CN101287411A - 药物信息系统 - Google Patents

药物信息系统 Download PDF

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CN101287411A
CN101287411A CNA2006800238386A CN200680023838A CN101287411A CN 101287411 A CN101287411 A CN 101287411A CN A2006800238386 A CNA2006800238386 A CN A2006800238386A CN 200680023838 A CN200680023838 A CN 200680023838A CN 101287411 A CN101287411 A CN 101287411A
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battery
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CN101287411B (zh
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M·兹德布利克
A·汤普森
A·皮克尔尼
T·罗伯森
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Otsuka Pharmaceutical Co Ltd
Otsuka America Pharmaceutical Inc
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Proteus Biomedical Inc
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Abstract

本发明提供了允许检测药物制剂实际内服药物释放到体内的组合物、系统和方法。这些组合物的实施方案包括识别器和活性剂。本发明发现在各种不同的应用中,包括但不限于监控治疗方案的依从性、跟踪药物制剂的历史等中的用途。

Description

药物信息系统
相关申请的交叉参考
按照35U.S.C.§119(e),本申请要求下列专利递交日的优先权:2005年4月28日递交的美国临时专利申请顺序号60/676,145、2005年6月24日递交的美国临时专利申请顺序号60/694,078、2005年9月1日递交的美国临时专利申请顺序号60/713,680和2006年4月7日递交及标题为“药物信息系统”的美国临时专利申请顺序号60/790,335,这些专利所公开的内容通过引用结合到本文中。
背景
本发明总体涉及医疗器械和方法。更具体地说,本发明涉及自动识别药物原料的摄取或其他实际的、内服给药的器械和方法。
处方药物治疗对许多患者而言当适当服用时,例如根据指导是有效的治疗法。然而,研究表明,平均来说约50%的患者对所开的药物治疗方案缺乏依从性。对药物治疗方案依从的低比率导致每年有大量的住院治疗和疗养所接纳。仅在美国,最近估计由患者不依从而造成的费用正接近每年1000亿美元。
因此,已有各种方法和器械用于改善患者对所开药物治疗方案的依从性,致力于改善患者的健康。迄今为止,已开发出许多不同类型的“智能”包装装置。在某些情况中,此类装置自动分发适当的药丸。在其他情况中,有电子控制器检测和记录从盒中取出的药丸。
虽然已经开发出了改善患者依从性的装置和方案,但是仍继续存在对开发新的监控患者依从性方法的兴趣。
概述
本发明首次使药丸和其他类型的药用释放系统,例如皮肤扩散贴剂可以特异性识别,因此药物实际地、物理(physical)释放到体内可以自动检测,并且此信息可以储存。因为本发明的内服药物给药的自动报告不需要患者或临床医生输入,避免了许多在当前药物给药监控系统中引入不确定性的不精确性。当考虑患者的依从性或心理能力时,例如在精神病药物的给药中,这些发明特征特别关键。本发明也能识别法律强制目的的违禁药物来源。
本发明的实施方案包括具有:活性剂;识别器和药学上可接受的载体的组合物。在本发明的一个实施方案中,可消化的药丸通过提供电子微型芯片作为该药丸结构的一部分制成可识别的。在某些方面,电子微型芯片完全装在药丸中。在该实施方案中,当溶解在离子溶液例如胃液中时药丸传播信号。所传播的信号由另一个装置,例如接收器在人体内或者靠近人体接收。然后接收器又记录该药丸事实上已达到胃并正在被溶解。
在某些实施方案中,信号是被植入或局部施用的接收器获得的振荡信号。该植入物具有一个或两个传感变化信号的电极。装配该植入物使得它能识别编码并记录特定时间摄取的特定药丸。
附图简述
图1提供本发明药丸实施方案的图解、示范性表示。
图2A和2B提供图1所示的药丸组合物的更详细的视图。
图3A-图3C提供本发明信号发生元件的不同实施方案的视图。
图4图解显示药丸摄取的作用,其中某些药丸已侵蚀掉。
图5提供类似于图4的排列,以线圈而不是两个电极作为输出。
图6A-6D提供本发明各种实施方案中电子线路的某些实施细节。
图7提供根据本发明实施方案的振荡器和计数器安装。
图8是振荡器的另外一个实施方案,其中V控制调节驱动该振荡器的电压的量。
图9是简单点滴式或异步计数器的另外的实施方案。
图10提供根据本发明实施方案的三个终端、单极信号发生元件的图解表示。
图11A-13B为显示根据本发明实施方案制备识别器的方法的图。
图14显示多路转换器和编址系统。
图15显示图14所示系统的4位多路转换器(mux)细节。
图16详细显示构成4位多路转换器的1位多路转换器。
图17是信号发生元件另外的单极实施方案。
图18A是按照本发明的一个实施方案,以固定频率传输信号的信号-转输驱动电路的示范性原理图。
图18B1-18B2提供按照本发明的一个实施方案的接收器电路的示范性原理图。
图19显示按照本发明的一个实施方案的一种示范性分组(即分节)电池设计。
图20显示按照本发明的一个实施方案,一种使用分组电池电极来传输的驱动电路的示范性设计。
图21显示按照本发明的一个实施方案,一种示范性具有分组阴极的分组电池设计。
图22显示按照本发明的一个实施方案的一种示范性设计,其中驱动电路的电池电极与驱动电路通过两根外部导线耦合。
图23显示用分组电池配制进行试验的原理。
图24显示一对分组电池的性能。
详述
本发明向临床医生提供其医疗设备中的重要的新工具:自动检测和识别实际释放到体内的药物。该新信息装置和系统的应用是多方面的。例如,当与其他医疗传感器一起使用时,药物释放、批和剂量之间的相关性可与生理反应相联系。以此方式,最佳药物治疗方案可由临床医生制订。例如,心脏刺激药可滴定到最适当的剂量,使副作用例如心肌衰竭和其中的回弹作用最小化,及使剂量和对各患者的时间选择最佳化。
本发明使替代药物范围的评估成为可能,而不用诉诸于等待明显的临床治疗后果,这些后果中的许多可能是严重不良的。例如,阳性作用可能是可迅速查明的而不被更多的随机因素弄得模糊不清。当药物与上述背景生理变化相关或不相关时负反应,例如血压的变化可能变得明显。
为药物的摄取或其他机体对药物的实际暴露引证的能力具有许多重要的临床应用。在最简单的形式中,该技术提供药丸何时被服用和哪种药丸被服用的准确数据。这使哪种药丸在具体的时间点被服用能够精确确定。此监控能力确保了患者正在正确地服用所开的药物。该信息避免了过量开实际上不会服用的药物的潜在性。例如如果打算给予患者镇痛药,可能要核查该患者在某些时间段上确实事实上服用那些镇痛药。这是限制未消费的药物非法销售给非计划团体的重要工具。在心血管药物的情况中,临床医生或护理人员能够查明所服用的药物的量在大约正确的点和时间被服用。因此,可准确地评价药物的真实有效性。适当的给药和患者的依从性在阿尔茨海默病、精神病及酒精厌恶药物(alcohol aversion drug)和在疗养院居住者的治疗中尤其关键。在意外和其他过量情形的情况中,进行干预的临床医生将能够辨别摄取进行到什么程度及涉及到多少药丸。
在一个临床中心,本发明与由某些本发明发明人开发的其他传感器一起,令心脏对那些药物的反应能够测定和评价。这些联合使用的传感器可以是其中下面所例举的那些。由某些本发明发明人开发的其他传感技术使心脏健康和心脏效率能够测定。与本发明装置一起使用这些工具,临床医生将能够比较心脏和机体对所给予的药物的反应。
由本发明提供的数据可任选随时间记录。记录系统记录通过心脏组织的信号的同步或传导速度,及它是如何通过某些药物的存在介导的。本发明使该唯一的数据成为可能,因为它可准确地电子测定药丸或其他药物何时被吸收进机体。
由该创造性数据,本发明提供给临床医生显示对该药物的反应和该药丸定时消化的精确的剂量反应曲线。该创造性数据具有许多应用。例如,临床医生现在有能力确定哪个患者对药丸中的药物无反应。在研究情形中,此类患者可从某些药物临床使用的研究或试验中剔除,这提供了仅对某些药物具有有益反应的人被保留在该试验中。该特征将改善药物的有效性并减少人们服用不再有用的药物的量。它也可用于确定哪些患者实际上消耗该药物,哪些未消耗的试验中。
在更标准的临床环境中,该唯一的数据使药物的给药能小心选择和滴定,而不诉诸于更明显的身体症状来确定禁忌症、有效性和最佳剂量水平。本发明向急救室技术员或医生提供患者被医院接受时的记录,以使该患者的状态可以准确地被确定。给药前最后小时或天内的剂量事件和最后药物的性质将立即可获得。
临床医生通过简单询问植入或可携带装置获得该信息。该装置将无任何不确定性地告诉他们什么药丸被服用了。随着本发明的技术更广泛地传播,该数据将变得更有规则地可获得。当置于大多数或所有药物理所当然地将与它们适合的标准制备中时,下面描述的本发明的微型芯片足够地便宜。
在本发明微型芯片的其他实施方案中,芯片可与可对询问敏感而不溶解在机体中的线圈相适应。这通过将RF能量以询问者在摄取之前将被告知药丸的存在和性质的方式传送到线圈中实现。
在本发明另外的实施方案中,提供了能够询问各药丸和确定其地址的“智能盒”。该盒可以写有区别的产品号或产品编码,以便提供给曾经制备的每个单一药丸独特的识别器。例如,保险丝可选择性地被销毁,因此地址可电子检测或光学检测。特别是在受控制的物质,例如麻醉药的情况中,这对限制先前合法药物的非法使用将是重要的。本发明使得准确识别谁从授权药剂师处买了该药丸成为可能。本发明的该用途将控制市场上受控物质的非法使用的数目。
在更详细地进一步描述本发明时,首先评论了组合物的实施方案,接着讨论了包括主题组合物的系统、使用主题组合物和系统的方法及其中这些组合物和方法发现用途的各种说明性应用。下面也更详细地评论了包括主题组合物的药剂盒。
组合物
本发明的实施方案包括具有与其稳定联系的识别器的活性剂组合物。在某些实施方案中,组合物在向患者给药时被破坏。照此,在某些实施方案中,组合物在例如通过摄取、注射等释放到体内后,被物理破碎,例如被溶解、分解、侵蚀等。这些实施方案中的组合物可与被装配成待摄取的并通过胃肠道运送基本上(如果不完全)完整存在的装置相区别。虽然这些实施方案中的组合物本身在给药时被破坏,该组合物的组分,例如识别器可幸免于胃肠道的运送,例如下面更详细地描述的。
在某些实施方案中,组合物包括活性剂/载体组分和识别器。下面更详细地分别评论这些不同组分中的每一种。
活性剂/载体组分
主题组合物包括活性剂/载体组分。“活性剂/载体组分”表示可以是固体或流体(例如液体),在药学上可接受的载体中有一定量的活性剂例如剂量的组合物。活性剂/载体组分可称为“剂量制剂”。
活性剂
“活性剂”包括与活的有机体如哺乳动物,例如人接触时,产生生理学结果,例如有益的或有用的结果的任何化合物或化合物的混合物。活性剂可与介质、载体、稀释剂、润滑剂、粘合剂及其他制剂助剂此类组分、封装组分或保护组分相区别。活性剂可以是能够调节活的患者生物过程的任何分子,以及其结合部分或片段。在某些实施方案中,活性剂可以是用于诊断、治疗或预防疾病的物质或作为药物的组分。在某些实施方案中,活性剂可以是化学物质,例如麻醉药或迷幻剂,它影响中枢神经系统并引起行为的改变。
活性剂(即药物)能够与活的患者中的靶相互作用。该靶可以是许多不同类型的天然存在的物质,其中靶标包括细胞内和细胞外靶。此类靶可以是蛋白质、磷脂、核酸等,其中蛋白质是特别有兴趣的。相关的具体蛋白质靶包括但不限于酶,例如激酶、磷酸酶、还原酶、环氧化酶、蛋白酶等;包含涉及蛋白-蛋白相互作用域,例如SH2、SH3、PTB和PDZ域的靶;结构蛋白例如肌动蛋白、微管蛋白等;膜受体、免疫球蛋白,例如IgE、细胞粘着受体,例如整联蛋白等;离子通道、跨膜泵、转录因子、信号蛋白等。
活性剂(即药物)可包括一种或多种对与靶结构相互作用所必需的官能团,例如对疏水性、亲水性、静电或者甚至共价相互作用所必需的基团,取决于特定的药物和其靶标。当靶为蛋白时,药物部分可包括对与蛋白结构相互作用所必需的官能团,例如氢结合、疏水-亲水性相互作用、静电相互作用等,并且可包括至少胺、酰胺、巯基、羰基、羟基或羧基,例如这些官能化学基团中的至少两种。
目的药物可包括环状碳或杂环结构和/或由一种或多种上述官能团取代的芳族或多芳族结构。作为药物部分也有兴趣的是在生物分子中发现的结构,这些分子包括肽、糖类、脂肪酸、甾体、嘌呤、嘧啶、衍生物、结构类似物或其组合。可筛选此类化合物用于识别那些目的药物,其中各种不同筛选方案在本领域是已知的。
药物可衍生自可从各种来源获得的天然存在的或合成的化合物,包括合成的或天然的化合物库。例如,许多方法可用于随机和直接合成各种有机化合物和生物分子,包括制备随机化的低聚核苷酸和寡肽。或者,细菌、真菌、植物和动物提取物形式的天然化合物库是可获得的或者易于制备。另外,天然或合成制备的化合物库和化合物易于通过常规化学、物理和生物化学手段修饰,并可用于制备组合库。已知的药理学药物可进行直接的或随机化学修饰,例如酰化、烷基化、酯化、酰胺化等,制备结构类似物。
这样,药物可由天然存在的或合成的分子库获得,这种分子库包括通过组合手段制备的化合物库,即化合物多样性组合库。当从此类库获得时,所采用的药物部分在适当的活性筛选试验中显示某些理想的活性。组合库,以及制备和筛选此类库的方法在本领域中是已知的,并在下列专利中描述:5,741,713;5,734,018;5,731,423;5,721,099;5,708,153;5,698,673;5,688,997;5,688,696;5,684,711;5,641,862;5,639,603;5,593,853;5,574,656;5,571,698;5,565,324;5,549,974;5,545,568;5,541,061;5,525,735;5,463,564;5,440,016;5,438,119;5,223,409,其公开的内容通过引用结合到本文中。
各种目的活性剂包括但不限于:心血管药;缓解疼痛药,例如止痛剂、麻醉剂、抗炎药等;神经作用药物;化学疗法药物(例如抗肿瘤药)等。
在某些实施方案中,活性剂为心血管药,即用于治疗心血管或心脏病症的药物。在某些实施方案中,活性剂为心血管药,即用于治疗心血管或心脏病症的药物。相关的心血管药包括但不限于:心脏保护剂,例如右雷佐生(dexrazoxane);血液调节剂,包括抗凝剂(例如香豆定(华法林钠)、法安明(达肝素钠)、肝素、innohep(亭扎肝素钠)、lovenox(依诺肝素钠)、orgaran(达那肝素钠));抗血小板剂(例如aggrasta(盐酸替罗非班)、aggrenox(阿司匹林/缓释双嘧达莫制剂)、agrylin(盐酸阿那格雷)、阿司匹林(乙酰水杨酸)、folan(依前列醇钠)、halfprin(阿司匹林肠溶衣片)、integrlilin(依替巴肽)、潘生丁(双嘧达莫USP)、plavix(氯吡格雷硫酸氢盐)、培达(西洛他唑)、阿昔单抗注射剂(阿昔单抗)、抵克立得(盐酸噻氯匹定));溶解血栓剂(活化酶(阿替普酶)、瑞替普酶粉针剂(瑞替普酶)、streptase(链激酶));肾上腺素阻断剂,例如卡度雷(甲磺酸多沙唑嗪)、台苯齐林(盐酸苯氧苄胺)、高特灵(盐酸特拉唑嗪)、minipress(盐酸哌唑嗪)、盐酸哌唑嗪-泊利噻嗪制剂(盐酸哌唑嗪/多噻嗪);肾上腺素能兴奋剂,例如甲基多巴和氯噻嗪片剂(甲基多巴-氯噻嗪)、爱多美(甲基多巴、盐酸甲基多巴)、aldoril(甲基多巴-氢氯噻嗪)、盐酸可乐定片剂(盐酸可乐定USP、可乐定)、clorpres (盐酸可乐定和氯噻酮)、combipres(盐酸可乐定/氯噻酮)、tenex(盐酸胍法辛);α/β-肾上腺素能阻断剂,例如coreg(卡维地洛)、normodyne(盐酸拉贝洛尔);血管紧张素转化酶(ACE)抑制剂,例如accupril(盐酸喹那普利)、aceon(培哚普利特丁胺)、altace(雷米普利)、卡托普利、lotensin(盐酸贝那普利)、mavik(群多普利)、monopril(福辛普利钠片剂)、prinivil(赖诺普利)、univasc(盐酸莫昔普利)、Vasotec(依那普利拉、马来酸依那普利)、zestril(赖诺普利);血管紧张素转化酶(ACE)抑制剂和钙通道阻断剂,例如lexxel(马来酸依那普利-非洛地尔ER)、lotrel(氨氯地平和盐酸贝那普利)、tarka(群多普利/维拉帕米盐酸盐ER);血管紧张素转化酶(ACE)抑制剂和利尿剂,例如accuretic(盐酸喹那普利/氢氯噻嗪)、lotensin(盐酸贝那普利和氢氯噻嗪USP)、prinizide(赖诺普利-氢氯噻嗪)、uniretic(盐酸莫昔普利/氢氯噻嗪)、vaseretic(马来酸依那普利-氢氯噻嗪)、zestoretic(赖诺普利和氢氯噻嗪);血管紧张素II受体拮抗剂,例如atacand(坎地少坦西酯)、avapro(厄贝沙坦)、cozaar(氯沙坦钾)、diovan(缬沙坦)、micardis(替米沙坦)、teveten(甲磺酸依普沙坦);血管紧张素II受体拮抗剂和利尿剂,例如avalide(厄贝沙坦-氢氯噻嗪)、diovan(缬沙坦和氢氯噻嗪)、hyzaar(氯沙坦钾-氢氯噻嗪);抗心律失常药,例如Group I(例如mexitil(盐酸美西律USP)、norpace(磷酸丙吡胺)、procanbid(盐酸普鲁卡因酰胺)、quinaglute(葡萄糖酸奎尼丁)、quinidex(硫酸奎尼丁)、奎尼丁(葡萄糖酸奎尼丁注射剂USP)、rythmol(盐酸普罗帕酮)、tambocor(醋酸氟卡尼)、tonocard(盐酸妥卡尼));Group II(例如betapace(盐酸索他拉尔)、brevibloc(盐酸艾司洛尔)、心得安(盐酸普萘洛尔)、sectral(盐酸醋丁洛尔));Group III(例如betapace(盐酸索他拉尔)、cordarone(胺碘酮盐酸盐)、corvert(延胡索酸伊布利特注射剂)、pacerone(盐酸胺碘酮)、tikosyn(多非利特));Group IV(例如calan(维拉帕米盐酸盐)、cardizem(盐酸地尔硫
Figure A20068002383800191
)以及adenocard(腺苷)、lanoxicaps(地高辛)、lanoxin(地高辛));antilipemic acids,包括胆酸螯合剂(例如colestid(微粉化colestipol盐酸盐)、welchol(盐酸考来维仑));fibric acid衍生物(例如atromid(氯贝特)、lopid(gemfibrozal片剂,USP)、tricor(非诺贝特胶囊));HMG-CoA还原酶抑制剂(例如baycol(西立伐他汀钠片)、lescol(氟伐他汀钠)、lipitor(阿托伐他汀钙)、mevacor(洛伐他汀)、pravachol(普伐他汀钠)、zocor(辛伐他汀));烟酸(例如Niaspan(烟酸缓释片));β肾上腺素能阻断剂,例如betapace(盐酸索他洛尔)、blocadren(马来酸噻吗洛尔)、brevibloc(盐酸艾司洛尔)、cartrol(盐酸卡替洛尔)、普萘洛尔(盐酸普萘洛尔)、kerlone(倍他洛尔盐酸盐)、纳多洛尔、sectral(醋丁洛尔盐酸盐)、tenormin(阿替洛尔)、toprol(美托洛尔丁二酸盐)、zebeta(富马酸比索洛尔);β肾上腺素能阻断剂和利尿剂,例如corzide(纳多洛尔和苄氟噻嗪片)、inderide(普萘洛尔盐酸盐和氢氯噻嗪)、tenoretic(阿替洛尔和氯噻酮)、timolide(马来酸噻马洛尔-氢氯噻嗪)、ziac(富马酸比索洛尔和氢氯噻嗪);钙通道阻断剂,例如硝苯吡啶(硝苯地平)、calan(维拉帕米盐酸盐)、cardene(尼卡地平盐酸盐)、cardizem(diltiazem HCl)、covera(维拉帕米盐酸盐)、isoptin(维拉帕米盐酸盐)、nimotop(尼莫地平)、norvasc(苯磺酸氨氯地平)、plendil(非洛地平)、Procardia(硝苯地平)、sular(尼索地平)、tiazac(盐酸地尔硫
Figure A20068002383800192
