Technical Field
[0001] The present invention relates to drug delivery devices, and in particular to an intradermal
drug delivery device for delivering a liquid drug to a subject
via the subject's skin.
Background Art
[0002] One type of transdermal drug delivery device is in the form of a patch applied to
the subject's skin and containing drug penetrating the skin by osmosis and/or by a
controlled mass transport phenomenon such as iontophoresis. Simple patches, however,
provide no control, or limited control, of the rate of drug delivery, which depends
on skin conditions, the nature (particularly molecular size) of the drug to be delivered,
and the like. Iontophoretic devices are also not entirely satisfactory in their ability
to deliver large molecules and to control the rate of delivery thereof. All such devices
are limited by the barrier function of the skin.
[0003] Another transdermal drug delivery device is described in International Patent Publication
WO 93/17754. In one embodiment this device comprises a housing containing a liquid
reservoir and a drug delivery body carried by the housing and engageable with the
subject's skin. The drug delivery body carries a plurality of hollow needles ( of
which there are preferably at least fifty) having an outer diameter of the order of
1 mm, which needles are designed to pierce the outer layer of dead cells (the
stratum corneum) of the skin, thereby enhancing the penetration of the drug through the skin.
[0004] However, certain disadvantages are associated with this method of drug delivery.
Firstly, there is a risk of considerable pain and traumatisation of the skin associated
with the application of the particular array of needles. Secondly, the drug may leak
out around the entry point of each needle as a result of the pressure being applied
to assist the delivery of the drug. A film of liquid drug covering the area of application
may cause irritation for subjects with sensitive skin; certain drugs may aggravate
this irritation. The leakage also results in a lower efficiency of drug delivery.
Thirdly, it can be difficult to ensure that the device is correctly applied with the
tips of the needles penetrating the
strateum corneum. The skin has a natural resilience and elasticity. The device is pressed onto the
skin such that the entire area of the needle arrangement depresses the surface of
the skin, even when considerable pressure is applied. For this reason, an extra degree
of pain is associated with the correct application of the device due to the amount
of force needed to properly pierce the
stratum corneum with all of the needles.
[0005] A further transdermal drug delivery device is described in International Publication
WO-A-89/12473. WO-A-89/12473 describes a disposable syringe comprising a housing containing
a drug ampoule with a hypodermic needle attached thereto. The drug ampoule is movable
within the housing such that the needle may be pushed into the skin of a subject for
subcutaneous delivery of the drug, the drug being pushed out of the ampoule by a piston
arrangement.
Disclosure of Invention
[0006] According to the present invention, there is provided an intradermal drug delivery
device for delivering at least one liquid drug to a subject
via the subject's skin, comprising a housing having a lower surface for application to
the skin of the subject; means for affixing the housing in position with the lower
surface in contact with the subject's skin; a drug reservoir within the housing; means
for actively discharging the drug from the reservoir to the subject's skin, needle
means associated with the drug reservoir extending through the lower surface, having
an inner end communicating with the drug reservoir and an outer end projecting outwards
a sufficient distance so as to penetrate through the epidermis and into the dermis
when the housing is pressed against the skin, characterised in that the drug is discharged
from the reservoir
via a single hollow needle which constitutes the said needle means, said single hollow
needle being fixed in relation to the housing and having an outer diameter of 0.5mm
or less.
[0007] Preferably, the housing further comprises a cover mounting means attached thereto,
a protective displaceable cover having an upper surface and a lower surface, forming
the lower surface of the housing facing the skin of the subject, the cover being capable
of being extendibly and retractably engaged in the cover mounting means such that
the cover is positioned substantially parallel to the housing and such that the outer
end of the hollow needle projects outwards a sufficient distance so as to extend no
further than the upper surface of the cover when the cover is extended and so as to
penetrate through the epidermis and into the dermis when the cover is affixed to the
subject's skin and retracted.
[0008] According to the preferred embodiments described below the lower surface of the housing
is shaped such that when it is pressed against the skin, a substantial proportion
of the pressure applied to the skin is directed through the needle tip.
[0009] According to the preferred embodiments described below, the needle projects outwardly
of the housing or, if the device has a protective displaceable cover, outwardly of
the protective displaceable cover when the device is affixed to the subject approximately
0.3-5.0 mm, more preferably 0.3-3.0 mm, most preferably 0.3-1.0 mm, and has an outer
diameter of 0.075-0.5 mm, most preferably 0.1-0.2 mm and an inner diameter of 0.05-0.3
mm, more preferably 0.05-0.15 mm, most preferably 0.05-0.075 mm.
[0010] As will be described more particularly below, such an intradermal drug delivery device
permits the delivery of a variety of drugs including drugs of relatively large molecular
size, and at slow rates which can be precisely controlled.
[0011] According to further features of the invention described below, the drug reservoir
may be an expansible-contractible chamber which is expanded upon being filled with
the drug and is contracted to dispense the drug therefrom at controlled rates by the
means for actively discharging the drug. These means can include an electrically-controlled
gas generator, such as an electrolytic cell, a prestressed spring or membrane, or
osmotic means to provide for osmosis between a pure water compartment and a saline
compartment included within the housing.
[0012] According to another aspect of the invention, there is provided a drug delivery device
having a plurality of drug reservoirs within the housing, all drug reservoirs communicating
with an outlet cavity with which the single hollow needle also communicates, and means
such as electrical means for individually controlling the feeding of drug from the
plurality of reservoirs to the outlet cavity.
[0013] According to further features of the invention described below, the housing can comprise
at least two parts: (1) an electronic control unit for controlling the discharge of
the drug from the drug reservoir, such as providing for preprogrammed continuous administration
of the drug, fully programmable continuous, pulsatile or intermittent administration
of the drug and/or patient controlled administration of the drug and (2) a disposable
cartridge unit for housing the drug reservoir or reservoirs and/or the means for actively
discharging the drug from the reservoir to the subject's skin.
[0014] Further features and advantages of the invention will be apparent from the description
below.
Brief Description of Drawings
[0015] The invention is herein described, by way of example only, with reference to the
accompanying drawings, wherein:
Fig. 1 illustrates one form of an intradermal drug delivery device constructed in
accordance with the present invention;
Fig. 2 is a side elevational view of the device of Fig. 1;
Fig. 3 is an enlarged longitudinal sectional view of the device of Fig. 1;
Fig. 4, 5 and 6 are longitudinal sectional view illustrating other intradermal drug
delivery devices constructed in accordance with the invention;
Fig. 7 is a diagrammatic view illustrating a multi-reservoir intradermal drug delivery
device in accordance with the invention;
Fig. 8 is a top plan view more particularly illustrating the internal structure of
the device of Fig. 7;
Fig. 9 is a view corresponding to that of Fig. 8, but showing a modification wherein
the drug reservoirs are connected in parallel with the outlet cavity rather than in
series as in Fig. 8;
Figs. 10 and 11 illustrate two further variations in the construction of the device;
Fig. 12 illustrates a form of the intradermal drug delivery device having a protective
displaceable cover constructed in accordance with the present invention;
Figs. 13 and 14 are side elevational views of the device of Fig. 12 in which the protective
displaceable cover is extended and retracted, respectively;
Fig. 15 is an enlarged longitudinal sectional view of the device of Fig. 12 in which
the protective displaceable cover is retracted;
Fig. 16 is an enlarged longitudinal sectional view illustrating the disposable cartridge
unit of a two-part intradermal drug delivery device constructed in accordance with
the present invention;
Figs. 17(a)-(c) are longitudinal sectional views illustrating electronic control units
of a two-part intradermal drug delivery device constructed in accordance with the
present invention which provide for fully programmable delivery, patient activated
delivery and continuous delivery, respectively;
Fig. 18 is a longitudinal sectional view illustrating the disposable cartridge unit
of a two-part intradermal drug delivery device constructed in accordance with the
present invention;
Figs. 19 and 20 show delivery characteristics of insulin and salmon calcitonin, respectively,
from a device constructed in accordance with the invention; and
Fig. 21 shows an enlarged longitudinal sectional view of the drug delivery device
of Fig. 12 illustrating a drug injection port.
[0016] The device according to the invention overcomes the disadvantages indicated above
for the following reasons: Firstly, since only a single needle is generally used,
only a single point of entry is associated with the application of the device, eliminating
most of the pain and trauma resulting from the application of the device. In addition,
the extremely narrow diameter of the single needle allows the application to be virtually
painless and minimally invasive.
[0017] Secondly, the amount of leakage is diminished to a very large extent, if not totally.
The delivery is far more controlled as a result. The leakage is reduced for two reasons:
(i) the drug is delivered below the epidermis (and not just to below the
strateum corneum); and (ii) only a single point exists at which leakage might occur.
