Background of the Invention
There is a growing number of drugs and vaccines for which the most effective, or most convenient method of administration is by intranasal delivery. This has led to the development of dosing devices for spray into the nose. These devices must deliver a precise dosage amount and it is important to deliver the dose in a way that the drug is absorbed in the nasal cavity and does not enter the back of the throat or the lungs.
Another issue that arises with intranasal drug delivery devices is the potential for abuse. Many drugs with a substantial potential for abuse are sprayed or snorted into the nose by drug abusers. One aspect of intranasal device design, therefore, is to prevent the re-use or re-tasking of a used drug intranasal device. A powder dispenser device described in U.S. Patent No. 5,683,361
provides a chamber with a powdery drug in which the chamber has a penetrable membrane enclosing either end. To dispense the drug, a plunger and piston are pressed against the lower end of the drug chamber, forcing it against a penetrating device connected to the dispensing nozzle and thus breaking the upper membrane. As the piston is depressed further, the lower membrane is penetrated by a lower penetration device, thus allowing the pressurized air above the piston to enter the drug chamber and expel the drug through the nozzle. This device requires that the air above the piston must be sterilized as well as the drug containing chamber, thus requiring sterilization of the entire device and secondary packaging. Another single dose dispenser is described in U.S. 5,307,953
. This device also includes a plunger and a sealed drug containing chamber. A stainless steel needle is provided that communicates with the outlet nozzle. As the plunger is pressed by a user, the drug chamber is forced against the needle, which penetrates a membrane that seals the drug chamber. As the piston is pressed further, the drug is forced through the needle and out the nozzle.
 U.S. 5,944,222
describes a dosing device in which a piston forces a drug containing chamber against a needle for release through the nozzle. The described device also includes a material bridge between the piston and the casing. By examining this bridge, one can determine if the piston has been previously pressed into the cylinder. This makes a tamperevident closure so that it is apparent when someone is attempting to re-use a spent device.
A similar device with a piston and penetrating needle is described in U.S. 6,708,846
. This device can also be placed in a reusable activating unit. The unit includes a ram which is adjustable with threads on the ram and on a sleeve containing the ram. During use of this device, a dispensing device is placed in the actuating unit and the ram is threaded into the sleeve so that the head of the ram rests against the piston of the dispensing device. A release detent holds the ram in place and prevents unwanted penetration of the drug compartment. The ram is also pressed against a compressed spring. Pressing the release button releases the detent, allowing the ram to push the piston and discharge the drug. A knob is then turned to reset the actuating device so it can receive another dispensing device for reuse.
Another dispenser, described in U.S. 6,725,857
is designed to dispense multiple doses of a drug, and is also designed for one-handed operation. Multiple drug doses are contained in storage chambers on a blister strip in the form of a drum store so that the strip is contained in the body of the device and is moved along a wheel as each dose is dispensed. An actuating lever is pressed against a spring and when the spring is compressed, a lock holding a carrier plate is released. The compressed spring then drives the plate and attached slides that push the wheel so that the next dose chamber is aligned with the punch, the punch is moved down into the chamber, puncturing the enclosing film, and air pressure created within the body of the device expels the drug from the chamber. The user then returns the actuating lever to the original position and the process can be repeated for the next dose. US-2006/237009
relate to further apparatus for dispensing substances.
The present disclosure provides a device as defined by the appended claims. The device can be used to dispense unit dosage forms containing medical compositions. As used herein, the term "unit dosage form" is intended to convey its art accepted meaning, and includes, but is not limited to ampule (ampoule), blister, cartridge, bottle, vial, unit-dose vial, or container, which terms are used interchangeably herein. In preferred embodiments, a unit dosage form contains a single-unit dose of a substance, or a two-unit dose of one substance or two different substances, in one or more compartments of the unit dosage form. Alternatively, a unit dosage form may administer three or more substances from one or more compartments in an unit dosage form. During manufacture, the unit dosage forms can be singulated, i.e., individually broken apart and individually loaded into, for example, an unit dosage form cartridge or a device. Alternatively, the unit dosage forms can be interconnected, for example through a strip, disk or connected webbing. The unit dosage forms can be manufactured as a disk or strip of unit dosage forms, which then may be manipulated into different forms for administration, such as a circle, ring, or tube. In other preferred embodiments, the unit dosage forms themselves, or the Unit dosage form Cartridge Holder, adhere to a numbering, color coding, icon system coding, or Braille system for assisting the user in administration of the unit dosage forms, and may also include a bar code or Radio Frequency Identification Device (RFID).
In certain embodiments the unit dosage forms of the present disclosure are blisters that can be manufactured as described in US Provisional Serial Number 60/972,634
. The manufacturing processes for shaping articles for unit-dose packaging with at least one formed recess (e.g., a blister), in particular for unit-dose packaging of pharmaceutical dosage forms, can include a step of drawing the film material (e.g., metal-plastic foil) with one or more plungers to form a primary contour, the contour having a depth of at least 100% and up to 150% of the depth of the formed recess. A second stage involves shaping the primary contour with one or more plunger(s) to the desired formed recess, with a depth that is less than the depth of the primary contour, while substantially maintaining the surface area of the primary contour formed in the first stage. The formed recess may be formed using warm-forming or cold-forming techniques.