)、vascor(苄普地尔盐酸盐)、verelan(维拉帕米盐酸盐);利尿剂,包括碳酸酐酶抑制剂(例如达拉奈(双氯非那胺));联合利尿剂(例如aldactazide(螺内酯和氢氯噻嗪)、dyazide(氨苯蝶啶和氢氯噻嗪)、maxzide(氨苯蝶啶和氢氯噻嗪)、moduretic(盐酸阿米洛-氢氯噻嗪));髓袢利尿剂(托拉塞米制剂(托塞米)、edecrin(依他尼酸、依他尼酸钠)、呋塞米);留钾利尿药(aldactone(螺内酯)、dyrenium(氨苯蝶啶)、midamor(盐酸阿米洛利));噻嗪类及相关利尿剂(例如diucardin(氢氟噻嗪)、diuril(氯噻嗪、氯噻嗪钠)、enduron(甲氯噻嗪)、hydrodiuril氢氯噻嗪)、吲达帕胺、microzide(氢氯噻嗪)、mykrox(美扎拉宗片)、renese(泊利噻嗪)、thalitone(氯噻酮,USP)、zaroxolyn(美扎拉宗));变力剂,例如digitek(地高辛)、dobutrex(多巴酚丁胺)、lanoxicaps(地高辛)、lanoxin(地高辛)、primacor(乳酸米力农);activase(重组阿替普酶);氯化肾上腺素(肾上腺素注射剂,USP);demser(甲基酪氨酸)、inversine(盐酸美加明)、reopro(阿昔单抗)、retavase(瑞替普酶)、streptase(链激酶)、tnkase(替奈普酶);血管舒张药,包括冠状血管舒张药(例如imdur(异山梨醇一硝酸酯)、ismo(异山梨醇一硝酸酯)、isordil(异山梨醇二硝酸酯)、nitrodur(硝酸甘油)、nitrolingual(硝酸甘油舌喷雾剂)、nitrostat(硝酸甘油片,USP)、sorbitrate(异山梨醇二硝酸酯));外周血管舒张药及联合药物(例如corlopam(甲磺酸非诺多泮)、fiolan(依前列醇钠)、primacor(乳酸米力农));血管加压药,例如aramine(间羟胺重酒石酸盐)、epipen(EpiPen0.3mg牌的肾上腺素自动注射器、EpiPen Jr.0.15mg牌的肾上腺素自动注射器)、proamatine(米多君盐酸盐);等。
在某些实施方案中,相关的具体药物包括但不限于:精神药理剂,例如(1)中枢神经系统抑制剂,例如全身麻醉剂(巴比土酸盐、苯并二氮杂
Figure A20068002383800201
类、类固醇、环己酮衍生物和各种药物);镇静剂-催眠剂(苯并二氮杂
Figure A20068002383800202
类、巴比土酸盐、哌啶二酮类和三酮类、喹唑啉衍生物、氨基甲酸酯、醛及衍生物、酰胺、非环状酰脲、苯并氮杂
Figure A20068002383800203
类及相关药物,吩噻嗪等);中枢自主肌肉紧张调节药物(抗惊厥剂,例如海因、巴比土酸盐、噁唑烷二酮、琥珀酰亚胺、酰脲、戊二酰亚胺、苯并二氮杂
Figure A20068002383800204
类、仲和叔醇、二苯并氮杂
Figure A20068002383800205
类衍生物、丙戊酸及衍生物、GABA类似物等);镇痛药(吗啡及衍生物、东罂粟碱衍生物、吗啡喃衍生物、苯基哌啶、2,6-甲烷-3-benzazocaine衍生物、二苯基丙胺和等排物、水杨酸盐、对-氨基苯酚衍生物、5-吡唑酮衍生物、芳基乙酸衍生物、fenamates和等排物等)和镇吐剂(抗胆碱能药、抗组胺药、抗多巴胺能药等);(2)中枢神经系统兴奋剂,例如苏醒剂(呼吸兴奋剂、惊厥兴奋剂、精神运动兴奋剂)、麻醉药拮抗剂(吗啡衍生物、东罂粟碱衍生物、2,6-甲烷-3-benzoxacine衍生物、吗啡喃衍生物)、促智药物;(3)精神病药,例如抗焦虑镇静剂(苯并二氮杂
Figure A20068002383800211
类、丙二醇氨基甲酸酯)、抗精神病药(吩噻嗪衍生物、thioxanthine衍生物、其他三环化合物、丁酰苯衍生物和等排物、二苯基丁胺衍生物、取代的苯甲酰胺、芳基哌嗪衍生物、吲哚衍生物等)、抗抑郁药(三环化合物、MAO抑制剂等);(4)呼吸道药物,例如中枢镇咳剂(鸦片生物碱及其衍生物);
药效学药物,例如(1)外周神经系统药、例如局部麻醉剂(酯衍生物、酰胺衍生物);(2)作用于突触或神经效应器结合部位的药物,例如胆碱能药、胆碱能阻断剂、神经肌肉阻断剂、肾上腺素能药、抗肾上腺素能药;(3)平滑肌活性剂,例如解痉剂(抗胆碱能药、musculotropic解痉剂)、血管舒张药、平滑肌兴奋剂;(4)组胺和抗组胺药,例如组胺及其衍生物(倍他唑)、抗组胺药(H1-拮抗剂、H2-拮抗剂)、组胺代谢药;(5)心血管药,例如强心剂(植物提取物、丁烯酸内酯、pentadienolids、围涎树属生物碱、实电解质、-肾上腺素受体刺激剂等)、抗心律失常药、抗高血压药、降血脂药(氯贝酸衍生物、烟酸衍生物、激素及类似物、抗生素、水杨酸及衍生物)、抗静脉曲张药物、止血剂;(6)血液和造血系统药,例如抗贫血药、血液凝结剂(止血剂、抗凝剂、抗血栓形成剂、溶解血栓药、血蛋白及其组分);(7)胃肠道药,例如助消化药(健胃药、利胆剂)、抗溃疡药、抗腹泻药;(8)局部作用药;
化学疗法药物,例如(1)抗感染药,例如杀外寄生物药(氯化碳氢化合物、pyrethins、含硫化合物)、驱虫药、抗原生动物剂、抗疟剂、抗阿米巴药、antileiscmanial药物、抗阴道滴虫药、抗锥体虫剂、磺胺、抗细菌药、抗病毒化疗药等;及(2)细胞抑制剂,即抗肿瘤药或细胞毒药,例如烷基化剂,例如盐酸氮芥(氮芥、盐酸氮芥、HN2)、环磷酰胺(Cytovan、Endoxana)、异环磷酰胺(IFEX)、苯丁酸氮芥(Leukeran)、美法仑(苯丙氨酸Mustard、L-溶肉瘤素、左旋溶肉瘤素、L-PAM)、白消安(麦里浪)、噻替哌(三亚乙基硫代磷酰胺)、卡莫司汀(BiCNU、BCNU)、罗氮芥(CeeNU、CCNU)、链佐星(Zanosar)等;植物生物碱,例如长春新碱(Oncovin)、长春碱(Velban、Velbe)、紫杉醇(泰素)等;抗代谢物,例如甲氨蝶呤(MTX)、巯基嘌呤(巯基嘌呤、6-MP)、硫鸟嘌呤(6-TG)、氟脲嘧啶(5-FU)、阿糖孢苷(Cytosar-U、Ara-C)、阿扎孢苷(Mylosar、5-AZA)等;抗生素,例如更生霉素(放线菌素D、Cosmegen)、阿霉素(阿霉素)、柔红霉素(duanomycin、Cerubidine)、伊达比星(Idamycin)、博莱霉素(Blenoxane)、Picamycin(普卡霉素、Mithracin)、丝裂霉素(突变霉素)等;及其他抗细胞增殖剂,例如羟基脲(Hydrea)、丙卡巴肼(Mutalane)、达卡巴嗪(DTIC-Dome)、顺铂(Platinol)、卡铂(Paraplatin)、天冬酰胺酶(Elspar)、依托泊苷(VePesid、VP-16-213)、安吖啶(AMSA、m-AMSA)、米托坦(Lysodren)、米托蒽醌(Novatrone)等;
抗生素,例如:氨基糖苷类,例如阿米卡星、阿泊拉霉素、阿贝卡星、班贝霉素、布替罗星、地贝卡星、双氢链霉素、福提霉素、庆大霉素、异帕米星、卡那霉素、小诺米星、新霉素、奈替米星、paromycin、核糖霉素、紫苏霉素、壮观霉素、链霉素、妥布霉素、丙大观霉素;amphenicols,例如叠氮氯霉素、氯霉素、florfenicol和theimaphenicol;安沙霉素类,例如利福米特、利福平、利福霉素、利福喷汀、利福昔明;β-内酰胺类,例如甲烯基取代7-氨基头孢烷酸核上的S产生的新头孢类抗生素、碳青霉烯类、头孢菌素、cehpamycins、单菌胺环、oxaphems、青霉素;lincosamides,例如克林霉素、林肯霉素;大环内酯类,例如克拉霉素、dirthromycin、红霉素等;多肽类,例如安福霉素、杆菌肽、缠霉素等;四环素类,例如阿哌环素、氯四环素、氯莫环素等;合成抗菌剂,例如2,4-二氨基嘧啶、硝基呋喃、喹诺酮及其类似物、磺胺、砜;
抗真菌剂,例如:多烯类,例如两性霉素B、杀念菌素、制皮菌素、非律平、制霉色基素、曲古霉素、哈霉素、意北霉素、美帕曲星、那他霉素、制霉菌素、倍西洛星、表霉素;合成抗真菌剂,例如丙烯胺类,例如布替萘芬、萘替芬、特比萘芬;咪唑类,例如联苯苄唑、布康唑、氯登妥因、氯米达唑等,硫代氨基甲酸酯,例如环托西拉酯,三唑类,例如氟康唑、itraconazole、特康唑;
驱虫药,例如:槟榔碱、绵马素、绵马酚、双氯酚、恩贝酸、苦辛、napthalene、氯硝柳胺、石榴碱、奎纳克林、阿兰内酯、阿莫卡嗪、硝硫氰胺、驱蛔素、苄酚宁、双硫氰苯、四氯化碳、香芹酚、环苯达唑、二乙碳酰嗪等;
抗疟药,例如:醋氨苯砜、阿莫地喹、蒿乙醚、蒿甲醚、青蒿素、青蒿琥酯、阿托伐醌、比比林、小檗碱、印度当药、氯胍、氯奎、氯丙胍、金鸡纳、金鸡尼丁、辛可宁、环氯胍、龙胆苦苷、卤泛群、羟氯奎、盐酸甲氟喹、3-甲基醋氨苯胂、帕马喹、抗疟素、伯氨喹、乙胺嘧啶、奎纳克林、奎尼丁、奎宁、喹西特、喹啉、砷酸二钠;
抗原虫剂,例如:氯甲氧丫胺、替硝唑、异丙硝唑、乙睇胺、戊双脒、乙酰胂胺、醋胺硝唑、茴香霉素、硝呋拉太、替硝唑、苯硝咪哇(benzidazole)、苏拉明等。
相关商标名称药物包括但不限于:曲格列酮片剂、洛伐他汀TM、依那普利TM、百忧解TM、奥美拉唑缓释剂TM、LipotorTM、克敏能TM、舒降之TM、环丙沙星TM、万艾可TM、佳息患TM、利他林TM等。
相关药物化合物也列于:Goodman & Gilman的ThePharmacological Basis of Therapeutics(第9版)(Goodman等编辑)(McGraw-Hill)(1996);和2001 Physician′s Desk Reference。
相关具体化合物也包括但不限于:
抗肿瘤药,如下列美国专利号所公开:
                                                           5880161,5877206,5786344,5760041,5753668,5698529,5684004,5665715,5654484,5624924,5618813,5610292,5597831,5530026,5525633,5525606,5512678,5508277,5463181,5409893,5358952,5318965,5223503,5214068,5196424,5109024,5106996,5101072,5077404,5071848,5066493,5019390,4996229,4996206,4970318,4968800,4962114,4927828,4892887,4889859,4886790,4882334,4882333,4871746,4863955,4849563,4845216,4833145,4824955,4785085,476925,4684747,4618685,4611066,4550187,4550186, 4544501,4541956,4532327,4490540,4399283,4391982,4383994,4294763,4283394,4246411,4214089,4150231,4147798,4056673,4029661,4012448;
精神药理学/精神病治疗药物,如下列美国专利号所公开:
     5192799,5036070,4778800,4753951,4590180,4690930,4645773,4427694,4424202,4440781,5686482,5478828,5461062,5387593,5387586,5256664,5192799,5120733,5036070,4977167,4904663,4788188,4778800,4753951,4690930,4645773,4631285,4617314,4613600,4590180,4560684,4548938,4529727,4459306,4443451,4440781,4427694,4424202,4397853,4358451,4324787,4314081,4313896,4294828,4277476,4267328,4264499,4231930,4194009,4188388,4148796,4128717,4062858,4031226,4020072,4018895,4018779,4013672,3994898,3968125,3939152,3928356,3880834,3668210;
心血管药,如下列美国专利号所公开:
                                                           4966967,5661129,5552411,5332737,5389675,5198449,5079247,4966967,4874760,4954526,5051423,4888335,4853391,4906634,4775757,4727072,4542160,4522949,4524151,4525479,4474804,4520026,4520026,5869478,5859239,5837702,5807889,5731322,5726171,5723457,5705523,5696111,5691332,5679672,5661129,5654294,5646276,5637586,5631251,5612370,5612323,5574037,5563170,5552411,5552397,5547966,5482925,5457118,5414017,5414013,5401758,5393771,5362902,5332737,5310731,5260444,5223516,5217958,5208245,5202330,5198449,5189036,5185362,5140031,5128349,5116861,5079247,5070099,5061813,5055466,5051423,5036065,5026712,5011931,5006542,4981843,4977144,4971984,4966967,4959383,4954526,4952692,4939137,4906634,4889866,4888335,4883872,4883811,4847379,4835157,4824831,4780538,4775757,4774239,4771047,4769371,4767755,4762837,4753946,4752616,4749715,4738978,4735962,4734426,4734425,4734424,4730052,4727072,4721796,4707550,4704382,4703120,4681970,4681882,4670560,4670453,4668787,4663337,4663336,4661506,4656267,4656185,4654357,4654356,4654355,4654335,4652578,4652576,4650874,4650797,4649139,4647585,4647573,4647565,4647561,4645836,4639461,4638012,4638011,4632931,4631283,4628095,4626548,4614825,4611007,4611006,4611005,4609671,4608386,4607049,4607048,4595692,4593042,4593029,4591603,4588743,4588742,4588741,4582854,4575512,4568762,4560698,4556739,4556675,4555571,4555570,4555523,4550120,4542160,4542157,4542156,4542155,4542151,4537981,4537904,4536514,4536513,4533673,4526901,4526900,4525479,4524151,4522949,4521539,4520026,4517188,4482562,4474804,4474803,4472411,4466979,4463015,4456617,4456616,4456615,4418076,4416896,4252815,4220594,4190587,4177280,4164586,4151297,4145443,4143054,4123550,4083968,4076834,4064259,4064258,4064257,4058620,4001421,3993639,3991057,3982010,3980652,3968117,3959296,3951950,3933834,3925369,3923818,3898210,3897442,3897441,3886157,3883540,3873715,3867383,3873715,3867383,3691216,3624126;
抗微生物药,如下列美国专利号所公开:
                                                  5902594,5874476,5874436,5859027,5856320,5854242,5811091,5786350,5783177,5773469,5762919,5753715,5741526,5709870,5707990,5696117,5684042,5683709,5656591,5643971,5643950,5610196,5608056,5604262,5595742,5576341,5554373,5541233,5534546,5534508,5514715,5508417,5464832,5428073,5428016,5424396,5399553,5391544,5385902,5359066,5356803,5354862,5346913,5302592,5288693,5266567,5254685,5252745,5209930,5196441,5190961,5175160,5157051,5096700,5093342,5089251,5073570,5061702,5037809,5036077,5010109,4970226,4916156,4888434,4870093,4855318,4784991,4746504,4686221,4599228,4552882,4492700,4489098,4489085,4487776,4479953,4477448,4474807,4470994,4370484,4337199,4311709,4308283,4304910,4260634,4233311,4215131,4166122,4141981,4130664,4089977,4089900,4069341,4055655,4049665,4044139,4002775,3991201,3966968,3954868,3936393,3917476,3915889,3867548,3865748,3867548,3865748,3783160,3764676,3764677;
如下列美国专利号所公开的抗炎药:
                                                           5872109,5837735,5827837,5821250,5814648,5780026,5776946,5760002,5750543,5741798,5739279,5733939,5723481,5716967,5688949,5686488,5686471,5686434,5684204,5684041,5684031,5684002,5677318,5674891,56726205665752,5656661,5635516,5631283,5622948,5618835,5607959,5593980,5593960,5580888,5552424,5552422  5516764,5510361,5508026,5500417,5498405,5494927:5476876  5472973  5470885,5470842,5464856,54648495462952,5459151,5451686,5444043 5436265,5432181,RE034918,5393756,5380738,5376670,5360811,5354768,5348957,5347029,5340815,5338753,5324648,5319099,5318971,5312821,5302597,5298633,5298522,5298498,5290800,5290788,5284949,5280045,5270319,5266562,5256680,5250700,5250552,5248682,5244917,5240929,5234939,5234937,5232939,5225571,5225418,5220025,5212189,5212172,5208250,5204365,5202350,5196431,5191084,5187175,5185326,5183906,5177079,5171864,5169963,5155122,5143929,5143928,5143927,5124455,5124347,5114958,5112846,5104656,5098613,5095037,5095019,5086064,5081261,5081147,5081126,5075330,5066668,5059602,5043457,5037835,5037811,5036088,5013850,5013751,5013736,500654,4992448,4992447,4988733,4988728,4981865, 4962119,4959378,4954519,4945099,4942236,4931457,4927835,4912248,4910192,4904786,4904685,4904674,4904671,4897397,4895953,4891370,4870210,4859686,4857644,4853392,4851412,4847303,4847290,4845242,4835166,4826990,4803216,4801598,4791129,4788205,4778818,4775679,4772703,4767776,4764525,4760051,4748153,4725616,4721712,4713393,4708966,4695571,4686235,4686224,4680298,4678802,4652564,4644005,4632923,4629793,4614741,4599360,4596828,4595694,4595686,4594357,4585755,4579866,4578390,4569942,4567201,4563476,4559348,4558067,4556672,4556669,4539326,4537903,4536503,4518608,4514415,4512990,4501755,4495197,4493839,4465687,4440779,4440763,4435420,4412995,4400534,4355034,4335141,4322420,4275064,4244963,4235908,4234593,4226887,4201778,4181720,4173650,4173634,4145444,4128664,4125612,4124726,4124707,4117135,4027031,4024284,4021553,4021550,4018923,4012527,4011326,3998970,3998954,3993763,3991212,3984405,3978227,3978219,3978202,3975543,3968224,3959368,3949082,3949081,3947475,3936450,3934018,3930005,3857955,3856962,3821377,3821401,3789121,3789123,3726978,3694471,3691214,3678169,3624216;