[0018] Thirdly, the shape of the lower surface results in a substantial proportion of the
pressure being directed through the needle tip. If the device is not correctly shaped,
too much pressure may be directed through the lower surface so that the skin is stretched
by the surface of the device and not the needle. According to the invention, the needle
must provide sufficient pressure to stretch and pierce the epidermis, i.e., the elasticity
of the skin must be directed against the needle. It should be noted that the effective
pressure (force applied to the housing
per unit area of skin contact) is, for a given force, far higher for the device according
to the invention, since the effective area of application is diminished approximately
fifty-fold when only one needle is applied as opposed to 50 needles, and is further
reduced as a result of the narrow diameter needle used.
[0019] The protective displaceable cover not only protects the needle from damage when the
device is not in use but also provides for a safer device in that the needle extends
beyond the cover only when the device is in use. Thus, accidental contact with the
needle is minimised. Additionally, the displaceable protective cover can be movably
positioned so as to allow the needle to project outward from the cover to a preselected
multiplicity of different lengths. In this manner, the depth of penetration of the
needle can be easily varied to accommodate administration of the device to different
parts of the body of the subject or to different thicknesses of skin.
[0020] Embodiments having a disposable cartridge unit and a reusable electronic control
unit have the advantage of providing reuse of the relatively expensive and/or long-lasting
electronic control unit part. The disposable (and replaceable) cartridge unit contains
those elements that are exhausted relatively quickly such as the drug or drugs and/or
the means for actively discharging the drug from the reservoir to the subject.
[0021] Since the intradermal device of this invention delivers the drug below the epidermis,
i.e., to the interface between the epidermis and the dermis or to the interior of
the dermis or subcutaneously, many of the problems of transdermal application are
non-existent; the drug is delivered directly to a capillary-containing tissue and
has no barriers to pass through before entering the vascular system.
[0022] Preferably, the means for holding the housing or, if the device has a protective
displaceable cover, the protective displaceable cover in position comprises a pressure-adhesive
coating, such as an acrylate adhesive, on the lower surface thereof. When the device
is pressed against the skin, the needle penetrates the epidermis and the pressure-adhesive
coating affixes the lower surface to the skin. A single-step, painless and trauma-free
application is thus provided by the invention. Additionally or alternatively, the
device may be held in position by a strap or bracelet.
[0023] According to one embodiment of the invention, the lower surface of the housing or,
if the device has a protective displaceable cover, the protective displaceable cover
has a convex shape and the hollow needle extends from (or through) the centre of the
convexity. Alternatively, the lower surface of the housing (or the lower surface of
the protective displaceable cover) is provided with a protuberance from which the
needle projects. In a further alternative, the lower surface of the housing or cover
is of a conical shape and the hollow needle extends from the apex of the cone. In
a further embodiment, the lower surface of the housing or cover can have a convex
shape and also be provided with a protuberance from which the needle projects.
[0024] When the device does not have a protective displaceable cover, the needle is positioned
to engage the skin directly so that it pierces the skin before a large part of the
surface has made contact. In effect, parts of the surface distal from the needle is
held back from the skin as a consequence of the shape of the lower surface. For this
reason, much of the pressure which might have been applied by the surface of a flat
device is instead directed through the needle tip.
[0025] The device may however have a flat surface provided that the size of the device or
the shape and elasticity of the skin to which the device is to be applied enables
a substantial portion of the pressure to be directed through the needle tip.
[0026] Preferably, the needle projects outward of the housing or, if the device has a protective
displaceable cover, outward of the protective displaceable cover when the device is
affixed to the subject by approximately 0.3 to 5.0 mm, more preferably 0.3-3.0 mm,
most preferably 0.3-1.0 mm, and has an outer diameter of 0.075-0.5 mm, most preferably
0.1-0.2 mm and an inner diameter of 0.05-0.3 mm, more preferably 0.05-0.15 mm, most
preferably 0.05-0.075 mm. Such a needle is relatively painless to apply, causes little
or no trauma to the skin and yet allows precisely controllable delivery of a liquid
drug, including drugs of relatively large molecular size.
[0027] Preferably, the reservoir is in the form of an expansible-contractible chamber which
is expanded when filled with the drug and which can be contracted to dispense the
drug therefrom.
[0028] Further, preferably, the drug reservoir, when filled, has a volume of 0.2-10.0 ml
or larger, more preferably 0.3-6.0 ml, most preferably 0.5 to 3.0 ml.
[0029] Further, preferably, the means for actively discharging the drug comprises an electrically
controlled gas generator within the housing for generating a gas to contract the drug
reservoir in order to discharge the drug therefrom.
[0030] Such an intradermal delivery device provides precise control over the rate of delivery
of the drug; in particular, it allows the drug to be delivered at precisely controllable
slow rates. The use of a narrow needle is also advantageous for achieving slow rates
of delivery, while still allowing the delivery of a variety of drugs, including those
of relatively large molecular size.
[0031] Suitably, the gas generator is an electrolytic cell. In a preferred embodiment of
the invention, the device further comprises a start button which is depressible in
order to activate the means for actively discharging the drug from the drug reservoir,
such as a start button which energizes a gas generator. Thus, the device may be supplied
and stored for an indefinite period of time and yet be immediately activated when
required.
[0032] Suitably, the device comprises an electronic circuit for controlling the time and
rate of gas generation, thereby controlling the discharge of the drug from the drug
reservoir. Preferably, the electronic circuit comprises a microprocessor which is
programmable with respect to the time and rate of gas generation. For instance, the
microprocessor can be programmed to deliver the liquid drug in a continuous infusion
(constant or variable rate), in a pulsatile manner or in intermittent doses as well
as in response to input from the subject, such as patient controlled analgesia.
[0033] It is thus possible to choose or devise a dosage regime which will suit the requirement
both of the individual patient and of the drug to be delivered. For example, the device
may comprise a microprocessor which controls the delivery such that the rate of delivery
is varied during a 24 hour cycle as is necessary due to the differing requirements
of drug dosage during period of activity, inactivity and sleep, and taking account
of the subject's requirements in relation to food intake.
[0034] Alternatively, the subject might be provided with separate daytime and nighttime
devices, each having a different electronic circuit for controlling the time and rate
of drug delivery.
[0035] It may be desirable to automatically deliver certain drugs only when required by
the subject, either by patient activation or passively, such as by a feedback mechanism.
In such a case, there is provided a device wherein the housing further includes a
sensor (feedback) for detecting a condition in the body of the subject and for controlling
the delivery of the drug in response thereto. The sensor may be, for example, a temperature
sensor, a pulse rate sensor, a blood glucose sensor, a blood pressure sensor or a
pH sensor.
[0036] Thus, where a device is intended to deliver a fever-reducing drug, for example, it
might be provided with a temperature sensor such that a detected increase in body
temperature above a certain value would activate the drug delivery or increase the
rate of drug delivery.
[0037] The sensor may rest against the skin, may be inserted through the skin, or may be
within the device and separate from the skin.
[0038] According to one embodiment of the invention, the housing includes a plurality of
drug reservoirs, each reservoir being contractible by a separate gas generator and
communicating with an outlet cavity with which the single hollow needle also communicates.
In one such embodiment, all of the drug reservoirs communicate in series with the
outlet cavity. In an alternative embodiment, all of the drug reservoirs communicate
in parallel with the outlet cavity.
[0039] Including a plurality of drug reservoirs provides for considerable variations in
the amounts of drug which can be delivered, in the rates at which drug can be delivered
and in the number of drugs which can be delivered by the same device. The provision
of a plurality of reservoirs allows the device to be used in a range of situations
for which a single reservoir device would be unsuitable.
[0040] A preferred embodiment of a device which is to deliver more than one drug has a housing
which includes a plurality of drug reservoirs, each having a single hollow needle
associated therewith. Such a device is especially suitable when the drugs are not
suitable to mix with one another or when they are to be delivered separately or sequentially.
Additionally, a secondary drug which is capable of reducing local irritation or pain
caused by the hollow needle and/or the interaction of the primary drug with the skin
of the subject can be either co-administered with the primary drug from the instant
intradermal device or incorporated into the adhesive such that the secondary drug
is passively transdermally administered when the device is affixed to the skin of
the subject.
[0041] In an alternative embodiment of a device according to the invention wherein the reservoir
is in the form of an expansible-contractible chamber, the means for actively discharging
the drug comprises a spring which is stressed by the expansion of the drug reservoir
upon filling it with a drug, and which tends to return to its unstressed condition
to contract the reservoir and, thereby, to discharge the drug
via the hollow needle.
[0042] In another alternative embodiment wherein the reservoir is in the form of an expansible-contractible
chamber, the means for actively discharging the drug comprises a membrane which is
stressed by the expansion of the drug reservoir upon filling it with a drug, and which
tends to return to its unstressed condition to contract the reservoir and, thereby,
to discharge the drug
via the hollow needle.