The disclosed devices may be described in certain embodiments as devices for dispensing a predetermined quantity of fluid into the nasal passage of a user, or into the eye or ear of a user, in which the predetermined quantity of fluid is contained in, or produced in an ampul or blister dosage form that is crushed by a plunger with sufficient force to drive the dosage form against a piercing mechanism, piercing the dosage form and forcing the liquid contents from the dosage form and through a delivery channel into a spray to be directed to the user. A predetermined quantity refers, in most instances to a single dose of medication or a pharmaceutical or medical composition, and in certain embodiments to a prescribed dose. A predetermined quantity of fluid may also be a partial dose when delivery of a dose is administered in two or more spray events. Any pharmaceutical agent that is deliverable in a powder or liquid from is contemplated in the present disclosure, including but not limited to antibiotics, antipyretics, antiinflammatories, biologies, vitamins, co-factors, enzymes, inhibitors, activators, nutrients, aptamers, thioaptamers, vaccines including killed or live virus or microorganisms, nucleic acids, proteins, peptides, antibodies, peptide mimetics, or other agents known in the art. The medical compositions are in the form of a liquid, a powder, or a combination of liquid and powder and include one or more active agents and combinations of pharmaceutically acceptable carriers, solvents, diluents, preservatives, surfactants, salts, adjuvants, viscosity agents, buffers, chelators, or other ingredients known to those in the art as needed.
Although preferred embodiments of the devices are described herein primarily for use as intranasal delivery devices, it is understood that in certain embodiments the described devices can also be used for delivery to the eye, ear, mouth, lungs, or topical cutaneous areas of a user, by modification of the nozzle end of the devices. The devices can also be produced for veterinary use, for delivery of drugs to the nose, eye or ear of an animal. For example, a device may include a nozzle for delivery into the ear canal of a user, or it may include a cup or nozzle for delivery to the eye of a user. The volume of a dose delivered for the various uses can also be adjusted as appropriate.
The volume of droplets or particles dispensed from the devices will depend on the site of dispensing as well as the content and viscosity of the medication to be delivered. In certain embodiments droplet to be delivered to the eye would be from 1 µl to 25 µl, or more typically from 7 µl to 25 µl. Dosage for nasal administration are typically from 75 µl to 500 µl and dosages for oral or topical cutaneous administration can be larger, as much as 1000 µl or more. The volume and size of droplets or particles released by a device can be adjusted to maximize the therapeutic benefit of the dispersed substance. The volume of substance dispensed depends on the size of the compartment containing the substance, the unit dosage form blister, the piercer, the fill level, the degree to which the dosage form is compressed by the device and other variables in the construction of the devices, as well as characteristics of the substance dispersed, which are well understood by those skilled in the art. These variables can be appropriately dimensioned to achieve dispersal of a desired volume or droplet size of liquid or particle size of substance to the user. One of skill in the art understands that residual liquid or other substance after dispersal is taken into account when formulating the appropriate parameters for dispersing the desired dosage volume.
An advantage of the devices and unit dosage form designs set forth herein is that the sterility of the administered substance is maintained until the moment of use. Maintaining sterility until the moment of use minimizes or eliminates the need to use preservatives or bacteriostatic compounds in the substances administered, without risking contamination. In addition, if the unit dosage form is damaged, or is otherwise defective, the devices do not administer the substance, which may no longer be sterile. For example, if a unit dosage form is defective in the area of the pierceable section, or develops a leak, the devices will not dispense the substance properly because sufficient pressure will not be generated in the unit dosage form to effectively release the substance.
The dosage forms of the disclosure are described, in certain embodiments as including a dispensing blister chamber that contain a piercing device, wherein the piercing device is a substantially hollow, elongate member with a base end and a piercing tip opposite the base end and providing a discharge nozzle. In certain embodiments the dispensing blister conforms to at least the base end of the piercing device effective to support and hold the piercing device in place during manufacture and use of the dosage form. The piercing devices include one or more inlet openings on or near the base end and an internal conduit providing fluid communication between the one or more inlet ports and the discharge nozzle; and the surface of the internal conduit comprises structural features such as contours, steps, flutes, ribs, constrictions, or a combination thereof to control the spray pattern and droplet size of a fluid forced through the piercing device. It is a further aspect of the disclosure that the inlet openings provide a fluid path from the interior of the dispensing blister chamber into the internal conduit that comprises one or more bends, and that the combination of angular turns and the structural features of the internal conduit create vortices in the fluid as it is forced through the piercing mechanism.
The structural features can be designed, for example, for different types of spiral, vertical and other flow and the design can be adjusted for different viscosities of the fluid or solid to be dispensed. For example, structural features may be added to create a vortex, to further mix the contents of the blister, to change the fluid property type from laminar to turbulent or vice versa or to change fluid properties such as pressure, velocity, surface tension or viscosity. Additionally, the inlets into the internal conduit can include bends of angles from about 0° to 90°, or more combinations in order to create the desired spray plume geometry for a particular medicament or liquid dose.
In certain embodiments, a shaped blister dosage form as described herein that contains medication and an internal piercing nozzle, is configured for use in a smaller diameter dispensing mechanism, while still providing an accurate dose of medicine in the form of a controlled spray. A blister strip including a plurality of such dosage forms can include a blister material layer in which the dosage forms are formed, and a lid material bonded to the blister material. A concentric sealing area provides a resilient seal that is not broken when the dosage forms are crushed to deliver the contained medication.
To produce a controlled spray of liquid when bursting a sealed formed recess, such as a shaped blister, an internal piercer inside the sealed blister may be used, and may be positioned such that it maintains contact with the lid material. Internal piercers are disclosed in U.S. Serial No. 11/114,251
, U.S. Prov. Nos. 60/853,328
. The internal piercer can take different shapes, including but not limited to a funnel design, or a disc shape design. The internal piercer can constructed of materials any suitable materials such as ceramic, glass, metal, styrene, polystyrene, plastics, including but not limited to PET, polypropylene, polyethylene, or PEEK, and other pharmaceutical grade FDA approved materials of sufficient hardness to penetrate the lid material. The second, subsequent and/or final plunger(s) may be designed to shape the formed recess such that the internal piercer is locked into place within the formed recess, e.g., through manufacture, handling, transportation, storage, and actual use. For example, in a shaped blister, a protruding structure, an indentation, a diaphragm or an annulus is formed to conform to the shape of the base of the internal piercer. The protruding structure, indentation, diaphragm, or annulus provides support for and holds the internal piercer in place during assembly and during dispensing. Thus, these structures functions to capture the internal piercer (e.g., restrict vertical movement of the piercer), thereby holding it in place. The internal piercer may also be held in place through manufacture and actual use by, for example, press fit, welding, hydrostatic forces, or electrostatic forces. The shaped blister can also be formed by the second or subsequent plunger such that it insures that the protruding structure, indentation, diaphragm, or annulus seals to the internal piercer in order to achieve the desired spray pattern.