免疫抑制剂,如下列美国专利号所公开:
                                                           4450159,4450159,5905085,5883119,5880280,5877184,5874594,5843452,5817672,5817661,5817660,5801193,5776974,5763478,5739169,5723466,5719176,5696156,5695753,5693648,5693645,5691346,5686469,5686424,5679705,5679640,5670504,5665774,5665772,5648376,5639455,5633277,5624930,5622970,5605903,5604229,5574041,5565560,5550233,5545734,5540931,5532248,5527820,5516797,5514688,5512687,5506233,5506228,5494895,5484788,5470857,5464615,5432183,5431896,5385918,5349061,5344925,5330993,5308837,5290783,5290772,5284877,5284840,5273979,5262533,5260300,5252732,5250678,5247076,5244896,5238689,5219884,5208241,5208228,5202332,5192773,5189042,5169851,5162334,5151413,5149701,5147877,5143918,5138051,5093338,5091389,5068323,5068247,5064835,5061728,5055290,4981792,4810692,4410696,4346096,4342769,4317825,4256766,4180588,4000275,3759921;
镇痛药,如下列美国专利号所公开:
                                                  5292736,5688825,5554789,5455230,5292736,5298522,5216165,5438064,5204365,5017578,4906655,4906655,4994450,4749792,4980365,4794110,4670541,4737493,4622326,4536512,4719231,4533671,4552866,4539312,4569942,4681879,4511724,4556672,4721712,4474806,4595686,4440779,4434175,4608374,4395402,4400534,4374139,4361583,4252816,4251530,5874459,5688825,5554789,5455230,5438064,5298522,5216165,5204365,5030639,5017578,5008264,4994450,4980365,4906655,4847290,4844907,4794110,4791129,4774256,4749792,4737493,4721712,4719231,4681879,4670541,4667039,4658037,4634708,4623648,4622326,4608374,4595686,4594188,4569942,4556672,4552866,4539312,4536512,4533671,4511724,4440779,4434175,4400534,4395402,4391827,4374139,4361583,4322420,4306097,4252816,4251530,4244955,4232018,4209520,4164514  4147872,4133819,4124713,4117012,4064272,4022836,3966944;
胆碱能药物,如下列美国专利号所公开:
                                                  5219872,5219873,5073560,5073560,5346911,5424301,5073560,5219872,4900748,4786648,4798841,4782071,4710508,5482938,5464842,5378723,5346911,5318978,5219873,5219872,5084281,5073560,5002955,4988710,4900748,4798841,4786648,4782071,4745123,4710508;
肾上腺素能药物,如下列美国专利号所公开:
                                                  5091528,5091528,4835157,5708015,5594027,5580892,5576332,5510376,5482961,5334601,5202347,5135926,5116867,5091528,5017618,4835157,4829086,4579867,4568679,4469690,4395559,4381309,4363808,4343800,4329289,4314943,4311708,4304721,4296117,4285873,4281189,4278608,4247710,4145550,4145425,4139535,4082843,4011321,4001421,3982010,3940407,3852468,3832470;
抗组胺药,如下列美国专利号所公开:
                                                  5874479,5863938,5856364,5770612,5702688,5674912,5663208,5658957,5652274,5648380,5646190,5641814,5633285,5614561,5602183,4923892,4782058,4393210,4180583,3965257,3946022,3931197;
甾体药物,如下列美国专利号所公开:
                                                  5863538,5855907,5855866,5780592,5776427,5651987,5346887,5256408,5252319,5209926,4996335,4927807,4910192,4710495,4049805,4004005,3670079,3608076,5892028,5888995,5883087,5880115,5869475,5866558,5861390,5861388,5854235,5837698,5834452,5830886,5792758,5792757,5763361,5744462,5741787,5741786,5733899,5731345,5723638,5721226,5712264,5712263,5710144,5707984,5705494,5700793,5698720,5698545,5696106,5677293,5674861,5661141,5656621,5646136,5637691,5616574,5614514,5604215,5604213,5599807,5585482,5565588,5563259,5563131,5561124,5556845,5547949,5536714,5527806,5506354,5506221,5494907,5491136,5478956,5426179,5422262,5391776,5382661,5380841,5380840,5380839,5373095,5371078,5352809,5344827,5344826,5338837,5336686,5292906,5292878,5281587,5272140,5244886,5236912,5232915,5219879,5218109,5215972,5212166,5206415,5194602,5166201,5166055,5126488,5116829,5108996,5099037,5096892,5093502,5086047,5084450,5082835,5081114,5053404,5041433,5041432,5034548,5032586,5026882,4996335,4975537,4970205,4954446,4950428,4946834,4937237,4921846,4920099,4910226,4900725,4892867,4888336,4885280,4882322,4882319,4882315,4874855,4868167,4865767,4861875,4861765,4861763,4847014,4774236,4753932,4711856,4710495,4701450,4701449,4689410,4680290,4670551,4664850,4659516,4647410,4634695,4634693,4588530,4567000,4560557,4558041,4552871,4552868,4541956,4519946,4515787,4512986,4502989,4495102;
其公开的内容通过引用结合到本文中。
目的化合物还有上述化合物的类似物。
对所有上述活性剂而言,活性剂可以药学上可接受的盐存在。
如上所示,组合物中的活性剂通常存在于药学上可接受的介质或载体中,例如下所描述。在某些实施方案中,活性剂中活性化合物存在的量为约0.1%-约90%(重量),例如约1%-约30%(重量)。
药学上可接受的载体
如上所概述,本发明的组合物还包括药学上可接受的介质(即载体)。相关的载体有普通载体和赋形剂,例如玉米淀粉或明胶、乳糖、葡萄糖、蔗糖、微晶纤维素、高岭土、甘露醇、磷酸二钙、氯化钠和藻酸。通常用于本发明制剂的崩解剂包括交联羧甲基纤维素、微晶纤维素、玉米淀粉、淀粉羟乙酸钠和藻酸。
液体组合物可包含化合物或药学上可接受的盐在合适液体载体,例如乙醇、甘油、山梨醇,非水溶剂例如聚乙二醇、油或水,及悬浮剂、防腐剂、表面活性剂、湿润剂、矫味剂或着色剂中的悬浮液或溶液。或者,液体制剂可由可再组成的散剂制备。例如,含有活性化合物、悬浮剂、蔗糖和甜味剂的散剂可与水重新组成形成悬浮液;而糖浆可由含有活性组分、蔗糖和甜味剂的散剂制备。
片剂或丸剂形式的组合物可用任何常规用于制备固体组合物的合适的药用载体制备。此类载体的实例包括硬脂酸镁、淀粉、乳糖、蔗糖、微晶纤维素和粘合剂,例如聚乙烯吡咯烷酮。片剂也可提供有有色膜包衣,或者作为载体的一部分所包含的颜色。另外,活性化合物可配制成控制释放的剂型,如包含亲水性或疏水性基质的片剂。
“控制释放”、“持续释放”及类似术语用于表示活性剂释放的模式,该药物释放模式是在一定时间段内,活性剂以可测定和可控制的速度从释放介质中释放,而不是在施用或注射时立即分散。控制释放或持续释放可延续几小时、几天或几个月,并可作为许多因素的函数变化。对本发明的药用组合物而言,释放速度将取决于所选的赋形剂的类型和该赋形剂在组合物中的浓度。释放速度的另一个决定因素是聚原酸酯单元之间及其内部的键的水解速度。水解速度反过来可通过聚原酸酯的组成和聚原酸酯中可水解的键的数目控制。决定活性剂从本发明药用组合物中释放的速度的其他因素包括粒度、介质(基质的内部或外部)的酸性和活性剂在基质中的物理和化学性质。
胶囊剂形式的组合物可用常规装填胶囊方法,例如通过将活性化合物和赋形剂加入到硬明胶胶囊中制备。或者,可制备活性化合物和高分子量聚乙二醇的半固体基质,并填入硬明胶胶囊中;或者可制备活性化合物在聚乙二醇中的溶液或在食用油,例如液体石蜡或分馏椰子油中的悬浮液,并填入软明胶胶囊中。
可包括的片剂粘合剂有阿拉伯胶、甲基纤维素、羧甲基纤维素钠、聚乙烯吡咯烷酮(聚维酮)、羟丙基甲基纤维素、蔗糖、淀粉和乙基纤维素。可使用的润滑剂包括硬脂酸镁或其他金属硬脂酸盐、硬脂酸、聚硅氧烷流体、滑石粉、蜡、油和胶体二氧化硅。
也可使用矫味剂例如薄荷、冬青油、樱桃矫味剂等。或者,可能需要加入着色剂,使得剂型在外观上更有吸引力或帮助区别该产品。
有活性的本发明化合物及其药学上可接受的盐当非肠道给药时,可配制成肌内、鞘内或静脉内给药形式。
肌内或鞘内给药的典型组合物将是活性成分在油,例如花生油或芝麻油中的悬浮液或溶液。静脉内或鞘内给药的典型组合物将是含有例如活性成分和葡萄糖或氯化钠,或葡萄糖和氯化钠的混合物的无菌等渗水溶液。其他实例有乳酸盐林格氏注射液、乳酸盐复方氯化钠葡萄糖注射液、Normosol-M和葡萄糖、Isolyte E、酰化林格氏注射液等。任选在制剂中可包括共溶剂例如聚乙二醇、螯合剂例如乙二胺四乙酸及抗氧化剂例如偏亚硫酸氢钠。或者,溶液可以冷冻干燥,然后在临给药前用合适的溶剂再重新组成。
直肠给药起效的本发明化合物及其药学上可接受的盐可配制成栓剂。典型的栓剂制剂通常由活性成分与粘合剂和/或润滑剂例如明胶或椰子油或其他低熔点植物或合成蜡或脂肪组成。
局部给药起效的本发明化合物及其药学上可接受的盐可配制成透皮组合物或透皮释放装置(“贴剂”)。此类组合物包括例如背衬、活性化合物储库、控制膜、衬里和接触粘合剂。此类透皮贴剂可用于以控制量提供本发明化合物连续或不连续的输出。透皮贴剂的构建及在药物释放中的用途在本领域是众所周知的。例如,可参见美国专利号5,023,252,其内容通过引用而整体结合到本文中。此类贴剂可制成药物连续的、脉冲或即期(demand)的释放。
任选药用组合物可含有其他药学上可接受的组分,例如缓冲剂、表面活性剂、抗氧化剂、粘度调节剂、防腐剂等。这些组分中的每一种在本领域中均众所周知。例如可参见美国专利号5,985,310,其公开的内容通过引用结合到本文中。
适合用于本发明制剂的其他组分可在Remington′s PharmaceuticalSciences,Mace Publishing Company,Philadelphia,Pa.,第17版(1985)中找到。
识别器
在主题组合物中也存在识别器。识别器可根据特定的实施方案和该组合物预定用途变化。在某些实施方案中,识别器是通过刺激例如询问、与靶生理部位接触等激活时发射信号的组分。因此,识别器可以是接触靶机体(即生理的)部位时发射信号的识别器。另外或另一方面,识别器可以是询问时发射信号的识别器。
在还其他实施方案中,识别器是惰性的、但是可识别的标记物,例如刻标识别器(例如由免于消化的一种或多种材料制备的识别器)。该标记物然后可被识别,例如在验尸或法医检查后。提供药丸更内部的装置以确定不仅其表面部分地被消化,而且内部药丸物质也被消化是可能的。该应用在试验性药理学环境中特别有用。这些实施方案中的识别器是不必发射信号,但是能够光学检查,例如凭视力或机器阅读,获得给药前与其相关的组合物的有关信息的那种识别器。
虽然识别器可以是不发射信号的识别器,但是在某些实施方案中(如上所概述),识别器是确实发射信号的那种识别器。根据特定应用的需要,信号可以是类属信号,例如仅识别组合物已接触靶部位的信号,或者是唯一的信号,例如以某种方式唯一可将特定的组合物与一批中已接触靶生理部位的一组不同组合物或许多不同组合物区别开的信号。因此,识别器可以是一种在一批单位剂量,例如一批片剂中应用时,发射不能与该批中任何其他单位剂量成员的识别器发射的信号相区分的信号的识别器。在还其他实施方案中,识别器发射唯一将给定单位剂量,甚至与给定批中的其他同一单位剂量相区别的信号。因此,在某些实施方案中,识别器发射区别给定类型的单位剂量与其他类型的单位剂量,例如给定药物与其他类型药物的唯一信号。在某些实施方案中,识别器发射区别给定单位剂量与单位剂量定义群体的其他单位剂量,例如剂量制剂的处方、批或有效期间成批制备的唯一信号。在某些实施方案中,识别器发射唯一的信号,即可与曾经制备的任何其他剂量制剂发射的信号区别的信号,其中该信号可视为普遍唯一的信号(例如类似于人指纹,与任何其他个体的任何其他指纹不同,并因此在普遍水平上唯一地识别个体)。在一个实施方案中,信号可直接传输关于组合物的信息,或者提供识别编码,该编码可用于从数据库,即连接识别编码与组合物的数据库中取回该组合物的信息。
识别器可以是激活后,能够产生响应刺激的可检测信号的任何组件或装置。在某些实施方案中,一旦组合物接触到生理靶部位,例如上所概述的,刺激激活识别器发射信号。例如,患者可摄取与胃液接触时产生可检测信号的药丸。根据实施方案,靶生理部位或位置可变化,其中代表性的相关靶生理部位包括但不限于:胃肠道中的位置(例如口、食道、胃、小肠、大肠等);机体内的另一个位置,例如母体(parental)位置、血管位置等;或者局部位置等。
在某些实施方案中,激活识别器的刺激是询问信号,例如扫描或其他类型的询问。在这些实施方案中,刺激激活识别器,因此发射例如以某种方式识别组合物的信号,该信号然后接收并处理。
在这些实施方案的某些中,识别器可包括转换广播功率的电源,和调节所转换功率的量的信号发生元件,以使信号不从识别器中发射,反而由识别器转换的广播功率的量以“信号”被检测和使用。此类实施方案可用于各种应用,例如其中特定组合物的历史为目的的应用,例如下面更详细地评述的。
在某些实施方案中,规定识别器的大小与组合物中的活性剂/药学上可接受的载体组分相关,以便产生可易于向有此需要的患者给药的组合物。因此,在某些实施方案中,规定识别器元件的大小使其宽度范围为约0.05mm-约1mm,例如约0.1mm-约0.2mm;长度范围为约0.05mm-约1mm,例如约0.1mm-约0.2mm及高度范围为约0.1mm-约1mm,例如约0.05mm-约0.3mm,包括约0.1mm-约0.2mm。在某些实施方案中,识别器为1mm3或更小,例如0.1mm3或更小,包括0.2mm3或更小。识别器元件可采取各种不同的构型,例如但不限于:芯片构型、柱体构型、球形构型、盘形构型等,其中特定的构型可基于预期的应用、制备方法等选择。
识别器可产生各种不同类型的信号,这些信号包括但不限于RF信号、磁信号、传导(近场)信号、声信号等。
如本领域已知(参见,例如J.D.Jackson,Classical Electrodynamics,第2版,pp.394-396(1975)),具有角频率ω和相应的波数k(其中k=ω/c,其中c为相关介质中的光速)的振荡电双极天线发射的电(E)场和磁(B)场由以下方程给出:
B = k 2 ( n × p ) e ikr r ( 1 - 1 ikr ) ;
E = k 2 ( n × p ) × n e ikr r + [ 3 n ( n · p ) - p ] ( 1 r 3 - ik r 2 ) e ikr ,