[0043] Either of the last mentioned alternative embodiments provide for devices which can
be reusable when provided with means for refilling the drug reservoir. This refilling
may take place either upon removal of the device or
in situ.
[0044] In another alternative embodiment of the device according to the invention, the means
for actively discharging the drug comprises a deformable liquid-impermeable membrane
and a rigid liquid-permeable membrane; one side of the deformable liquid-impermeable
membrane defining one side of the drug reservoir; the opposite side of the deformable
liquid-permeable membrane and one side of the rigid liquid-permeable membrane defining
a saline reservoir for receiving a saline solution; the opposite side of the rigid
liquid-permeable membrane defining, with a rigid part of the housing, a pure water
reservoir for receiving pure water to expand the saline reservoir by osmosis, thereby
to contact the drug reservoir in order to dispense the drug therefrom
via the hollow needle.
[0045] Such a device provides for a predictable and continuous delivery of the liquid drug,
whose rate of delivery can be chosen according to the volume, concentration and nature
of the saline solution used, since the expansion of the saline reservoir (and thus
the contraction of the drug reservoir) depends on the osmotic pressure across the
membrane separating the pure water reservoir from the saline reservoir.
[0046] Preferably, the device further comprises a membrane which is permeable to the liquid
drug and impermeable to solid impurities, the membrane covering the inner end of the
hollow needle. The advantage of the membrane covering the inner end of the hollow
needle is to filter out solid particles to prevent clogging of the needle. Preferably,
the pore size of this membrane may range from 0.2 µm to 1.0 µm. Alternatively, particularly
when the drug to be administered is a protein or peptide, the interior surface of
the drug reservoir and/or hollow needle can be coated with a substance, such as a
silicone coating, to minimise precipitation of the drug and/or reduce interactions
(such as absorption) of the drug reservoir or needle with the administered drug.
[0047] The protective displaceable cover can be extendibly and retractably engaged in the
cover mounting means. For instance, when the device is not in use, the cover edges
or tabs extending from the cover can engage a first set of notches or cavities located
in the cover mounting means such that the cover is positioned substantially parallel
to the lower surface (surface that is closest to the subject's skin when in use) of
the housing but distal from the lower surface of the housing so that the needle extends
no further than the upper surface (surface that is furthest from the subject's skin
when in use) of the cover. Thus, when the device is not in use, the needle is generally
intermediate to and enclosed by the housing and the cover. As the device is pressed
to the skin of the subject, the protective displaceable cover is disengaged from the
first set of notches or cavities and moved so as to engage a second set of notches
or cavities located in the cover mounting means to position the cover substantially
parallel to the lower surface of the housing and proximal to the lower surface of
the housing. In this snap-action manner, the displaceable cover moves close to the
housing to allow the fixed hollow needle to extend through or past the cover mounting
means and penetrate through the epidermis and into the dermis of the subject. Alternatively,
the notches or cavities can be located in the protective displaceable cover and the
edges or tabs located in the cover mounting means.
[0048] An adhesive or other means for affixing the lower surface of the cover in contact
with the subject's skin holds the device in place during administration of the drug.
As the device is removed from the subject, the needle is extracted from the skin and,
due to the adhesive force of the adhesive, the protective displaceable cover moves
or snaps back to the first set of notches or cavities. Thus, the needle, which again
extends no further than the upper surface of the cover, is generally intermediate
to and enclosed by the housing and the cover.
[0049] The number of notches or cavities in the first and second sets (and the corresponding
tabs) can range from two to four or more notches or cavities, such as notches positioned
on opposite sides of the housing, to a continuous notch or cavity circumventing the
housing. Three notches or cavities spaced around a circular housing is a particularly
advantageous configuration. The protective displaceable cover can cover substantially
all of the lower surface of the housing or an area of the lower surface of the housing
immediately surrounding the single hollow needle.
[0050] Alternatively, the cover mounting means can comprise screw means located in the housing
which mate with screw means associated with the protective displaceable cover. Thus,
the protective displaceable cover can be movably positioned with respect to the housing
by screwing the protective displaceable cover onto the lower surface of the housing
either before, during or after the device is affixed to the skin of the subject. This
alternative embodiment has the advantage of maintaining a parallel alignment between
the cover mounting means and the protective displaceable cover, thus preventing unnecessary
sideways forces on the hollow needle.
[0051] Other means to movably attach the protective displaceable cover to the cover mounting
means can be employed, such as interlocking steps or mated slides with stops (in the
cover and the cover mounting means) in which the cover and cover mounting means are
held in juxtaposition by, for instance, springs.
[0052] Additionally, the displaceable protective cover can be extendibly and retractably
engaged in the cover mounting means so as to be capable of being positioned at a multiplicity
of depths relative to the housing to allow the needle to project outwards from the
cover to a multiplicity of different lengths. For instance, the displaceable protective
cover can engage a third set of notches or cavities located intermediate to the first
and second set of notches or cavities in the cover mounting means. In this manner,
the depth of penetration of the needle into the skin of the subject when the device
is in contact with the subject's skin can be easily varied to accommodate administration
of the device to different parts of the body of the subject or to different thicknesses
of skin.
[0053] The tip of the outer end of the single hollow needle can be cut at a bias, cut flat,
made conical or made inverse conical to enhance the penetration of the drug into the
skin of the subject. Furthermore, the outer end of the needle, whether cut at a bias,
made conical, made inverse conical or cut flat, may be closed at the outer end ; in
this case, an opening in the hollow needle exists within, for example, 2.0 mm of the
tip of the outer end of the single hollow needle to provide for delivery of the drug
from the reservoir to the subject's skin
via the needle. The inner end of the hollow needle may extend into the drug reservoir,
may be flush with the bottom surface of reservoir, may comprise a fluted funnel shape,
or otherwise be shaped to promote fluid flow of the drug from the reservoir through
the needle.
[0054] The present invention also encompasses a method of delivering a biologically effective
amount of a liquid drug intradermally to an animal subject, especially a human, comprising
the steps of: (1) affixing an intradermal drug delivery device as described above
to the skin of the subject, the drug delivery device having a lower surface for application
to the skin of the subject; means for affixing the device in position with the lower
surface in contact with the subject's skin; a drug reservoir within the device and
containing a biologically effective amount of at least one one liquid drug; a single
fixed hollow needle associated with the drug reservoir having an outer diameter of
0.5 mm or less, preferably 0.2 mm or less and extending through the lower surface
and having an inner end communicating with the drug reservoir and an outer end projecting
outwards a sufficient distance so as to penetrate through the epidermis and into the
dermis when the device is affixed to the skin; and means for actively discharging
at least one drug from the reservoir to the subject's skin
via the needle; and (2) activating the means for actively discharging at least one drug
to deliver a biologically effective amount of at least one drug to the subject.
[0055] As used herein, the term, "liquid drug", is meant to encompass any drug-containing
fluid capable of being passed through the hollow needle in a controlled manner, such
as a liquid, solution, gel or fine suspension. There is essentially no limitation
on the type of liquid drug which can be used with the invention other than to exclude
those liquid drugs which would be inappropriate to deliver to the subject intradermally
or subcutaneously. Representative drugs include peptides or proteins, hormones analgesics,
anti-migraine agents, anti-coagulant agents, anti-emetic agents, cardiovascular agents,
anti-hypertensive agents, narcotic antagonists, chelating agents, anti-anginal agents,
chemotherapy agents, sedatives, anti-neoplastics, prostaglandins and antidiuretic
agents.
[0056] 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 or γ interferon,
somatropin, somatotropin, somatostatin, insulin-like growth factor (somatomedins),
luteinizing hormone release 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, methodone, lidocaine, bupivacaine, diclofenac, naproxen,
paverin, and analogues thereof; anti-migraine agents such as sumatriptan, ergot alkaloids,
and analogues thereof; anti-coagulant agents such as heparin, hirudin, and analogues
thereof; anti-emetic agents such as scopolamine, ondanesetron, 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 the treatment of heart disorders, and analogues thereof;
sedatives such as benzodiazepines, phenothiozines, and analogues thereof; narcotic
antagonists such as naltrexone, naloxone, 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 5-fluorouracil, bleomycin, and analogues
thereof; prostaglandins and analogues thereof; and chemotherapy agents such as vincristine,
and analogues thereof.
The Embodiment of Figs. 1-3
[0057] The intradermal drug delivery device illustrated in Figs. 1-3 includes a housing
2 of disc or cylindrical configuration having a flat lower surface 4 coated with a
pressure-sensitive adhesive 6 for adhering the housing to the skin of the subject
to receive the drug. The interior of housing 2 includes a flexible liquid-impermeable
membrane 8 defining an expansible-contractible chamber 10 between it and the lower
section 2a of housing 2, and a second expansible-contractible chamber 12 between it
and the upper section 2b of the housing. Chamber 10 serves as a reservoir for receiving
the drug to be delivered, whereas chamber 12 serves as a gas chamber for controlling
the delivery of the drug from the reservoir 10.
