation thereby advancing theratchet bar17 by a fixed step.
• For example, the cycle might be chosen to allow the delivery of a quantity of drug corresponding to the advancement of a single step of theratchet bar17 every five minutes. In such a case theelectrolytic cell28 could be switched on for one minute and then switched off for four minutes. As long as the timing of the microprocessor is accurate, this will ensure that precisely one stepwise advance is made in that five minute period.
• The precision ofdevice10 is to a certain extent independent of the exact quantity of gas generated because theratchet bar17 is quantised, i.e. it can only move by a fixed step (or number of steps) at a time. Similarly, because themembrane30 provides a controlled constant leakage from the system even during gas generation, other minor leaks which might affect the accuracy of conventional gas driven delivery devices are not important (although of course if the leak is bad enough the chamber will be unable to pressurise fully when the gas is generating).
• It will be noted from the first embodiment shown inFIG. 1 thatpawl18 is split in two halves, i.e. alonger half31, and ashorter half32. Thepawl18 is a leaf spring which is biased down ontoratchet bar17. Thehalves31,32 of thepawl18 are of unequal length.
• FIG. 2 shows a cross-sectional enlarged view of a portion of theratchet bar17 which has a series of evenly spaced steps orteeth33,34. The difference in length between thehalves31,32 of thepawl18 is exactly half of the distance betweenadjacent teeth33,34 on theratchet bar17. It can be seen that eachtooth33,34 has a slopedsurface35 having apeak36 and atrough37, as shown in detail inFIG. 2A. At the point of the cycle illustrated inFIG. 2, thelonger half31 of thepawl18 presses against the slopedsurface35 oftooth33, midway between the peak36 andtrough37, and theshorter half32 presses against thetrough37 of theadjacent tooth34.
• When gas is generated to drive the drivingrod22 in the direction away from thefirst end15 of cartridge12 (seeFIG. 1), the twohalves31,32 of the pawl extending from lever19 (FIG. 1) move left as viewed inFIG. 2. This results in the situation shown inFIG. 3, in which theshorter half32 has been pushed back up the slopedsurface35 oftooth34, and thelonger half31 has passed thepeak36 oftooth33 to rest in thetrough37 ofadjacent tooth34 formerly occupied by theshorter pawl half32. In practice, the distance travelled by thepawl18 will be slightly further than the minimum necessary so as to allow for any variations between components. This does not affect the operation of the invention as a whole since thepawl18 when making its return stroke will press against the correct tooth as it begins its travel.
• After thegas generation chamber25 is pressurised fully and thedevice10 is in theFIG. 3 position, gas generation ceases and the controlled leakage from thechamber25 allows thereturn spring29 to push thelever19 back to its starting position, leading to the configuration shown inFIG. 4.
• InFIG. 4, thelonger pawl half31 when being driven forward (i.e. to the right) has abutted againsttooth33 and pushed theratchet bar17 forward. This completes one reciprocation of thepawl18, and when theelectrolytic cell26 again fills thegas generation chamber25 to drive thepawl18 to the left (as seen inFIG. 5), theshort pawl half32 passes over thepeak36 oftooth34 as shown inFIG. 5, ready to push againsttooth34 and thereby once again advance theratchet bar17.
• The reason for using a pawl in two halves of unequal length is seen by observing the movement of apoint38 on the ratchet bar. After a complete cycle has been completed, i.e. fromFIG. 2 toFIG. 5, thepoint38 has moved by a distance ½ L. This is exactly half of the length L of one of theteeth33,34 on theratchet bar17, as can be seen with reference toFIG. 2A.
• In effect this means that although the manufacturing quality and tolerances are such that the tooth length is not as small as what would be desired (perhaps because the manufacturing technique, chosen for its cost effectiveness, is incapable of achieving a smaller length of adjacent teeth), it is nevertheless possible to deliver amounts of drug corresponding to an advance of half of the length of one of theteeth33,34, thereby halving the minimum deliverable volume.
• FIG. 6 shows the device ofFIG. 1 in operation at the completion of gas generation, and before thelever19 has begun its return stroke. Thus, it can be seen thatgas generation chamber25 has expanded by pushing thediaphragm24 outwards, and thelever19 is thus pivoted on itsaxis20 against the force of thereturn spring29. When thelever19 is driven back to theFIG. 1 position, a small volume ofliquid drug13 will be forced from thecartridge12.
