DE102017012248B3 - SCHEULLER COMPREHENSIVELY A REPLACEABLE CARTRIDGE, AND USE OF A MEDICINE IN A PACIFIER - Google Patents

Abstract

Pacifier (1) comprising:
- a sucker,
a flat plate (20) to which the sucker is attached,
- A replaceable cartridge (70) having an active substance (18), with at least one opening (71) through which the active substance (18) can be discharged; and
- A holding element (75) for receiving the cartridge (70), wherein the holding element (75) on the suction (10) facing away from the shield (20) is mounted and designed so that the at least one opening (71) of the Cartridge (70) in the use state of the pacifier (1) is exposed on the nose of the child so that the active ingredient (18) can be delivered in the direction of the nose, wherein the cartridge (70) to be removed before use, a closure (72) the openings (71).

Description

TECHNICAL AREA

The present disclosure relates to pacifiers for use in the treatment of upper respiratory tract disorders of infants and infants, and generally for the targeted local delivery of drugs to infants and toddlers. Embodiments further relate to the use of dosage forms comprising the correspondingly provided active ingredients in corresponding pacifiers.

BACKGROUND OF THE INVENTION

In the first two years of life, infants or young children (that is, children aged 0 to 2) have a number of problems. So they are often caught cold due to the not yet fully developed immune system. Respiratory diseases, such as sore throats, cause them especially in the evening before falling asleep, as well as considerable difficulties at night. Even the so-called "teething" can cause complaints such as irritability, sleep disorders, local pain and inflammation in the oral cavity. As a rule, this also has an immediate effect on the well-being of the parents. If home remedies, such as frequent drinking or calf wrap, as well as homeopathic treatments, such as the use of globules to combat the aforementioned problems are no longer sufficient, (school) medical help may be useful.

According to conventional medicine, medicinal products (e.g., cough syrup), painkillers as a suppository (e.g., paracetamol suppositories), and inhalation solutions (e.g., NaCl solution) are used in medical treatment of respiratory diseases, depending on the indication of infants and infants. Lozenges, such as throat pills, are indicated for use in children from the age of about 3 to 4 years at the earliest. The reason for this is that infants and very young children easily swallow such lozenges, which can lead to severe coughing fits or, in the worst case, to a refractory cardiovascular arrest.

To make teething more bearable, for example, a mouth gel can be used with the local anesthetic lidocaine hydrochloride for pain relief. However, in practice, in the application of such a mouth gel in infants and toddlers has shown that it is often difficult for the user due to lack of cooperation of the small patient to apply the oral gel targeted and evenly on the sensitive areas on the palate. In addition, in the absence of a metering device, overdosing or underdosing can easily occur. The gel is merely pressed out of the tube on a fingertip, which is why the dose of active ingredient can vary greatly from application to application. In addition, there is a risk that right at the beginning of the administration of the gel, a substantial portion is swallowed before it reaches the painful area in the palate.

US Pat. No. 5,395,392 describes a pacifier for administering an anti-caries agent to infants whose mouth ( 11 ) detachable with a mouthpiece ( 10 ), the interior of which serves as a receiving chamber for an active substance which contains xylitol and / or combinations of xylitol and fluorides such as sodium fluoride or xylitol with sorbitol and fluorides. CH 684 160 A5 describes a pacifier for teething toddler, consisting of a nipple with perforation and a lip shield in which the nipple is held by means of a Saugerklemmstück, characterized in that the nipple is divided internally by a partition in two parts, namely a closed Gaum part and a perforated , hollow teat neck. DE 20 2008 005 693 U1 describes a suction object consisting of a mouthpiece and a closure, characterized in that it can be filled with active ingredients and / or flavorings through a filling opening. DE 17 90 504 U describes a medicament carrier for administering medicaments acting on the mucosa of the mouth and throat of infants and toddlers, characterized by a lollipop made of thin-walled elastic plastic or rubber for accommodating the medicament with a lollipop preventing the ingestion of the lollipop, located at the outer end of the neck portion of the lollipop A sheet of flexible material, such as plastic, celluloid or the like, having a lollipop-shaped gap-shaped opening approximately closed in use of the lollipop and opening into the lollipop by bending the disc along the gap-shaped opening for insertion of the medicament can be spread. EP 0 681 824 A1 describes a medical nipple with a closable, cup-shaped receptacle for a drug which is sealed to the outside via a flow channel with a mouthpiece for sucking the liquid or liquefied drug, characterized in that the effective channel cross-section of the flow channel is variable for metering the to Mouthpiece flowing drug flow. US Pat. No. 6,557,548 B1 describes an apparatus for administering a vapor of an aromatic substance to a child comprising inter alia a replaceable vapor emitter. US 2007/0021783 A1 describes a pacifier for vaporizing substances into which a tablet or fluid container can be interchangeably inserted.