其中n为在从来源的距离r上,从双极来源的中央到位置x的方向上的单位矢量,p为由p=∫x′ρ(x′)d3x′给出的电荷空间积分密度。
从方程式(1)和(2)可以看出,在“远场”区域中,其中r>>λ(其中波长λ=2π/k),电和磁场由随距离1/r减少的术语决定。在该区域中,相互垂直的电和磁场彼此输入以将信号穿越空间传播。其中方程式(1)和(2)中的λ~r、1/r2(“诱导”)术语变得重要,而其中λ>>r,即以1/r3变化的另一个准静电术语也变得重要。
常规的RF通讯在距离r~λ至r>>λ处发生。例如,可植入的医疗装置例如起博器通常以405-MHz的频率带通讯,相应于波长为0.75米,多少小于人体的规模。正如本领域已知的,最好不使用更高的频率,因为机体内的结构开始吸收发射,导致不期望的信号损失;明显更低的频率(更长的波长)通常被认为是不期望的,因为很多能量又回到诱导和/或准静电场组件中,而不是用常规天线可传感的远场组件中。也应说明的是,具有发射应答器和基本单位的RFID应用通常采用的波长使r~λ和通常依赖磁诱导将动力从发射应答器传送到基本单位。在某些实施方案中,采用这些RF信号。
与这些方法相反,本发明的某些实施方案最好以比人体大得多的波长(λ>>1米)运行以在患者体内交流信息,例如美国临时专利申请序号60,713,680中所描述的;其公开的内容通过引用结合到本文中。例如,在某些实施方案中,最好使用100kHz数量级的频率,相应于大约3km的波长(空气中)。在与波长λ相比是短的距离r处,方程式(1)和(2)中的准静电场术语占优势,因此正传播的信号主要是电的而不是电磁的。此类信号易于在传导介质例如人体中传播。例如,以100kHz的频率和1-2米数量级的距离,估计方程式(2)的准静态(1/r3)组件比远场(1/r)组件强数量级106倍。因此,用近场耦合发长波长信号是有效的。此外,因为信号需要传送相对短的距离(通常2米或更短),可检测的信号可用非常小的天线传送。
宽范围的频率可用于信号的传送。在某些实施方案中,传送频率在RF光谱的“LF”带内(低频率,定义为30-300kHz),在AM收音机的频率范围以下(大约500-1700kHz)。在LF带内,160-190kHz的范围通过试验使用的FCC指定,并规定在外部信号强度上的上限。在其中如下面所描述的信号在患者体内大量受限的本发明实施方案中,可使用该试验带。
然而,本发明不限于160-190kHz带或LF(30-300kHz带)。也可使用更低的带;例如,在VLF带(3-30kHz,空气中的波长为10-100km)中,信号可进入到水中10-40米的距离。因为人体的电性质类似于盐水的电性质,预计该带中的信号也将易于通过机体传播。因此,可使用相应于至少数量级大于人体的波长的任何频率带-例如,λ~10m或更长,或者频率在30MHz数量级或以下。
虽然对所使用的信号频率无必须的更低的限制,几种实际的考虑可影响频率的选择。例如,众所周知,人体带有由附近AC-动力的装置诱导的低水平的振荡信号,这些装置以60Hz(US)或类似的频率在世界上其他地方运行。为了避免由AC电动力系统引起的干扰,最好不使用接近60Hz的频率。另外,如本领域已知的,更长的波长与更低的信息传送速度相关,而长波长处的信息传送能力(例如在3kHz-30kHz VLF带以下)对在特定系统中待传送的信息的量而言可能太小。此外,更长的波长通常需要更长的双极天线以产生可检测的信号,而在某种程度上天线的大小可成为频率选择的限制因素。
根据本发明的某些实施方案,给定频率的适当选择,强到足够传送到机体内接收器的信号可用非常小的天线产生。例如,由仅几毫米长的双极天线产生的100kHz信号可以传播到置于1-2米远的接收器天线。该准静电传送被认为受到植入的天线直接与传导介质,例如患者的组织接触的事实的帮助。对分析电性质的目的而言,人组织可能接近于具有可与盐水性质相当的电性质的电解质溶液。因此,当在电解质浴中时,由振荡双极天线产生的准静电场在机体中诱导振荡电流。作为机体固有电阻系数的结果(可与盐水相当),该振荡电流在机体内产生可用合适的接收器检测的振荡电位变化。(参见,例如L.D.Landau等的Electrodynamics of Continuous Media,Ch.3(1960))。合适的接收器的实例包括起博器的导线,它们产生具有约20cm的轴的双极或者长度为10-100cm的其他植入电线。
应说明,这些电流在常规RF通讯的背景中是不期望的,其中近场中的电流流动导致远场中的功率损失。事实上,许多RF发送器包括设计成使近场电流泄漏最小化的装置。在本发明实施方案的近场发送器中,使此类电流最大化是理想的。
此外,对准静电信号而言,患者的皮肤有利的起传导屏障的作用,限制患者体内的信号。这限制了机体内的信号,也使杂散外部信号进入机体并在所传送的信号中产生噪音或干扰困难。信号的限制可以减轻,在某种程度上,近场信号的1/r3下降,进一步减少了功率的需要。此类作用在实验室中已观察到,例如在盐水浴中,其中水/空气界面起传导屏障作用。类似的作用在通过用ELF(3-30Hz)和SLF(30-300Hz)带的RF传送与水下通讯中已观察到。这些作用也已在声纳通讯中观察到;虽然声纳使用声的,而不是电的或电磁的场传送信息,水表面起声能传导屏障的作用并减轻信号强度随距离的下降。
作为这些现象的结果,具有非常小天线和小电源的发送器足够产生可在患者体内检测的近场信号。例如,天线可通过长度为几毫米或更小、间隔几毫米,施加反相振荡电压以产生振荡电双极的一对电极形成。此类天线几乎可置于机体内的任何地方。
此外,在某些实施方案中,选择频率、发送器天线长度和接收器天线长度以使仅需要微瓦的功率产生可检测的信号,其中常规的RF通讯(例如大约405MHz)将需要至少毫瓦。因此,可使用仅产生小量功率的非常紧凑的动力供应;实例在下面的第1V部分中描述。
因此,根据相关的特定实施方案,频率的范围可在约.1Hz或更低-约100mHz或更高,例如约1kHz-约70mHz,包括约5kHz-约200kHz。
在某些实施方案中,由识别器发射的信号是声信号。在这些实施方案中,任何方便的声信号发生元件可存在于该识别器中,例如压电元件等。
识别器的传送时间可变化,其中在某些实施方案中,传送时间的范围可在约0.1μ秒-约4小时或更长,例如约1秒-约4小时。根据特定的实施方案,识别器可传输信号一次或传输信号两次或更多次,以使信号可作为冗余信号被观察。
在某些实施方案中,在由识别器产生的信号可在制备该识别器后测定的意义上,识别器可以是制备后可编程的,其中该识别器可以是现场可编程的、质量可编程的、保险丝可编程的、甚至可重编程的。此类实施方案目的是在其中首先制备未编码的识别器,然后加入到组合物中,然后编码以发射该组合物的识别信号。可采用任何方便的编程技术。在某些实施方案中,所采用的编程技术是RFID技术。可在主题识别器中采用的相关的RFID智能标记技术包括但不限于:美国专利号7,035,877;7,035,818;7,032,822;7,031,946中所描述的,以及已公布的申请号20050131281等,其公开的内容通过引用结合到本文中。用RFID或其他智能标记技术,制备商/销售商可以将唯一的ID编码与给定的识别器联系起来,甚至在该识别器已加入到组合物中后。在某些实施方案中,涉及使用前处理组合物的每个个体或实体可将信息导入到识别器中,例如以有关由识别器发射的信号编程的形式,例如美国专利号7,031,946中所描述的,其公开的内容通过引用结合到本文中。
某些实施方案中的识别器包括记忆元件,其中该记忆元件可随其容量变化。在某些实施方案中,记忆元件的容量范围为约1位-1千兆位或更多,例如1位-1兆位,包括约1位-约128位。所采用的特定容量可随应用而变化,例如信号是类属信号还是编码信号,及其中信号可以或可以不用某些另外的信息,例如活性剂的名称注释等。
本发明实施方案中的识别器组件具有:(a)激活组件和(b)信号发生组件,其中信号发生组件通过该激活组件激活产生识别信号,例如以上所描述的。
激活组件
激活组件是经历刺激时,例如组合物与相关靶生理部位例如胃的接触激活信号发生组件发射信号的组件。激活组件可以配制成以许多不同的方式被激活。下列部分详细描述了识别器可被激活的某些不同方式。可从下列评论看出,激活组件可以或可以不与电源,例如电池形成整体。说明性的激活方法包括但不限于:电池完全,例如由加入电解质激活的电池和由加入阴极或阳极激活的电池;电池连接,例如由加入导体激活的电池;晶体管介导的电池连接,例如由晶体管栅电路激活的电池,几何修改(modification),由共振结构检测几何修改,压力检测,共振结构修改等。现在更详细地评论各种这些说明性的激活方法。
电池完全
由加入电解质激活的电池
在这些实施方案中,当完全时,电池包括阳极、阴极和电解质。当组合物(例如药丸)给药,例如摄取,并通过食管运行时,它开始进入胃。组合物中的阳极和阴极不构成完整的电池。然而,当组合物溶解使阳极和阴极暴露时,胃液起电池电解质组件的作用。所加入的胃液组件因此使电池完全。因此,当组合物例如通过进入胃并溶解到阳极和阴极暴露点而接触靶部位时,提供激活识别器例如芯片配制的识别器的电源。然后传送数据信号。该配制在下面,例如根据图4更详细地描述。
由加入阴极或阳极激活的电池
在该方法的扩展中,系统通过触发事件加入阴极或阳极组件激活,而电解质是在部分的、预电池配制中原有的。电池完全后,产生动力并激活组合物,虽然不必在同一时间点上。
电池连接
由加入导体激活电池
在本发明的另一个实施方案中,当进入胃中时电池与电路连接。通过加入导体电池开始连接,因此激活了识别器。在该情况中,存在身体上的完全电池和完全晶片。当这两种组件在体液中,例如在胃中被冲打时,它们电子连接。该触发事件使电池与发信号的微型芯片电连接,因此激活了智能药丸。
晶体管介导的电池连接
由晶体管栅电路激活的电池
使电池和晶片能够一起激活智能药丸的另一个设计在电池和报告芯片之间具有晶体管栅电路的特征。一旦晶体管栅电路打开,例如通过胃激活,就传送报告信号。
有许多对本领域普通技术人员而言是众所周知的打开晶体管栅电路的方法。它们中的大多数涉及通过关闭开关而激活该晶体管栅电路,该开关可包括晶体管开关或其他类型的开关。
该栅电路可通过施加小的栅控电流(gate current)激活。这是例如晶体管通常是如何被激活的。栅控电流可以本领域普通技术人员众所周知的任一方式产生。检测在相关环境,例如胃中药丸存在的任何电路产生栅控电流,并开启系统。
栅控电流可通过检测电导率变化开启。例如,可提供检测胃中电导率微小变化的电路。虽然胃有传导性,但是药丸可能不具有。结果,当检测到电导率的变化时,晶体管栅电路被激活,使小药丸开启并产生报告信号。
电导率可通过溶液浓度的变化调节。例如,系统检测胃中与胃外区域对照的不同溶液浓度。通过调节电导率检测溶液pH,它开启栅电路,并接通药丸产生报告信号。
胃含有离子传导流体。那些离子传导流体可用于调节栅电路的电导率并接通智能药丸,产生报告信号。胃中的每种酶均可检测。例如,可使用寻找胃中胃蛋白酶含量的chem-FET,将药丸接通,因此报告该酶的存在。
也可用本发明的创造性检测温度变化。胃中的温度通常稳定在37℃。胃外区域的温度更通常是20℃或更低。当药丸进入胃中并被加热,如此设计药丸以致这调节电导率并将识别器开启,产生报告信号。
晶体管的电导率可通过称为载体迁移率的微观性质调节。采用该性质的检测方法用晶体管本身作为检测器。载体迁移率通过温度-众所周知的现象调节。以该方式,晶体管通过使用该晶体管开启智能药丸,产生报告信号而用作温度传感器。
另一种方法是改变MOSFET晶体管栅电路上的电荷。栅电荷可通过待检测的因素调节。这又是使用晶体管开启电路,产生报告信号的配制。
在另一个配制中,栅电荷通过待在溶液中检测的材料调节。选择性离子将优先改变栅电荷。该系统通过晶体电位调节。当晶体在某些情况下产生电场时出现晶体电位。
电场可改变栅电路上的电荷,开启晶体管并产生报告信号。该变化可通过化学电位调节,该化学电位由渗透或离子方法产生。这引起电荷在栅电路上的积聚,因此,接通并产生报告信号。
电位的改变也可产生使用各种电位的报告信号。例如,重力势可检测检测器高度的变化。在患者吞咽药丸的情况中,药丸高度的变化将显示摄取。
在另一个实施方案中,晶体管栅电路与电容相联系。该电容然后通过靶部位,例如胃特有的某些性质调节。
在一种情况中,电容通过在胃中被封装而改变。对电容的该作用然后被检测。栅电荷通过载体浓度的变化而调节。载体浓度通过温度调节。该方法提供了稍微不同的方法,但是原理上类似于上述用晶体管作为温度传感器。
几何修改
也提供了具有变化几何学的晶体管结构。栅电容通过胃中发生的几何变化测定,检测电容的变化。这些变化可以各种方式发生,例如下面进一步描述的。
各种生理因素改变了几何学。不同于胃外压力的胃内压力在食糜产生期间,以及在其他时间随自然推挤作用产生。这改变了栅电容。该变化通过栅电路上的电介质检测。在该情况中,栅电路由许多层组成,其中之一是电介质。
在另外的实施方案中,胃中的酶溶解电介质,改变了栅电容,该电容然后被检测到。胃中的各种物理和化学条件溶解该栅电介质,因此激活该电路。
由共振结构检测几何修改
提供了栅电路上的共振结构的其他变体。在该情况中,提供了具有特性频率的机械结构。该频率由触发事件激发并测定。与胃的各种相互作用将引起该共振的改变。
压力检测
栅电容和具有调制源的共振也可用于检测。在该情况中,激发被提供给来自调制源的共振结构,例如声波。该共振结构的栅电容可用于检测压力波。共振结构保留在胃中并被接通至晶体管的检测电路上。在胃中,共振电路检测压力波。
在机体内的压力声波中,存在特征性的特殊声音,例如心脏跳动和呼吸。这些声音被检测并用于开启电路。
压力波也可通过共振Q因数调制检测。Q因数调制可以用许多不同的方式实现。该共振结构具有两个组件,即频率和Q因数。Q因数通过检测某些环境变化调制。
共振结构修改
例如,结构在空气中具有非常不同于胃液中的Q因数。因此,阻尼可通过流体粘度检测。另外,结构可配制成被胃中的酸或某些酶腐蚀掉,这改变了提示。
被胃酸或酶降解也改变了共振频率。检测该结构的频移是简单的。当该结构在胃中改变时频移。有两种方法修改结构。当结构溶解时分解代谢过程可发生,这容易检测。同样,当胃中的酶与该结构结合时合成代谢过程将发生,使得它更大。该作用也将修改共振结构。共振修改以频率改变或Q因数调制被检测。
电池电源
如上所评论,在某些实施方案中,激活元件是电源与靶部位,例如生理靶部位如胃例如胃酸接触时被接通的电源。在某些实施方案中,电源是在与生理靶部位接触时被接通以提供动力的电池,其中该电池与信号发生组件耦合,以使当该电池被接通时,信号发生组件发射识别信号。
在某些实施方案中,所采用的电池是包含两种构成电池两极的不同材料的电池。在某些实施方案中,这两种材料由另外的材料层屏蔽周围环境。当屏蔽材料(例如活性剂/载体基质)被周围流体溶解或侵蚀时,电极材料被暴露并接触到体液,例如胃酸或其他类型的电解质流体。作为两种电极材料分别遭受的氧化和还原反应的结果,电位差,即电压在电极之间产生。因此可形成伏打电池或电池。因此,在本发明的实施方案中,配制此类电池以使当两种不同的材料暴露于靶部位例如胃、消化道等时,在其中存在信号发生元件的组合物的物理和化学侵蚀期间,产生电压。在此类实施方案中,上述电源不是普通词义上的“电池”,而是按物理学的原则定义的。电解质中的两种不同材料有不同的电位,类似于“马铃薯电池”的物理模型。作为实例,当放入电池中时铜和锌具有不同的电位。类似地,金和镁具有不同的电位。结果,产生两种不同材料之间的电位差。
各种电池激活配制是可能的。代表性的电池激活方法的类型包括但不限于:通过电解质的存在激活,通过阴极材料的存在激活,通过传导材料的存在激活。
电池激活后,可使用其他激活配制激活信号发生组件。例如,信号发生组件可通过激活金属氧化物半导体(MOS)电路的栅,例如CMOS开关激活。MOS电路的栅的激活可基于一种或多种参数,这些参数包括但不限于:栅控电流、栅电荷和栅电容。
栅控电流,就激活目的而言,可以是周围体液或组织电导率的函数。该电导率可进一步是一种或多种参数的函数,这些参数包括但不限于:溶液浓度、溶液pH值、溶液的离子含量、溶液的酶含量、温度和载体迁移率。载体迁移率也可以是温度的函数。
类似地,栅电荷可以是一种或多种参数的函数,这些参数包括但不限于:溶液组成、晶体电位、电位、重力势、栅电容和载体浓度。载体浓度也可以是温度的函数。
栅电容可以是栅电容几何学的函数,它可以进一步是压力、共振输入或与栅电路耦合的电介质材料的特性的函数。电介质材料的特性可随一种或多种参数变化,这些参数包括但不限于:消化道的化学内容物、生理位置的化学特征及体液中电介质材料溶解的量。
在某些实施方案中,电池是由活性电极材料、电解质和非活性材料例如电流收集器、包装等组成的电池。活性材料是任何一对具有不同电化学电位的材料。合适的材料不限于金属,在某些实施方案中,成对的材料选自金属和非金属,例如由金属(例如Mg)和盐(例如CuI)组成的一对。关于活性电极材料,物质-金属、盐或层间化合物与适当不同的电化学电位(电压)和低界面电阻的任何配对是合适的。
各种不同材料可用作电池电极。在某些实施方案中,选择电极材料用于在与靶生理部位例如胃接触时,提供足够驱动识别器的信号发生元件的电压。在某些实施方案中,在电源的金属与靶生理部位接触时,由电极材料提供的电压是0.001V或更高,包括0.01V或更高,例如0.1V或更高,例如0.3V或更高,包括0.5伏或更高,并包括1.0伏或更高,其中在某些实施方案中,电压的范围为约0.001-约10伏,例如约0.01-约10V。
相关的材料和配对包括但不限于下列表1中所报道的那些。
Figure A20068002383800461
Figure A20068002383800462
保护的阳极:某些高能量阳极材料例如Li、Na和其他碱金属在水或氧的存在下其纯的形式是不稳定的。然而如果被稳定这些材料可用于水性环境。该稳定化的一个实例是Polyplus Corporation(Berkeley,CA)开发的所谓的“保护的锂阳极”,其中将聚合物膜置于锂金属表面以使其不被迅速氧化并使其能用于水性环境或空气环境。(Polyplus对此具有待审的IP)。
Figure A20068002383800463
溶解的氧也可起阴极作用。在该情况中,体液中所溶解的氧在合适的催化表面例如在Pt或金表面将被还原成OH-。其他催化剂也是可能的。
在某些实施方案中,这些金属之一或两种可掺杂非金属,例如以提高电池的电压输出。可用作掺杂剂的非金属在某些实施方案中包括但不限于:硫、碘等。
在某些实施方案中,电极材料是碘化亚铜(copper iodine)(CuI)作为阳极和镁(Mg)作为阴极。本发明的实施方案使用对人体无伤害的电极材料。
在某些实施方案中,电池具有小型因子。电池可以是10mm3或更小,例如1.0mm3或更小,包括0.1mm3或更小,包括0.02mm3或更小。因此,在某些实施方案中,电池元件的大小规定为宽度范围为约0.05mm-约1mm,例如约0.1mm-约0.2mm;长度范围为约0.05mm-约1mm,例如约0.1mm-约0.2mm;及高度范围为约0.1mm-约1mm,例如约0.05mm-约0.3mm,包括约0.1mm-约0.2mm。
如下所评论,在某些实施方案中,电池具有分组或分节配制。
在某些实施方案中,电池是无包装的电池。因此,电极被暴露并不受任何保护或密封结构的保护。因此,除去电池可与其相联系的活性剂/载体基质材料后,电池本身不自己包括保护性包装,因此电极自由地接触靶生理位置的电解质。
在某些这些实施方案中,电池电源可视为在离子溶液例如胃液、血液或其他体液和某些组织中利用反向电解的电源。图4显示具有由反向电解产生动力的信号发生元件40的识别器30。信号发生元件40与金属电极32和33电连接,它们由两种不同材料制成并且相互电绝缘。当金属电极32和33浸没在离子溶液39中时,它们之间形成电位差;例如,电极33上升到更高的电位V+,而电极32下降到更低的电位V-。该电位差可用于驱动电路40。
电极32和33可以各种方式实现;例如,在集成电路芯片的对侧表面的区域可用两种不同金属涂覆,并将整个芯片置于离子溶液中。或者,电极32和33可如所示从元件40延伸开。也可使用其他安排。
如上所示,电极32和33可由任何两种适用于识别器30将在其中运行的环境的材料制成。例如,在某些实施方案中,其中离子溶液39包含胃酸,电极32和33可由贵重金属(例如金、银、铂、钯等)制备,以使它们不过早地被侵蚀。或者,电极可由铝或任何其他传导材料制备,该材料在可使用的离子溶液中的存在时间足够长,使识别器30能够行使其预定的功能。
当电源是电池时,该电池可以许多不同的方式制备。在某些实施方案中,采用可被归类为“平面”加工方案的制备方案,如下面更详细地阐述。
另外的电源
除了或代替上述那些电源外,在远程装置的内部或外部也可采用其他电源。例如,具有合适形式因子的化学或放射性同位素电池可用于驱动某些远程装置。最近开发的用血液作为能源的燃料电池可以制成微型的,并用于向低功率微型芯片提供电能。将机械能(例如压缩)转化为电能的压电晶体可用于可施加合适的机械力的远程装置,例如在心脏、胃、关节或机体其他活动部分中或在其周围。在还其他实施方案中,采用在细胞能量工厂模型化的电源,从血液中的ATP提取动力,使得血液事实上“滋养”识别器。在其他实施方案中,声能(例如超声)可通过压电转换器或类似的转换器耦合到远程装置中。