• Because the device ofFIG. 1 delivers small volumes in a stepwise fashion, it is possible to achieve an extremely low delivery rate. For example instead of operating in 5-minute cycles, thegas generator25 could be activated for 1 minute as previously described and then switched off for 59 minutes to give cycles of one hour duration. Unlike other gas-driven devices which cannot achieve these long-term low-volume rates because of pressure losses in the system, thedevice10 of the present invention does not require a system pressure to be maintained above atmospheric pressure.
• As can be seen fromFIGS. 1 and 6, the volume of thegas generation chamber25 is small relative to the size of the device. This minimises variations in the volume of gas per stroke, and helps ensure a constant delivery rate. Preferably, thedevice10 will generate in excess of 10-30% volume of gas over the required amount on each stroke so that the device can compensate of variations due to temperature, atmospheric pressure, materials used, etc. (The device will never drive the ratchet 10-30% further than necessary, since the ratchet can only move in fixed steps.) This extra gas is stored as an overpressure in the system and is of course released during the venting part of the cycle.
• FIG. 7 shows a cross-sectional side view of a second alternative embodiment of the present invention, indicated generally at50. Thedevice50 is similar in most respects to the first embodiment shown inFIG. 1. In the device ofFIG. 7, however, thepawl51 is not split into two halves, so that it advances theratchet bar52 by full steps equal to the tooth length (“L”). In all other respects thedevice50 is identical to thedevice10 ofFIG. 1. It can be seen fromFIG. 7 that theneedle53 of the device50 (as with theFIG. 1 device) is bent at 90° to the axis of thecartridge54.
• Thedevice50 ofFIG. 7 is shown before use. Aprotective sheath55 is provided on theneedle53 and a displaceablelower cover56 is hinged to themain housing57 by a hinge (not shown). The displaceablelower cover56 and themain housing57 are prevented from moving relative to one another by asafety tab58. Thelower surface61 of thedisplaceable cover56 is covered by a contact adhesive which is protected before application to the user by aprotective liner60. Theliner60 has apull tab59 to ease removal of the liner by the user immediately before application of thedevice50.
• Before use, theprotective sheath55 is removed as indicated inFIG. 8 by grasping and pulling thepull tab59. This also causes therelease liner60 to be pulled away revealing the contact adhesive on thelower surface61 of thedisplaceable cover56. Thelower surface61 is adhered to the user's skin. Then, thesafety tab58 is pulled away from thedevice50 as shown inFIG. 9.
• As shown in Fig,10, themain housing57 is then pressed towards the skin whereupon it snaps towards thedisplaceable cover56. Theneedle53 projects beyond thelower surface61 to penetrate into the skin for subcutaneous drug delivery.
• The delivery mechanism is then actuated, either by the user, or more preferably, in automatic fashion by the microprocessor. Upon activation either manually or automatically, theratchet bar52 is advanced by thepawl53 in stepwise manner as described above with regard to the operation of the first embodiment as shown inFIG. 1.
• When delivery is completed (seeFIG. 11) the user can see thepiston62 through anaperture63 in themain housing57 as shown inFIG. 11. Themain housing57 is then pulled away from the skin whereupon it snaps away from thedisplaceable cover56 and locks in this position by a locking mechanism (described in more detail in our United States Provisional Application No. 60/045,745) which prevents further actuation of the device, i.e. prevents theneedle53 from projecting beyond thedisplaceable cover56 due to further relative movement of themain housing57 and thedisplaceable cover56.
• InFIG. 12 there is indicated, generally at70, a further embodiment of a device according to the invention. In the illustration of this embodiment, only those details necessary to understand the differences relative to the devices of the first and second embodiments are shown, and thus the gas generation mechanism, for example is not shown.