[0058] A hollow needle 14 extends through the housing section 2a. The inner end of needle
14 communicates with the drug reservoir 10, whereas the outer end of the needle projects
outwardly of the flat surface 4 of the housing a short distance so as to penetrate
the epidermis of the subject's skin when the housing is applied and adhered thereto.
Preferably, hollow needle 14 projects outwardly of the flat surface 4 a distance of
0.3-1.0 mm, just sufficient to penetrate through the epidermis of the subject's skin.
The outer diameter of the needle is preferably from 0.1-0.2 mm and its inner diameter
is preferably from 0.05.-0.075 mm. These dimensions permit a slow, precisely-controllable
delivery of drug from the drug reservoir 10. The inner end of the hollow needle 14
may be covered by a filter membrane to prevent clogging particles from entering the
needle.
[0059] The rate and time of delivery of the drug is controlled by a gas-generator 16 within
the gas compartment 12. Preferably, gas generator 16 is an electrolytic cell energised
by a battery 18 and controlled by a microprocessor 20 when actuated by a START button
22 mounted on housing section 2b.
[0060] Housing section 2a further includes an injection plug 24 which may be pierced by
a syringe needle, for example, in order to fill reservoir 10 with the drug to be dispensed.
In addition, the adhesive coating 6 on the flat lower surface 4 of the housing section
2a is normally covered by a protective strip 26 (Fig. 2) which is peeled away when
the device is to be used. Protective strip 26 preferably includes a tab extension
27 (Fig. 1) to facilitate removing the strip.
[0061] Optionally, housing section 2a further includes a sensor 28 flush with surface 4
so as to be pressed against the skin of the subject when the device is applied to
the subject and held by the adhesive coating 6. For instance, sensor 28 may be a temperature
sensor for sensing the temperature of the subject and for controlling microprocessor
20, and thereby the dispensing of the drug, in response to the subject's temperature.
Sensor 28 may be a pulse rate sensor for sensing the pulse rate of a subject and for
controlling,
via processor 20, the dispensing of the drug in response thereto.
[0062] It will be seen that the device illustrated in Figs. 1-3 may be used in the following
manner.
[0063] Drug compartment 10 is filled with the drug to be dispensed by injecting same
via a syringe needle through the injection plug 24, thereby expanding the drug reservoir
10, e.g., to the full-line position shown in Fig. 3. Microprocessor 20 is preprogrammed
according to the desired time and rate of delivery of the drug. Protective strip 26
is removed to expose the hollow needle 14, and the device is then pressed against
the subject's skin such that the needle 14 penetrates only through the epidermis.
The adhesive coating 6 firmly adheres the device to the subject's skin.
[0064] When the delivery is to start, the START button 22 is depressed. This energises the
electrolytic cell 16 to generate a gas under the control of microprocessor 20. This
increases the pressure within gas chamber 12, thereby deforming membrane 8 to contract
the drug chamber 10, to feed the drug from chamber 10 to the subject
via the hollow needle 14 at a rate dependent on the rate of generation of the gas by
the gas generator 16. This rate is controlled by the microprocessor 20.
[0065] The sensor 28 senses a predetermined condition of the subject and controls the delivery
of the drug from reservoir 10 in accordance therewith. For example, sensor 28 may
be a temperature sensor, for controlling the delivery of a fever-reducing drug; alternatively,
it could be a pulse rate sensor or a blood pressure sensor for controlling the delivery
of a drug appropriate to the sensed condition.
The Embodiment of Fig. 4
[0066] Fig. 4 illustrates a similar device to that illustrated in Figs. 1-3, and therefore
corresponding parts have been identified by the same reference numbers. In the construction
illustrated in Fig. 4, however, the drug reservoir 10 is contracted to feed the drug
via the hollow needle 14, not by a gas generator as in Figs. 1-3, but rather by a spring
30 included in compartment 12 between the diaphragm 8 and the housing section 2b.
The latter section is formed with an atmospheric vent 32.
[0067] The device illustrated in Fig. 4 is used in the same manner as described above with
respect to Figs. 1-3, except that, instead of effecting the delivery of the drug by
means of a gas generator under the control of a microprocessor as in Figs. 1-3, the
delivery of the drug is effected by spring 30 which is pre-stressed upon introducing
the drug into reservoir 10
via the injection plug 24.
The Embodiment of Fig. 5
[0068] The device illustrated in Fig. 5 is similar to that illustrated in Fig. 4, and therefore
its corresponding parts are identified by the same reference numbers. In the device
of Fig. 5, however, instead of including a spring (30) which is stressed upon filling
the chamber 10 with the drug, the diaphragm 8 is made of an elastic material which
is pre-stressed when so filling the drug chamber, and thereby effects the delivery
of the drug
via the hollow needle 14.
The Embodiment of Fig. 6
[0069] Fig. 6 illustrates another device similar to those described earlier, and therefore
the corresponding parts are also identified by the same reference numerals. In this
case, however, the housing 2 includes not only the deformable liquid-impermeable membrane
8, but also a rigid liquid-permeable membrane 40. Thus, one side of the impermeable
membrane 8 defines with housing section 2a the drug reservoir 10, whereas the other
side of membrane 8 defines, with one side of the rigid liquid permeable membrane 40,
a saline chamber 42. The other side of the permeable membrane 40 defines with housing
section 2b a pure water chamber 44. Drug reservoir 10 may be filled as described above
via the injection plug 24. The saline chamber 42 may be filled
via another injection plug 46, and the pure water chamber 44 may be filled
via another injection plug 48.
[0070] It will be seen that when the three chambers 10, 42 and 44 are filled as described
above, water from chamber 44 will permeate by osmosis through membrane 40 into the
saline chamber 42, thereby expanding the chamber and contracting the drug reservoir
10, forcing the drug out through the hollow needle 14.
The Embodiment of Figs. 7 and 8
[0071] Figs. 7 and 8 illustrate a device similar to that illustrated in Figs. 1-3, except
that the device includes a plurality of separate drug reservoirs 50 (six being shown
in Fig. 8 for example), each individually controlled by a gas generator 52. All the
drug reservoirs are connected in series
via conduits 54 to a central outlet cavity 56 with which the hollow needle 58 communicates.
An injection plug 60 may be used for filling all the reservoirs 50 in series.
[0072] Each of the gas generators 52 is a separate electrolytic cell including a pair of
electrodes 52a, 52b for applying electrical current to an electrolyte within the cell,
thereby generating a gas within the cell corresponding to the electrical current applied.
The so-generated gas is applied to the gas chamber of its respective drug reservoir
50, i.e. between a displaceable diaphragm 50a (Fig. 7) and a rigid cover 50b, to thereby
contract the drug reservoir and to feed its drug
via its conduit 54 to the outlet cavity 56, which is in communication with the injection
needle 58.
[0073] The electrolytic cells 52 are energised by a battery 62 (Fig. 7) under the control
of a microprocessor 64
via electrical conductors 66 carried by a printed circuit board 68 connected to the electrodes
52a, 52b of each electrolytic cell.
[0074] It will be seen that including a plurality of drug reservoirs 50 each separately
controllable by its own gas generator 52, enables the device to be controlled to provide
a wide range of dispensing rates. The series connections of the drug reservoirs with
the outlet cavity 56, which is in communication with the injection needle 58 permits
the device to be conveniently primed by injecting the drug
via injection plug 60 into all the reservoir in series until the drug begins to discharge
through the needle.
The Embodiment of Fig. 9
[0075] Fig. 9 illustrates a variation in the construction of the device of Figs. 7 and 8,
in that the plurality of drug reservoirs, therein designated 150, are connected,
via their respective conduits 154, to the outlet cavity 156, which is in communication
with the injection needle 158. As in the device of Figs. 7 and 8, the device of Fig.
9 is also provided with a separate gas generator 152, e.g., an electrolytic cell,
for each of the plurality of drug reservoirs 150. Each reservoir is separately filled
via its own injection plug 160.
[0076] It will be seen that the device illustrated in Fig. 9 permits the delivery of a single
drug, or a mixture of drugs, all under the control of the microprocessor (e.g., 64,
Fig. 7). Thus, if a large quantity of drug is to be delivered, the microprocessor
could be preprogrammed to energise a plurality of the electrolytic cells 152 at one
time; and if two or more drugs are to be simultaneously delivered, the various reservoirs
150 would be filled with the respective drugs and dispensed as required under the
control of the microprocessor.