在还其他实施方案中,激活元件不是已装电源,而是由分开的电源驱动并且在组合物与靶部位接触时向信号发生元件提供激活信号的元件。例如,激活元件可与配制成接收广播能,并将该广播能转换成适用于驱动信号发生元件的形式的能量接收器耦合。在某些实施方案中,能量接收器可以是线圈。或者,激活元件可通过不同的电源,例如密封电池,即将药丸的机械能转化成电能的能量元件,例如压电能量元件等驱动。因此,激活剂本身可以是或可以不是电源,在它不是电源的那些实施方案中,识别器可包括不同的电源,例如接收器或电力发电机。
信号发生元件
识别器元件的信号发生元件的结构是,当通过激活元件激活时,发射可检测的信号,例如可由接收器接收的信号,例如下面所更详细地描述的。某些实施方案的信号发生元件可以是任何方便的装置,该装置能够在由激活元件激活时,产生可检测的信号和/或调制被转换的广播能。相关的可检测信号包括但不限于:传导信号、声信号等。如上所评论,由信号发生器发射的信号可以是类属信号或唯一信号,其中代表性的相关信号的类型包括但不限于:频移编码的信号;调幅信号;调频信号等。
在某些实施方案中,信号发生元件包括电路,如下面更详细展开的,该电路发生或产生信号。所选择的电路类型可取决于,至少部分取决于由识别器电源提供的驱动功率。例如,当驱动功率为1.2伏或以上时,可采用标准CMOS电路。在其他实施方案中,其中驱动功率的范围在约0.7-约1.2V,可采用亚阈电路设计。对约0.7V或更小的驱动功率而言,可采用零阈晶体管设计。
在某些实施方案中,信号发生元件包括可产生响应激活元件激活的数字钟信号的电压控制振荡器(VCO)。VCO可由数字电路控制,该电路赋值地址,并且可以用控制电压控制该VCO。该数字控制电路可嵌在包括激活元件和振荡器的芯片上。用调幅或相移键控编码地址,传送识别信号。
信号发生元件可包括不同的起传送产生的信号到远程接收器作用的发送器组件,它可以在患者的内部或外部,如下面更详细评论的。当存在时,发送器组件例如根据所产生的和待发射的信号的类型,可采取许多不同的配制。在某些实施方案中,发送器组件由一种或多种电极组成。在某些实施方案中,发送器组件由一种或多种电线,例如以天线形式组成。在某些实施方案中,发送器组件由一种或多种线圈组成。因此,信号发送器可包括各种不同的发送器,例如电极、天线(例如电线形式的)、线圈等。在某些实施方案中,信号通过一个或两个电极或通过一根或两根电线传送。两个电极的发送器是双极;一个电极的发送器形成单极。在某些实施方案中,发送器仅需要一个功率的二极管压降(diode drop of power)。
在某些实施方案中,发送器单元使用电双极或电单极天线传输信号。图6A显示双极天线。振荡器504向电极驱动器506提供驱动信号(φ和本文中以/φ表示的反转信号)。图6C是详细显示使用常规CMOS驱动电路的双极电极驱动器600的电路图。电极602由响应驱动信号φ的晶体管604、606驱动到电位E0,而电极608由响应反转驱动信号/φ的晶体管610、612驱动到电位E1。由于驱动信号φ和/φ与反相一起振荡,电位E0和E1也与反相一起振荡。应认识到,驱动器600和本文中描述的所有其他电子电路可用本领域已知的超微型CMOS处理技术实现;因此,电路的大小不是远程装置大小的限制因素。
在某些实施方案中,单极天线可被图6A的双极天线取代。图6D显示可在常规CMOS集成电路中使用的单极天线的驱动电路。该天线驱动器通常类似于图6C的驱动电路的一半,具有驱动信号电极706到响应驱动信号φ的电位Em的驱动器晶体管702、704。
在双极或单极情况中,驱动电路由终端V+和V-之间的电位差(ΔV)产生动力。如需要,该电位差可以是常量或变量。
图6A是根据本发明实施方案的识别器的发送器信号发生元件500的方框图。在该实施方案中,发生元件500接收来自激活元件的信号M,该激活元件激活信号发生元件产生并发射信号。信号发生元件500包括控制逻辑502、振荡器504、电极驱动器506和天线508(在该情况下,一对电极作为电双极天线运转)。在运转中,振荡器504产生响应来自控制逻辑502的信号的振荡信号(波形)。来自控制逻辑502的信号可启动或停止该振荡器,并在某些实施方案中,也可使振荡信号的一个或多个方面例如振幅、频率和/或相成形。振荡器504向电极驱动器506提供波形,该驱动器驱动天线508上的电流或电压,将信号传输到机体组织或流体的传导介质中。
根据特定的实施方案,信号可以或可以不调制。例如,在某些实施方案中,信号的频率可以保持恒定。在还其他实施方案中,信号可以某种方式调制,例如通过基于载体的调制方案、超宽带(或基于时域)调制方案等。
再来看图6A,在某些实施方案中,振荡器504以恒定的频率运转。接收其中和其本身恒定频率信号可提供有用的信息,例如远程装置存在并可操作的信息。在某些实施方案中,振荡器504调制其信号以将另外的信息编码。
信息可以各种方式编码,通常通过调制(改变)所传送的信号的某些性质,例如频率、振幅、相或其任一组合。可采用本领域已知的调制技术。
一般而言,信息可用模拟技术或数字技术传送。“模拟技术”通常指所调制的性质在不同的程度上,随与表示待传送信息的值相关联的变化程度变化的情况。例如,假设元件500正传输信号。振荡器504可设计成在频率的某种范围内运行。“数字技术”通常指待传送的信息以二进制位(位)顺序表示,并且基于位流调制信号的情况。例如,再假设发送器500正传送采用数字技术的信号。振荡器504可设计成以至少两个不同频率-一个频率相应于位值为0,而另一个频率相应于位值为1运转。在本发明的实施方案中,无论模拟技术、数字技术还是其组合均可用于传送信息。另外,可实行各种类型的调制。
例如,在一个实施方案中,采用调频。振荡器504可以是电压控制的振荡器(VCO)-一种振荡频率取决于其中施加的电压的振荡器电路。控制逻辑502提供适当的电压(例如反映测量数据的值,M),而信号的频率表示该数据的值。在另一个实施方案中,采用调幅;例如,驱动信号φ和/φ的振幅可改变,或者驱动电路的正轨迹和负轨迹(例如V+和V-)可改变以控制振幅。在另一个实施方案中,采用调相。例如,在数字信号传输中,一个相相应于位值为0,反相相应于位值为1,而相移表示转换。振荡器504可包括将驱动信号φ和/φ与驱动电路的输入直接连接或交叉连接的转接器电路。也可按所期望的采用调频、调幅和/或调相的组合。
在某些实施方案中,发送器可传送包括识别器的唯一识别器的“包”,该唯一识别器又是与该识别器相联系的组合物的识别器。该唯一的识别器也可提供来自远程装置的信息(例如活性剂的识别(即注解信息))。区别不同信号的其他技术也可采用,这些技术包括:以不同频率带运行不同发送器,使各发送器能够通过其频率被识别,和/或配制不同的发送器在不同(及已知)时间传送,使发送器能够在其传送时被识别。
另外的组件
根据特定的实施方案,识别器可包括许多不同的另外的组件。某些相关的组件包括但不限于下面所评论的那些。
功率放大器
当激活剂是与靶生理部位接触时接通的电源时,在某些实施方案中,提供了提高或促进电源例如电池电压输出的电路,例如电荷激励电路、电荷倍加器等。此类电压增强元件可将电压输出提高到约2倍或更高,例如约5倍或更高。
储能
在某些实施方案中,激活元件包括能量存储元件。例如,可采用占空度配制,例如,其中电池的缓慢能量产生存储在能量存储元件中,例如在电容器中,然后它提供展开到信号发生元件的能量脉冲。在某些实施方案中,激活元件包括调节例如延迟能量向信号发生元件的释放的定时元件,例如,使由在基本上相同时间给药的不同组合物,例如药丸的信号在不同时间产生,因此是可区别的。
另外的特征
在某些实施方案中,组合物的特征通过具有一种或多种下列特征描述。在某些实施方案中,组合物包括识别器,该识别器采用机体本身在其中用作传导介质的通讯传导近场模式。在此类实施方案中,组合物包括电路,当该组合物破坏从该组合物中释放时(如上所描述),该电路直接接触到机体,并且不以某种方式保持被密封或被保护。在这些实施方案中,信号不是磁信号或高频(RF)信号。在某些实施方案中,系统是包括接收器的那些系统,该接收器与机体稳定地相联系,例如植入或局部应用于外部,以使系统能与其中采用不与机体稳定联系的外部装置收集数据的那些系统相区别。在某些实施方案中,组合物不包括成像系统,例如照相机或其他显形或成像元件或其组件,例如CCD元件、照明元件等。在某些实施方案中,组合物不包括例如,越过检测与靶向的生理部位接触的激活器,检测生理参数的传感元件。在某些实施方案中,组合物不包括推进元件。在某些实施方案中,组合物不包括取样元件,例如流体检索元件。在某些实施方案中,组合物不包括可驱动的活性剂释放元件,例如使活性剂与组合物保持在一起,直到收到引起释放元件释放该活性剂的信号的元件。
识别器制备
在某些相关的实施方案中,识别器元件包括半导体支持组件。任何各种不同的方案可用于制备识别器结构及其组件。例如,可采用模塑、沉积和材料除去,例如平面处理技术例如微电机械系统(MEMS)制备技术,包括表面微型机械加工和体微型机械加工技术。可在制备这些结构的某些实施方案中采用的沉积技术包括但不限于:电镀法、阴极弧沉积法、等离子喷涂法、溅射法、电子束蒸发法、物理蒸气沉积法、化学蒸气沉积法、等离子体增强化学蒸气沉积法等。材料除去技术包括但不限于:反应性离子蚀刻法、各向异性化学蚀刻法、各向同性化学蚀刻法、平面化法,例如通过化学机械抛光法、激光烧蚀法、放电机械加工法(EDM)等。相关的技术还有平版印刷方案。在某些实施方案中相关的技术是使用平面处理方案,其中结构用以顺序的方式,将应用于基底的各种不同的材料除去和沉积方案,由最初平面基底的一个或多个表面构建和/或从中除去。
图11A-13B为显示制备根据本发明的实施方案的识别器的方法的简图。图11A描绘了半导体晶片121的横截面,该晶片由硅铸造厂例如IBM或台湾半导体制造厂(Taiwan SemiconductorManufacturing Company)加工。晶片122的顶部表面含有许多电接触点123及绝缘电介质层124。接触点可以是Al,但也可以是Cu、Ti或类似金属;电介质可以是SiO2和Si3N4的组合,但是也可以是其他绝缘体。在第一加工步骤中,如图11B所示,晶片121通过研磨或化学/机械抛光从后面削薄,将厚度减少到所期望的厚度。最终的厚度可以为约300μm,但是它的范围可以在约10-约1000μm,例如约50-约500μm。
图12A显示第二加工步骤,其中耐侵蚀金属层125被加到晶片的前面以覆盖电接触123。通常的金属是铂,但是也可以使用其他耐侵蚀金属例如Au、Ti、Ir或另一种铂族金属。例如,耐侵蚀金属可通过物理蒸气沉积法沉积,其厚度可以在约0.05-约100μm,例如约0.5-约5μm厚。金属125通过为标准半导体加工技术的光刻法和蚀刻法,形成所期望的图案。
图12B显示阴极材料126的沉积。如上所述,相关的阴极材料包括但不限于:Cu或CuI。其中它们通过物理蒸气沉积法、电沉积法或等离子体沉积法沉积。阴极的厚度可以在约0.05-约500μm,例如约5-约100μm厚。阴极的形状通过阴蔽沉积法或光刻法和蚀刻法控制。各芯片按所期望的可含有两个或多个阴极材料区域127和127A。
下一个阳极材料128A如图12C所示沉积。相关的阳极材料包括但不限于:Mg、Zn或其他电负性金属。粘合层128B对帮助阳极材料与硅粘合可能是必须的。通常的阳极粘合层是Ti、TiW、Cr或类似材料。阳极材料和粘合层可通过物理蒸气沉积法、电沉积法或等离子体沉积法沉积,阴极的厚度可以在约0.05-约500μm,例如约5-约100μm。
图13A显示所沉积的和形成图案的任选保护层129A。在某些应用中,控制阳极或阴极暴露于电解质环境中的速度可能是有利的,所以绝缘层可以具有有限大小的开口129B的方式沉积和形成图案。以该方式,溶液以受控速度到达阳极或阴极材料。图13A显示晶片前面(阴极)的保护层,但是它也可以沉积在晶片的后面(阳极侧面)。通常的保护层材料为聚酰亚胺,或任何可以旋涂或喷涂的其他光可定义聚合物。或者,如SiO2、SiC、SiN的电介质可通过物理蒸气沉积法或化学蒸气沉积法沉积。
然后如图13B所示,晶片单个的进入单个模具115、116、117中。划线可通过用钻石板锯划线或通过反应性离子蚀刻法完成。这些是标准的硅半导体加工技术。如上所评论,芯片的尺寸可变化。因此,在某些实施方案中,芯片(即识别器)元件的大小规定为宽度范围在约0.05mm-约1mm,例如约0.1mm-约0.2mm;长度范围在约0.05mm-约1mm,例如约0.1mm-约0.2mm;及高度范围在约0.1mm-约1mm,例如约0.05mm-约0.3mm,包括约0.1mm-约0.2mm。
具体药丸实施方案
在进一步描述本发明组合物的各种实施方案中,现在结合附图更详细地描述特定的实施方案。图1提供了本发明药丸/胶囊实施方案的示范性示意图,其中组合物以药丸或胶囊形式的口服可摄取药物制剂配制。显示了摄取组合物14的患者10的胃12。显示该“智能药丸”从口16运行到该患者的胃内部18。到达胃后,药丸/胶囊经历胃的机械运动和胃液中各种化学物质,例如盐酸和其他消化剂的溶解过程。
图2A和2B提供了图1中所示的药丸组合物的更详细的视图。图2A显示置于药丸14内部的识别器20。识别器20以集成电路(IC)存在。电路20的后面(底部)至少部分地用第一种金属21涂覆,电路20前面(顶部)的一部分用不同金属22涂覆,使电路20能够通过反向电解通电,例如上述与图4的连接。在顶部表面也有两个晶体管电极23、24。
在制备药丸14时,集成电路20被至少一个可包括药理活性和/或惰性原料任一组合的外层包围。该外层在胃中,通过胃的机械运动和胃液中各种化学成分(例如盐酸)的作用的组合溶解。
药丸14溶解后,集成电路20的区域暴露于胃内容物,该内容物对本发明的目的而言可看作是电解质溶液。当药丸溶解,使金属层21和22暴露时,提供给电路20电源,该电路开始运行并继续运行,直到金属层21和22或该电路本身被消化过程和酸充分溶解,变成非功能性的。最后,剩余的芯片从机体排出。
在替代实施方案中,集成电路20与药丸14附接,而不是封装在其中。例如,电路20可在药丸正在制备中、在药丸表面上的可溶性涂层中等置于该药丸的一端。在电路20全部或部分暴露的实施方案中,药丸一进入胃中而不是在药丸溶解后,集成电路20就开始运行。
在一个实施方案中,电路20传送识别药丸14的信号。识别器可显示药丸14的类型(活性成分、商标等)和/或剂量,并且如上所评论的,也可提供将使特定药丸能够被跟踪的批号、顺序号或类似的识别信息。
图2B是电子电路20的一个实施方案的方框图。在该实施方案中,电路20是用频移键控循序地传送预定系列地址(识别器)位的发送器单元,其第一振荡频率相应于位值为0,及第二振荡频率相应于位值为1。如上所描述,金属层21和22向电路20提供电源。该电源(未在图2B中明确显示)提供给振荡器25、计数器26、读出电路27和驱动发送器电极29A、29B传输信号的电极驱动器28。振荡器25通常可以是常规设计(例如环形振荡器),并最好配制成在如上描述的准静电频率区域内运行。振荡器25产生在高和低电压水平之间振荡的驱动信号φ,及在相上与驱动信号φ相反的反转驱动信号/φ。在一个实施方案中,振荡器25是电压控制振荡器(VCO),该振荡器具有取决于在信号路径25A上提供的控制电压的振荡频率。计数器26计数驱动信号φ和/φ的振荡,并向读出电路27提供电流计数。在一个实施方案中,计数器26是一般常规设计的八位计数器;也可使用其他类型的计数器(包括不同宽度的计数器)。读出电路27配制地址(识别器)位组27A,它们最好例如在制备电路20的时候固定。如上说明,位对药丸14的特定情况可以是唯一的,或者对在相同条件下制备的一批药丸是共同的,或者对含有特定药物的所有药丸是共同的。地址位14可储存在一般常规设计的非挥发性存储电路中,并可提供地址位的任何数字(例如8、16、32、48等)。读出电路27在控制VCO 25的频率的线25A上产生振荡器控制信号(例如电压)。在一个实施方案中,读出电路27配制成例如基于由计数器26提供的电流计数选择电流地址位,并产生在选择相应于该位值的频率的信号线25A上的控制信号。某些周期数后(由计数器26测定),读出电路27选择下一个地址位,并在信号线25A上产生相应的控制电压。各种频率可用于代表地址位值“1”和“0”。在一个实施方案中,100kHz和200kHz的频率可用于分别代表值“0”和“1”。也可使用其他值(例如1MHz和2MHz或1kHz和5kHz)。所选择的频率最好是在人组织的吸收模式下很好,它通常在400MHz以上。如上所描述,VCO 25产生补充信号φ、/φ,它们以通过在信号线25A上控制信号测定的频率振荡。信号φ、/φ用于控制例如图6D所示可使用的电极驱动器28。应指出由于当电路20运行时电极21和22与胃液接触,近场组件直接耦合到患者身体的传导介质中,并可通过合适配制的如下所述数据收集器检测。在一个实施方案中,收集器配制成记录所接收的地址(识别器)和接受的时间。该数据收集器也可配制成在实时或当患者在医疗设备中时,向外部装置重发该信息。应认识到,本文中描述的发送器是说明性的,并且可能有变化和修改。例如,其他编码方案可用于传送数据;在一个该实施方案中,采用相移键控而不是频率键控。在某些实施方案中,可将多地址位编码到用本领域已知的各种键控方案传送的单一符号中。
图3A提供信号发生元件30实施方案的详细描述,该元件标记药用原料并被封装在该组合物的中央。信号发生元件30的形式是由硅芯片构成的IC,其中各种功能性元件,例如以一个或多个电路层的形式置于硅基底31。该芯片可用标准集成电路技术制备。该制备方法的实例是AMI Semiconductor in Idaho,USA开发的0.5μCMOS方法。如在该基底的后面所显示,芯片31的底部是起一个电池电极作用的金属132,而该芯片的顶部是起其他电池电极作用的金属233。同样在该芯片31的顶部是电极134和电极235,它们构成一对信号传送电极。
在某些实施方案中,电极134和电极235由在胃环境中不易于侵蚀的材料制备,例如,它们由贵重金属制备。或者,在某些情况中,电极可由标准铝例如可从AMI Semiconductor获得的铝制备。电极材料选择的标准将容易地由本领域普通技术人员确定。即如果电极的存在时间对检测而言足够长,它适于使用。标准铝金属或其他更低成本的金属如果在适当的应用中用于电极1和2(34和35),可降低该装置的成本。在某些情况中,电极的溶解,并且因此熄灭报告信号可提供该药丸和所加入的装置完全溶解的次级指示。
与本发明装置的电极组件的材料选择不同,金属1和金属2(32和33)是两种不同的金属。选择金属1和金属2使得施加于硅上的电位在顶部表面是正电压,而在底部表面是负电压。这样基底基本上与阴极处于相同的电位,该阴极可以是电路的接地参考,而具有SiO2绝缘层的顶部表面与正电压耦合,是底侧接地的参考。
图3B提供根据本发明的实施方案的替代信号发生元件视图。替代电极,图3B中描述的信号发生元件30包括与硅芯片31附接的两个天线36和37。也显示了金属1和2(32和33)。组件30包括硅芯片31上的电路,和与其附接的两个或四个金属结构(32、33、36和37)。在采用两种不同金属的实施方案中,这两种金属结构起电池金属的作用,即金属1和金属2(32和33)。这些金属结构可以各种形式提供。例如,在一个实施方案中,金属1和金属2是芯片表面,即前面和后面上非常厚的电镀元件(例如下面描述的图3C所示)。在另一个实施方案中,金属1和金属2是相对长的电线,这些电线在某些点上简单地与芯片连接,例如图3B所示。金属1和金属2在某些情况中是绝缘的。在该情况下,侵蚀出现在尖端,然后向芯片31蔓延。当溶解在溶液中时,侵蚀从电线的终端开始并逐渐地向芯片31的方向发展。该配制改善了电池的寿命。在另一个配制中,将金属电镀在芯片的前面和后面,然后表面消失。两根电线也可用作天线。在一种配制中,提供了一对垂直的天线(36和37)。在该应用中,可能有通常是相同材料的两种其他金属结构。该材料可从各种金属中选择,例如铂或金。这些金属结构与芯片附接,并从该芯片延伸出一些距离。通常这些结构的总长度在毫米-厘米的数量级。在某些配制中,金属结构的相当大部分是绝缘的,以使所产生的双极有最大的尺寸。在其他配制中,例如下面结合图3C所描述的,正是电池金属行使该双极功能,或者提供了分开的天线。
在某些实施方案中,信号发生元件不包括天线,而是使用电池元件作为天线,如图3C所示。在图3C中,信号发生元件30包括置于金属1层32和金属2层33之间的硅支持层31。同样也显示了电路层38。在此类实施方案中,当芯片上例如电路层中的开关闭合,电流就在电池的两种金属之间产生,该电流然后被检测。在某些实施方案中,提供了比芯片大的膜,它限定电流运行的路径。
图3D和3E中显示了在与生理液体接触时被激活的电池的另一个实施方案。在这些图中所显示的结构中,电池包含各自支持电极的顶部和底部部分,其中顶部和底部部分可以放在一起,产生包含通过使第一和第二电极相反连接的体积的结构,其中该体积在激活时可用电解质,例如生理液体填充。图3D显示该电池的底部部分31A,其中材料132A被置于基底(例如硅芯片)34A顶部上的凹室33A中。凹室33A具有一个或多个终端开口,使得电解质能够进入。材料235A被置于分开的基底36A上产生第二部分37A,该部分然后在“倒装法”类型的方法中,例如通过将38A和38B与芯片连接来结合。所有加工可以晶片规模进行。如果期望,凹室的开口可用可降解材料例如用聚合物填充,以控制该电池被激活有多快。材料34A和35A的基底34A和36A可以是硅、金属或聚合物/塑料。在某些实施方案中,图3D和3E中所示的结构是第一电极被置于芯片顶部的凹室中的电池。该凹进空间具有一个或两个开放终端,使得电解质能够流动。第二个电极被置于分开的基底上(例如硅晶片、金属膜或聚合物膜),然后在“倒装法”类型的方法中,在晶片的顶部结合芯片。该加工以晶片规模进行,并且电池照常切片。该配制的优点包括:保护电极表面免受胃中或胃内层本身组分的阻滞;防止电池上产生的任何种类物质(例如Cu)和胃内层之间可能具有毒性危险的接触;3)提供电极材料穿过电极表面的均匀消耗,和电极之间更均匀的电流分布。
