This disclosure relates to an iontophoresis device for delivering medicine through a patient's skin. In more particular, this disclosure relates portable iontophoresis device that allows self-administration in a convenient and reliable fashion.
Iontophoresis (ION) is a technique by which a low electric current is establish an electric field to drive ions across the skin. This technique has been used to deliver a number of classes of drugs, but predominantly for the treatment of local tissue injury and not for therapeutic systemic effect. In addition, iontophoresis devices are commonly large wired devices requiring treatment to be implemented at medical facilities rather than allowing self-administered treatment in a residential or other non-medically supervised facility.
In one particular non-limiting example, constipation and straining during bowel movement, collectively referred to as “difficulty with evacuation” (DWE), are common complaints in clinical settings and are often resistant to the usual interventions in persons with neurogenic bowel disorders. Fecal incontinence (FI) is reported to occur in approximately 10% of patients with chronic constipation, but it is suspected to occur at higher rates, being underreported due to patient embarrassment. Neostigmine (NEO) is known to have an effect on gastrointestinal (GI) function and is useful to induce a prompt and predictable bowel movement. NEO is a cholinergic agent which, when concomitantly administered with glycopyrrolate (GLY), a cardiopulmonary selective anticholinergic, has been shown to be safe and effective in promoting bowel evacuation and well tolerated in persons with spinal cord injury (SCI). The observed effectiveness and reliability of the combination of these agents is far greater than that of oral or rectal cathartics. The aforementioned combination of these medications has shown to be effective when delivered by intravenous or intramuscular routes. Neither intravenous nor intramuscular administration of NEO and GLY, however, are suitable for the practical, long-term bowel care in people with chronic constipation. It would, therefore, be beneficial to have a reliable and safe method to induce a prompt bowel evacuation that is suitable for long-term outpatient use.
In summary a wireless ION device to systemically deliver a positively charged compound in a safe manner would be highly desirable. A wireless ION device capable of delivering any number of other positively charged agents would expand the range of self-administered pharmacokinetics. The ability to use a wireless ION device is far more practical for patients to use, especially those with SCI, which will permit the self-administration of these agents in the home setting to induce a bowel evacuation. This novel approach for the delivery of these agents to induce a safe and predictable bowel evacuation holds the potential to dramatically improve bowel care for individuals with SCI.
This disclosure concerns an iontophoresis device for delivering a drug to a patient across a layer of skin. In one aspect, the iontophoresis device includes a membrane applied to the skin, the membrane having a drug delivery aperture, a solvent delivery aperture and a vent aperture for applying a vacuum between the membrane and the skin. A drug cartridge defines a drug containing chamber and a drug air chamber, the drug containing chamber and the drug air chamber separated by a first flexible membrane. The drug containing chamber is in fluid communication with the drug delivery aperture. The drug cartridge has a first drug cartridge port in fluid communication with the drug air chamber for pressurizing the drug containing chamber and a second drug cartridge port in fluid communication with the drug delivery aperture. The device further includes a solvent cartridge defining a solvent containing chamber and a solvent air chamber. The solvent containing chamber and the solvent air chamber are separated by a second flexible membrane. The solvent containing chamber is in fluid communication with the solvent vehicle aperture. The solvent cartridge has a first solvent port in fluid communication with the solvent air chamber for pressurizing the solvent containing chamber and a second solvent port in fluid communication with the solvent delivery aperture. An electrode extends between a positive terminal and a negative terminal. The electrode is positioned between the membrane and the skin and surrounds the drug delivery aperture and the solvent delivery aperture.
In another aspect of the disclosure, a removable delivery apparatus including a compressor is in communication with a processor configured with logic controller to control the compressor to deliver a vacuum to the vent aperture and a pressure to said first drug cartridge port and said first solvent cartridge port. The logic controller is further configured to supply current to the electrode. The drug cartridge and the solvent cartridge are housed within the removable delivery apparatus.
In another aspect of the disclosure, a non-permeable frame is in communication with the membrane. The non-permeable frame defines a drug receiving chamber and a solvent receiving chamber. The drug receiving chamber is in communication with the drug delivery aperture and the solvent receiving chamber is in communication with the solvent receiving aperture. The electrode is positioned between said non-permeable frame and the skin.