• In the device ofFIG. 12, the ratchet bar has been replaced by ahelical spring71. Alever72 is caused to reciprocate in identical manner to that previously described. A pair of resilientreciprocable fingers73 are mounted on thelever72 and reciprocate as the lever reciprocates. Thesereciprocable fingers73 are inclined in the direction of movement of thepiston74 as it empties thecartridge75. Thus, when they move in the direction in which they are inclined they tend to grip and push the coils of thehelical spring71 forward. As thehelical spring71 moves forward it slips past a pair of resilient fixedfingers76 mounted directly in front of thereciprocable fingers73, and inclined in identical manner.
• When thelever72 moves away from the piston74 (as the gas generator generates the gas) thehelical spring71 is prevented from moving back because it is gripped by the fixedfingers76. Thereciprocable fingers73 thus slip over the coils of thehelical spring71.
• When thelever72 reverses its travel again thehelical spring71 is again gripped and pushed forward by thereciprocable fingers73.
• FIG. 13 shows a sectional side view of the device taken along the line XIII-XIII (inFIG. 12), in which the fixedfingers76 andhelical spring71 are visible.
• Thus, the arrangement ofreciprocable fingers73 and fixedfingers76 act as a pawl and thehelical spring71 acts as a ratchet, such that on each reciprocation of thelever72, thehelical spring71 advances by an amount equal to a set number of coil diameters. Accordingly, as with previously described embodiments, precisely controlled delivery rates are achievable, and in particular, extremely low volume delivery rates are possible with this invention.
• While there is a tendency for thehelical spring71 simply to stretch between thereciprocable fingers73 and the fixedfingers76, this tendency can be overcome by choosing the correct stiffness (for both sets of fingers). Furthermore, the closer together thereciprocable fingers73 andfingers74 are mounted, the less likely thehelical spring71 is to stretch, since the force is spread over fewer coils.
• One advantage of this embodiment is that because thehelical spring71 is curved within thedevice70, it does not have to project directly out of thecartridge75 and thus a shorter device can be realised, or the shape of the device can be varied as required.
• A further embodiment of the present invention is shown in cross-sectional plan view inFIG. 14. The device, indicated generally at80, is in many respects identical to the device ofFIG. 1 but differs in that as well as the gas-drivenlever81, a secondmanual lever82 is provided.Manual lever82 is mounted on acommon axis83 with gas-drivenlever81, as can be seen referring additionally toFIG. 15.Manual lever82 passes under theratchet bar84 and also carries asecond pawl85. Both theupper surface86 andlower surface87 ofratchet bar84 are provided with ratchet teeth, so that either gas-drivenlever81 ormanual lever82 can drive theratchet bar84 forward.
• Thus, in normal operation, gas-drivenlever81 will drive the drug from thecartridge88, and in this mode, theratchet bar84 simply slides past thepawl member85 onmanual lever82 as described previously.
• However, if a bolus dosage of drug is required at any point in time, themanual lever82 can be actuated to advance theratchet bar84 by a pre-determined number of teeth. Referring toFIG. 14, themanual lever82 can be seen to have an adjustable threaded lockingmember89 which determines the extent of travel of themanual lever82, and hence the volume of the bolus delivery. InFIG. 14, thelever82 is prevented from travelling because the threadedmember89 is fully torqued, and this locks thelever82 preventing it from being actuated. However, if the threadedmember89 is partially torqued and thereby partially withdrawn from the housing in the axial direction, thelever82 is free to move inwards by an amount equal to the distance of axial travel of the threadedmember89. Thelever82 can then be actuated by depressing the threadedmember89. The degree of travel of thelever82 is determined by the extent to which the threadedmember89 is turned, and by providing marked gradations on the threadedmember89 one can give the user visual control over the volume delivered in such a bolus dosage.
• The movement of theratchet bar84 under the action of thesecond pawl85 is independent of the primary pawl-and ratchet mechanism. Thus, thesecond pawl85 will, when actuated manually, advance theratchet bar84 by a whole number of steps. When advanced in this way, theratchet bar84 slides under thepawl member90 on gas-drivenlever81, but this has no effect on the basal delivery rate or on the operation of the gas-drivendelivery mechanism80. Thus, each individual ratchet mechanism is independent of the other, and bolus delivery can take place against the background basal rate without complication.