图4提供药丸被摄取,并溶解到某些药丸已经化学和/或物理侵蚀掉的那一点时发生的事件的图示。金属1和金属2(32和33)现在在离子溶液39中。当应用于电子电路40时,这产生低电压(V-)和高电压(V+)。电子电路40的两个输出是E0 41和E1 42,它们是顶部表面上的信号-传送电极。在未在图4中显示的替代实施方案中,其中信号发生元件30包括单一电极,输出是E0 41。
图5显示与图4类似的安排。然而,作为具有作为输出的两个电极的替代,提供了线圈。金属1和金属2(32和33)被应用于信号发生元件30的电子电路40中。电子电路40的输出耦合到线圈43。该配制提供了当暴露于离子溶液中时,电池通过金属1和金属2(32和33)产生。该电池驱动电路40,该电路产生振荡频率。该振荡电流经过线圈并产生RF磁信号。与近场准静电信号不同,该准静电信号经过机体组织可遭受严重衰减,RF磁信号可通过机体组织传送而较少衰减。RF磁信号然后通过具有磁信号检测机构的外部或内部接收器获得。如果以足够高的频率提供广播,患者用的纸样装置将检测无论何时摄取药丸。
图6B显示可用于信号发生元件中的电子电路的一个应用的细节。左边是两个电池电极-金属1和金属2(32和33)。这些金属在与电解质接触时,形成电池并向振荡器61提供动力,在该情况中以示意图显示。金属132向振荡器61提供低电压(接地)。金属233向振荡器61提供高电压(V)。当振荡器61开始运行,它产生时钟信号62和反转时钟信号63,它们相互相反。这两种时钟信号进入计数器64中,计数器64只是计时钟周期的数目并将计数贮藏在许多寄存器中。在此处所示的实例中,采用8位计数器。因此,计数器64的输出从第一个时钟周期的值″00000000″变成″00000001″开始,并继续最大到″11111111″。计数器64的8位输出与地址多路转换器(mux)65的输入耦合。在一个实施方案中,多路转换器65含有地址注释器,该注释器可以在电路中接有硬电线,并产生控制电压以控制振荡器61。多路转换器65利用计数器64的输出,在连续位流中再生地址,它进一步输送到信号传输驱动电路中。多路转换器65也可用于控制信号传输的忙闲度。在一个实施方案中,多路转换器65使用计数器64产生的时钟计数,仅用十六分之一的时间接通信号发送器。该低忙闲度保存了能量,并且也使得其他装置能够传送而不干扰其信号。特定芯片的地址可以是8位、16位或32位。通常,在产品中将使用超过8位,因为有如此多不同类型的药物。各药物将具有其自己特定的地址。
本发明也允许适当时,各批药物可提供批特定地址的可能性。这使得能够识别药丸在哪里制备的、该药丸是何时制备的及它在何批中制备的。在某些情况中,各药丸将具有唯一的识别器。这在药物更可能随后被盗窃或违法使用,因此应跟踪时,或在污染的问题可能产生时将特别有用。
根据一个实施方案,多路转换器65产生控制电压,该电压将地址连续地编码,并用于改变振荡器61的输出频率。例如,当控制电压低时,即当连续地址位为0时,该振荡器产生1兆赫信号。当控制电压高时,即当地址位为1时,该振荡器产生2兆赫信号。或者,这可以是10兆赫和20兆赫,或该装置限于调制相的相移键控方法。多路转换器65的目的是控制振荡器或者振荡放大信号的AC替代实施方案的频率。
多路转换器65的输出与电极驱动66耦合,该驱动66可驱动电极以把微分电位赋予溶液,驱动振荡电流通过线圈产生磁信号,或者驱动信号电极将电荷推到溶液中或从该溶液中拉出。
以该方式,装置广播构成存储在多路转换器65中的地址的0和1的序列。该地址将重复地广播,并将继续广播直到金属1或金属2(32和33)耗尽,并溶解在溶液中,此时电池不再运行。
图7是本发明的替代实施方案。电路70的安装显示振荡器71和计数器72。多路转换器73从计数器72中取出5位作为其输入。图7的右上角是信号传输电极驱动器的示范性电路图。两位CMOS发明人分别采用时钟和反转时钟信号作为其输入,并驱动电极e0和e1。
图8提供振荡器80的一个安装。在该情况中,V控制81基本上控制驱动振荡器80的电压的量。当V控制低时,20,000欧姆电阻器82将是低功率供应电压的V83,与振荡器控制线V振荡-控制84分开。当V控制高时,V振荡-控制走到V,使最大电压穿过振荡器电路,并导致由时钟信号和反转时钟信号(85和86)产生的更高的频率。
图9显示简单点滴式或异步计数器,该计数器在该情况中具有四个触发器和某些简单反相器,它们只是一路向上计数然后倒退到零再开始,并且开始再一路向上计数。在一个实施方案中,多路转换器可采用A0和A1、A2、A3作为其地址输入,并可用存储的地址与这些输入比较,然后取存储的地址输出作为振荡器控制信号。
如上所示,在某些实施方案中,信号发生元件可包括单一电极,因此具有单极配制。在本发明的一个实施方案中,如图10所示,提供了三个终端的单极信号发生元件100。在该实施方案中,药丸的信号发生元件100具有一个电容与芯片107耦合的电极101。两个金属电极103和102构成了该电池的电极,该电池向信号发生元件100提供动力。电极102和103通过两个电阻器104和105和任选存储电容器106与芯片107耦合。在一个实施方案中,电极102接地,而电极103向信号发生元件提供V。电极101是单极信号发生元件的输出。在运行期间,电极101将以高频率将电流推入和推出体液。接受器将在体液外检测该电荷的推入和推出。要说明的是,该配制与前面描述的配制之间的最大差别是该配制提供单极。当芯片107的输出改变时,电容器108强迫电极101上的电位立即改变,这产生机体电位的相应变化。与机体接触的接受器因此可以检测大的瞬时电压变化。
本发明的设计产生由接受器检测的从机体进入和出去的交流电(未显示)。输出耦合的电容器可以是任选的。然而,这些电容器的存在阻止了任何DC电流并产生AC信号。
图14显示了图7中的信号发生元件电路的多路转换器和编址系统73。在该情况中,有两个4位多路转换器(141和142)及1位多路转换器143,其中1位多路转换器143采用两个4位多路转换器141和142的输出作为其输入。多路转换器141和142的各输入端口或者与高电压V或者与低电压V耦合。本发明的该配制将使得32位数字(它与两个多路转换器的32输入硬连线连接),转换成多路传输的连续输出144。当计数器进入到5位计数时,多路转换器144的输出顺序选择多路转换器141和142的输入。当5位计数器达到“11111”时,顺序将再从头开始。就这样16位地址重复发送。替代方法是交替发送零的16位和地址的16位,以使接收电路可以被唤醒和同步。
图15显示图14中所示的系统的4位多路转换器141的细节。该4位多路转换器由4水平的1位多路转换器构成。
图16详细显示了组成4位多路转换器141的1位多路转换器。
图17是信号发生元件另外的单极实施方案170。与前述实施方案的最大差别是电源171与M1 172和M2 173产生的电源串联。这构成了M1 172和M2 173之间的DC电流。该DC电流不与电极174产生的AC信号竞争。该DC电流然后将进入一个或另一个电容器(175和176),并将给电极充电或给另一个电容器充电。该实施方案的原理是具有M1和M2之间产生的DC电流和在信号电极上产生的AC信号。耦合电容器176是任选的。
图18A是信号传输驱动电路的示范性示意图。该电路基于8-针(pin)555计时器芯片。如图18A所示,555计时器芯片的针命名如下:针1是接地;针2是触发器,针3是输出,针4是复位,针5是控制电压,针6是阈,针7是放电,针8是芯片Vdd的电源。输出针和接地针分别与两个传送电极电容耦合。运行期间,该电路以固定的频率传输信号。
图18B1-18B2是接收器电路的示范性示意图。该图左上部分显示的是前端放大阶段,它通过一对电极接收信号并用测量放大器进行信号的差别放大。该图的中间部分是级联四级过滤器。在一个实施方案中,头两级是截止频率高于1KHz,例如截止频率约为10KHz的高通滤波器。该高通滤波器将低频率噪音和干扰,例如60Hz电源线噪音删除。最后两级是截止频率低于500KHz,例如截止频率约为200KHz的低通滤波器。该低通滤波器可将高频率噪音和干扰删除。将过滤并放大的信号输入到LED,如该图的左下部分所示。在信号被检测时,LED点亮,显示信号的存在。
上述装置通常包括两个电路:一个是产生地址位序列的逻辑电路,而另一个是基于该地址位序列驱动传送电极的驱动电路。这两个电路的功率消耗特征是不同的。通常逻辑电路需要高电压电源,例如1.2V的电源,以开启CMOS电路。然而,从该逻辑电路发出的电流相对小。例如,在一个实施方案中,从该逻辑电路发出的电流约为5μA。
另一方面,驱动电路可拉大得多的电流,因为它需要动力传送可足够检测的信号。所以,电源的电压可以降低到更低的水平。例如,驱动电路可拉100μA,并使电池电压降低到0.5V。
因为电池电极的面积可由于装置的大小约束受到限制,有关电源的两个电路之间的干扰可能是严重的。结果,驱动电路可将电池电压降低到使得逻辑电路不能运行的程度。本发明的一个实施方案利用分组电池配制使逻辑电路和驱动电路的电源去耦。
图19显示一个示范性分组(即分节)电池设计。两个电池电极193和194(它们由碘化亚铜制备)分别构成逻辑电路191和驱动电路192的电池阳极。事实上,电极193和194形成两个共享共同的镁阴极195的分开的电池。这样,驱动电路192可以拉足够的电流驱动传送电极196,而不严重地损害逻辑电路191的电源。
运行期间,驱动电路192从电极194和195形成的电池中拉出电流,并推动该电流通过传送电极196进入机体。在再一个实施方案中,通过使用传送的电池电极可避免使用分开的传送电极。图20显示该配制。驱动电路206基本上含有在阳极204和阴极之间耦合的开关。该开关可由来自逻辑电路201的地址信号开启或关闭。当开关接通时,驱动电路的电池事实上在芯片内短路。所以,电流207从阴极到阳极204流经机体。机体组织的抵抗因此可以产生电压差,该电压差可容易地通过例如差动放大器检测。
在某些情况中,可以限制阴极的大小,导致甚至具有分组阳极的逻辑电路和驱动电路的电源之间的耦合。根据一个实施方案,如图21所示,阴极也可以拆分以进一步使这两个电源去耦。在此,两个分开的镁电极211和212分别起服务于逻辑电路和驱动电路的两个电池的分开的阴极作用。这两个电路之间的耦合因此可以最小化。
在再一个实施方案中,驱动电路的电池电极可与芯片分离,而通过两根外部电线与驱动电路耦合,如图22所示。在另一方面,逻辑电路的电池电极仍可以置于芯片上,向逻辑电路提供高电压电源。外部电线221和222,它们各自可以约1cm长,形成长双极并可提供在场的信号放大。结果,传送的有效性不受芯片大小的限制。在一个实施方案中,电线最初折叠在药丸中,药丸消化后可以展开。
制备组合物的方法
可采用各种制备方案制备根据本发明的组合物。在制备主题组合物时,信号发生元件以某种方式稳定地与药物剂型相联系。稳定地联系表示信号发生元件和剂型相互分离,至少直到例如通过摄取,向有此需要的患者给药。信号发生元件可以许多不同的方式,稳定地与该组合物的药用载体/活性剂组件联系。在某些实施方案中,当载体/活性剂组件是固体结构时,例如片剂或丸剂,该载体/活性剂组件以提供给信号发生元件空腔的方式制备。信号发生元件然后被放入该空腔中,并将该空腔密封,例如用生物相容性材料密封,制备最终的组合物。例如,在某些实施方案中,片剂用包括在所得压缩片剂中产生空腔的特征的冲模制备。将信号发生元件置于空腔中,并将空腔密封,制备最终的片剂。在该实施方案的变体中,片剂用可移动的元件例如棒形的或其他方便形状的元件压制。然后将该可移动元件除去,在该片剂中产生空腔。将信号发生元件置于空腔中,并将空腔密封,制备最终的片剂。在该实施方案的另一个变体中,首先制备无任何空腔的片剂,然后在该片剂中制备空腔,例如通过激光钻孔。将信号发生元件置于空腔中,并将空腔密封,制备最终的片剂。在还其他实施方案中,片剂通过将信号发生元件与该片剂的配件(subparts)组合制备,其中配件可以是预制的配件或者是随后制备的。例如,在某些实施方案中,片剂通过以下方法制备:首先制备该片剂的底部一半,将信号发生元件置于该片剂底部一半的位置上,然后将该片剂的顶部部分盖在底部一半和信号发生元件上,制备最终期望的组合物。在某些实施方案中,片剂在信号发生元件周围制备,以使该信号发生元件位于所制备的片剂的内部。例如,信号发生元件,它可以或可以不封装在生物相容性顺从性材料例如明胶(以保护该信号发生元件)中,与载体/活性剂前体例如散末混合,并以信号发生元件位于片剂内部位置的方式压缩或模压成片剂。作为模压或压缩的替代,在某些实施方案中,载体/活性剂组件以构成片剂结构的方式喷涂到信号发生元件上。在再一个实施方案中,活性剂/载体组分前体可以是与信号发生元件混合的液体制剂,然后固化,制备最终的组合物。在再一个实施方案中,预制片剂可通过将信号发生元件与片剂稳定地附接,与该信号发生元件配制在一起。相关的方案不改变该片剂的性质,例如溶解性等。例如,在某些实施方案中,采用了啪地安装在片剂的一端上,并具有与其结合的芯片的明胶元件。该明胶元件在某些实施方案中有色,以易于识别已与信号发生元件配制在一起的片剂。当组合物具有活性剂/载体组合物填充的胶囊构型时,例如明胶胶囊填充的构型,信号发生元件可与胶囊组件例如顶部或底部胶囊壳结合,该胶囊用活性剂/载体组合物填充制备最终的组合物。上面综述的制备方法仅举例说明了可以制备本发明组合物的各种不同方法。
系统
也提供了包括主题组合物的系统。在某些实施方案中,本发明的主题系统包括如上所综述的含有一种或多种活性剂的组合物,以及信号检测组件(例如接收器形式的)。如上所评论的信号检测组件可随该组合物的信号发生元件产生的信号性质明显地变化。
在某些实施方案中,信号检测组件是可植入组件。可植入组件表示信号检测组件例如,为植入患者而在半永久或永久的基底上设计,即配制。在这些实施方案中,信号检测组件在使用期间在体内。在还其他实施方案中,信号检测组件离体,这表示该检测组件在使用期间在机体的外面。在某些这些实施方案中,如下面将更详细地展开的,与离体检测组件分离或者结合的可以是,例如为了基于由检测器的信号发生元件检测到的信号分配组合物的剂量的剂量分配器元件。此类特征也可以在可植入的检测组件中存在,例如以提供基于前面剂量有关摄取的输入,给予随后的剂量的闭循环给药系统。
如上所评论,在某些实施方案中,组合物的信号发生元件在与靶机体部位接触时被激活。在某些这些实施方案中,信号检测组件在检测来自信号发生元件的信号时被激活。在某些这些实施方案中,组合物产生断续信号。在某些这些实施方案中,检测组件能够同时检测许多组合物。
信号检测组件可包括各种不同类型的信号接收器元件,其中接收器元件的性质随由信号发生元件产生的信号的性质必要地变化。在某些实施方案中,信号检测组件可包括一种或多种检测由信号发生元件发射的信号的电极。在某些实施方案中,接收器装置将装备两个以某种距离分散的电极。该距离使电极能够检测微分电压。在某些实施方案中,第一个电极与导电性机体元件例如血液接触,第二个电极与相对于所述导电性机体元件电绝缘的机体元件例如脂肪组织(脂肪)接触。在替代实施方案中,采用使用单一电极的接收器。在某些实施方案中,信号检测组件可包括检测由信号发生元件发射的信号的一个或多个线圈。在某些实施方案中,信号检测组件包括检测由信号发生元件发射的信号的声检测元件。
如上所评论的,对那些由识别器产生的信号是近场传导信号的实施方案而言,本发明系统的接收器也可视为“数据收集器”。如本文中使用,“数据收集器”是装备接收天线检测由如上所述的发送器在机体中产生的电位差,因此接收所传送的信息的任何装置。数据接收器可以各种方式处理所接收的数据。在某些实施方案中,接收器只是重新将数据传输到外部装置(例如用常规RF通讯)。在其他实施方案中,数据接收器处理所接收的数据,以决定是否采取某种行动,例如运行受其控制的效应器,启动可见的或可闻的警报,向位于机体别处的效应器传送控制信号等。在还其他实施方案中,数据收集器存储所接收的数据,随后在再传送到外部装置或者用于处理随后的数据(例如检测某种参数随时间的变化)。应理解,数据收集器可用所接收的数据进行这些和/或其他操作的任何组合。
虽然接收天线最好在患者体内,或者与患者皮肤接触,但是数据收集器完全在患者体内是不需要的。例如,按照本发明的一个实施方案,外面使用并装备合适的接收电极的手表或带可用作数据收集器。数据收集器可通过所收集的数据可被患者或健康护理人员摘录的方式,提供更进一步的通讯路径。例如,植入的收集器可包括常规RF电路(例如以405-MHz的医疗装置带运行),医师可用它例如使用数据检索装置例如本领域已知的条形码读入器通讯。当数据收集器包括外部组件时,该组件可具有输出装置以提供,例如声频和/或视觉反馈;实例包括可闻警报、LED、显示屏等。外部组件也可包括通过它该组件可以与电脑连接,读出其中存储的数据的界面端口。
在某些实施方案中,数据收集器被植入。如上所说明,起博器导线提供合适大小的接收天线。通常的起博器包括控制单元(称为“外壳”),该单元将配制成进行各种数据收集的逻辑电路和处理操作结合在一起。该外壳也与RF发送器/接收器电路连接,使起博器和由健康护理人员操作的外部条形码读入器之间能够沟通。因此,当患者有起博器时,使现存的单元作为数据收集器起杠杆作用可能是有效率的选择。
在某些实施方案中,系统还包括存储数据的元件,即数据存储元件。通常说,数据存储元件是电脑可读介质。如本文中使用的术语“电脑可读介质”指参与向电脑提供执行和/或处理的指令和/或数据的任何存储或传送介质。存储介质的实例包括软盘、磁带、CD-ROM、硬盘驱动器、ROM或集成电路、磁光碟或电脑可读卡例如PCMCIA卡等,不管此类装置在电脑的内部或外部。含信息的文件可以存储在电脑可读介质中,其中“存储”表示记录信息使得它以后可由电脑获得并检索。关于电脑可读介质,“永久性存储器”指为永久的存储器。永久性存储器不被电脑或处理器的电供应终端抹去。电脑硬驱动ROM(即不用做虚拟内存的ROM)、CD-ROM、软盘和DVD都是永久性存储器的例子。随机存取存储器(RAM)是非永久性存储器的实例。永久性存储器中的文件可以是可编辑的和可重写的。
在某些实施方案中,记录在数据存储元件中的数据包括时间、日期和给予患者的各组合物中的识别器中的至少一种(如果不是所有),其中识别器可以是该组合物或其编码版本的通用名称。在某些实施方案中,相关的数据包括血液动力学测定。在某些实施方案中,相关的数据包括心脏组织性质。在某些实施方案中,相关的数据包括压力或体积测量。
本发明也提供电脑可执行指令(即程序设计)执行上述方法。电脑可执行指令存在于电脑可读介质中。因此,本发明提供电脑可读介质含其用于检测和处理由如上所综述的本发明组合物产生的信号的程序设计。
因此,在某些实施方案中,系统包括下列元件中的一种或多种:数据存储元件、数据处理元件、数据显示元件、数据传输元件、通知机构和使用者界面。这些另外的元件可加入到接收器中和/或存在于外部装置上,例如为处理数据和做决定、向提供此类活动的远处转送数据等而配制的装置。
在某些实施方案中,信号检测元件包括心脏监控元件,例如图1的系统中所示。图1显示具有植入心血管装置“外壳”8和导线6的人10,这些组件用于监控和检测从药丸14发射的信号。监控装置也可置于其他位置,例如皮下、心脏中或者例如在接近胃的腰部。安置可由特定的应用建议。
本发明的监控系统也可作为外部装置安置。例如,它可以通过穿在机体外并具有一个或多个在不同位置与皮肤附接的电极的马甲安置。本发明的构造可与可携带装置,例如具有分散在手腕上的一个或两个电极的手表连接。有许多此类接收电极系统可以安置和构建的地方,例如发出嘟嘟声的助听器、项链、腰带、鞋(PZT-动力的)或耳环。
如上所示,在某些实施方案中,系统包括不同于接收器(在某些实施方案中它可植入或局部应用)的外部装置,其中该外部装置提供许多功能。该仪器可包括向患者提供反馈和适当的临床调节的能力。该装置可采取许多形式中的任一种。例如,该装置可配制成挨着患者坐在床上。装置可在受试患者应用的其他部分中读出更详细描述的信息,该信息来自药物的摄取报告和心理传感装置,例如由起博器装置或检测药丸的专用植入物在内部产生的。外部仪器的目的是从患者处得到数据并将数据输入外部装置。外部仪器的一个特征是其提供可通过传送介质,例如电话线传送到远处例如临床医生或中央监控处形式的药理和生理信息的能力。
在某些实施方案中,心脏监控元件包括传导速度测量元件。在某些实施方案中,心脏监控元件包括压力传感器。在某些实施方案中,心脏监控元件包括尺寸传感器。
具有各种设计的另外的生理传感器由某些本发明的发明人在其他申请中描述。这些传感器可与本发明的系统联合使用。另外,某些本发明的发明人的其他申请描述了本发明可以相互作用、协同的方式非常有用地应用的多路转换系统。
某些本发明的发明人的这一先前的工作描述了为了有助于适当的治疗干预,例如再同步治疗,尺寸传感器在测定心脏参数上的用途。利用本发明测定心脏治疗药物的血流吸收时间并将这与那些装置感觉到的心脏功能中产生的变化相联系,为临床医生在滴定药物和提供药理和电生理治疗之间的协同上提供了高度有价值的信息。