In another aspect of the disclosure, a semi-permeable membrane is in communication with the drug delivery aperture, the solvent delivery aperture and the vent aperture. The semi-permeable membrane transferring vacuum from the vent aperture to the drug delivery aperture and to the solvent delivery aperture.
In another aspect of the disclosure, the non-permeable frame and the semi-permeable membrane are positioned on opposing surfaces of the membrane. The iontophoresis device further includes a non-permeable cover configured to surround the semi-permeable membrane. The non-permeable cover is configured to engage the removable delivery apparatus.
In another aspect of the disclosure, the semi-permeable membrane is positioned between the non-permeable frame and the membrane. The iontophoresis device further includes a bleeder cloth positioned between the semi-permeable membrane and the membrane. The bleeder cloth is configured to distribute vacuum between the vent aperture and the drug delivery aperture and the solvent delivery aperture.
In another aspect of the disclosure, an electrode film layer is positioned between the semi-permeable membrane and non-permeable frame, the electrode film layer transferring current from the removable delivery apparatus to the electrode.
In another aspect of the disclosure, a conductive drug nozzle is in communication with the electrode film layer, the drug delivery aperture, and the drug receiving chamber, the conductive drug nozzle transferring current from the removable delivery apparatus to the electrode film layer. A conductive solvent nozzle is in communication with the electrode film layer, the solvent deliver aperture, and the solvent receiving chamber. The conductive solvent nozzle transferring current from the electrode film layer to the removable delivery apparatus.
In another aspect of the disclosure, the drug cartridge and the solvent cartridge comprise removable and refillable cartridges. A first conductive spring pin engages a first conductive portion of the drug cartridge. The first conductive spring pin retains the drug cartridge within the removable delivery apparatus and transfers current from the removable delivery apparatus the said first conductive portion to the conductive drug nozzle. A second conductive spring pin engages a second conductive portion of the solvent cartridge. The second conductive spring pin retains the solvent cartridge within the removable delivery apparatus and transferring current from the conductive solvent nozzle through the second conductive portion to the removable delivery apparatus.
The invention further encompasses an iontophoresis device characterized by a membrane applied to the skin, the membrane having a barb projecting therefrom and defining a bore providing fluid communication through the membrane to the skin. Intake openings in the barb provide fluid communication with the bore, and a vent aperture allows application of a vacuum between the membrane and the skin in this example embodiment.
A drug cartridge defines a solvent chamber and an agent chamber adapted to contain a lyophilized agent. The solvent chamber and the agent chamber are separated by an impermeable membrane. The agent chamber is in fluid communication with the bore through the intake openings. The solvent chamber is in fluid communication with a compressor for pressurizing the solvent chamber.
A barb isolation chamber is positioned within the agent chamber. The barb isolation chamber is adapted to receive the barb. A self-sealing membrane isolates the barb isolation chamber from the agent chamber. A plurality of cartridge openings are positioned in the barb isolation chamber to provide fluid communication between the agent chamber and the barb isolation chamber.
When the barb is received within the barb isolation chamber the barb pierces the self-sealing membrane and the impermeable membrane thereby releasing solvent from the solvent chamber into the agent chamber. The solvent mixes with the agent and enters the bore through the cartridge openings and the intake openings for application to the skin.
By way of example, the iontophoresis device may be further characterized by
a removable delivery apparatus including a compressor in communication with a processor configured with logic controller to control the compressor to deliver a vacuum to the vent aperture and a pressure to the solvent chamber.
In an example embodiment, a plurality of turbulent flow extrusions may be positioned within the agent chamber. The turbulent flow extrusions are adapted to create turbulent flow of the solvent and thereby promote mixing of the solvent and the agent.
Further by way of example, the self-sealing membrane seals around the barb to force solvent to flow through the cartridge openings when the barb pierces the self-sealing membrane. In an example embodiment the barb comprises a pointed tip and may further comprise a plurality of shaped cavities arranged proximate to the barb tip. The shaped cavities are adapted to allow free flow of the solvent between the solvent chamber and the agent chamber when the barb pierces the impermeable membrane. In an example embodiment the impermeable membrane may comprise a thin foil separation membrane. Further by way of example, a flexible membrane may be positioned within the solvent chamber.
An example iontophoresis device according to the invention may further include cartridges comprising a solvent in the solvent chamber and an agent in the agent chamber. In a particular example, the solvent comprises distilled water and the agent comprises neostigmine and glycopyrrolate.