In preferred embodiments, the internal piercer includes a hollow tube or channel (the delivery channel) through which the pharmaceutical dosage form flows as the shaped recess is compressed and pierced. The tip of the piercer preferably has an angled edge to aid in penetration of the lid material. The inside diameter of the piercer tube can range from about 0.038cm to about 0.1cm (about 0.015 inches to about 0.05 inches), but in certain preferred embodiments is about 0.064cm (about 0.025 inches). The internal diameter, shape, or surface texture of the delivery channel, whether in, near, and/or at the exit point, may contain a nozzle or may be varied to form the optimum droplet size and spray plume geometry of the pharmaceutical dosage form as it exits the shaped article, as well as control the velocity, pressure, pattern, distribution, and aim of the released substance. Thus, the nozzle system and the piercer may be integrated into a single unit. The nozzle system can also be designed to determine the mixing of the substance as it is released.
To successfully dispense the medication, the medication must flow through the piercing nozzle with enough velocity to create the desired spray geometry. As described herein, this is accomplished by pressing on the blister form with sufficient force to push the piercing nozzle through the Hd material, completely crushing the dosage form and forcing the contents through the nozzle with the required velocity. During this dispensing operation, the seal of the Hd material to the blister material must be strong enough that no leakage occurs prior to the nozzle piercing the Hd. The smaller size required by certain dosage situations, such as intranasal administration present greater challenges to the seal of the lid material to the blister material.
It is an aspect of the disclosure that the disclosed devices also include actuator mechanisms that provide a mechanical advantage, a mechanical disadvantage, or a combination thereof to the discharge process. Mechanical advantage, as used herein, indicates that the amount of force exerted on the plunger or piston to crush a dosage form and deliver the medication is greater than the amount of force applied by a user on the trigger device. Mechanical disadvantage, as used herein, indicates that the amount of force exerted on the plunger or piston is less than the amount of force applied by a user on the trigger device. In certain embodiments, the actuator mechanism provides a mechanical disadvantage during a first stage of the firing action and a mechanical advantage during a second stage of the firing action. In an example of such a system, an actuator can provide a mechanical disadvantage in a first stage of the firing process, forcing a user to exert an increased level of force to the trigger mechanism, during the firing process, the actuator can then shift to a mechanical advantage in which the increased force being exerted by the user is enhanced to provide sufficient force to correctly dispense the dosage. It is understood that the first and second stages, however, do not necessarily refer to the time position in the firing order, but could occur in reverse order. The devices are thus able to drive the plunger with sufficient force to crush the dosage form and deliver the composition in the dosage form through the nozzle with sufficient force to create the desired spray pattern and geometry.
The mechanical advantage is provided by a toggle mechanism, as defined in the appended claims. The toggles of the present disclosure include jointed rods or bars with several flex points so the toggle is joined to the trigger device by a flexible joint and joined to the piston device with a flexible joint. The toggle further includes a flex point at or near the center of the bar or rod. At the flex point, the two sections of the toggle form at an angle of about 90° or greater. It is understood that at 90°, the force at the apex and at the end of the linkage are in a 1:1 ratio, but as the angle increases, the force at the piston end becomes greater than the force at the apex. As such, the angle formed at the apex may any angle that is about 90° or more, including 90°, 95°, 100°, or even 135° to provide the required amount of mechanical advantage. The apex of this angle contacts the trigger device when the device is in the ready mode or position. When the trigger is then activated or pressed by a user in the direction of the angle bisector, as the toggle moves away from the direction of force and the plunger is pushed against the dosage form flattening the angle in the toggle toward 180°, then the force applied to the end of the toggle that is joined to the plunger is greater than the force applied at the apex of the angle.
The device of the appended claims includes an activation knob that is rotatable from an inactive to an active position. The activation knob is particularly suitable for use with a toggle mechanism for providing mechanical advantage. In the inactive or storage position the knob, the cross section of the knob conforms to the shape of the body of the device such that the long axis of the knob is aligned with the long axis of the body. The knob is joined to the toggle is such a way that the plane of the angle in the toggle is also aligned or parallel to the long axis of the body. Rotating the knob through 90° into the ready position, places the long axis of the knob perpendicular to the long axis of the body, and raises the angled toggle against the button or trigger device. This pushes the button up into the ready, or cocked position. In certain embodiments, the underside of the button provides a depression that complements the geometry of the toggle and prevents the toggle from slipping when the button is pushed.
The described devices include devices designed for a single use, or the devices are designed to be disposable after a single use. Certain devices are also reloadable or capable of holding and/or dispensing more than a single dose. The devices incorporate designs that prevent a reuse of or repurposing of the devices. The toggle can be made of an inexpensive material, therefore, such as a semi-rigid plastic or polymer material, or of any other semi-rigid material known in the art including metals such as aluminum, for example. The toggle mechanism comprising the activation knob, actuator and plunger can be made of two or more pieces.