本发明的实施方案可用于各种系统中。此类系统可包括各种类型的传感器。此类传感器和系统已由某些本发明的发明人在各种申请中描述。这些申请也描述了由某些本发明的发明人先前开发的,用它本发明可以实施的多路转换系统。这些申请包括:以20040193021公布的美国专利申请号10/734490,标题为:“监控和治疗血液动力学参数的方法和系统”;以20060058588公布的美国专利申请号11/219,305,标题为:“用于组织激活和监控的方法和仪器”;国际专利申请号PCT/US2005/046815,标题为:“可植入可寻址分节电极”;美国专利申请号11/324,196,标题为:“可植入的基于加速计的心壁状态检测器”;美国专利申请号10/764,429,标题为“提高心脏跳动的方法和仪器”;美国专利申请号10/764,127,标题为“测定心脏参数的方法和系统”;美国专利申请号10/764,125,标题为“用于远程血液动力学监控的方法和系统”;国际专利申请号PCT/US2005/046815,标题为“可植入气密封结构”;美国专利申请号11/368,259,标题为:“视纤维组织运动传感器”;国际专利申请号PCT/US2004/041430,标题为:“可植入压力传感器”;美国专利申请号11/249,152,标题为“可植入多普勒X线体层照相术系统”,并要求享有美国临时专利申请号60/617,618的优先权;国际专利申请序号PCT/USUS05/39535,标题为“应变仪测定的心脏运动特征”。这些申请通过引用而整体结合到本文中。
某些本发明的发明人已开发出了各种协调多种来源的传感器信息的显示工具和软件工具。这些工具的实例可见于PCT专利申请序号PCT/US2006/12246,标题为:“用于心脏再同步的多重电极调步的自动优化”,及2006年3月31日递交的并要求享有均在2005年3月31日递交的美国临时专利申请“自动定时组合选择”和“利用电机延迟的自动定时组合选择”的优先权。这些申请通过引用而整体结合到本文中。
上面描述的系统根据药用组合物上的识别器和接收器之间的通讯综述。然而,系统不是如此受限制的。在更广泛的意义上,系统由两种或多种相互交流的不同模块组成,例如利用如上所综述的发送器/接收器功能,例如利用如上所描述的单极发送器(例如天线)结构。因此,上述识别器元件可加入到许多不同装置中的任一种中,例如提供机体中两种自动力装置之间的通讯系统,其中自动力装置可以是传感器、数据接收器和存储元件、效应器等。在示范性的系统中,这些装置之一可以是传感器,而其他的可以是与外界沟通的通讯中心。本发明的实施方案可采取许多形式。可有多个传感器、多个发送器和一个接收器。它们可以是收发器,所以这两者可根据已知的通讯方案轮流发送和接收。在某些实施方案中,两种或多种单个装置之间的通讯手段是例如以上所描述的单极系统。在这些实施方案中,每个这些发送器可配制成用将电荷拉进和拉出机体的单极轮流将高频率信号发送到机体中,该机体是大电容器和导体。接收器-单极接收器正以电荷进出机体,并将加密信号例如调幅信号或调频信号解码的频率检测。本发明的该实施方案具有广泛的用途。例如,多个传感器可安置和植入在测定位置或加速度的机体的各部位上。不用电线与中央枢纽连接,它们可将该信息通过通讯介质传输。
方法
在本发明的方法中,将有效量的本发明组合物给予有该组合物中存在的活性剂需要的患者,其中“有效量”指足够产生所期望的结果的剂量,例如病症或与此病症相关的症状的改善,所期望的生理变化的实现等。所给药的量也可视为治疗有效量。“治疗有效量”指当为了治疗疾病给药予患者时,足够进行该疾病的治疗的量。
可用能够产生所期望的结果的任何方便的手段将组合物给予患者,其中给药途径至少部分地取决于如上所综述的组合物特定形式。如上所综述,组合物可以制成各种治疗给药用的制剂,这些制剂包括但不限于固体、半固体或液体制剂,例如片剂、胶囊剂、散剂、颗粒剂、软膏剂、溶液、栓剂和注射剂。因此,组合物的给药可以各种方式实现,这些方式包括但不限于:经口、口颊、直肠、非肠道、腹膜内、皮内、透皮、intracheal等给药方式。在药物剂型中,特定组合物可单独给药或与其他药学活性化合物组合给药,例如它们也可以是具有稳定地与其联系的信号发生元件的组合物。
主题方法发现用于各种不同病症的治疗,包括疾病症状。可用主题组合物治疗的具体病症随可存在于主题组合物中的活性剂的类型而变化。因此,病症包括但不限于:心血管疾病、细胞增殖性疾病例如肿瘤疾病、自身免疫疾病、激素异常性疾病、感染性疾病、疼痛治疗等。
治疗表示至少与折磨该患者的病症相关的症状的改善,其中在广泛的意义上使用的改善指至少参数值的减少,例如与正治疗的病理状况相关的症状的参数值的减少。这样,治疗也包括其中病理状况,或至少与其相关的症状完全被抑制,例如被防止发生或被制止例如被终止的情况,使得患者不再受病理状况,或者至少描述该病理状况的症状之苦。因此,疾病的“治疗”包括防止疾病在先倾向于该疾病但还未经历或表现出该疾病的症状的动物中发生(预防治疗),抑制疾病(减慢或停止其发展),提供该疾病的症状或副作用的减轻(包括矫形治疗),及减轻疾病(引起该疾病的消退)。对本发明的目的而言,“疾病”包括疼痛。
各种患者均可根据本发明的方法治疗。通常此类患者是“哺乳动物”或“哺乳动物”,其中这些术语广泛地用于描述在哺乳类内的有机体,包括食肉动物(例如狗和猫)、啮齿目(例如小鼠、豚鼠和大鼠)和灵长目(例如人、猩猩和猴子)。在代表性的实施方案中,患者将是人。
在某些实施方案中,如上所描述的主题方法是例如在延长的时间范围内,例如1周或更长,1个月或更长,6个月或更长,1年或更长,2年或更长,5年或更长等控制病症的方法。主题方法可与一种或多种另外的疾病控制方案联合使用,例如心血管疾病控制中的基于电刺激的方案,例如调步方案、心脏再同步方案等;生活方式例如对各种不同病症而言的饮食和/或锻炼原则等。
在某些实施方案中,方法包括调节基于从组合物获得数据的治疗方案。例如,可获得包括有关患者依从所开的治疗方案的信息的数据。该数据有或无另外的生理数据,例如用一种或多种传感器例如上面描述的传感器装置获得的数据,可与例如所期望的适当的决策工具一起,用于做出特定的治疗方案是否应维持或以某种方式例如通过药物治疗方案和/或植入物活性方案的修改而修改的决定。因此,本发明的方法包括其中治疗方案基于从组合物获得的信号修改的方法。
在某些实施方案中,也提供了确定本发明组合物的历史的方法,其中该组合物包括活性剂、识别器元件和药学上可接受的载体。在识别器发射响应询问的信号的某些实施方案中,识别器被例如条形码读入器或其他合适的询问装置询问以获得信号。所获得的信号然后用于测定有关该组合物的历史信息,例如来源、保管链等。
在识别器是免于消化的识别器的还其他实施方案中,方法通常包括例如通过从已摄取该组合物的患者处取回,获得该组合物的信号发生元件,然后由所获得的信号发生元件确定该组合物的历史。例如,信号发生元件包括刻标识别器,例如条码或其他类型的识别器,该刻标识别器可从已摄取组合物的患者处取回,然后阅读以识别至少该组合物历史的某些方面,例如最后已知的购买者、在该组合物保管链中的另外的购买者、制备商、处理历史等。在某些实施方案中,该测定步骤可包括进入所存储的该组合物历史数据库或类似的编辑文件中。
实用性
本发明向临床医生的治疗性医疗设备中提供重要的新工具:药物实际释放进机体的自动检测和识别。该新信息装置和系统的应用是多方面的。这些应用包括但不限于:(1)监控患者对所开的治疗方案的依从性;(2)基于患者的依从性裁剪治疗方案;(3)监控临床试验中患者的依从性;(4)监控受控物质的使用等。这些不同的说明性应用的每一种现在更详细地综述如下。
监控患者对所开的治疗方案的依从性
如上所概述,主题组合物和系统于其中发现用途的一种应用类型是监控患者对所开的治疗方案的依从性。监控患者的依从性指跟踪患者实际上是否按开给该患者的方式服用药物。因此,本发明提供了药丸何时被服用及哪个药丸被服用的准确数据。这使得能够精确确定在具体的时间点上哪个药丸被服用。该监控能力确保了患者正在正确地服用所开的药物。该信息避免了过量开实际上不服用的药物的潜在性。例如如果打算将镇痛药给予患者,用本发明核实该患者事实上确实在某个时间段服用了那些镇痛药是可能的。该知识在限制将未消费药物违法销售给过失团体上是重要的工具。在心血管药物的情况中,临床医生或护理人员能够核实药物服用的量已经在大约正确的点和时间服用。因此,该药物的真实功效可准确地被评价。适当给药和患者的依从性在阿尔茨海默病、精神病和酒精厌恶药物,及在疗养院居住者的治疗中尤其关键。在事故和其他过量情形的情况中,干预临床医生将能够辨别摄取已进行到了多远,及涉及多少药丸。
在本发明更复杂的实施方案中,药物正确的、及时的摄取将自动触发发送到药房数据系统的处方再填充(refill)信号,在某些情况中该再填充将自动直接释放到患者的家中,或者某些时间以后通过装置释放到患者的家中。该特征对具有折中的意识能力和/或有限的身体活动性的患者特别有价值。
本发明对复杂的给药方案特别有用,例如在正在服用多种药物,及混淆更可能发生时。本发明的药丸可以具有多个外层,及使药物组件能够溶解和吸收的唯一正确的剂量。具体的指示器,例如心脏中的电传导速度或血液中响应药物的电解质水平也可被滴定。
在某些实施方案中,当患者在某种程度上不依从给定的治疗方案时可以提醒该患者。例如如果药理学方案未准确地被遵循,声音、视觉或电脑提醒器会提供提示。如果该提醒器未准确地响应,该系统可向家庭成员、护理人员或临床医生发出提醒,以弥补治疗或过量间隙。该装置也可自动调节给药方案的剂量和时间选择,以补偿先前的非标准给药。
基于患者的依从性裁剪治疗方案
如上所概述,主题组合物和系统于其中发现用途的一种应用类型是基于患者的依从性裁剪治疗方案。在此类应用中,将所获得的有关患者是否已经服用特定剂量的数据用于确定此类剂量的进一步剂量和/或时间选择。在某些实施方案中,将涉及患者依从性的数据与另外的数据,例如感觉到的生理数据相结合,对给定的治疗方案进行定制的改变或修改。例如,当根据本发明获得的有关剂量依从性的数据与其他医疗传感装置一起使用时,可将药物释放、批和剂量之间的关系与生理反应相关联。以该方式,最佳药物治疗方案可由临床医生制订。例如,心脏刺激药物可滴定到最适当的剂量,使副作用例如心肌衰竭和其中的回弹作用最小化,并使每位患者的剂量和时间选择最佳化。
本发明使得替代药物范围的评估成为可能,而不需等待明显的临床治疗后果,这些后果中的许多可能是严重不利的。例如,阳性作用将是迅速可查明的,而不被更多的随机因素所干扰。负反应,例如相关的或独立的药物在背景生理变化之上的血压变化将变得更加明显。
在一个临床中心中,本发明允许与某些本发明的发明人开发的其他传感装置一起,测定和评价心脏对那些药物治疗的反应。这些联合应用的传感装置,可以是其中下面列举的那些。某些本发明的发明人开发的其他传感技术(如上所提及的)允许测定心脏健康和心脏效率。与本发明的装置一起使用这些工具,临床医生将能够比较心脏和身体对所给药物的反应。本发明所提供的数据可以任选随时间记录。记录系统记录经过心脏组织的信号的同步或传导速度,及这是如何由某些药物的存在介导的。本发明使得这唯一的数据成为可能,因为当药丸或其他药物正在被吸收进机体时,它可以电子准确测定。
在更标准的临床环境中,该唯一的数据使得药物给药能够小心选择和滴定,而不诉诸于更明显的身体症状来弄清禁忌症、功效和最佳剂量水平。当患者入院时,本发明提供给急救、病房技术员或医生记录,使得该患者的状况可以准确地查清。住院前最后一小时或一天内的给药事件,及最后给药的识别将可立即获得。因此,可基于患者药物治疗历史的准确记录,制订进一步的治疗方案。
在某些实施方案中,临床医生通过简单询问植入或可携带装置获得该信息。该装置将无任何不确定性地告诉他们什么药丸已被服用。随着本发明技术更广泛地传播,该数据将可更有规则地获得。本发明的微型芯片足够便宜,所以当它们进行标准制备时,大多数或所有药物当然将与它们相适应。
外部报告仪器的患者监控能力是本发明装置可提供的重要功能。当与内部或外部生理传感数据相协调时,该装置可读出该患者对药物摄取的生理反应,然后将该信息传送回临床医生。临床医生然后按对修改过的治疗方案的反应新数据所指出的,将治疗方案修改到最有效等等。
在本发明更尖端的实施方案中,在某些参数内的剂量调节功能,可通过该仪器内的智能电路执行。例如,对血压药物而言,患者服用其降压药。20分钟后,可植入装置中的内部监控电路记录血压的下降。电路将该下降定量,并将其传送到床边仪器。该仪器然后可以调节该药丸的剂量,以最佳地治疗该患者。类似地,当该患者与IV连接时,剂量可直接分配到IV流体中。在某些实施方案中,提供闭循环系统作为完全可植入的装置。
当前的药物治疗优化的临床实践相当程度上比通过使用本发明装置获得的更有限。目前,血压药物治疗设置为每天服用如此众多的药丸。这样钝的给药方案要花长时间去适当地优化,因为反馈循环非常慢。相反,用本发明,对药物剂量的生理反应的反馈循环非常迅速并且非常有效。最后,本发明允许天天剪裁药物剂量,或者甚至更细地剪裁,以说明活性的变化、患者生理状况的变化和其他剂量参数。
在本发明更尖端的实施方案中,对特殊剂量和时间间隔的生理反应也将继续监控。在某些实施方案中,监控药物在血流中的水平,允许药物代谢中的个体和天时间变化。
本发明的该方面有效地使受控物质低于剂量或超过剂量给药最小化,在某些情况中,在它们产生明显的外部症状之前,将这些变化告诉患者或临床医生。药物剂量可自动滴定,使得例如平息由于疼痛产生的焦虑的最小适当水平、对疼痛的其他生理反应或者提供该药物稳定的或逐渐减小的血液水平将被特许。本发明的该特征提供自动的、适当逐渐的、药物戒断,减小严重成瘾或者严重、不利戒断反应的机会。
临床试验应用
本发明的重要应用是提供对临床药物试验中药物制剂的给药反应的生理数据立即反馈。当前的挑战是试验性药物被广泛地给予群体,而无该群体中的哪个亚群最有可能从该治疗中受益的理解性预知。另一个挑战是通过确定试验患者是否正按说明服用该药物,监控患者对治疗方案的依从性。后一个挑战在上面部分中提出。因此可以确定患者的非依从性水平和对药物摄取的实际反应。因此,依从性干预然后可在该研究中稍早提出。
在本发明的某些实施方案中,给临床研究者提供了可立即获取生理数据。临床研究者能够识别该药物在试验的可能参加者中的最初试验群体内最有可能对谁有效的子集。患者接收血压药物并立即得到反馈的上述例子显示新药的有效性可以如何迅速地确定。
当药物的第一个剂量给予最初的试验患者时,临床研究者可能发现群体中的某些患者对该药物有反应,而其他人不反应。该立即的反馈允许该试验的管理者排除对该药物不反应的那些患者,并只针对对其有清楚的功效的那个亚群。该剔除程序使得试验的全部结果达到高得多的有效百分比,因为人们能够将该药物针对对其有效的群体。它也避免了对可能对此类危险无利益平衡的患者的副作用挑战。
因此,根据该创造性数据,本发明提供给临床医生显示对该药物的反应和该药丸消化的时间的精确的剂量反应曲线。该创造性数据具有许多应用。例如,临床医生现在有能力确定那些患者对药丸中的药物无反应。在研究情形中,此类患者可以从研究中或者从某些药物的临床使用试验中除去。该能力提供仅对某些药物有有益反应的人被保留在该试验中。该特征将改善药物的有效性,并减少人们服用不再有用的药物的量。它也可用于确定那些患者实际上消耗了该药物,而那些没有的试验中。
本发明允许识别药物功效的生理代理。例如,对在明显的临床变化发展之前长期给药的药物而言,通常有摄取该药后立即出现的某种短期生理因素。例如,需要许多月来显示作用的癌症药物,在一个或一群生理因素中可具有其功效的更短期的标记。血压、体温、内部化学酶或其他因素局部的或贯穿全身的变化,将起长期期望的作用的代理作用。这些因素与药丸摄取的时间的精确联系提高了发现有意义的标记能力。
由于本发明创造性地首次提供对药丸摄取的非常接近定时的相关反应,证明生理反应是药物摄取的结果,而不是任何其他可能性混淆因素的结果,更加有可能。本发明的该能力可以为临床试验起部分或全部代理作用。
本发明提供非常迅速地确定患者是应该服该药物还是不应该,它将是有效的或无效的,及允许其适当的滴定的方式。药物之间的协同作用,包括有帮助的和不利的也将变得更明显。
监控受控物质的用途
如上所综述,在本发明的微型芯片的其他实施方案中,识别器可以装配线圈,这些线圈对询问敏感而不被溶解在机体内。这通过以摄取前询问者将被告知药丸的存在和身份的方式,将RF能量传送到线圈中完成。
在本发明另外的实施方案中,提供了可以询问各药丸和查明其地址的“智能盒”。该盒可以写出不同产品数或产品编码,以使每个曾经制备的单个药丸提供有唯一的识别器。保险丝例如可以选择性地被破坏,因此地址可以用电或光检测。特别是在受控物质的情况中,例如麻醉剂,这在限制先前合法药物的违法使用上将是重要的。本发明使得准确地识别谁从授权的药剂师处购买该药丸成为可能。本发明的该用途将限制受控物质在市场上违法使用的数目。
本发明的外部仪器方面的重要应用是监控和规范受控药用物质的使用。开给患者大量麻醉剂用于疼痛控制的严重危险是成瘾的可能性。在其最简单的分析中,成瘾性由通过非故意过量、预定误用或通过不精密的剂量处方摄取太多的受控药物发生。另外,如上所描述,此类药物上提供了个别序列号,以在此类药物的违法分配之前跟踪该药物的合法分配。
在本发明的一个应用中,提供了锁定和规范潜在的成瘾性药物的剂量的手段。本发明的该能力的一个实例是当患者服了其麻醉药丸时,其中该药物的摄取由内部装置记录。该信息然后自动传送到外部仪器。
本发明的仪器如此配制使得仅在患者服了药丸并在适当的时间经过后,该附属仪器才再分配药丸。以该方式,通过在精确的适当时间间隔准确地分配所开的剂量,限制合法药物的可获得性,戏剧性地降低了该药物的成瘾率。
外部仪器也可有效地用于强制药物法医应用。例如,在判定罪犯的情况中,罪犯可能被要求服用法庭命令的药物作为从监狱释放的条件。用本发明,法庭或缓刑监督管获得了该药物给药的真实时间记录,因为该信息通过该附属仪器反馈回适当的官员。法庭命令的治疗精神病药或对性罪犯的化学绝育药维持的当前趋势,将通过本发明的该方面说明。本发明的该用途类似于身体状态监控带被戴在罪犯的踝关节上的软禁。
药剂盒
也提供了实施主题方法的药剂盒。药剂盒可包括一种或多种如上所描述的本发明组合物。药剂盒中所提供的一种或多种药物的剂量对单次应用或多次应用可以是足够的。因此,在主题药剂盒的某些实施方案中,单剂量的药物可存在于药剂盒中,而在某些其他实施方案中,多剂量的药物可以存在于药剂盒中。在那些具有多剂量药物的实施方案中,这些药物可以包装在单个容器中,例如单个管、瓶、小瓶等,或者一个或多个剂量的量可以分别包装,以使某些药剂盒可含有超过一个药物的容器。
也可用主题药剂盒提供一种或多种药物释放给患者的合适的手段。在药剂盒中提供的特定释放手段,由所采用的如上所描述特定药物决定,例如该药物的特定形式例如该药物是否配制成固体、半固体、液体或气体形式的制剂,例如片剂、胶囊剂、散剂、颗粒剂、软膏剂、溶液、栓剂、注射剂、吸入剂和气雾剂等,及该药物给药的特定方式,例如是否是经口、口颊、直肠、非肠道、腹膜内、皮内、透皮、intracheal等。因此,某些系统可以包括栓剂给药器、注射器、I.V.袋和管、电极等。
在某些实施方案中,药剂盒也可包括如上所综述的信号接收元件。在某些实施方案中,药剂盒也可包括例如以上所描述的外部监控装置,其可提供与远程位置,例如医生的办公室、中央设施等的通讯,它获得并处理所获得的有关该组合物的使用的数据。
主题药剂盒也可包括如何使用该药剂盒中的组件实施主题方法的说明。说明可记录在合适的记录介质或基体上。例如,说明可以印刷在例如纸或塑料等基体上。因此,说明可存在于药剂盒中作为包装插入物,存在于在该药剂盒或其组成(即与该包装或内包装相关的)的容器的标签中等。在其他实施方案中,说明作为存在于合适的电脑可读存储介质,例如CD-ROM、软盘等中的电子存储数据文件存在。在还其他实施方案中,实际说明不存在于药剂盒中,而是提供通过从远程来源,例如通过因特网获得说明。该实施方案的实例是包括说明可以被查看和/或说明可以从中下载的网址的药剂盒。由于用这些说明,获得说明的该手段被记录在合适的基体上。
主题药剂盒的某些或所有元件可包装在合适的包装中,以保持无菌。在主题药剂盒的许多实施方案中,药剂盒的元件包装在药剂盒抑制元件(containment element)中,制成单个的、易于操作的单元,其中该药剂盒抑制元件例如盒或类似的结构可以是或可以不是气密性容器,例如以进一步保持该药剂盒中的某些或所有元件的无菌性。
通过举例说明及并非限制性的提供下列实施例。
试验
实施例1
在下列试验中,采用了发送器(Tx)和接收器(Rx),它们各自通过电池供电并装在不透水的RubbermaidTM容器中。Tx和Rx漂浮在生理盐水浴中,当将Tx置于该浴中时LED在Rx上发光。Tx和Rx均完全与外界隔离。
Tx代表本申请的组合物例如具有活性剂和信号发生元件的药物组合物,是基于CMOS计时器芯片的振荡器电路。它由锂电池产生约3V振幅的80kHz方波。紧密缠绕的双股电线从该电路延伸,从该容器中出来,并进入该浴。在该双股电线的终端,电线用约1mm的条绝缘,并被分开以形成双极天线。发现信号振幅与描绘该双极特征的分隔距离成线性比例。当双极的范围为5mm时,信号用该装置易于检测。