The present disclosure can be understood more readily by reference to the following detailed description, examples, drawings, and claims, and their previous and following description. However, before the present devices, systems, and/or methods are disclosed and described, it is to be understood that this invention is not limited to the specific devices, systems, and/or methods disclosed unless otherwise specified, as such can, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular aspects only and is not intended to be limiting.
The following description of the invention is provided as an enabling teaching of the invention in its best, currently known embodiment. To this end, those skilled in the relevant art will recognize and appreciate that many changes can be made to the various aspects of the invention described herein, while still obtaining the beneficial results of the present invention. It will also be apparent that some of the desired benefits of the present invention can be obtained by selecting some of the features of the present invention without utilizing other features. Accordingly, those who work in the art will recognize that many modifications and adaptations to the present invention are possible and can even be desirable in certain circumstances and are a part of the present invention. Thus, the following description is provided as illustrative of the principles of the present invention and not in limitation thereof.
Referring now to
Additionally in this aspect, the patient application assembly 14 may further include a semi-permeable membrane 42 in communication with the drug delivery aperture 30, the solvent delivery aperture 32 and the vent aperture 34. The semi-permeable membrane 42 transferring vacuum from the vent aperture 34 to the drug delivery aperture 30 and to the solvent delivery aperture 32. In at least one aspect of the disclosure, the semi-permeable membrane 42 may comprise a hydrofera blue membrane. In this aspect, it is contemplated that the semi-permeable membrane 42 and the non-permeable frame 36 are mounted on opposing sides of the membrane 28. In this aspect, a non-permeable cover 44 includes a cover base 46 configured to surround and seal the semi-permeable membrane 42 and a cover top 48 configured to securely engage the removable delivery apparatus 12. The non-permeable cover 44 allows the vacuum from the vacuum conduit 26 to be distributed through the semi-permeable membrane 42 from the vent aperture 34 to the drug delivery aperture 30 and the solvent delivery aperture 32.
Referring back to
Similarly, in another aspect of the disclosure, the removable delivery apparatus 12 may include a solvent cartridge 62 defining a solvent containing chamber 64 and a solvent air chamber 66. The solvent containing chamber 64 and the solvent air chamber 66 are separated by a second flexible membrane 68. A first solvent cartridge port 70 is in communication with the second air conduit 24 and the solvent air chamber 66. A second solvent cartridge port 72 is in communication with both the solvent containing chamber 64 and the solvent delivery aperture 32. When the compressor 16 is activated, pressurized air is introduced into the second air conduit 24 which flows through the first solvent cartridge port 70 and thereby expands the second flexible membrane 68 into the solvent containing chamber 64. This pressurizes any solvent within the solvent containing chamber 66 and forces it through the second solvent cartridge port 72, through the solvent delivery aperture 32 and into the solvent receiving chamber 40. It should be understood that the first solvent cartridge port 70 and the second solvent cartridge port 72 maybe sealed with self-healing seals that only allow passage of air or liquid solvent when a sufficient pressure is achieved.
In one aspect of the disclosure, the logic controller 20 is configured to activate the compressor 16 to generate a vacuum in the vent aperture 34. The vacuum is transferred via the semi-permeable membrane 42 to the solvent receiving chamber 40 and the drug receiving chamber 38. Afterwards, the logic controller 20 is configured to add pressure to the first drug cartridge port 58 and the first solvent cartridge port 70. When the solvent has filled the solvent receiving chamber 40 and the drug has filled the drug receiving chamber 38, the logic controller 20 is configured to supply a current to an electrode 74 positioned on the non-permeable frame 38 and located between the non-permeable frame 38 and the patient's skin. The electrode 74 substantially surrounds the drug delivery aperture 30 and the solvent delivery aperture 32. Through the activation of current in the electrode 74, the iontophoresis process is activated and the drug and solvent are ionically drawn through the patient's skin.