It is a further aspect of the disclosure that the described devices can include a latch that locks the dispensing mechanism upon discharge, thus preventing re-use or re-purposing of the device. In certain embodiments a hook-shaped latch is forced into a similar opposite facing hook-shaped latch when the devices are fired, locking the pieces together and preventing reversal of the process to return the device to ready position. The latches may be on the actuators or on the pistons and mate with similar latches on the body of the devices. In certain embodiments, the linkage device is designed to break or separate when the plunger has reached its full stroke, thus disabling the device for further use. As a further safety feature, the devices can be designed such that the bodies cannot be opened without destroying the device to prevent re-use.
In certain embodiments the devices also include detent devices. A detent can be a projection, tab or flange on the plunger or piston, for example, that impinges on a groove or slot in the body. The detent is semi-rigid so that it resists a certain amount of force, and only flexes and thus releases the piston when a sufficient, predetermined force is applied. In this way, the devices ensure that sufficient force is applied to the piston to completely crush the dosage form and deliver the entire dose in the desired spray geometry.
The devices of the present disclosure employ dosage forms that contain an internal piercing mechanism. Preferred piercing mechanisms include a piercing point positioned adjacent the piercable membrane of the dosage form and a tube providing fluid communication from the piercing point to the discharge nozzle. In certain embodiments the piercing mechanism comprises a piercing body, wherein the outer dimensions of the piercing body closely fit in the inner dimensions of the dosage form such that when the piercing body pierces the dosage form and discharges the fluid during use, the piercing body displaces substantially the entire internal volume of the dosage form.
The piercing mechanism is contained in the dosage form with the fluid to be delivered. Such internal piercing mechanisms can include an internal chamber, one or more inlet openings arranged to force one or more bends or changes in direction as the fluid flows into the internal chamber, a discharge outlet, and features on the internal surface to control the spray pattern and droplet size of a fluid forced to flow through the nozzle. The changes in direction can be of any appropriate angle, including from about 1 ° to about 90° or more. The design of such features are known to those of skill and include steps, flutes, ribs, or a combination thereof.
Certain embodiments of the delivery devices of the disclosure can be reusable. A reusable device can include a removable tip that contains one or more dosage forms and a piercing mechanism. The dosage form can be swaged into the removable tip thereby reducing the overall diameter of the dosage form while preserving the seal area of the dosage form. The piercing mechanism can be contained in an internally pierced dosage form as described herein. The removable tip is fit onto the body to place the dosage form adjacent the plunger, and can be connected to the body with a bayonet fitting, or other type of connection known to those of skill in the art.
The present devices can also be designed to provide the dosage in two separate discharges. Such devices can include a rotatable tip, for example that controls the amount to be discharged. The tip is designed so a shoulder in the interior of the tip is contacted by a tab on the plunger, stopping the plunger and thus the discharge when the dosage form is partially emptied. In certain embodiments the plunger stops when the dosage form is half empty. Rotating the tip, then, would rotate the shoulder away from the tab, aligning a channel or multiple channels with one or more tabs on the plunger. This second alignment would allow the rest of the dose to be dispensed when the trigger is again activated. In preferred embodiments the tip includes position indicators and the body includes an alignment mark. In this way, when a "1" on the tip is aligned with the alignment mark on the body, the device will dispense the first portion, and when a "2" is aligned with the alignment mark the device will dispense the remaining dose. Any numbers, letters, symbols, colors or other indicators can be used on the tip to indicate the position of the tip for dispensing drug. It is also understood that there can be a position marked "0" for example, in which the device is locked and cannot be used until the tip is rotated to the first active position. In this embodiment, a series of detent mechanisms may be used so that the detent is active for each portion of the dose.
In certain embodiments the disclosure may be described as a piercing nozzle for dispensing fluid from a dosage form in a controlled spray pattern and droplet size. The nozzle includes a substantially elongate member with an inlet end and a discharge end, an internal channel connecting the inlet end and the discharge end in fluid communication, one or more inlet openings in the inlet end, a discharge opening in the discharge end, and features on the internal chamber surface to control the spray pattern and droplet size of a fluid forced through the nozzle. The inlet ports are designed to provide a fluid path into the internal channel that includes one or more right angle turns. The inlet ports can also be designed to produce a vortex in the liquid as it is forced through the ports. Features in the internal channel can also include, but are not limited to steps, flutes, ribs, and related structures to produce the desired droplet size and spray geometry. In certain embodiments, the piercing tip may be on the discharge end of the elongated member, or on the inlet end. The piercing nozzle can be contained in a dosage form. The disclosure includes, therefore, a dosage form containing the piercing nozzle and a medical or pharmaceutical composition.
In certain embodiments the present disclosure can be described as an internally pierced dosage form that includes a substantially dome shaped, flexible blister, a substantially round pierceable surface sealed to the base of the dome-shaped blister, and an internal chamber containing a piercing nozzle as described herein and a liquid composition. In certain embodiments the piercing nozzle includes a base and a piercing end, and wherein the base is attached to the dome shaped blister and the piercing end is proximate the piercable surface.
Certain embodiments of the disclosure include dosage forms in which two or more components are mixed just prior to dispensing. Such a dosage form can include a blister and a backing, where the blister is divided into two or more chambers. The chambers are divided by seals that are less adhesive than the primary seal that surrounds the circumference of the total blister. In this embodiment, each chamber contains a powder or liquid portion of the final dose to be mixed, and at least one chamber contains a liquid such that the final mixture is in liquid form. It is an aspect of this embodiment that the contents of one chamber is forced into the interior of an adjacent chamber where the two components are mixed. This is accomplished by applying a force to the first chamber that is sufficient to break the less adhesive seal between chambers without breaking the primary circumferential seal around the blister, and crushing the first chamber to force the contents to enter the second chamber under pressure. The second chamber is preferably composed of a flexible blister material with the top inverted to minimize the volume of the second chamber prior to mixing. Breaking the seal and forcing the contents of the first chamber into the second chamber causes the top of the chamber to pop up or expand to accommodate the contents of both chambers. The second chamber, that contains or is adjacent a piercing mechanism is then crushed by a plunger to dispense the mixed composition. The multi-chambered dosage form for mixing components prior to dispensing can be essentially doughnut shaped, with one or more chambers encircling or partially encircling a central chamber, or they may be positioned in a side by side arrangement or even stacked.