• FIG. 16 is a graph of typical results achieved in a test of a device according to the invention, of the design shown inFIG. 1. The graph shows two lines, namely the cumulative delivery of drug against time (the stepwise steadily ascending line), and the delivery pressure against time (the line consisting of a succession of sharp peaks and troughs).
• It can be seen that the device was tested over an80 hour period (more than 3 days) and delivered just under 1.35 grams of drug solution in this time. This gives a delivery rate of less than 17 μg/hour. Furthermore, this delivery rate is absolutely constant, i.e. shows no deviation from a straight line. Accordingly, the device ofFIG. 1 has a delivery rate whose accuracy is unmatched in the prior art, particularly for extremely slow delivery rates.
• FIG. 17 shows a portion of the graph ofFIG. 16 in greater detail, over a five hour period in the middle of the test. It can be seen that the pressure on each cycle immediately shoots up to a maximum, and then slowly falls off as gas is released through the silicone membrane.
• It can be seen that the delivery overpressure reaches over 400 mbar (0.4 atm or 40 kPa) on each cycle, and this assists in providing a constant delivery rate, since any minor needle blockages will be forced out, and variations in blood pressure (when intravenous delivery is effected will have a negligible effect on the delivery rate. This is to be contrasted with other low volume pumps which generally achieve low delivery rates with low delivery pressures.
• A further alternative embodiment is illustrated inFIG. 18. The device, indicated generally at100, has ahousing101 containing aninternal needle102 connected via a length offlexible tubing103 to a delivery needle104 (seen in sectional side view inFIG. 19). As with previously illustrated embodiments,delivery needle104 is protected by asheath105 before use.Internal needle102 is also protected by asheath106 which is provided with atab107 extending the length of aninternal bore108 to the exterior of thehousing101.
• Flexible tubing103 is carried on aratchet bar109 which can be driven to move theinternal needle102 in the direction of theinternal bore108. It can be seen fromFIG. 19 that aleaf spring110 acting as a pawl is carried on alever111 to drive the ratchet bar in the manner previously described. Referring back toFIG. 18, thelever11 is driven by the expansion and contraction of anelectrolytic cell112 which is powered bybatteries113.
• FIG. 20 shows a step in the preparation ofdevice100 for use. Theinternal sheath106 has been removed and is no longer visible, thereby exposing internal needle which is in the centre of acylindrical cup114. Adrug cartridge115 is provided in the form of acylindrical container116 sealed at itsopen end117 by apiston118 slidably received in thecontainer116.Bore108 is dimensioned to receivecartridge115, and a pair ofresilient projections119 inside thebore108 hold the cartridge in place when it is pushed home within the bore.
• FIG. 21 shows thedevice100 when thecartridge115 has been pushed home.Internal needle102 penetratespiston118, such that theinternal needle102 is in fluid communication with the drug inside thecartridge115. Thus, movement of theratchet bar109 into thecartridge115 causes thepiston118 to be pushed along the length of thecartridge115, and thereby pump drug through theinternal needle102 andflexible tubing103 to thedelivery needle104. As theinternal needle102 moves with the piston into thecartridge115, theflexible tubing103 is pulled behind, thereby maintaining communication betweeninternal needle102 anddelivery needle104.
• Another advantage offlexible tubing103 is that it enablesdelivery needle104 to be mounted at any point on the device, and thus the placement of the delivery needle in this embodiment is not constrained by the design of the other features.
• Although theelectrolytic cell112 indevice100 operates in exactly the same manner as the cells in previously described embodiments, the configuration oflever111 and thepivot119 on which it is mounted causes pawl110 to advanceratchet bar109 during the gas generation step rather than during the venting step.