The Embodiments of Figs. 10 and 11
[0077] While in the above-described embodiments, the lower surface of the housing (e.g.,
4) is flat, Figs. 10 and 11 illustrate variations in this construction. Thus, Fig
10 illustrates the housing 102 having a housing section 102a of convex configuration
on the lower surface 104 and coated with the pressure-sensitive adhesive 106. A diaphragm
108 divides the interior of the housing into a drug reservoir 110 and a gas chamber
112 containing an electrolytic cell gas generator 116. The hollow needle 114 extends
through the centre of the lower surface 104 of the housing, and is dimensioned as
described above to penetrate through the epidermis of the subject's skin. Fig. 11
illustrates a similar construction, where a diaphragm 208 divides the interior of
the housing into a drug reservoir 210 and a gas chamber 212 containing an electrolytic
cell gas generator 216, except that the housing section 202a of the housing 202 is
formed with a central projection 202c on the lower surface 204 thereof, through which
the hollow needle 214 extends.
[0078] The constructions of Figs. 10 and 11 counteract the natural resilience or stretching
of the skin when the device is applied, so as to achieve penetration of the epidermis
by the needle. The use of a narrow diameter hollow needle minimises trauma, minimises
leakage and better ensures more controlled delivery.
The Embodiment of Figs. 12-15 and Fig. 21
[0079] The embodiments illustrated in Figs. 1-11 are designed to operate without a protective
displaceable cover. The present invention also provides for embodiments having a protective
displaceable cover. For instance, the intradermal drug delivery device illustrated
in Figs. 12-15 and Fig. 21 includes housing 301 (301a and 301b in Fig. 15 and Fig.
21) of approximately disc or cylindrical configuration and having a lower surface
308. Other convenient housing shapes, such as rectangular, hexagonal, ovoid, etc.
are also contemplated by the present invention. Protective displaceable cover 303
having an upper surface 304 and a lower surface 322 is attached to housing 301
via cover mounting means 307, which comprise a first set of notches or cavities 305 and
a second set of notches or cavities 306. The lower surface 322 of the protective displaceable
cover 303 is coated with a pressure-sensitive adhesive or doubled-sided adhesive 309
for affixing the cover 303 to the skin of the subject to receive the drug. Optional
release line 302, which is peeled away prior to application of the device to the subject,
projects the device prior to use.
[0080] The interior of housing 301 includes a flexible liquid-impermeable membrane 311 defining
an expansible-contractible drug reservoir 312 between it and the lower section 301b
of housing 301, and a second expansible-contractible electrolyte chamber 313 between
it and the upper section 301a of housing 301. Chamber 312 serves as a reservoir for
receiving the drug to be delivered, whereas chamber 313 serves as a gas chamber for
controlling the delivery of the drug from the reservoir 312.
[0081] Hollow needle 310 extends through housing section 301b. The inner end of needle 310
communicates with the drug reservoir 312, whereas the outer end of the needle projects
outwardly of the housing lower surface 308. When cover 303 is retracted (e.g., attached
via notches or cavities 306), hollow needle 310 extends outwardly of the lower surface
322 of the protective displaceable cover 303 a short distance so as to penetrate through
the epidermis and into the dermis when the cover 303 is affixed to the subject's skin.
Preferably, hollow needle 310 projects outwardly of the cover 303 a distance of approximately
0.3-5.0 mm, more preferably 0.3-3.0 mm, most preferably -0.3-1.0 mm, and has an outer
diameter of 0.075-0.5 mm, most preferably 0.1-0.2 mm and an inner diameter of 0.05-0.3
mm, more preferably 0.05-0.15 mm, most preferably 0.05-0.075 mm. These dimensions
permit a slow, precisely-controllable delivery of the drug from the drug reservoir
312. The inner end of hollow needle 310 may be covered by a filter membrane 320 to
prevent clogging from particles entering the needle. Optionally, the inner end of
hollow needle 310 may extend into reservoir 312, may be flush with the bottom surface
of reservoir 312, may comprise a fluted funnel shape, or otherwise be shaped to promote
fluid flow of the drug from reservoir 312 through needle 310. The tip of the outer
end of single hollow needle 310 can be cut at a bias, cut flat, made conical or made
inverse conical or otherwise shaped to enhance the penetration of the drug into the
skin of the subject. Furthermore, the outer end of needle 310, whether cut at a bias,
made conical, made inverse conical or cut flat, may be closed at the outer end; in
this case, an opening in the hollow needle exists within, for example, 2.0 mm of the
tip of the outer end of the single hollow needle to provide for delivery of the drug
from the reservoir to the subject's skin
via the needle.
[0082] Optionally, diaphragm backing disc 314, e.g. a plastic disc, abuts diaphragm 311
to maintain a relatively parallel orientation between diaphragm 311 and lower housing
301b. Seal 315, e.g., a silicone elastomer, is multi-functional. For instance, seal
elastomer 315 seals gaseous electrolyte chamber 313 from the outside environment,
provides a housing for electrodes 316a and 316b, optionally comprises an injection
port 315b for injection of the electrolyte into the electrolyte chamber 313, and optionally
comprises occlusion switch diaphragm 315a, which upon occlusion in the path of drug
delivery or after the deliverable amount of drug has been delivered elevates contact
317, which disconnects contact 317 from contact/electronic circuit 318 to terminate
current supply from battery 319 to the electrolytic cell. Optional filter 320 prevents
small particles from entering and clogging needle 310. The rate and time of delivery
of the drug is controlled by the electrolytic cell energised by battery 319 when actuated
by the on/off switch (not shown in Figs. 12-15 and Fig. 21). Optionally, a microprocessor
(not shown in Figs. 12-15 and Fig. 21) can be included in the electronic circuit to
further control the rate and time of delivery of the drug.
[0083] Similar to Fig. 3, the at least one drug can be loaded into the device of Figs. 12-15
via a syringe needle, which may sealably pierce housing 301 or
via an injection port through housing 301. Fig. 21 illustrates one configuration for
a drug injection port. In this configuration, three pairs of notches or cavities 306
and 305 are spaced substantially equidistant around the circumference of housing 301b.
Opposite one pair of notches or cavities 306 and 305 is injection port 324, which
is plugged by plug 323, e.g., an elastomer plug. Drug reservoir 312 is filled with
the drug to be dispensed by injecting the drug
via a syringe needle through plug 323 and injection port 324 into drug reservoir 312.
For instance, to fill and prime the device, the device can be placed upside down so
that needle 310 is directed upwards and the drug can be injected into drug reservoir
312 with air venting from venting from needle 310. The convex shape of drug reservoir
312 promotes exhaustion of the air from the reservoir as drug is injected to prime
the device.
[0084] It will be seen that the device illustrated in Figs. 12-15 and Fig. 21 may be used
in the following manner. Drug reservoir 312 is filled with the drug to be dispensed,
thereby expanding the drug reservoir 312. Upon removal of the release liner 309, the
device is pressed against the subject's skin. As pressure is applied to housing 301,
the displaceable protective cover 303 moves by snap action from engagement in notches
or cavities 305 to notches or cavities 306 such that needle 310 penetrates through
the displaceable protective cover and through the subject's epidermis. The adhesive
309 firmly adheres the device to the subject's skin. Following actuation of the on/off
switch, the electrolytic cell is energised and produces a gas which increases the
pressure within electrolyte chamber 313, deforms membrane 311 to contract the drug
chamber 312 and feeds the drug from reservoir 312 to the subject
via the hollow needle 310. Confirmation that the device is delivering/has delivered the
at least one drug to the subject can be obtained by viewing the level of the electrolyte
in electrolyte chamber through optional transparent window 321. The amount of drug
that is delivered to the subject during a treatment period can be ascertained by visual
observation, particularly if a dye is incorporated into the electrolyte. Upon termination
of therapy, the device is removed from the subject. Application of force to remove
the device from the subject's skin (to separate the adhesive 309 from the skin) results
in the protective displaceable cover moving by snap action from engagement in notches
or cavities 306 to notches or cavities 305.
Best Mode for Carrying Out the Invention
The Embodiments of Figs. 16-18
[0085] The embodiments shown in Figs. 1-15 are designed to be wholly disposable. The present
invention also provides for two-part intradermal drug delivery devices in which the
electronic control unit (see Fig. 17) can be reused while the disposable cartridge
unit (see Figs. 16 and 18) is disposable and replaceable. The combination of the units
illustrated in Fig. 16 and Fig. 17 provides for a two-part device similar to the one-part
embodiments illustrated in Figs. 12-15 and Fig. 21 while the combination of the units
illustrated in Fig. 17 and Fig. 18 provides for a two-part device similar to the one-part
embodiments illustrated in Figs. 1-11.