The dosage form can include a first dosage chamber containing a first component of the pharmaceutical composition, a second dosage chamber containing a second component of the pharmaceutical composition, and a dispensing chamber that includes a piercable membrane. The second dosage chamber and the dispensing chamber may be two separate chambers, or the same chamber. The piercable membrane is a section of the membrane that is designed to be pierced by a piercing mechanism or device. The piercable membrane may include an area that is weakened by scoring, or thinned, effective to inhibit production of loose pieces of the membrane during use as it is penetrated, and to promote a seal of the pierced membrane to outer walls of the piercing tip. The dosage form also comprises a seal, for example first delamination seal, that prevents mixing of the contents of the first dosage chamber with the contents of the second dosage chamber, and may comprise a second delamination seal that prevents mixing of the contents of the second chamber with the dispensing chamber. The dosage form may further comprise a permanent seal, wherein the permanent seal surrounds the outer perimeter of all the chambers, and in which the first and second delamination seals have less adhesion than the permanent seal, such that the first and second delamination seals delaminate under significantly less pressure than the permanent seal.
As used herein, the term "dosage chamber", which encompasses the term "dosage blister chamber", refers to a compartment of the disclosed dosage forms that contain a component or a portion of the final pharmaceutical composition. A dosage chamber can contain a liquid or a solid composition, to be mixed with other components to form the final pharmaceutical composition when the contents of the chambers are combined during or just prior to administration. A "dispensing chamber", which encompasses the term "dispensing blister chamber", refers to a chamber that includes a piercable membrane and can include an internal piercing mechanism. Delamination zones are seals that are designed to break or delaminate when pressure is applied to the chambers so that the contents of the chambers can be mixed.
Certain dosage forms of the disclosure have two dosage chambers separated by a delamination zone, or in certain embodiments by a high vapor barrier material such as aluminum foil, for example. Embodiments also include dosage forms with three, four, five, or more dosage chambers, the contents of all of which are mixed as the pharmaceutical composition is delivered. The chambers can contain liquids or solids in any combination, however, in preferred embodiments, the final pharmaceutical composition is in liquid form. In certain embodiments one or more or even all of the dosage chambers can contain the same composition, or aliquots portions of the same composition when the volume of a dose is too large to fit within a single dosage chamber. It is an aspect of the disclosure that the dosage chambers are separated from each other during storage by delamination zones, or by membranes that can be pierced by a piercing device or burst by pressure, such that the barrier is removed when pressure is applied to the chambers in a delivery device, and that the final delamination or designed membrane failure is effective to allow the completed composition to enter the dispensing chamber for discharge to the site of treatment.
It is a further aspect of the disclosure that any of the delivery devices or dosage forms described herein can include an indicator that the contents of the device has been exposed to extreme or potentially damaging high or low temperatures or to radiation levels that can cause the ingredients within the dosage forms to degrade or become inactive. A device can include, for example, irreversible temperature sensitive products such as strips, dots, decals, or labels containing crystalline materials that undergo an irreversible color change upon exposure to a particular temperature. Indicators can be used with various temperature sensitivities to create a visual history of temperature maxima and/or duration that the product has experienced. An example of such products are commercially marketed under the trade name, Thermax®, for example. Alternatively thermal sensitive ink can be used in the manufacture of the packaging for any of the devices or products disclosed herein, or such ink can be incorporated into or printed on the housing of a device or dosage form. Similar indicators can be used for the disclosed delivery devices and dosage forms to indicate radiation exposure. Typical indicators that detect high energy radiation change color from yellow to red upon exposure to radiation such as gamma rays. Other indicators can be used to detect exposure to ultraviolet or electron beam radiation. Certain of such labeled devices will find particular use in military applications or in extreme environments including deserts, tropical climates, extreme cold climates or even for use in space travel.
It is a further aspect of the disclosure that certain delivery devices can include a marking device such that a mark is produced on the user when a dosage is dispensed into the nostril of the user. Such a device is particularly useful in environments or situations such as pandemics, biological or chemical agent release or exposure events, or in institutions such as military, medical, educational or penal institutions in which a large number of subjects are required to receive an intranasal dose and it is important to be able to quickly determine who has received a dose. A preferred marking refill tip is a replaceable tip with dosage form for a nasal dispensing device similar to devices described in Figures 30 and 31. The purpose of the tip is both to dispense medication and to leave an identifying mark on the person receiving the medication. This mark may be in the form of a visible, colored ink or an ink that is only visible under infrared or ultraviolet light. The mark can assist in assuring compliance with regulations, in reducing duplication of dosing, reducing the chance of a missed dosage, as well as other situations. The marking agent, such as ink can be color-coded, for example, or otherwise coded to indicate a particular dosage or medical ingredient that is administered to a subject.
Throughout this disclosure, unless the context dictates otherwise, the word "comprise" or variations such as "comprises" or "comprising," is understood to mean "includes, but is not limited to" such that other elements that are not explicitly mentioned may also be included. Further, unless the context dictates otherwise, use of the term "a" or "the" may mean a singular object or element, or it may mean a plurality, or one or more of such objects or elements.
Brief Description of the Drawings
The following drawings form part of the present specification and are included to further demonstrate certain aspects of the present invention. The invention may be better understood by reference to one or more of these drawings in combination with the detailed description of specific embodiments presented herein.