• A further embodiment is shown inFIGS. 22-26. InFIG. 22, theembodiment120 comprises ahousing121 containing acartridge122 filled with adrug123. Thecartridge122 is provided with aneedle124 for delivery ofdrug123 to a patient. Thecartridge122 includes apiston125 which is slidably received in thecartridge122. The piston has anouter recess126 for receiving aneedle sterility cover127. Theneedle sterility cover127 covers afirst end128 of theneedle124 and prevents contamination thereto. Asecond end129 of theneedle124 is connected to a length oftubing130. Thetubing130 has afirst end131 and asecond end132, as shown inFIG. 24. Thetubing130second end132 is secured within anactivation assembly163. Asecond needle134 is also secured to theactivation assembly163. Adrug pathway133 is machined into theactivation assembly163, and thetubing130 and second needle are secured within the activation assembly by means of an adhesive, preferably an ultra-violet bonding agent. A secondneedle sterility cover135 is slidably received on theexterior end136 of thesecond needle134. Prior to use, the secondneedle sterility cover135 is manually removed so as to uncover theexterior end136 of thesecond needle134 so that it is ready for penetration into the user's skin.
• Returning now toFIG. 22, thepiston125 andneedle124 are mounted on aratchet bar137 having a multitude of steppedincrements138 thereon. Theratchet bar137 is moved by aleaf spring139 integral with areciprocating lever140. Thelever140 is mounted on anaxis141 and has areturn spring142 that applies constant pressure to thelever139 in a single direction. Thelever139 rests against a gas generator sub-assembly144 and moves in response to pressure differentiation created therein.
• The gas generation sub-assembly144, includes a pair ofelectrolytic cells145,146, as shown inFIG. 26. Thefirst cell145 is the propulsion cell. Thepropulsion cell145 has afirst diaphragm147 made of a low permeability material, such as bromo-butyl, ethylene propylene, or EPDM. Thelever140 rests against thefirst diaphragm147. Thesecond cell146 has asecond diaphragm148 thereon. Thesecond diaphragm148 is made of a high permeability material, such as silicone rubber. Thefirst cell145 has ahose149 extending from the side of thefirst cell145 to above the surface of the top of thesecond cell146. Agap143 is created between the end of thehose149 and the top surface of thesecond cell146. Thecells145,146 are activated with electrical energy frombatteries150.
• Additional components in thepresent embodiment120 include adrug cartridge recess151, as shown inFIG. 23. The drug cartridge has asleeve152 for receiving and supporting thecartridge122 and ensuring safe and accurate operation of thedevice120. Thesleeve152 is slidably received into therecess151. Thesleeve152 has alip153 on the exterior at theinsertion end154 of the sleeve. Therecess151 has ashelf155 for receiving thelip153 of the sleeve when thecartridge122 is fully inserted, as shown inFIG. 21. Acartridge receiving channel156 is located within thehousing121 and is proximate to therecess151. The channel provides further support for the cartridge when it is inserted within thedevice120. The channel includes anouter edge157, aninner edge158 and anarched portion159. The outer and inner edges are parallel and align with the cartridge recess to guide and support thecartridge122 upon insertion and during use. Thearched portion159 of the channel is integral with theinner edge158 and is curved away from the cartridge and ratchet assembly. Prior to operation, thearched portion159 rests against adepressable button160 that is part of thegas generating sub-assembly137. Thebutton160 has a puncturing device on the inner surface thereof. When depressed, the puncturing mechanism breaks aseal161 of thecompartment162 containing the chemical entity used in theelectrolytic cells145,146 of the gas generating sub-assembly144, as shown inFIG. 22. The chemical entity is typically potassium chloride, and in the present embodiment, it is preferably in a less viscous form so as to enable the liquid to move to gaseous form more quickly.
• With this design, in the event the electrical connection is made prior to use, gas generation in the sub-assembly144 is not possible because the gas generating chemical is sealed within itscompartment162. In addition, this design prevents operation of the device unless the drug cartridge is fully engaged. Thearched portion159 is located so as to only be deflectable by the drug cartridge when the cartridge is in its fully inserted position. Thus, ensuring that the full dosage of the drug will be delivered.
• FIG. 24 shows a cross-sectional view ofmanual activation assembly163 along line A-A. Theactivation assembly163 includes a spring loadedstart button164 which is slidably received within abutton channel165. Thebutton164 is. maintained in an outward position by means of ahelical spring166, located and supported in thebutton channel165. Thehelical spring166 is loaded both axially and torsionally within thebutton channel165.FIG. 25 is a cross-sectional view of the activation assembly along line B-B, which shows apin169 which moves within agroove170 in thebutton channel165 from a first, pre-operational position [shown asposition169A], to a second, operational position [169B], to a third, locked position [169C].