In view of the above, there is a need for the present invention.

SUMMARY OF THE INVENTION

The present invention relates to a pacifier according to claim 1, as well as a use according to claim 10.

According to a first aspect, there is provided a pacifier comprising: a nipple, a sheet-like shield to which the nipple is attached, an exchangeable cartridge having an active agent with at least one opening through which the active substance can be dispensed; and a holding element for receiving the cartridge, wherein the holding element is attached to the suction side facing away from the shield and is designed so that the at least one opening of the cartridge in the use state of the pacifier is exposed aligned to the nose of the child, so that the Active substance can be delivered in the direction of the nose, wherein the cartridge has to be removed before use a closure of the openings.

In another aspect, the use of a dosage form in a pacifier according to the present invention is proposed. In particular, the dosage form is used as a refillable element.

list of figures

• 1 zeigt schematisch eine perspektivische Ansicht eines Saugers gemäß Ausführungsformen, für einen Schnuller gemäß Ausführungsformen, sowie eine Detailvergrößerung eines der Durchlässe in dem Sauger;
• 2 zeigt den Sauger der 1 in einer Frontansicht;
• 3 zeigt in einer rückwärtigen Ansicht den Sauger der 1 und 2;
• 4 zeigt eine perspektivische Ansicht eines Schnullers gemäß Ausführungsformen;
• 5 zeigt perspektivisch eine Explosionsdarstellung eines Schnullers gemäß weiteren Ausführungsformen;
• 6 zeigt eine andere perspektivische Ansicht der Explosionsdarstellung der 5;
• 7 zeigt eine auswechselbare Kartusche für bzw. aus einem Schnuller gemäß Ausführungsformen.

Features and advantages of the present invention will become apparent to those skilled in the art upon reference to the detailed description taken in conjunction with the appended drawings. Showing:

• 1 schematically shows a perspective view of a nipple according to embodiments, for a pacifier according to embodiments, as well as an enlarged detail of one of the passages in the nipple;
• 2 shows the sucker the 1 in a front view;
• 3 shows in a rear view the sucker of 1 and 2 ;
• 4 shows a perspective view of a pacifier according to embodiments;
• 5 shows in perspective an exploded view of a pacifier according to further embodiments;
• 6 shows another perspective view of the exploded view of 5 ;
• 7 shows a replaceable cartridge for or from a pacifier according to embodiments.

DETAILED DESCRIPTION

Although preferred embodiments are described below, the scope of the invention is not limited to illustrated embodiments, but also includes embodiments obvious to those skilled in the art.

In the following, more detailed reference will be made to various embodiments of the invention, one or more examples of which are illustrated in the drawings. In the following, unless otherwise stated, the same reference numerals are used for identical and equivalent elements.

According to the present disclosure, a pacifier is a pacifier designed to satisfy the sucking needs of infants (especially infants and toddlers).

In general, embodiments pacifiers for infants (especially for infants and toddlers), with which in a novel way, one or more drugs in / to the mouth, and / or throat, and / or nose area can be applied. For this purpose, a sucker made of a rubber-like, elastic material is provided, which has a central cavity. In a wall (outer surface) of the Sucker, which simultaneously represents the wall or enclosure of the central cavity, a plurality of passages or perforations are provided. The passages provide a fluidic connection between the central cavity and the exterior around the pacifier.

If an active ingredient, for example in the form of a lozenge or a fruit gum, is present in the central cavity, it comes into contact with the saliva of the child via the passages. The saliva dissolves the active ingredient successively. Through the passages, the drug comes into contact with the mouth of the child through the return of the drug-enriched saliva. It is absorbed or swallowed via the oral mucosa. The instinctive, dynamic suction movement promotes the above process or salivation in both directions - in and out. If the passages are arranged in a targeted manner or in a focal point in certain regions of the nipple, for example in the area close to the palate, and / or a region facing the tongue, and / or the region close to the nasal cavity, it can be ensured that the active substance is focused in the region concerned and operates there. The cavity is thus configured to receive a first active substance. The cavity is further configured so that liquid can only pass through the passages into the cavity.

