US 4,668,219 AGrant
Exponential Mixing and Delivery System
Issue Date:1987-05-26
•10 Claims
•1 Drawing Sheets
Abstract
A nonvented gravity fed exponential mixing and delivery system and apparatus for the administration of a drug in a precalculated manner to give constant therapeutic blood plasma levels in the recipient, (patient), which provides an inexpensive, quick and simple exponential mixing procedure to deliver an infusion containing exponentially decreasing concentrations of a drug, which the exponential mixing of a dilute solution of the drug or isotonic solution which flows by gravity from a conventional IV container, through a coupling means, into a vertically aligned nonvented nondeformable mixing chamber, filled to capacity with a concentrated solution of said drug, said mixing container being provided with a verticle inlet conduit means and a vertical outlet conduit means at opposing ends, each conduit means extending into said mixing container at a height to provide a sufficient height differential to induce exponential mixing of the solutions, to effect an exponentially decreasing concentration of said drug during a constant infusion rate, flowing through said outlet conduit and into a conventional non-vented administration apparatus.
Metadata
Inventor
- Michael B. Israel
Application Information
Application Number:US 8382441
Filing Date:1986-03-10
Priority Date:1984-11-16
Art Unit:336
Classifications
IPC:
A61M 500
Field of Search:
60456;82-85;92;411-415
Patent Drawings (1 sheets)
Description
Description of the Drawings
The following drawing more specifically describes present invention, wherein:
FIG. 1 is an elevational view of the exponential mixing and delivery system embodying the principles of this invention in operation.
In said drawing, the gravity fed exponential mixing and delivery system comprises a standard non-vented deformable IV solution container 10, containing a sterile diluting solution of a therapeutic agent or a solvent, provided with peirceable connector means 11, such as a standard pierceable female plug, adaptable for the insertion of male plug 12, provided with a peircing tip 13, at the upper end of inlet conduit means 14, of mixing container 15, filled to capacity with a concentrated sterile solution of said agent, to permit the gravity flow of liquid from the upper container 10, into lower mixing container 15, through inlet tube 14, depending from top wall 16, said inlet tube 14 extending downwardly into mixing container 15, to a height 16, such that the height differential H, between inlet tube 14, and outlet tube 17, integral with bottom wall 18, and extending upwardly to a height 19, is operable to effect exponential mixing in container 15. Said mixture of exponentially decreasing concentrations of the drug flows via outlet tube 17, into a minidrip chamber 20, at a regulated flow rate and through IV tubing 21, to the patient by opening a valve 28 for controlling the flow rate. The flow rate is regulated by the diameter of the flexible IV tubing. Exponential mixing of solutions commences in mixing container 15, upon opening outlet tube 17, to the flow of solution into the minidrip chamber 20, of the administration set. This ensures no mixing until this apparatus is connected to the patient and the infusion commences by opening flow rate valve 28.
Piercing tips 13 are covered with a removable plastic cover (not shown) to ensure sterility and prevent loss of solution prior to use.
Mixing container 15 is ductile but nondeformable and preferably made of clear plastic or glass.
Nondeformable exponential mixing container 15, may be further provided with an inlet means 23, in the top wall 16, for adding the drug in varying concentrations to the empty container 15, if desired. This provides greater versatility to the present novel exponential mixing and delivery system and apparatus for implementing said system. The mixing container 15 may be empty, or prepackaged and filled to capacity with a concentrated drug solution, prior to its connection to a non-vented IV administration set; or said exponential mixing container may be prepackaged as an integral unit with a nonvented IV administration set.
Deformable container 10, is in the form of a standard flexible IV bag sealed at the top and provided with a suitable suspension means for suspension from a bracket or other suitable support means (not shown).
Container 10 may be further provided with a pierceable inlet means 22, such as a rubber diaphragm, for adding the drug to the solution in the IV bag 10 to formulate a dilute solution of the drug, if desired.