Rx是具有输出以检测所传送信号的过滤放大器电路。方形铜边长10cm,与容器的外侧底部附接,并与电路的负微分输入附接;这代表调步外壳(can)。双极调步导线,约40cm长,与该电路的正微分输入附接;选择环状电极用于输入。将差分信号通过0.1μF串联电容器耦合到增益100测量放大器的输入中。该测量放大器的输出进入到增益为100及截止频率为5kHz的4极高通滤波器中。将该输出输入到增益20及截止频率为100kHz的2极低通滤波器中。因此,该电路的总增益为200,000。施加该输出信号穿过LED和串联的电阻器,当输出信号超过几伏特时它发光。
当不在浴中时,当它从环境中获得干扰和电源线噪音时,Rx LED始终接通。当调步导线对模拟外壳(mock can)短路时,LED关闭。
当置于溶液中时,LED关闭。当Tx也置于溶液中时,Rx LED接通,并研究对位置和方向的依赖。发现LED的强度取决于Rx和Tx双极之间角的余弦,垂直方向为零,及当该双极的检测反转时,用外部示波器观察到变符。发现LED的强度直接随位置变化,对间隔小于5cm观察到明亮的、饱和的发光,而对该浴允许的最大间隔约50cm观察到暗淡的、扩散的发光。
使得该检测稳健的关键是从假的干扰中区分所期望的信号。这在该试验中通过将灵敏度的频率带限制在5-100kHz之间实现。该带可以被缩窄的范围越窄,该系统将越稳健。此处的挑战是按照Tx频率可由于制备变化而改变30%的事实,使Tx和Rx电路的频率相匹配。通过使用窄的通带或通过使用收音机的解调技术,Rx电路可能非常窄。可以在调谐频率范围内扫描Rx电路,以检测药丸的存在。药丸的存在可通过将该药丸传送的数字信息中不太可能的位序列编码来证实。
该方法的两个问题是当它扫描频率时,消耗Rx电路的电源,及与多个药丸同步是困难的,这可能爆发其编码的传送。由于电路微调或高级制备方法是可能的,如果自始已知Tx的频率,则提出了这两个问题的很好的解决方案。在Rx电路的输入端,当所期望的信号存在时,与Tx频率匹配的调谐LC振荡器将“记录(ring up)”。该功率可通过简单的二极管电路检测,该电路起触发该检测电路接通的作用,极大地减少了它必须拉电流的时间。该调谐输入也起缩窄带宽和拒绝假信号的作用。
该上述试验显示通过合成的生物介质传送和检测信号的能力。Tx可易于使化学电池例如Pt/Mg系统断电。此外,数字信息易于用各种编码技术在信号中编码,以消除误差并改善该系统的整体可信度。
实施例2
根据本发明的发送器按下述安装。电路的9V电池断电,并漂浮在生理盐水浴中。该电路是基于TLC551芯片、CMOS版的大众化555计时器的振荡器。该振荡器以~7kHz运行,忙闲度大概是15%。该振荡器的输出各自通过7μF电容耦合到双绞线,该电线以小“Y”形双极终止,裸露电线的臂分开~1mm和~2mm,暴露于生理盐水浴中。
信号通过两个Cu电极接收,各电极的~1cm2暴露于该浴中。这通向由电池断开运转的Stanford前置放大器的输入,设置增益为1000和3kHz-30kHz之间的通过带。前置放大器的输出用电池产生动力的示波器观察。
观察到~20cm Rx电极分离的参考放大器输入的~200μV的最大信号。观察到双极耦合强度,显示正弦角依赖,垂直方向的接收信号为零;平行的和反平行的方向之间发现逆相。观察到所接收的信号强度与Rx电极的分离成线性比例。
上述显示经适当的放大和过滤,信号是可以清楚地检测的。此外,Rx放大器的输入上的电容器不是必需的;用在信号链中随后与高通滤波器在输入端耦合的DC,得到相同的结果。
上述结果也证实Tx可以用掉Mg/Pt马铃薯(potato)电池。
实施例3
原型的智能药丸微型芯片,用频移键控播送固定编码,首先由1.5V AA电池供电。将传导信号用双绞T-形双极施加于生理盐水浴中,大约1cm×1mm的导体暴露在T形的各臂上。信号通过两个铜电极检测,这两个电极间隔开约10cm,它们输入到电池驱动的、分离的差动前置放大器中。信号在示波器上观察。振荡信号,即所传送数据的清楚代表,观察到约300kHz的频率和约10mV的输入参考的振幅。此外,观察到所接收的信号强度对传送和接收导体之间角度的余弦的依赖,它是双极相互作用的特征。
配制了Mg-CuI水激活电池,各电极的暴露表面积为~1mm2。Mg电极通过简单地将商业级Mg带嵌铸在环氧树脂中,并用砂纸将扁平终端抛光形成。CuI电极通过首先将嵌铸在环氧树脂中的Cu电线末端抛光制备。
然后在Cu电线的终端,用标准技术电镀约100μm的Cu,选择参数以得到大的粗糙系数,增加该电极的有效面积。该电镀的Cu的表面然后通过施加相应于I-离子溶液中Cu+离子电位的电位,电化学法转化成CuI。在约15分钟内生成40mC的CuI。该电池显示出在相应于胃的通常酸度的pH 2溶液中具有~1.05V的开路电池电压。
将CuI-Mg电池与芯片的电源端连接,并将输出终端与上述生理盐水浴中的双极导体连接。该电池通过将电极放在浴中激活,观察到振幅为~2mV、频率为20kHz的信号至少1分钟。
最后,芯片的输出终端缩短在一起,有效地配制用于上述2-终端运行的芯片。观察到输出信号,但是其振幅要弱得多,可能是由于该配制中的有效发送器双极的长度减少。即在该4-终端配制中,有效传送导体的大小由电池和双极T之间的间隔决定,该间隔为几厘米;在2-终端模式中,有效双极长度被减小至将Mg和CuI电极之间分离,该距离小于1cm。所观察到的信号大概为几百μV,并可以用求平均值克服被宽带接收器放大的干扰信号而定量。更尖端的检测方案几乎没有可靠地检测该信号的问题。
实施例4
如上所描述的药物组合物在摄取前可由两种主要组件-地址产生逻辑电路和信号传输电路组成。地址产生电路用适用于所需任务的低电流供电。然而,如果供给该地址产生电路的电压改变,此处的振荡器的频率也将改变。这可产生信号传输的改变,将噪音引入传送中,并产生其他不期望的影响。
为了设计的目的,用恒定电压驱动地址产生电路更简单。然而,在某些实施方案中,可能期望更复杂的配制。例如,当传送开始,发送器消耗相当多的能量。结果,电压将下降,因为随着更多的能量被消耗,电源的电压下降。电压的变化将导致地址产生电路内的振荡器频率的改变。
工程学不同领域中的该挑战的实例是在远程控制装置由接收器和伺服装置组成时。相反,接收器永久地工作,并消耗与消耗非常大量的电流的伺服装置成比例的低电流。伺服装置仅在信号被传送到远程位置时工作。在该情况中,当伺服装置开始工作,整个系统消耗相对大量的动力。当伺服装置开始工作,电压下降,并产生一些噪音。结果,信号传输的稳定性被打折扣。
为了避免该问题,系统的实施方案用两种电压电源供电。接收器用一个电池供电,伺服装置用另一个电池供电。有该配制,无论什么在伺服装置中发生都不会影响该接收器。因此,产生更稳定的远程控制,因此改善了该完整系统的性能。
在一个实施方案中,提供了共同的阴极。也有两个正电极A1和A2。在该情况中,电池分成两部分,该电池的一部分将驱动地址产生电路,而另一部分将驱动传送电路。该配制向地址产生电路提供稳定的电压。当该装置的发送器部分被接通,仅发送器上的电压将改变,而在该装置的地址产生部分将无电压变化发生。因此,变化将通常引起信号振幅的改变,但是不引起频率的改变。结果,转换将更稳定,RF传送的频率将不受影响,或仅受最小的影响。
如果电池电极的面积大,上述现象并不是问题,因为该系统的电压总体上将不改变。然而,在小电池电极的情况中,发送器可潜在地降低电池的电压,并且整个电路的电压将改变。如果电池被分成两部分,一个电池的电压可以改变,而另一个的将继续以恒定电压驱动地址产生电路。
设计发展上的考虑是一个电池将如何影响另一个。由某些本发明的发明人进行的试验显示一个电池上负荷的改变不影响另一个;即它们独立地工作。在该试验中,如图23所示,两个碘化亚铜阳极电极提供有作为共同阴极的镁电极。这些电极与零电阻安培计连接,并进行测定。一个碘化亚铜电极通过2.5KΩ电阻器连接,另一个通过200KΩ电阻器连接。所有电极均浸没在约37℃的pH 2HCl溶液中。由该试验产生的数据在图24中显示。两个碘化亚铜电极相互独立地工作。
本领域普通技术人员将容易地识别用于上述装置的不同材料和配制。可理解或迅速地发展该碘化亚铜的化学和制备的各种方法。
在碘化亚铜形成前的表面制备是感兴趣的。一种方法是使用嵌入在环氧树脂中的铜丝。这可用电解的铜镀。铜在碘化钾溶液中极化后,碘化亚铜在电极的尖端形成。碘化亚铜也可通过化学沉积形成。其他方法也可采用。
10μm是产生适当量的电流,以实现装置活动15分钟的通常的碘化亚铜厚度范围。如果采用更小的厚度,传送将持续更短的时间。因此,碘化亚铜的厚度由产生提供特定应用所需的结果的电流所需的时间决定。对几秒钟的传送而言,小于1μm的碘化亚铜将是合适的。对一微秒的传送而言,几纳米的碘化亚铜厚度例如范围在约10-100纳米,更尤其是约20-50纳米是足够的。
应理解,本发明不限于所描述的特定的实施方案,因此这些实施方案可以变化。也应理解,本文中所使用的术语目的仅为描述特定的实施方案,而无意用于限制,因为本发明的范围将仅由权利要求限制。
在提供值的范围时,应理解在该范围的上限和下限之间,到下限单位的十分之一(除非上下文中另外清楚地说明)的各插入值,及在该指定范围中的任何其他指定的或插入的值,都包括在本发明内。这些更小范围的上限和下限可独立地包括在更小的范围内,并且也包括在本发明内,受限于指定范围内的任何具体排除限制。当所指定的范围包括这些限制之一或其中两个时,排除那些包括的限度之一或其中两个的范围也包括在本发明中。
除非另外说明,本文中使用的所有技术和科学术语具有通常被本发明所属领域普通技术人员理解的相同含义。虽然任何类似于或等同于本文中所描述的那些方法和材料也可用于本发明的实施或试验,现在描述了代表性的说明性方法和材料。
本说明书中引用的所有出版物和专利均通过引用结合到本文中,好像各个出版物或专利专门并单独地被指明通过引用结合到本文中,并通过引用结合到本文中以公开并描述与引用的出版物相关的方法和/或材料。任何出版物的引用是递交日期之前的其公开的内容,并且不应被解释为承认本发明由于先有发明而在该出版物之前没有权利。此外,所提供出版物的日期可能与实际出版物日期不同,这可能需要独立地核实。
应说明,如本文中及在权利要求中使用,单数形式″一″和″该″包括复数指示物,除非上下文中清楚地指明。应进一步说明的是,权利要求可能被拟定排除任何任选元件。因此,该陈述打算用作先行基础,用于与权利要求元件的叙述相关的如“仅”、“只有”等穷尽性术语的使用,或者“负”限制的使用。
阅读本公开后,对本领域技术人员来讲显而易见的是,本文中所描述的和例举的各个实施方案具有不连续的组件和特征,这可容易地与任何其他一些实施方案的特征相分离或者组合,而不背离本发明的范围或宗旨。任何引用的方法可以按所引用的事件的顺序,或按任何其他逻辑上可能的顺序实施。
虽然为了清楚理解的目的,前述发明在某种程度上通过举例说明和实施例已详细描述,对本领域普通技术人员而言,按照本发明的教导,可对其进行某些改变和修改而不背离权利要求的宗旨或范围是显而易见的。
因此,前面仅说明了本发明的原则。应认识到,本领域技术人员将能够设计各种安排,虽然这些安排未在本文中清楚地描述或显示,它们使本发明的原则具体化,并包括在其宗旨和范围内。此外,本文中引用的所有实施例和条件性语言主要打算用于帮助读者理解本发明的原则,和发明人贡献的促进本领域的概念,并应解释为对此类具体引用的实施例和条件无限制。而且,本文中引用本发明的原则、方面和实施方案以及其具体实施例的所有陈述,打算包括其结构性和功能性等同物。因此,此类等同物将包括当前已知的等同物和将来开发的等同物,即所开发的行使相同功能的任何元件,不论结构如何。因此,无意将本发明的范围限制在本文中所显示和描述的示范性实施方案。而是本发明的范围和宗旨由权利要求限定。

Claims (98)

1.一种组合物,所述组合物包含:
活性剂;
当它接触靶向部位时发射信号的识别器;及
药学上可接受的载体。
2.一种组合物,所述组合物包含:
活性剂;
当被询问时发射信号的识别器;及
药学上可接受的载体;
其中该组合物在给予患者后被破坏。
3.一种组合物,所述组合物包含:
活性剂;
限制在机体发射信号的识别器;及
药学上可接受的载体。
4.一种组合物,所述组合物包含:
活性剂;
在与体液接触后接通的电源;及
药学上可接受的载体。
5.一种组合物,所述组合物包含:
活性剂;
转换广播功率的电源;
调节所转换功率的量的信号发生元件,及
药学上可接受的载体。
6.一种组合物,所述组合物包含:
活性剂;
免于消化的识别器;及
药学上可接受的载体。
7.权利要求1-6中任一项的组合物,其中所述信号是类属信号。
8.权利要求1-6中任一项的组合物,其中所述信号是唯一信号。
9.权利要求8的组合物,其中所述唯一信号是编码信号。
10.权利要求1-6中任一项的组合物,其中所述信号是传导信号。
11.权利要求1-6中任一项的组合物,其中所述信号是声信号。
12.权利要求1-6中任一项的组合物,其中所述信号是恒定信号。
13.权利要求1-6中任一项的系统,其中所述组合物产生断续信号。
14.权利要求1-6中任一项的组合物,其中所述信号是已调信号。
15.权利要求14的组合物,其中所述已调信号的振幅、频率和相中的至少一个已调制。
16.权利要求15的组合物,其中所述信号是调频信号。
17.权利要求15的组合物,其中所述信号是调幅信号。
18.权利要求15的组合物,其中所述信号是调相信号。
19.权利要求1-5中任一项的组合物,其中所述识别器包含激活剂和信号发生元件,其中所述激活剂激活所述信号发生元件以发射信号。
20.权利要求19的组合物,其中所述激活剂包含与所述靶生理部位接触后接通的电源。
21.权利要求20的组合物,其中所述电源包含电池。
22.权利要求21的组合物,其中所述电池包含两种不同的材料。
23.权利要求19的组合物,其中所述信号发生元件包含控制逻辑。
24.权利要求19的组合物,其中所述信号发生元件包含振荡器。
25.权利要求19的组合物,其中所述信号发生元件包含声发生元件。
26.权利要求25的组合物,其中所述声发生元件是压电装置。
27.权利要求19的组合物,其中所述信号发生元件包含信号发送器。
28.权利要求27的组合物,其中所述信号发送器包含至少一个电极。
29.权利要求28的组合物,其中所述电极包含电池元件。
30.权利要求27的组合物,其中所述信号发送器包含至少一根电线。
31.权利要求27的组合物,其中所述信号发送器包含至少一个线圈。
32.权利要求19的组合物,其中所述信号发生元件还包含功率接收器。
33.权利要求1-6中任一项的组合物,其中所述活性剂是心血管药物。
34.权利要求1-6中任一项的组合物,其中所述活性剂是疼痛缓解药物。
35.权利要求1-6中任一项的组合物,其中所述活性剂是神经作用药物。
36.权利要求1-6中任一项的组合物,其中所述活性剂是化疗药物。
37.权利要求1-6中任一项的组合物,所述组合物是固体。
38.权利要求37的组合物,所述组合物是片剂。
39.权利要求1-6中任一项的组合物,所述组合物是流体。
40.一种系统,所述系统包含:
(a)权利要求1-3中任一项的组合物;及
(b)用于检测由所述识别器产生的信号的接收器。
41.一种系统,所述系统包含:
(a)权利要求1-5中任一项的组合物;及
(b)接收器,该接收器装配用于检测由所述识别器与所述机体接触产生的信号。
42.一种系统,所述系统包含:
(a)组合物,所述组合物包含:
(i)药学上可接受的载体,
(ii)发射信号的识别器,该识别器限制在机体内,
(b)接收器,该接收器与机体接触以检测由所述识别器产生的信号。
43.权利要求40-42中任一项的系统,其中所述接收器是体内接收器。
44.权利要求40-42中任一项的系统,其中所述接收器是离体接收器。
45.权利要求40-42中任一项的系统,其中所述接收器包含电极。
46.权利要求45的系统,其中所述接收器包含第一和第二电极。
47.权利要求46的系统,其中所述第一电极与导电性机体元件接触,且所述第二电极与相对于所述导电性机体元件电绝缘的机体元件接触。
48.权利要求47的系统,其中所述第一电极与血液接触,且所述第二电极与脂肪组织接触。
49.权利要求40-42中任一项的系统,其中所述接收器包含线圈。
50.权利要求40-42中任一项的系统,其中所述接收器包含声检测元件。
51.权利要求40-42中任一项的系统,其中所述接收器包含心脏监控元件。
52.权利要求51的系统,其中所述心脏监控元件包含传导速度测量元件。
53.权利要求52的系统,其中所述心脏监控元件包含压力传感器。
54.权利要求52的系统,其中所述心脏监控元件包含尺寸传感器。
55.权利要求40-42中任一项的系统,其中所述接收器提供从所述信号发生元件获得数据的读出。
56.权利要求40-42中任一项的系统,所述系统还包含剂量分配器元件。
57.权利要求46的系统,其中所述剂量分配器元件基于从所述识别器获得的信号,分配权利要求1-6中任一项的组合物剂量。
58.权利要求40-42中任一项的系统,其中所述接收器能够同时检测从权利要求A1-AE1中任一项的各种组合物发射的信号。
59.权利要求40-42中任一项的系统,所述系统还包含至少一种以下的元件:数据存储元件、数据处理元件、数据显示元件、数据传输元件、通知机构和使用者界面。
60.一种方法,所述方法包括:
给予患者有效量的活性剂用于治疗病症,其中所述活性剂以权利要求1-6中任一项的组合物给药。
61.权利要求60的方法,所述方法还包括在所述患者的一定位置植入接受器,该接受器用于检测由所述识别器产生的信号。
62.权利要求60的方法,所述方法还包括将所述接受器与所述患者的局部位置联系。
63.权利要求60的方法,其中所述病症是心血管病症。
64.权利要求60的方法,所述方法还包括评价所述患者对所述活性剂的反应。
65.权利要求60的方法,所述方法还包括基于所述评价调节所述患者的治疗方案。
66.权利要求66的方法,所述方法包括给予两种或多种各自发射可辨别信号的所述组合物。
67.一种方法,所述方法包括:
(a)询问组合物,所述组合物包含:
活性剂;
在被询问时发射信号的识别器;及
药学上可接受的载体;
其中该组合物在给予患者后被破坏,获得所述组合物的数据;及
(b)根据所述数据确定所述组合物的历史信息。
68.权利要求67的方法,其中所述历史信息包括所述组合物的最后已知购买者的识别。
69.一种药剂盒,所述药剂盒包含:
至少一种权利要求1-6中任一项的组合物。
70.权利要求69的药剂盒,所述药剂盒包含许多所述组合物。
71.权利要求69的药剂盒,所述药剂盒还包含接收器。
72.权利要求69的药剂盒,所述药剂盒还包含给药剂量元件。
73.权利要求72的药剂盒,其中所述给药剂量元件含有所述组合物的多个剂量。
74.权利要求69的药剂盒,所述药剂盒还包含至少一种以下的元件:数据存储元件、数据处理元件、数据显示元件、数据传输元件、通知机构和使用者界面。
75.一种制备权利要求1-6中任一项的组合物的方法,所述方法包括:将与靶生理位置接触后被激活发射信号的识别器,与活性剂及药学上可接受的载体(考虑上述识别器进行调整),以足够制备所述组合物的方式组合。
76.权利要求75的方法,所述方法还包括制备所述识别器。
77.权利要求76的方法,其中所述识别器用平面处理方法制备。
78.权利要求75的方法,所述方法还包括在所述与所述活性剂和药学上接受的载体组合前,将所述识别器封装在保护性材料中。
79.权利要求75的方法,其中所述组合包括将所述识别器与所述活性剂和所述载体的组合物稳定的联系。
80.权利要求79的方法,其中所述稳定的联系包括将所述识别器置于所述组合物的空腔中,然后将所述空腔密封。
81.权利要求79的方法,其中所述稳定的联系包括围绕所述识别器制备所述组合物。
82.权利要求79的方法,其中所述稳定的联系包括将所述识别器粘合至所述组合物。
83.一种小于10mm3的电池,所述电池包含两种具有不同电化学活性的材料,该电化学活性在与生理流体接触后被激活。
84.权利要求83的电池,所述电池小于约1mm3
85.权利要求83的电池,其中所述两种材料是置于半导体支持物对侧面上的电极层。
86.权利要求83的电池,其中所述两种材料是在独立的半导体支持物上的电极层,并且处于相反的关系。
87.权利要求83的电池,其中所述两种材料是电极线。
88.权利要求83的电池,所述电池存在于还包括信号发生元件的识别器中。
89.权利要求88的电池,所述电池存在于包含活性剂和药学上可接受的载体的组合物中。
90.一种制备电池的方法,所述方法包括:
提供具有第一和第二表面的平面半导体支持材料;
在所述支持材料的第一表面上制备具有第一种电化学活性的第一种材料;及
在所述支持材料的第二表面上制备具有第二种电化学活性的第二种材料,其中所述第一种和第二种电化学活性是不同的;
制备所述电池。
91.权利要求90的方法,所述方法还包括在所述支持材料上提供电路。
92.权利要求90的方法,所述方法还包括将所述支持材料分成两个或多个部分。
93.权利要求92的方法,其中所述两个或多个部分各自小于约10mm3
94.权利要求90的方法,其中所述电池在与生理流体接触后被激活。
95.一种识别器,所述识别器包含:
(a)电源,及
(b)在与靶机体部位接触后发射信号的信号发生元件。
96.一种识别器,所述识别器包含:
(a)转换广播功率的电源,及
(b)在与靶机体部位接触后调节所转换功率的量的信号发生元件。
97.权利要求95-96中任一项的识别器,其中所述电源是电池。
98.权利要求95-96中任一项的识别器,其中所述电源将广播功率转换成适用于驱动所述信号发生元件的形式。
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