• Returning toFIG. 24, thebutton164 has afinger167 extending therefrom. Thefinger167 is located directly above a deflectableelectrical contact168. When thebutton164 is depressed, thefinger167 contacts theelectrical contact168 and causes it to deflect, thus causing electrical communication between the contacts and initiating operation of thedevice120.
• In operation, theembodiment120, shown inFIG. 22, is supplied with adrug cartridge122. Thecartridge122, filled withdrug123 is fully inserted into thecartridge recess151. When thecartridge122 is fully inserted, thelip153 of thesleeve152 lockably engages with theshelf155 and prevents thecartridge122 from being removed. As thecartridge122 is inserted, theneedle sterility cover127 engages with the pistonouter recess126, and the tip of the needle pierces theneedle sterility cover127 andpiston125 and moves into the interior of the cartridge, as shown inFIG. 23. The travel of the cartridge ends when the sleeve lip engages with the shelf and the inner and outer edges of the channel. As the cartridge is fully inserted, the cartridge edge contacts the arched portion of thechannel156 causing it to deflect away from the cartridge. Such deflection applies pressure to the depressable button which depresses and pierces the container of chemical used to generate the gas within the electrolytic cells. Thedevice120 is then applied by the user or health care worker to the skin.
• The device is then activated when thestart button164 is depressed causing thefinger167 to contact theelectrical contact168 thus closing an electrical circuit which initiates gas generation in the sub-assembly. Once thebutton164 is depressed, the torsional force of thehelical spring166 prevents the button from springing back up and locks the button, andsecond needle134 in position [169B] during operation, as shown inFIG. 25.
• When thecells145,146 are activated with electrical energy from thebatteries150, both cells begin to generate gas. Thefirst cell145 builds pressure quickly because of the low permeability of thefirst diaphragm147, as shown inFIG. 26A. However, pressure is released through the hose and exits into the atmosphere within thehousing121. As pressure builds in thesecond cell146, thesecond diaphragm148 deforms outwardly, closing thegap143 between the hose and the top surface of the second cell, as shown inFIG. 26B. When this is closed, the gas from the first cell can no longer escape into the atmosphere, causing the first diaphragm to elastically deform outwardly. This deformation applies pressure to thelever140, as shown inFIG. 26C. When pressure is applied on the lever, it causes the leaf spring to move from a first steppedincrement138A to asecond increment138B. This movement causes thepiston125 to move further along the length of thedrug cartridge122, decreasing the volume ofdrug123 in the cartridge and moving such drug into the patient via theneedle124.
• Once pressure has built sufficiently in thefirst cell145 so as to move the leaf spring incrementally forward, gas generation in the cells is deactivated so as to begin to decrease pressure within the cells. As the pressure in the second cell decreases, the second diaphragm flattens out, thereby re-creating thegap143 and allowing air to bleed quickly from the first cell, as shown inFIG. 26D.
• The gas-generation sub-assembly is designed in such a way so as to provide maximum efficiency in the cycle of moving the leaf spring from afirst increment138A to asecond increment138B. The low permeability of thefirst diaphragm147 allows the pressure to build in thefirst cell145 and thus results in quick deformation of the diaphragm and movement of thereciprocating piston143. However, the integration between the first and second cells,145,146, is important in order to quickly release the pressure within thefirst cell145 after the leaf spring has been moved forward. Thehose149 between the first and second cell connects the two cells during deflection and provides first for the build up of pressure. After the pressure within the first cell builds sufficiently move the reciprocating piston, the electrical connection to thebatteries150 is disconnected, or decreased. This causes a rapid decrease in the pressure of thesecond cell146 because much of the gas created escapes through the second diaphragm. As the pressure in thesecond cell146 declines, the second diaphragm looses height and recreates thegap143, thus allowing gas from the first cell to quickly bleed off and return to a low pressure state to begin the next cycle. It should be noted that it is possible to maintain a minimum current level within the cells in order to keep a minimum level of pressure in the cells so as not to start the build up of pressure from a lower point than necessary, thus maximizing the efficiency of the cycle time. In one application, the current needed during the gas generation portion of the cycle may range from 5-7 milliampers, and the current to maintain the minimum level of pressure may range from 30-50 microampers. This cell design has enabled the cycle time to decrease from 20 minutes to 5 minutes in the present embodiment.