In another aspect of the disclosure, depicted in
In this aspect, the iontophoresis device 10 may include a conductive drug nozzle 80 in communication with the electrode film layer 78, the drug delivery aperture 32, and the drug receiving chamber 38. The conductive drug nozzle 80 transfers current from the removable delivery apparatus 12 to the electrode film layer 78. The removable delivery apparatus 12 further includes a conductive solvent nozzle 82 in communication with the electrode film layer 78, the solvent deliver aperture 34, and the solvent receiving chamber 40. The conductive solvent nozzle 82 transfers current from the electrode film layer 78 to the removable delivery apparatus 12. In this fashion, a conductive loop is formed through the electrode 74. In at least one aspect of the disclosure, the conductive drug nozzle 80 and the conductive solvent nozzle 82 are formed of a conductive material such as copper. The conductive drug nozzle 80 and the conductive solvent nozzle 82 act both as conduits for flow of drug and solvent as well electrical conduits for current to flow to the electrode 74.
In one aspect of the disclosure, it is contemplated that the drug cartridge 50 and the solvent cartridge 62 comprise removable and refillable cartridges. In this aspect the drug cartridge 50 may include a drug insertion port 84 and a drug relief port 86. The drug insertion port 84 and the drug relief port 86 comprise self-healing ports that allow a syringe to insert drugs into the drug insertion port 84 and another syringe to release pressure from the drug relief port 86 while the drugs are being inserted into the drug cartridge 50. Similarly, the solvent cartridge 62 may include a solvent insertion port 88 and a solvent relief port 90. These ports are self-healing ports as well that allow a syringe to insert solvent into the solvent insertion port 88 and another syringe to release pressure from the solvent relief port 90 while the solvent is being inserted into the solvent cartridge 62.
In still another aspect of the current disclosure, the removable delivery apparatus 12 may include a first conductive spring pin 92 engaging a first conductive portion 94 of the drug cartridge 50. The first conductive spring pin 92 retains the drug cartridge 50 within the removable delivery apparatus 12 and transfers current from said removable delivery apparatus 12 through the first conductive portion 94 to the conductive drug nozzle 80. Similarly, the removable delivery apparatus 12 may include a second conductive spring pin 96 engaging a second conductive portion 98 of the solvent cartridge 62. The second conductive spring pin 96 retains the solvent cartridge 62 within the removable delivery apparatus 12 and transfers current from the conductive solvent nozzle 82 through the second conductive portion 98 to the removable delivery apparatus 12.
The example embodiments described above use cartridges containing the agents in liquid form. However, significant advantage may be realized if the agent or agents (e.g., neostigmine and glycopyrrolate) are placed in the cartridges in a lyophilized (dry powder) form for administration because agents in dry powder form have significantly longer shelf life than agents in liquid form. This embodiment will, of course, require reconstitution of the lyophilized agent(s) with solvent (distilled water in this example) prior to delivery of agent(s) to the patch for administration. The function of the iontophoresis device is otherwise unchanged.
When device 13 is ready for use, the membrane patch 23 (see
Once the device 13 is installed on the patch 23 and initiated to function, the device compressor (not shown) pushes air against a flexible membrane 35 (for example, a nitrile membrane) positioned within and sealing the solvent chamber 17. The flexible membrane 35 expands into the solvent chamber 17, thereby displacing the liquid solvent into the lyophilized agent chamber 19. As the liquid solvent is forced into the lyophilized agent chamber 19 the liquid solvent mixes with the lyophilized agent. As shown in
Once the process of agent dispensing is initiated, the liquid solvent follows on a path to interact with the lyophilized agent with the extrusions 37, cartridge openings 39 and barb intake openings 45 that cause the liquid solvent to travel down a turbulent channel, thereby uniformly mixing the lyophilized agent(s) into solution for more predictable iontophoretic drug delivery.
Although the present disclosure contemplates the application is directly applicable to the self-administration of a wide variety of drugs, in one particular aspect the disclosure contemplates the application of a combination of neostigmine (NEO; a cholinergic agent) and glycopyrrolate (GLY; a selective cardiopulmonary anticholinergic agent) to facilitate bowel moments in individuals. This allows self-administration of such a motility drug in the privacy of an individual's home as well as self-control over their bodily functions.
This application is based upon and claims benefit of priority to U.S. Provisional Application No. 63/241,151, filed Sep. 7, 2021 and U.S. Provisional Application No. 63/320,762, filed Mar. 17, 2022, both of which are hereby incorporated by reference herein.
Filing Document | Filing Date | Country | Kind |
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PCT/US2022/042600 | 9/6/2022 | WO |
Number | Date | Country | |
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63241151 | Sep 2021 | US | |
63320762 | Mar 2022 | US |