In embodiments, the passages are conical, that is, their outer opening has a significantly larger diameter than the inner opening facing the central cavity with the active agent. This allows for a given number and surface density (number of passages per unit area) of the passages to increase the contact surface with the oral mucosa. Depending on the active ingredient, its water solubility and the desired administered dose, this may be useful to achieve the application of the desired dose in an acceptable period of time at all. The conically shaped passages are particularly useful in solid forms of the drug, as they also prevent about fragments of the drug or drug body (dosage form), such as a tablet, undesirably get out of the cavity of the teat into the mouth of the child.

To introduce the active ingredient in the central cavity, the sucker has a kind of valve. This can be provided in the form of a passage passage as a slot (preferably as a cross slot) in a - remote from the mouth of the child during use - the back wall of the teat. This reduces the risk that the drug form, or fragments of it, will not accidentally get into the child's mouth, which in extreme cases may lead to an unwanted swallowing with following respiratory disturbance. Especially with an opening for drug loading in a - during use the mouth of the child facing - area of the teat unwanted ingestion of at least fragments of the dosage form due to incorrect insertion of the dosage form and depending on the fragility of the dosage form is quite possible. A drug coating applied to the outer suction wall (ie, the suction wall facing the child's mouth during use) is even less suitable for the reasons mentioned above because larger pieces of the coating detach themselves from the wall of the teat as a result of the suction movement and thus penetrate the suction Can reach the child's mouth. In embodiments, the above-mentioned passage passage is designed as a purely structural modification of the (wall) material of the nipple. This facilitates the manufacture of the nipple, makes it less expensive, since no additional material has to be processed, and further prevents the occurrence of possible breakages (as might be the case with the use of a slider or a flap made of a different material).

The passage passage allows to introduce an active substance body, such as a tablet or a fruit gum, in the teat or its central cavity. At the same time, the passage passage prevents the escape of liquid, ie saliva or active ingredient or a mixture of both, from the nipple or through the shield in the rear part of the pacifier.

The nipple, ie the mouthpiece of the pacifier, is typically connected to a label (releasably) in use. The sucker can thus be separable from the shield so that it can be cleaned individually, e.g. by decoction. Also, it can be replaced as a single item. Furthermore, it is conceivable to provide different, replaceable pacifiers for a pacifier in order to achieve the greatest possible flexibility in the treatment of various diseases. Preferably, a nose attached to the nipple prevents the nipple from rotating relative to the shield (tongue and groove principle). The sign should also prevent the swallowing of the mouth part. The shield may according to embodiments have any known in the prior art forms. For example, the shield may have a butterfly-like shape. The shield may have at least two through holes, which is beneficial for ventilation.

According to the present invention, the mouthpiece is made of latex and / or silicone and / or a rubber-like material. In principle, the mouth part can have any desired shape. For example, the mouthpiece may have a round cherry shape, or the anteriorly sloped palate shape adapted to the oral cavity.

In embodiments, the pacifier is provided with a retainer or retainer for a replaceable cartridge. The retaining element is mounted on the opposite side of the sucker of the shield. The cartridge is designed to receive a (preferably) liquid second active substance. On one side, the cartridge has at least one opening, which is aligned after insertion of the cartridge in the holding element so that it is located near the nostrils of the child and is aligned therewith. If a cover or a closure is removed, the second active ingredient evaporates at room temperature through the at least one opening and is discharged in the direction of the nose. In this way, volatile compounds, e.g. an essential oil for the relief of cold symptoms. The cartridge can be fixed in place by means of a cap which is placed on the holding element. The cap may also be releasably connectable to the retaining element by means of a locking mechanism which requires a combination of at least two simultaneous or sequential movements. For example, the cap can be releasably connected to the holding element by means of a push-turn closure. In particular, the cap can be fastened to the holding element by means of a rotatably detachable bayonet closure, which can not be opened by small children. This is a parental control against accidental loosening / opening and prevents injury from loose parts or their ingestion.

The suckers and pacifiers according to embodiments are similar in shape and design to commercial pacifiers. An applying child thus sees little or no difference to his usual pacifier. The controlled, relatively slow (sustained release) delivery of both the first active ingredient through the nipple and the second active ingredient via the cartridge, a longer lasting (prolonged and / or retarded) drug delivery is possible, e.g. over several minutes / hours. Thus, no waking up of the child is usually necessary to perform a pacifier exchange, because an active ingredient is consumed.