• The length between activating and deactivating the electrolytic cells may be controlled by means of a microprocessor, along with the use of different diaphragm materials. Thus, the cycle time to move the leaf spring a single increment may be adjusted depending upon the delivery rate desired. Moreover, the number and size of increments may be altered to provide further flexibility in the delivery rate.
• When the delivery is complete, thehelical spring166 which is torsionally loaded, forces thepin169 to move from the operation position [169B] to a locked post-operational position [169C]. This causes the entire activation assembly to retract and theexterior end136 of thesecond needle134 to be recessed into the housing, thereby avoiding any accidental injury or attempted further use of thedevice120.
• It should also be noted that in thepresent embodiment120, the number of sterile components has been minimized so as to eliminate the need to sterilize the entire device. The following components are sterilized as an assembly prior to being assembled into the device. The sterilized sub-assembly includes theneedle sterility cover127, theneedle124, thetubing130, thestart button164, thedrug pathway133, thesecond needle134, and the penetratingneedle sterility protector135.
• It will be appreciated that the embodiments discussed above are preferred embodiments, falling within the scope of the appended claims, and that various alternative embodiments are contemplated. For example, while leaf and coil springs were discussed in the preferred embodiments, it is anticipated that other types of springs may also be used.
• The term “drug” used herein includes but is not limited to peptides or proteins, hormones, analgesics, anti-migraine agents, anti-coagulant agents, narcotic antagonists, chelating agents, anti-anginal agents, chemotherapy agents, sedatives, anti-neoplastics, prostaglandins, antidiuretic agents, anti-sense agents, oligonucleotides, mucosal vaccines, gene-based medicines and permeability and enhancing agents.
• Typical drugs include peptides, proteins or hormones such as insulin, calcitonin, calcitonin gene regulating protein, atrial natriuretic protein, colony stimulating factor, betaseron, erythropoietin (EPO), interferons such as α, β or65 interferon, somatropin, somatotropin, somastostatin, insulin-like growth factor (somatomedins), luteinizing hormone releasing hormone (LHRH), tissue plasminogen activator (TPA), growth hormone releasing hormone (GHRH), oxytocin, estradiol, growth hormones, leuprolide acetate, factor VIII, interleukins such as interleukin-2, and analogues thereof; analgesics such as fentanyl, sufentanil, butorphanol, buprenorphine, levorphanol, morphine, hydromorphone, hydrocodone, oxymorphone, methadone, lidocaine, bupivacaine, diclofenac, naproxen, paverin, and analogues thereof; anti-migraine agents such as sumatriptan, ergot alkaloids, and analogues therof; anti-coagulant angents such as heparin, hirudin, and anlogues therof; anti-emetic agents such as scopolamine, ondansetron, domperidone, metoclopramide, and analogues thereof; cardiovascular agents, anti-hypertensive agents and vasodilators such as diltiazem, clonidine, nifedipine, verapamil, isosorbide-5-mononitrate, organic nitrates, agents used in treatment of heart disorders, and analogues thereof; sedatives such as benzodiazepines, phenothiozines, and analogues thereof; chelating agents such as deferoxamine, and analogues thereof; anti-diuretic agents such as desmopressin, vasopressin, and analogues thereof; anti-anginal agents such as nitroglycerine, and analogues thereof; anti-neoplastics such as fluorouracil, bleomycin, and analogues thereof; prostaglandins and analogues thereof; and chemotherapy agents such as vincristine, and analogues thereof.
• Other drugs include antiulcer agents, such as but not limited to cimetidine, and ranitidine; antibiotics; anticonvulsants; anti inflammatories; antifungals; antipsychotics; corticosteroids; immunosuppressants; electrolytes; nutritional agents and vitamins; general anesthetics; antianxiety agents, such as but not limited to compazine; and diagnostic agents.