[0086] Fig. 17 illustrates three basic models for the reusable electronic control unit according
to the present invention. Fig. 17(a) illustrates a fully programmable electronic control
unit having microprocessor 362 in electrical communication with push buttons 360 and
display 361, such as a liquid crystal display, as well as disposable cartridge contacts
363. This unit can be fully programmable with respect to the time and rate of gas
generation and allows for delivery of the liquid drug at a variety of delivery protocols,
including continuous infusion at a constant or variable rate, pulsatile or intermittent
delivery and delivery in response to input from the subject, such as patient controlled
analgesia. Similarly, Fig. 17(b) illustrates a patient controlled electronic control
unit having microcontroller 371 in electrical communication with push button 370 and
disposable cartridge contacts 372. This unit is particularly useful for use in patient
controlled analgesia. Likewise, Fig. 17(c) illustrates an electronic control unit
preprogrammed for continuous delivery having current controller 380 in electrical
communication with disposable cartridge contacts 381. The choice of the particular
electronic control unit determines the range of different electronic control features
available when an electronic control unit is combined with a disposable cartridge.
While on/off buttons can be incorporated in the electronic control units, activation
of the two-part embodiments formed from the combination of the units illustrated in
Figs. 16-18 is automatically accomplished by engaging a particular electronic control
unit with a disposable cartridge unit (engaging means not shown) so that contacts
350 or 400 are in electrical communication with contacts 363,372 or 381.
[0087] Fig. 16 illustrates a disposable cartridge unit according to the present invention
which incorporates all of the features found in the embodiments illustrated in Figs.
12-15 and Fig. 21 (including the presence of a protective displaceable cover) except
that (1) contacts/electronic circuit of Fig. 15 are replaced by contacts 351 of Fig.
16, (2) an on/off switch is not present in the disposable cartridge unit of Fig. 16
and (3), the disposable cartridge of Fig. 16 possesses multiple electronic control
unit contacts 350 which are capable of electrically contacting disposable cartridge
contacts 363, 372 or 381 of the electronic control units illustrated in Fig. 17(a),
(b) and (c), respectively, when the two units are engaged.
[0088] Similarly, the disposable cartridge unit of Fig. 18 is similar to the one-part devices
shown in Figs. 1-11. For instance, the disposable cartridge unit of Fig. 18 includes
a housing 405 having a lower surface 406 coated with a pressure-sensitive or double-sided
adhesive for adhering the housing to the skin of the subject to receive the drug.
The interior of housing 405 includes a flexible liquid-impermeable membrane 407 defining
an expansible-contractible drug reservoir chamber 403 between it and the lower section
of housing 405, and a second expansible-contractible electrolyte chamber 401 between
it and the upper section of housing 405. Chamber 403 serves as a reservoir for receiving
the drug to be delivered, whereas chamber 401 serves as a gas chamber for controlling
the delivery of the drug from the reservoir 403. Hollow needle 402 of Fig. 18 corresponds
to hollow needle 14 of Figs. 1-3 and battery 404 of Fig. 18 corresponds to battery
18 of Figs. 1-3. Similar to Fig. 16, electronic control unit contacts 400 are capable
of electrically contacting the disposable cartridge contacts 363, 372 or 381 of the
electronic control units illustrated in Fig. 17(a), (b) and (c), respectively, when
the two units are engaged.
Example 1
[0089] A device according to the present invention containing 0.6 ml of a solution of insulin
(100 I.U./ml) was affixed to each of two rabbits and the devices were switched on.
The insulin solution was infused at a rate of 0.1 ml/hour for two hours. As shown
in Fig. 19 blood glucose concentrations for these rabbits were measured at various
times following activation of the devices. At one hour, mean blood glucose concentration
had fallen from a control value of 6.25 mmol/l to 3.2 mmol/l. This value stayed relatively
constant at 1.5 hours following activation (2.65 mmol/l) and at 2 hours (2.5 mmol/l),
at which time the devices were removed. One hour later the mean value was 3.7 mmol/l,
which value continued to rise with time.
Example 2
[0090] A device according to the present invention containing 0.6 ml of a solution of salmon
calcitonin (1.0 mg/ml) was affixed to each of four rabbits. This solution was infused
at the rate of 0.1 ml/hour for 6 hours. Serum calcium concentrations were measured
via an ear vein at 0, 0.5, 1, 2, 3, 4, 5 and 6 hours following activation of the device,
at which point the device was removed. As shown in Fig. 20, mean calcium concentrations
fell steadily throughout the period of application and reached values representing
62.5% and 66.6% of the control values at 5 and 6 hours, respectively.
Example 3
[0091] Devices manufactured according to the present invention were used to study the delivery
of insulin, heparin and salmon calcitonin to New Zealand white rabbits weighing between
2.5 kg and 3.5 kg. Hair was removed from the dorsal surface of the animal using an
electric clipper twenty-fours prior to application of the device. Arterial blood samples
were withdrawn for determination of plasma concentration of drug through an indwelling
canula placed in the ear artery.
[0092] Diabetes was induced in test rabbits by administration intravenously of a 150 mg/kg
dose of alloxan (monohydrate) to fasted rabbits. The rabbits were provided with a
dextrose solution for three days after alloxan administration and after this time
normal diet was resumed. Test animals were maintained healthy with a commercial insulin
preparation prior to the study. The devices were attached to the rabbits and delivery
of insulin at a rate of 5 IU/h was commenced to normoglycaemic animals (for 3 hours)
and to diabetic animals (for 3.25 hours). Whole blood glucose concentrations were
measured using an Ames glucometer and plasma insulin concentration were measured using
a RIA method. Insulin administered in this fashion resulted in considerably increased
plasma insulin concentration in both normal (increased from approximately 25 fmol/ml
at time 0 to approximately 275 fmol/ml at time=3h) and diabetic animals (increased
from approximately 10 fmol/ml at time 0 to approximately 240 fmol/ml at time=3h).
A corresponding decrease in blood glucose concentration was observed for both normal
and diabetic animals.
[0093] To compare delivery of calcitonin using devices according to the present invention
to conventional delivery, 40 IU calcitonin was delivered to a rabbit over 2 hours
from a device according to the present invention and 20 IU calcitonin was delivered
by a conventional single subcutaneous injection. In a further study, calcitonin was
delivered at a rate of 25 IU/h and 100 IU/h for a period of 6 hours from devices according
to the present invention. Plasma concentrations of calcium were measured using a photometric
analysis while calcitonin concentrations were measured by an EIA method. Delivery
of calcitonin from devices according to the present invention was found to be dose
proportional and comparable to that from conventional routes.
[0094] Delivery of heparin from devices according to the present invention was studied by
administering heparin at a rate of 1000 IU/h for 5 hours. Plasma heparin was assayed
using an EIA method. Heparin was delivered significant anticoagulant amounts with
a pharmacokinetic profile similar to that of a conventional subcutaneous injection.
[0095] While the invention has been described with respect to several preferred embodiments,
it will be appreciated that these are set forth merely for purposes of example, and
that many other variations, modifications and application of the invention may be
made, within the scope of the claims.
1. An intradermal drug delivery device for delivering a liquid drug to a subject via the subject's skin, comprising a housing (2; 102; 202; 301; 301a, 301b; 405) having
a lower surface (4; 104; 322; 406) for application to the skin of the subject, means
(6; 106; 206; 309) for affixing the housing (2; 102; 202; 301; 301a, 301b; 405) in
position with the lower surface (4; 104; 322; 406) in contact with the subject's skin,
a drug reservoir (10; 50; 110; 150; 210; 312; 403) within the housing (2; 102; 202;
301; 301a, 301b; 405), means (8; 8, 16; 8, 30; 8, 40, 42, 44; 50a, 52; 108, 116; 152;
208, 216; 311, 316a, 316b; 407) for actively discharging the drug from the reservoir
(10; 50; 110; 150; 210; 312; 403) to the subject's skin, needle means (14; 58; 114;
158; 214; 310; 402) associated with the drug reservoir (10; 50; 110; 150; 210; 312;
403) extending through the lower surface (4; 104; 322; 406), having an inner end communicating
with the drug reservoir (10; 50; 110; 150; 210; 312; 403) and an outer end projecting
outwards a sufficient distance so as to penetrate through the epidermis and into the
dermis when the housing (2; 102; 202; 301; 301a, 301b; 405) is pressed against the
skin, characterised in that the drug is discharged from the reservoir (10; 50; 110; 150; 210; 312; 403) via a single hollow needle (14; 58; 114; 158; 214; 310; 402) which constitutes the said
needle means, said single hollow needle (14; 58; 114; 158; 214; 310; 402) being fixed
in relation to the housing (2; 102; 202; 301; 301a; 301b; 405) and having an outer
diameter of 0.5mm or less.
2. A device according to Claim 1, wherein the housing (301) further comprises a cover
mounting means (307) attached thereto, a protective displaceable cover (303) having
an upper surface (304) facing the housing and a lower surface (322), forming the lower
surface (322) of the housing facing the skin of the subject, the cover being capable
of being extendibly and retractably engaged in the cover mounting means (307) such
that the cover (303) is positioned substantially parallel to the housing (301), and
such that the outer end of the hollow needle (310) projects outwards a sufficient
distance so as to extend no further than the upper surface (304) of the cover (303)
when the cover (303) is extended and so as to penetrate through the epidermis and
into the dermis when the cover (303) is affixed to the subject's skin and retracted.