Fig. 1A-1C are different views of a device in the storage mode. Fig. 1A is a perspective view showing the bottom of the device with the activation knob in the inactive position, Fig. 1B is an end view of the device and Fig. 1C is another perspective view in which the spray tip is shown.
Fig. 2A-2C are different view of a device as shown in Fig. 1A-C in a ready mode.
Fig. 3A-C are different views of a device as shown in Fig. 1A-C in fired mode.
Fig. 4. is a cross section view of a device as shown in Fig. 1A-C in storage mode.
Fig. 5. is a cross section view of a device as shown in Fig. 2A-C in ready mode.
Fig. 6 is a cross section view of a device as shown in Fig. 2A-C during discharge.
Fig. 7 is a cross section view of a device as shown in Fig. 3 A-C in discharged/locked mode.
Fig. 8 is a cross section view of a device with an internally pierced dosage form.
Fig. 9 is a cross section view of a device with an internally pierced dosage form in discharged mode.
Fig. 18 is a cross section view of a positive displacement dosage form.
Fig. 19 is a cross section view of a positive displacement dosage form during discharge.
Fig. 20 is a cross section view of a positive displacement dosage form discharged.
Fig. 21 A and 21 B are views of a dosage form.
Fig. 22 is a cross section view of a piercing nozzle.
Fig. 23 is a cross section view of an internally pierced dosage form.
Fig. 24 is a perspective view of a Bi-dose push button dispenser in a first position.
Fig. 25 is a perspective view of a rotatable tip used on the device as shown in Fig. 24.
Fig. 26 is a perspective view of a Bi-dose push button dispenser in a second position.
Fig. 32 is a cross section view of a dual medication blister dosage form.
Fig. 33 is a cross section view of a dual medication blister dosage form in mixing mode.
Fig. 34 is a cross section view of a dual medication blister dosage form ready to dispense.
Figs. 35-38 are schematic view of a strip-type multiple medication dosage form during the steps of moving a dose into position and discharging the dose.
Fig. 63 is a cross section of a marking tip assembly.
Fig. 64 is a perspective view of a marking tip assembly.
Fig. 65 is a marking tip assembly ready to be installed on a dispensing device.
Fig. 66 is a marking tip assembly ready to dispense with a tip in place a dispensing device.
A preferred embodiment of an intranasal delivery device is shown in storage, ready and fired configurations in Figs. 1, 2, and 3, respectively. The device 1 as shown, is a push button version of an intranasal delivery device. This embodiment includes a button 2, a body 3 with nozzle end 32 and an activation knob 5. The device shown in Fig. 1 is in storage mode, as can be seen by the positions of the activation knob 5, which is aligned with the body 3, and the button 2, which is in the depressed position. As shown, the activation knob 5, and the body 3, have a generally ovoid cross sectional shape. As used herein, when the activation knob 5 is in the storage position, the long axis of the activation knob 5 is aligned with the long axis of the body 3 cross section. A cross section of the push button device in storage position is shown in Fig. 4. In this view, the linkage 10 is horizontal under the button 2. The plunger 9 is in the retracted mode.
The embodiment of an intranasal delivery device shown in Fig. 1 is shown in Fig. 2 in the ready or activated mode. In the ready mode, the activation knob 5 has been rotated 90° moving the internal mechanism into the dispensing position and raising the button 2. Although in the device shown in the figures, the activation knob is turned clockwise in order to place the device in ready mode, it is understood that the knob could also be configured to turn counterclockwise with the same effect. The device in ready or activated mode is shown in cross section in Fig. 5. The linkage 10 is attached at one end to the activation knob 5, and at the opposite end the linkage engages or is attached to a plunger 9. Rotation of the activation knob 5 rotates the linkage 10 causing it to contact the button 2, and to push the button into the raised or ready position. In certain embodiments, an audible click or snap indicates that the device is ready to dispense. The linkage 10 is made of any appropriate material that is semi rigid to provide the necessary mechanical strength, and is cost effective for use in a disposable device. The material is typically a polymer or metal with flex points indicated at points 10a, 10b & 10c. The activation knob 5, linkage 10, and plunger 9 may all be made as a single piece or as two or more pieces that are assembled during assembly of the device.
The nozzle end 32 designed for insertion into the nostril of a user, also provides an internal channel that contains the plunger 9, and a cavity designed to contain the dosage form 60 containing medication 62, and the external piercing mechanism 6. The piercing mechanism includes a piercing tip 8 and discharge channel 7 in fluid communication with the outlet 4.
Fig. 6 shows the device during dispensing. Pressing down on the button 2 transfers force to the flex point 10b of the toggle linkage 10. The force is then transferred to the plunger 9, driving it and the dosage form 60 forward. The dosage form 60 moves forward until it is pierced by the piercing tip 8. Then the plunger 9 continues to move forward collapsing the dosage form 60 and expelling the medication 62 out the discharge channel 7 in the form of a spray 13.
The device is shown in the fired or dispensed mode in Figs. 3 and 7. The activation knob 5 is still in the vertical orientation and the button 2 has been fully depressed, the medication 62 dispensed and the toggle linkage 10 locked in the fired position. The locking of the toggle linkage is accomplished by the upper latch 41 being pressed past the lower latch 42 into a locking interference, preventing the device from being re-charged or re-used.