The nondeformable mixing container 15 is provided with an airtight pierceable seal which may be in the form of a plug 24, or a plastic diaphragm 24', inserted into outlet tube 17, adaptable for the insertion of conventional non-vented administration sets by means of a hollow spike 25, leading into a minidrip chamber 20, connected to IV tubing 21, with sealed side-arm 26. Alternatively, the prepackaged mixing container may also include the administration set, i.e. the plug 24 or diaphragm 24' may be omitted, and the outlet tube 17 may be directly connected to the minidrip chamber 20, which is connected to IV tubing 21, provided with flow control valve 28, side-arm 26, and leak proof seal 27, to insure no flow prior to use, i.e. befdre connection to the infusion needle in the patient.
For example, a standard flexible IV bag 10 is filled with 1 liter of an aqueous solution containing 5% dextrose and 2 grams lidocaine, and the nondeformable container 15 is filled to capacity with 20 cc of dextrose water containing 1% lidocaine (200 mg lidocaine). The solution from bag 10 flows by gravity into container 15 through inlet tube 14 which is 1/2" diameter 27 gauge, wherein the solutions are exponentially mixed, and flows out of container 15 through outlet tube 17 which is 11/2" diameter 22 gauge, into minidrip chamber 20, and is delivered to standard width IV tubing 21 at a rate of 1 drop/sec which is equal to 1 cc/min. A sufficient height differential of inlet tube 14 and outlet tube 17 ensures exponential mixing according to the equation: ##EQU1## wherein R.sub.t =delivery rate gradient
C.sub.i =initial drug concentration of volume V in mixing chamber
C.sub.d =drug concentration of the diluting solution in flexible bag
Q=constant rate of delivery of diluent and removal of solution from the mixing chamber
t=time
e=exponential function.
According to this equation, this should deliver an infusion with a concentration of therapeutic agent which decreases exponentially from an initial rate of 10 mg/min to 2 mg/min with a half-life of 13.86 minutes.
While equation 1 is specific to the exponentially decreasing delivery of lidocaine from container 15 as induced by a solution from container 10 which is of lower concentration than the initial concentration, the invention can also be used to address the problem of an exponentially decreasing delivery rate of a solution from container 15 at a constant rate, as induced by a pure solvent from container 10, equation 1 then being altered as detailed by C. J. Morris and P. Morris in Separation Methods in Biochemistry. 2nd Edition, 1976; 103-4.
This invention is also applicable to other agents which are not governed by the same pharmacokinetic approach as lidocaine which would then follow the equations to obtain an instantaneous plasma drug concentration and to maintain it at a constant value, as derived by D. P. Vaughan and G. T. Tucker, in the European Journal of Clinical Pharmacology, 1976, Vol. 10, 433-40.
The height differential of outlet tube and inlet tube is effected by the volume and thus the design of the container itself. Generally, for containers of small capacity, such as discussed above, as long as the end of each tube is positioned at the extreme opposite end to the tubes' point of entry without restricting flow, the criteria of the design is met. To be more specific, the laws of diffusion/mass transport are governed by the rate of mass transfer.
This novel and useful invention provides an exponential mixing and delivery system and apparatus for the administration of a therapeutic agent to yield rapidly attained and maintained constant therapeutic plasma levels, by simply connecting the exponential mixing container to a standard IV solution bag suspended from a suitable support, connecting the outlet tube of said mixing container to the minidrip chamber of an IV administration kit, which leads into the patient; or connecting a prepackaged unit of the nonvented mixing container integral with a nonvented administration set to a standard IV bag suspended from a suitable support, administering one bolus injection of 1 mg/kg body weight, through side-arm 26 at the start of said infusion or shortly thereafter. The infusion starts immediately and requires no other human intervention until the contents are exhausted. The exponentially decreasing amount of therapetuic agent insures a constant concentration of therapeutic agent in the blood plasma, thereby avoiding toxicity due to an overdose, or ineffectual drug therapy due to an underdose. This is of particular importance in emergency or critical clinical situations such as in patients with cardiac failure or with concurrent decreased hepatic or renal function.
It is understood that the foregoing detailed description is given merely by way of illustration and that variations may be made therein without departing from the spirit of the invention. The "Abstract" given above is merely for the convenience of technical searchers and is not to be given any weight with respect to the scope of the invention.