3. A device according to Claim 1 or 2, wherein the lower surface (4; 104; 322; 406) ofthe
housing (2; 102; 202; 301; 301a, 301b; 405) is shaped such that when it is pressed
against the skin a substantial proportion of the pressure applied to the skin is directed
through the tip of the needle (14; 58; 114; 158; 214; 310; 402).
4. A device according to Claim 3, wherein the shape of the lower surface (4; 104; 322;
406) of the housing is selected from a flat shape, a convex shape and the hollow needle
(14) extends from the centre of the convexity, a conical shape and the hollow needle
(214) extends from the apex of the cone, and a surface having a protuberance from
which the needle (310) projects.
5. A device according to any preceding claim, wherein the hollow needle (14; 58; 114;
158; 214; 310; 402) projects outwards from about 0.3 mm to 5.0 mm and has an outer
diameter from about 0.075 mm to 0.5 mm and an inner diameter from about 0.05 mm to
0.3 mm.
6. A device according to any preceding claim, wherein the drug reservoir (10; 50; 110;
150; 210; 312; 403) is in the form of an expansible-contractible chamber (10; 50;
110; 150; 210; 312; 403) which is expanded when filled with the drug and which can
be contracted to dispense the drug therefrom.
7. A device according to any preceding claim, wherein the means (8, 16; 50a, 52; 108,
116; 152; 208, 216; 311, 316a, 316b) for actively discharging the drug comprises an
electrically controlled gas generator (16; 52; 116; 152; 216; 316a, 316b) within the
housing for generating a gas to contract the drug reservoir (10; 50; 110; 210; 312)
in order to discharge the drug therefrom.
8. A device according to Claim 7, wherein the housing includes a plurality of drug reservoirs
(50, 150), each reservoir (50, 150) being contractible by a separate gas generator
(52, 152) and communicating with an outlet cavity (56, 156) with which the single
hollow needle (58, 158) also communicates.
9. A device according to Claim 8, further comprising means for individually controlling
the feeding of drug from the plurality of reservoirs (50, 150) of the outlet cavity
(56, 156).
10. A device according to Claim 1, wherein the housing includes a plurality of drug reservoirs,
each having a single hollow needle associated therewith.
11. A device according to any preceding claim, wherein the housing (2) further includes
a sensor (28) for detecting a condition in the body of the subject and for controlling
the delivery of the drug in response thereto.
12. A device according to Claim 10, wherein the sensor (28) is selected from a temperature
sensor, a pulse rate sensor, a blood glucose sensor, a blood pressure sensor and a
pH sensor.
13. A device according to any preceding claim, wherein the outer end of the hollow needle
is closed and the hollow needle has an opening within 2.9 mm of the outer end.
1. Gerät zum intrakutanen Verabreichen von Medikamenten zur Verabreichung eines flüssigen
Medikaments an eine Person über die Haut der Person, enthaltend ein Gehäuse (2; 102;
202; 301; 301a, 301b; 405) mit einer unteren Oberfläche (4; 104; 322; 406) zum Anlegen
an die Haut der Person, eine Vorrichtung (6; 106; 206; 309) zum Fixieren des Gehäuses
(2; 102; 202; 301; 301a, 301b; 405) in Position, wobei die untere Oberfläche (4; 104;
322; 406) in Kontakt mit der Haut der Person steht, ein Medikamenten-Behälter (10;
50; 110; 150; 210; 312; 403) innerhalb des Gehäuses (2; 102; 202; 301; 301a, 301b;
405), eine Vorrichtung (8; 8, 16; 8, 30; 8, 40, 42, 44; 50a, 52; 108, 116; 152; 208,
216; 311, 316a, 316b; 407) zum aktiven Ausstoßen des Medikaments aus dem Behälter
(10; 50; 110; 150; 210; 312; 403) auf die Haut der Person, eine Nadel-Vorrichtung
(14; 58; 114; 158; 214; 312; 402), die dem Medikamenten-Behälter (10; 50; 110; 210;
312; 403) zugeordnet ist und sich durch die untere Oberfläche (4; 104; 322; 406) erstreckt
und ein inneres Ende hat, das mit dem Medikamenten-Behälter (10; 50; 110; 150; 210;
312; 403) kommuniziert und ein äußeres Ende hat, das um eine ausreichende Distanz
nach außen ragt, um durch die Oberhaut in die Lederhaut einzudringen, wenn das Gehäuse
(2; 102; 202; 301; 301a, 301b; 405) gegen die Haut gepresst wird, dadurch gekennzeichnet, dass das Medikament aus dem Behälter (10; 50; 110; 150; 210; 312; 403) über eine einzelne
Hohlnadel (14; 58; 114; 158; 214; 310; 402) ausgestoßen wird, die die Nadel-Vorrichtung
bildet, wobei die einzelne Hohlnadel (14; 58; 114; 158; 214; 310; 402) in Beziehung
zum Gehäuse (2; 102; 202; 301; 301a, 301b; 405) fixiert ist und einen Außendurchmesser
von 0,5 mm oder weniger hat.
2. Gerät nach Anspruch 1, wobei das Gehäuse (301) außerdem eine Deckel-Befestigungsvorrichtung
(307) aufweist, die daran befestigt ist, einen abnehmbaren Schutzdeckel (303) mit
einer oberen Oberfläche (304), die dem Gehäuse zugewandt ist, und einer unteren Oberfläche
(322), die die untere Oberfläche (322) des Gehäuses bildet, die der Haut der Person
zugewandt ist, wobei der Deckel ausziehbar und rückstellbar in der Deckel-Befestigungsvorrichtung
(307) angebracht sein kann derart, dass der Deckel (303) im Wesentlichen parallel
zum Gehäuse (301) positioniert ist, und derart, dass das äußere Ende der Hohlnadel
(310) um eine ausreichende Distanz nach außen ragt, um sich nicht weiter als die obere
Oberfläche (304) des Deckels (303) zu erstrecken, wenn der Deckel (303) ausgezogen
ist, und um durch die Oberhaut in die Lederhaut einzudringen, wenn der Deckel (303)
an der Haut der Person fixiert und zurückgezogen ist.
3. Gerät nach Anspruch 1 oder 2, wobei die unter Oberfläche (4; 104; 322; 406) des Gehäuses
(2; 102; 202; 301; 301a, 301b; 405) derart geformt ist, dass, wenn sie gegen die Haut
gepresst wird, ein wesentlicher Teil des auf die Haut ausgeübten Druckes durch die
Spitze der Nadel (14; 58; 114; 158; 214; 310; 402) gerichtet ist.
4. Gerät nach Anspruch 3, wobei die Form der unteren Oberfläche (4; 104; 322; 406) des
Gehäuses ausgewählt ist aus einer flachen Form, einer konvexen Form, wobei die Hohlnadel
(14) vom Zentrum der Ausbauchung herausragt, und eine Oberfläche mit einem Vorsprung,
aus dem die Nadel (310) herausragt.
5. Gerät nach einem der vorhergehenden Ansprüche, wobei die Hohlnadel (14; 58; 114; 158;
214; 310; 402) um ungefähr 0,3 mm bis 5,0 mm nach außen ragt und einen Außendurchmesser
von ungefähr 0,075 mm bis 0,5 mm und einen Innendurchmesser von ungefähr 0,05 mm bis
0,3 mm hat.
6. Gerät nach einem der vorhergehenden Ansprüche, wobei der Medikamenten-Behälter (10;
50; 110; 150; 210; 312; 403) in der Form einer ausdehnbaren und zusammenziehbaren
Kammer (10; 50; 110; 150; 210; 312; 403) ausgebildet ist, die beim Füllen mit dem
Medikament ausgedehnt wird und die zusammengezogen werden kann, um das Medikament
daraus auszustoßen.
7. Gerät nach einem der vorhergehenden Ansprüche, wobei die Vorrichtung (8; 16; 50a,
52; 108, 116; 152; 208, 216; 311, 316a, 316b) zum aktiven Ausstoßen des Medikaments
einen elektrisch gesteuerten Gasgenerator (16; 52; 116; 152; 216; 316a, 316b) innerhalb
des Gehäuses umfasst, um ein Gas zu erzeugen zum Zweck des Zusammenziehens des Medikamenten-Behälters
(10; 50; 110; 210; 312), um das Medikament daraus auszustoßen.
8. Gerät nach Anspruch 7, wobei das Gehäuse eine Mehrzahl von Medikamenten-Behältern
(50, 150) enthält und jeder Behälter (50, 150) durch einen getrennten Gas-Generator
(52, 152) zusammenziehbar ist und mit einem Auslass-Hohlraum (56, 156) kommuniziert,
mit dem auch die einzelne Hohlnadel (58, 158) kommuniziert.