Certain embodiments of the present disclosure are designed for use with an internally pierced blister 80. An example of such a device 90 is shown in Fig. 8. The blister 80 contains medication 84 and a piercing nozzle 70. Device 90 includes a body 91 and nozzle end 33, designed for insertion into the nostril of a user. The nozzle end provides a cavity for the plunger 9 and blister 80. The embodiment shown also includes an activation knob 5, linkage 10, plunger 9 and button 2 as in the previously described device 1. The button has an outer surface and an inner surface. The inner surface 37 forms a channel configured to receive the linkage 10 when the activation knob rotates the linkage against the button, raising it to the ready position. This channel in the inner surface 37 of the button holds the linkage in place against the button so the linkage doesn't slip when the button is pushed to fire the device. In the embodiment shown in Fig. 8, the plunger 9 has a detent 94 that imposes on a rib 92 on the bore 93 of the nozzle end 33 of body 91. The device 90 is activated and dispensed in the same manner as described for device 1. In the present embodiment, however, the rib 92 interferes with the detent 94 and resists the forward motion of the plunger 9 until sufficient pressure is developed to force the plunger detent 94 past the rib 92. This restriction insures that enough force has been generated to drive the plunger 9 into the blister 80 and to produce an internal pressure sufficient to create the desired spray pattern 13.
Fig. 9 shows the device 90 in the fired mode. The plunger 9 compresses the blister 80 almost completely resulting in a more complete and accurate dispensing of the medication 84. It is understood that the linkage 10 can be locked in the fired position as shown for device 1. Additionally, the detent 94 can be made to lock when moved past rib 92 and to hold the plunger 9 in the fired position, thus preventing reuse of the device.
An aspect of intranasal drug delivery devices as disclosed herein is delivery of the correct droplet size to the correct location. Droplets of 50 µm may be too large to penetrate the nasal cavities and droplets of less than 5 µm may pass directly into the lungs without being absorbed in the nasal mucosa. Up to 90% of the drug delivered using by conventional spray pumps is deposited in the anterior chamber of the nasal cavity then quickly cleared and swallowed. Doses are not consistent due to a poor user interface and variable spray characteristics. An aspect of the present disclosure is embodiments in which the device is correctly aligned for optimal delivery of drug to the nasal mucosa.
An aspect of the present disclosure is the dosage forms to be used in the described delivery devices. Fig. 18 illustrates a positive displacement dosage form 50 including an outer body 51, a thin membrane 52, and an inner chamber 56 that contains the fluid or drug to be administered. Also shown is a complementary piercing mechanism 54, that provides a piercing feature 53 and discharge channel 55. The delivery of the drug contained in the dosage form is demonstrated in Figs. 19 and 20. When used in a device as described herein, a piston presses the dosage form and moves it against the piercing mechanism. This force causes the piercing feature 53, which may be a needle-like object to penetrate the thin membrane 52, allowing the liquid to pass into and through the discharge channel 55 to create the desired spray discharge 13.
Fig. 20 shows the dosage form 50 completely collapsed. An important feature of the positive displacement dosage form is that the piercing body 54 is so matched to the interior geometry of the dosage form body 51 that it displaces virtually all the interior volume of the dosage form 50.
A top view and a section view at line A-A of an externally pierced dosage form 60 is shown in Fig. 21. The dosage form 60 includes an interior chamber which holds the fluid medication 62 until the time of dispensing and a thin membrane or film 61 designed to rupture around the piercing tip of the various intranasal delivery devices. The dosage form further includes a parting line 63 where the dosage form halves are sealed around the fluid medication.
An embodiment of a piercing nozzle 70 used to pierce the dosage form, control the flow of fluid and control the spray pattern and droplet size is illustrated in Fig. 22. The nozzle includes an inner chamber 71 with openings at each end, a piercing tip 72 and a plurality of inlet openings 73. The presence of steps, flutes, ribs and other features 74 on the surface of the inner chamber 71 has been demonstrated to control the spray pattern and droplet size of the fluid flowing through the nozzle. For example, vortexing can be controlled by spiral cuts, conically tapered holes, flow routing channels, and other means known to those of skill in the art. Droplet size can be controlled by factors such as exit hole geometry (length, diameter, angle) or pressure buildup, through controlling the force required to puncture the blister. It is understood that the geometry and droplet sized for the discharge spray from the described devices can be controlled by matching the features of the nozzle to the viscosity of the fluid to be dispensed and that the design of the nozzle will vary according to properties of the fluid.
Since the rate and method of absorption of various fluid medications are influenced by the droplet size and distribution inside the nasal cavity, it is beneficial to control this spray pattern. The surface features 74 can be designed for different types of spiral, vertical and other flow and the design can be adjusted for different viscosities of the fluid to be dispensed. For example, surface features may be added to create a vortex, to further mix the contents of the blister, to change the fluid property type from laminar to turbulent or vice versa or to change fluid properties such as pressure, velocity, surface tension or viscosity. This use of surface features to control spray pattern can also be applied to the discharge channel 55 of the piercing body 54 of the positive displacement dosage form 50 described earlier.
An embodiment of an internally pierced dosage form 80 containing a piercing nozzle 70 inside is illustrated in Fig. 23. The dosage form 80 is constructed of a dome-like blister 81 made of flexible material and a pierceable surface 82. The blister and pierceable surface have a circumferential seal 83 allowing the containment of a fluid 84 and the piercing nozzle 70. When the internally pierced dosage form 80 is compressed from the direction of the piercable surface 82, the piercing tip 72 penetrates the pierceable surface 82. As the internally pierced dosage form 80 is further compressed, the outer surface 75 of nozzle 70 forms a seal against the pierceable surface 82, the fluid 84 contained in the blister is forced to flow through inlet openings 73 and out the opening in the piercing tip 72. This path produces two 90° turns in the flow of the fluid, the first as the fluid, moving in a downward direction away from the piercable surface enters the inlet openings, and the second when the fluid then enters the delivery channel through the center of the piercing tip. This fluid movement improves the control of the flow and droplet size during dispensing.