Claims
I claim:
1. A non-vented, gravity fed exponential mixing and delivery system for the administration of a therapeutic agent in a precalculated manner to give constant therapeutic blood plasma levels in the recipient which comprises an upper non-vented deformable intravenous container for containing a dilute solution of a therapeutic agent, a lower non-vented, nondeformable mixing container vertically aligned with the upper container for containing a concentrated solution of said agent, a coupling means between the upper and lower containers for the gravity flow of solution from the upper container directly into a vertical inlet conduit means extending downwardly into the lower mixing container, the end of said vertical inlet conduit means extending to a point adjacent the bottom of the mixing container at the extreme opposite end of its point of entry without restricting flow, a vertical outlet conduit means extending upwardly from the bottom of the mixing container, the end of said vertical outlet conduit means extending to a point adjacent the top of the mixing container at the extreme opposite end of its point of entry without restricting flow to provide a height differential between inlet and outlet conduit means for the exponential mixing of the dilute and concentrated solutions, said conduit means being non-aligned in parallel, said vertical outlet conduit means tube also extending downwardly into a minidrip chamber for the flow of exponentially decreasing concentrations of said therapeutic agent at a constant influsion rate and at a regulated flow rate to the patient by means of intravenous tubing, provided with a control valve for simultaneously initiating the exponential mixing in said mixing container and the infusion into the patient.
2. A non-vented gravity fed exponential mixing and delivery apparatus comprising a non-vented deformable upper intravenous (IV) container containing a drug free solvent or diluent or dilute solution of the drug, vertically aligned with a non-vented, nondeformable exponential mixing container filled to capacity with a concentrated solution of said drug, a pierceable outlet means in the upper IV container for coupling with an inlet means in the lower mixing container for the gravity flow of the dilute solution from the upper container directly into the lower mixing container, said lower mixing container being provided with a top inlet conduit means and a bottom outlet conduit means on opposing ends, said inlet means being provided with a connector means for coupling with the pierceable outlet means of the upper container, the ends of the inlet and outlet conduit means within the mixing container extending to a point adjacent the respective bottom and top of said mixing container at the extreme opposite ends of each conduit means' point of entry without restricting flow, the height differential between said conduit mcans operable to effect exponential mixing in said mixing container, said conduit means being non-aligned in parallel a minidrop chamber connected to said outlet conduit means to receive and regulate the flow of the exponentially decreasing concentration of said drug in the infusion per unit of time, at a constant flow rate, to the patient, by means of intravenous (IV) tubing, provided with a control valve to simultaneously initiate the exponential mixing in the mixing container and the infusion into the patient.
3. An exponential mixing container for use with an intravenous administration set, comprising a non-vented, nondeformable mixing container provided with a vertical inlet conduit means extending downwardly from the top wall into said container, and a vertical outlet conduit means extending upwardly from the bottom wall into said container said conduit means being non-aligned in parallel, the ends of the inlet and outlet conduit means within the mixing container extending to a point adjacent the respective bottom and top of said mixing container at the extreme opposite end of each conduit means' point of entry without restricting flow, the height differential between said conduit means operable to effect exponential mixing in said mixing container, a means for coupling said inlet to an IV solution container, a pierceable closure means at the lower end of said outlet conduit means adapted to connect to conventional non-vented administration sets.
4. The exponential mixing container according to claim 3, wherein said outlet conduit means is connected directly to a minidrip chamber, IV tubing, sealed side-arm, and terminating in a leak proof seal, as a prepackaged unit.
5. The exponential mixing container according to claim 3 or 4, additionally provided with an inlet means on the top wall thereof for receiving a concentrated solution of the drug to be exponentially mixed and delivered to the patient.
6. The exponential mixing container according to claim 3 or 4, wherein the upper end of the inlet conduit means is provided with a connector having a piercing tip adapted to enter an IV solution container, said tip having a removable cover to ensure sterility,
7. The system according to claim 1, wherein the upper deformable container is filled with a drug fee solvent.
8. The exponential mixing container according to claim 3 or 4, which is filled to capacity with a concentrated solution of a drug.
9. The apparatus according to claim 2, wherein the exponential mixing container is additionally provided with an inlet means on the top wall thereof for receiving a concentrated solution of the drug to be exponentially mixed and delivered to the patient.
10. The apparatus according to claim 2, wherein the upper end of the inlet conduit means of the mixing container is provided with a connector having a piercing tip adapted to enter the IV solution container, said tip having a removable cover to ensure sterility.