9. Gerät nach Anspruch 8, außerdem enthaltend eine Vorrichtung zum individuellen Steuern
der Zufuhr von Medikamenten aus der Mehrzahl von Behältern (50, 150) des Auslass-Hohlraumes
(56, 156).
10. Gerät nach Anspruch 1, wobei das Gehäuse eine Mehrzahl von Medikamenten-Behältern
enthält, wobei jedem eine einzelne Hohlnadel zugeordnet ist.
11. Gerät nach einem der vorhergehenden Ansprüche, wobei das Gehäuse (2) außerdem einen
Sensor (28) enthält, um einen Zustand im Körper der Person festzustellen und dementsprechend
das Verabreichen des Medikaments zu steuern.
12. Gerät nach Anspruch 10, wobei der Sensor (28) ausgewählt ist aus einem Temperatur-Sensor,
einem Pulsraten-Sensor, einem Blutzucker-Sensor, einem Blutdruck-Sensor und einem
pH-Wert-Sensor.
13. Gerät nach einem der vorherigen Ansprüche, wobei das äußere Ende der Hohlnadel geschlossen
ist und die Hohlnadel eine Öffnung innerhalb von 2,9 mm vom äußeren Ende hat.
1. Dispositif d'administration intradermique de médicament, destiné à l'administration
à un sujet d'un médicament liquide à travers la peau du sujet, comprenant une enveloppe
(2 ; 102 ; 202 ; 301 ; 301a, 301b ; 405) qui présente une surface inférieure (4 ;
104 ; 322 ; 406) que l'on doit appliquer sur la peau du sujet, des moyens (6 ; 106
; 206 ; 309) qui permettent de maintenir l'enveloppe (2 ; 102 ; 202 ; 301 ; 301 a,
301b ; 405) en place, la surface inférieure (4 ; 104 ; 322 ; 406) étant en contact
avec la peau du sujet, un réservoir à médicament (10 ; 50 ; 110 ; 150 ; 210 ; 312
; 403) situé à l'intérieur de l'enveloppe (2 ; 102 ; 202 ; 301 ; 301a, 301b ; 405),
des moyens (8 ; 8, 16 ; 8, 30 ; 8, 40, 42, 44 ; 50a, 52 ; 108, 116 ; 152 ; 208, 216
; 311, 316a, 316b ; 407) destinés à libérer activement le médicament du réservoir
(10 ; 50 ; 110 ; 150 ; 210 ; 312 ; 403) sur la peau du sujet, des moyens d'aiguille
(14 ; 58 ; 114 ; 158 ; 214 ; 310 ; 402) associée au réservoir à médicament (10 ; 50
; 110 ; 150 ; 210 ; 312 ; 403) et traversant la surface inférieure (4 ; 104 ; 322
; 406), qui présente une extrémité intérieure communiquant avec le réservoir à médicament
(10 ; 50 ; 110 ; 150 ; 210 ; 312 ; 403) et une extrémité extérieure se prolongeant
vers l'extérieur dans une mesure suffisante pour traverser l'épiderme et pénétrer
dans le derme lorsque l'enveloppe (2 ; 102 ; 202 ; 301 ; 301 a, 301b ; 405) est pressée
contre la peau, caractérisé par le fait que le médicament est libéré à partir du réservoir (10 ; 50 ; 110 ; 150 ; 210 ; 312 ;
403) par l'intermédiaire d'une aiguille creuse unique (14 ; 58 ; 114 ; 158 ; 214 ;
310 ; 402) qui constitue ladite aiguille, cette unique aiguille creuse (14 ; 58 ;
114 ; 158 ; 214 ; 310 ; 402) étant en position fixe par rapport à l'enveloppe (2 ;
102 ; 202 ; 301 ; 301 a ; 301b ; 405) et présentant un diamètre extérieur de 0,5 mm
ou moins.
2. Dispositif selon la revendication 1, dans lequel l'enveloppe (301) comprend en outre
des moyens de fixation de couvercle (307) liés à l'enveloppe, un couvercle de protection
déplaçable (303) qui présente une surface supérieure (304) disposée face à l'enveloppe
et une surface inférieure (322) constituant la surface inférieure (322) de l'enveloppe
disposée face à la peau du sujet, le couvercle étant capable d'entrer en prise, de
manière extensible et rétractable, avec le moyen de fixation de couvercle (307) de
telle façon que le couvercle (303) soit disposé de façon essentiellement parallèle
à l'enveloppe (301), et que l'extrémité extérieure de l'aiguille creuse (310) se prolonge
vers l'extérieur dans une mesure suffisante pour ne pas se prolonger au-delà de la
surface supérieure (304) du couvercle (303) lorsque ce couvercle (303) est en extension
et de façon à traverser l'épiderme et à pénétrer dans le derme lorsque le couvercle
(303) est fixé à la peau du sujet et en position rétractée.
3. Dispositif selon la revendication 1 ou 2, dans lequel la surface inférieure (4 ; 104;
322 ; 406) de l'enveloppe (2; 102; 202; 301 ; 301a, 301b ; 405) présente une conformation
telle, que lorsqu'elle est pressée contre la peau, une proportion substantielle de
la pression appliquée à la peau passe par la pointe de l'aiguille (14 ; 58 ; 114 ;
158 ; 214 ; 310 ; 402).
4. Dispositif selon la revendication 3, dans lequel la surface inférieure (4 ; 104 ;
322 ; 406) de l'enveloppe est de forme plate ou convexe et l'aiguille creuse (14)
s'étend depuis le centre de la convexité, de forme conique et l'aiguille creuse (214)
s'étend depuis l'apex du cône, et présente une protubérance à partir de laquelle l'aiguille
(310) se prolonge vers l'extérieur.
5. Dispositif selon l'une quelconque des revendications précédentes, dans lequel l'aiguille
creuse (14 ; 58 ; 114 ; 158 ; 214 ; 310 ; 402) se prolonge vers l'extérieur d'environ
0,3 mm à 5,0 mm et présente un diamètre extérieur d'environ 0,075 mm à 0,5 mm et un
diamètre intérieur d'environ 0,05 mm à 0,3 mm.
6. Dispositif selon l'une quelconque des revendications précédentes, dans lequel le réservoir
à médicament (10 ; 50 ; 110 ; 150 ; 210 ; 312 ; 403) présente la forme d'un compartiment
capable d'expansion et de contraction (10 ; 50 ; 110 ; 150 ; 210 ; 312 ; 403), l'expansion
ayant lieu lorsque le réservoir est rempli de médicament et la contraction se produisant
pour effectuer l'administration du médicament à partir du réservoir.
7. Dispositif selon l'une quelconque des revendications précédentes, dans lequel les
moyens (8, 16 ; 50a, 52 ; 108, 116 ; 152 ; 208, 216 ; 311, 316a, 316b) destinés à
libérer activement le médicament comprennent un générateur de gaz à commande électrique
(16 ; 52 ; 116 ; 152 ; 216 ; 316a, 316b) situé à l'intérieur de l'enveloppe et destiné
à produire un gaz permettant de contracter le réservoir à médicament (10 ; 50 ; 110
; 210 ; 312) afin que le médicament puisse en être évacué.
8. Dispositif selon la revendication 7, dans lequel l'enveloppe comprend plusieurs réservoirs
à médicament (50, 150) dont chacun peut se contracter sous l'effet d'un générateur
de gaz séparé (52, 152) et communiquer avec une cavité de sortie (56, 156) avec laquelle
l'aiguille creuse (58, 158) est également en communication.
9. Dispositif selon la revendication 8, comprenant en outre des moyens qui permettent
de commander de façon individualisée l'introduction du médicament depuis la pluralité
de réservoirs (50, 150) des cavités de sortie (56, 156).
10. Dispositif selon la revendication 1, dans lequel l'enveloppe comprend plusieurs réservoirs
à médicament dont chacun comporte une seule aiguille creuse qui lui est associée.
11. Dispositif selon l'une quelconque des revendications précédentes, dans lequel l'enveloppe
(2) comprend en outre un détecteur (28) qui sert à détecter l'état corporel du sujet
et à commander l'administration du médicament en réponse à cette détection.
12. Dispositif selon la revendication 10, dans lequel le détecteur (28) est choisi parmi
un détecteur de température, un détecteur de la fréquence du pouls, un détecteur du
taux sanguin de glucose, un détecteur de la tension et un détecteur de pH.
13. Dispositif selon l'une quelconque des revendications précédentes, dans lequel l'extrémité
extérieure de l'aiguille creuse est fermée et l'aiguille creuse présente un orifice
à moins de 2,9 mm de l'extrémité extérieure.