Certain embodiments of the disclosure are designed to deliver a dose of medication in two increments, as a user might deliver one half dose to each nostril, for example. Such a device is termed a bi-dose device 100 as shown in Fig. 24. The example shown in the figure includes a body 101, a button 102, and an activation knob 105 that can function as in the single dose push button devices described above. The nozzle end of device 100 includes a rotatable tip 110. The device body includes an arrow or other mark as a position indicator 103 and the rotatable tip includes indicators for a first position 111 and a second position 112. The numbers 1 and 2 can be used for the first and second positions, respectively, as in the example shown, but it is understood that any other numbers, symbols, letters, or even colors could be used to indicate the correct alignment of the rotatable tip for administration of each of the two half doses. The tip 110, which is a hollow cylinder includes an internal shoulder 114 proximate the edge that adjoins the body of the device, and further includes one or more channels 113. In the example shown there are 2 channels disposed in 180° opposition along the length of the tip, but various numbers of channels and configurations are also contemplated. Rotating the tip 110 in the direction of the arrow moves the internal channels 113 to a predetermined position, the top and bottom positions inside the tip in the example shown in the figures. Fig. 24 shows the device with the rotatable tip in the first position and Fig. 26 shows the device with the rotatable tip in the second position.
Fig. 32 illustrates an embodiment of a dual medication blister 140. In some cases it is desirable to mix two medications just before dispensing. Some examples of such applications is the use of a freeze-dried active agent that is re-hydrated in the blister just prior to administration. Other examples are drugs that are unstable in the solvent or carrier that could be stored separately until just prior to dispensing, salicylic acid or aspirin is one such drug that is unstable in saline and could be stored in dry form and mixed in the blister prior to dispensing. The blister 140 includes a central chamber 141 and a surrounding chamber 142. The central chamber contains the first medication and may be of a powder of liquid form. The surrounding chamber, which is an annular, or doughnut shaped chamber, contains a second liquid medication or activating ingredient. The flexible skin 143 of the central chamber is formed in an inverted manner allowing it to expand or pop out to a larger volume. The seal 144 between the two chambers is of a light adhesion such that it can be separated without damaging the skin material and without separating the outer seal 145. The plunger mechanism has two stages. The outer plunger 151 can advance independently of the inner plunger 152.
Fig. 33 shows the mixing stage of the device 140. The outer plunger 151 is forced forward compressing the surrounding chamber 142. The pressure of the liquid in the surrounding chamber 142 forces the seal 144 between the chambers to release and permits the liquid of chamber 142 to flow into the central chamber 141 mixing with the first medication. Fig. 34 shows the device when the outer plunger is completely depressed. The outer chamber is completely collapsed and the liquid from that chamber has flowed into the central chamber 141 producing the mixture 146. The skin 143 of the central chamber 141 has popped out to accept the larger volume of the mixture 146. The inner plunger 152 can now be driven into the blister 140 in a manner similar to the devices previously described, thus dispensing the mixed medication through the piercing nozzle 70.
In certain embodiments, mixing of two separate compositions just before dispensing can be accomplished with the device shown in Fig. 35. This example uses a strip of blisters 160 that include an inverted blister 161 containing a first medication and a second blister 162 containing a liquid medication or activating ingredient. The blisters 161 and 162 are joined by a weak adhesive seal 163. The drive wheel 167 is connected to the cog wheel 165 by gears or other structures with similar function such that they turn together and advance the strip 160 between them. The base 168 supports the strip 160 and holds a piercing tip 169 under a plunger mechanism 170.
Fig. 36 shows the mechanism in the mixing step. The cog 166 of the cog wheel 165 has crushed the blister 162 containing the second medication or activating ingredient forcing the seal 163 to separate and the second medication or activating ingredient to flow into the first blister 161, popping it up to hold the volume of both blisters. Fig. 37 shows the strip with the mixed medication blister 161 advancing into the dispensing position under the plunger mechanism 170.
As shown in Fig. 38, the plunger 171 is activated by mechanisms as described herein, collapsing the blister 161 and dispensing the medication. The cog wheel 165 is positioned to compress the next blister 162, thus mixing the medications and move the next mixture under the plunger mechanism 170.
There are occasions when it is desirable to introduce medication to both sides of the nose or nostrils. It may be preferred to introduce the medication or medications simultaneously or sequentially. Additionally, each nostril may receive the same medication, or a different medication may be delivered to each side.
A preferred embodiment of a marking tip assembly 600 is shown in cross- section in Fig. 63. The assembly shown in the Figure is designed to be used as a disposable tip containing a dosage form. The assembly includes a cap 610, a dispensing tip 620, a dosage form 630 and an ink pad 640. The cap 610 forms a seal against the dispensing tip 620 along area 611 preventing the ink from drying prior to use. The dispensing tip 620 contains bayonet receptacles 621 for mating to a dispensing device 650 (shown in Fig. 65). The marking tip assembly of Fig. 63 is shown in perspective view in Fig. 64. In this view, the ears 612 are more clearly seen. These ears are useful for twisting the assembly in order to engage the bayonet receptacles 621 with the tabs 652.
Fig. 65 illustrates how the marking tip assembly 600 is installed on a dispensing device 650. The marking tip assembly 600 is placed on a protrusion 651 on the dispensing device 650 with bayonet receptacles aligned with tabs 652. When properly aligned the assembly is pressed down and twisted as shown by the arrows. The twist first locks the tip 620 to the dispensing device 650 and a further twist releases the cap 610 from the tip 620.
Fig. 66 shows the device ready to dispense with tip 620 in place on the dispensing device 650 and the cap removed. When the cap 610 is removed from the tip 620, the discharge opening 623 and the ink pad 640 are exposed. When the tip 620 is inserted into the patient's nostril, the ink pad 640 makes contact with the external rim of the nostril, leaving a mark.