Claims (21)

1-55. (canceled)

56. A wearable drug delivery device, comprising:

a housing with an adherent patient surface for placing on a patient, and a reservoir disposed within the housing;

a cannula in fluid communication with the reservoir and movable relative to the patient surface between a retracted position within the housing and an exposed position in which at least a portion of the cannula extends through the patient surface outside of the housing;

a piston slidably supported within the reservoir and operable to expel a drug from the reservoir;

a first drive member, at least a portion of which is rotatably moveable relative to the housing and the reservoir; and

a second drive member, at least a portion of which is linearly moveable relative to the housing and the reservoir, the piston being slidably displaced by cooperation of the first and second drive members;

wherein the first drive member continuously contacts the second drive member, and the linear motion of the second drive member is caused by rotation of the first member.

57. The device according toclaim 56, wherein the first drive member is slidable relative to the second drive member for expelling a drug from the reservoir.

58. The device according toclaim 56, wherein the second drive member contacts the piston; and

wherein during rotational movement of the first drive member, a portion of the first drive member slidingly engages a portion of the second drive member for linearly advancing the second drive member to slidably advance the piston within the reservoir to expel drug from the reservoir.

59. The device according toclaim 56, wherein the second drive member has an irregular surface defined by a series of peaks and troughs along a direction of its linear motion.

60. The device according toclaim 59, wherein the first drive member continuously engages the irregular surface of the second drive member.

61. The device according toclaim 59, wherein the first drive member slidably engages the irregular surface of the second drive member.

62. The device according toclaim 56, wherein the cannula is retractable into the housing subsequent to the expelling of a drug from the reservoir.

63. The device according toclaim 56, wherein the entire first member is rotatably moveable relative to the reservoir and the patient surface.

64. The device according toclaim 56, wherein the first drive member is rotatably moveable about an axis that is substantially perpendicular to a direction of the linear movement of the second drive member.

65. The device according toclaim 56, wherein the first drive member is rotatably moveable about an axis that is substantially perpendicular to a longitudinal axis of the reservoir.

66. The device according toclaim 56, wherein the first drive member comprises a reciprocable lever.

67. The device according toclaim 56, wherein the reservoir comprises a prefilled cartridge.

68. The device according toclaim 56, further comprising a controller to effect rotation of the first drive member.

69. The device according toclaim 68, wherein the controller comprises a microprocessor that times the movement of the first drive member thereby controlling a delivery rate of the wearable drug delivery device.

70. The device according toclaim 69, wherein the microprocessor is programmed during the manufacture of the wearable drug delivery device.

71. The device according toclaim 69, wherein the microprocessor is programmed by the patient of the wearable drug delivery device.

72. A wearable drug delivery device, comprising:

a housing with an adherent patient surface for placing on a patient, and a reservoir disposed within the housing;

a cannula, fluidly connectable with the reservoir and movable relative to the patient surface between a retracted position within the housing and an exposed position in which at least a portion of the cannula extends through the patient surface outside of the housing;

a piston slidably supported within the reservoir and operable to expel drug from the reservoir;

a first drive member, at least a portion of which is rotatably moveable relative to the housing, the reservoir, and the patient surface; and

a second drive member, at least a portion of which is linearly moveable relative to the housing and the reservoir, the linear motion of the second drive member being caused by rotation of the first member, and the piston being slidably displaced by cooperation of the first and second drive members.

73. The device according toclaim 72, wherein the first drive member is rotatably moveable about an axis that is substantially perpendicular to a longitudinal axis of the reservoir.

74. The device according toclaim 72, wherein the reservoir comprises a prefilled cartridge.

75. The method according toclaim 74, wherein the prefilled cartridge is linearly slid into the housing through an opening in the housing.

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