1 shows a sucker 10 according to embodiments for a pacifier 1 , The nipple comprises a rubbery material, such as silicone, rubber, latex, or similar materials. The nipple has a central cavity 15 for receiving a first active ingredient. In at least part of its outer surface 25 (Wall) he has a plurality of passages 30 on. These provide a fluidic connection of the cavity 15 with an outdoor space 35 around the nipple dar. In use state of the nipple 10 or a pacifier equipped with it connect the passages 30 the cavity 15 with the mouth of a child (especially baby or baby).

To the sucker 10 loaded with a first active ingredient, the sucker points to a surface in use outside the mouth 45 a passage passage 50 on. This is liquid-tight in the normal state and can be opened temporarily by mechanical pressure from the outside - for example by a manually pressed tablet with the first active substance. The first active ingredient is typically carried out generally as part of a solid dosage form, for example a lozenge. The drug form with the first active ingredient is thereby manually through the passage passage 50 in the cavity 15 introduced. Typically, the passage is passage 50 as a purely structural modification of the rubbery material of the nipple 10 executed. This can be about a slot as in 1 sketched, (and in particular a Phillips). The slot (or cross slot) can be designed with partially overlapping walls, which increases the tightness. Passage passage 50 typically has an extension (length) of 0.5 cm to 1.5 cm, more typically from 0.7 cm to 1.2 cm. As a result, a solid dosage form can be conveniently and easily brought into the central cavity.

In 2 is a front view of the nipple of the 1 shown, with passages 30 on the top and bottom of the mouthpiece 60 of the teat 10 , 3 shows a passage passage 50 in a plane 45 of the round tail 55 is provided. The round tail 55 also serves for attachment to a sign 20 , The part of the teat at least partially in the mouth of a child during use 10 is the mouthpiece 60 , In certain embodiments, the passages 30 only in certain areas of the mouthpiece 60 , or focused or reinforced in certain areas of the mouthpiece 60 be provided. It is between an upper area 61 which rests on the palate in use, and a lower portion 62 , which rests mainly on the tongue in use, distinguished. Because of the usually asymmetrical in at least two dimensions design of the mouthpiece 60 the distinction between the two areas mentioned above may usefully be taken as follows: A passage 30 belongs to the upper area 61 if the normal vector 63 the outer surface 25 at the position of the passage 30 a component in the direction of the lower area 62 (tongue-near) to the upper area 61 (palate-close) has. On the other hand, there is a passage 30 to the lower area 62 if the normal vector 63 the outer surface 25 at the position of the passage 30 a component towards the top 61 (near the palate) to the lower area 62 (tongue-near) has. An example of such a normal vector 63 for a passage 30 in the upper area 61 is in 2 shown.

As an alternative to the above-mentioned geometric definition, depending on the specific case, the purely functional distinction may also be expedient, according to which the following assignment applies: Is an aperture 30 In the typical usage mode palate-facing or in contact, he belongs by definition to the upper area 61 , is a passage 30 tongue-facing in typical usage mode or in contact with it, it belongs by definition to the lower area 62 , passages 30 at the throat-side end and the tip of the teat 10 may suitably be assigned according to the above geometric definition, since in use they have neither contact with the palate nor the tongue or can not be unambiguously assigned to it.

The central cavity 15 of the teat 10 is thus defined as that space which is limited by a) the inside (ie the side facing away from the palate or tongue) of the wall of the mouthpiece 60 and b) the inside (ie, the direction of use in the direction of the throat side) of the wall of the surface 45 , The drug form with the first drug through the passage passage 50 in the cavity 15 introduced, the dosage form is freely movable within the central cavity, that is, that the dosage form does not cover the entire space of the central cavity 15 occupies. This promotes the play instinct of the child, stimulates the production of saliva and thereby increases the fluid removal from the mouth and throat, which is beneficial for colds, for example.

In embodiments, the nipple 10 a total of four to one hundred (4 to 100), typically ten to eighty (10 to 80), more typically twenty to sixty (20 to 60) ports 30 exhibit. Thus, the present nipple is not suitable for liquid dosage forms, as they are delivered too quickly in the mouth and throat, which in extreme cases can lead to an unwanted ingestion with the following breath disorder. Nor is a teat with only one passage in principle not suitable for solid dosage forms (eg lozenges or the like). Firstly, it would take too long to dissolve the drug form, on the other hand, the release of active ingredient through only one opening is not effective in the local treatment of oral and pharyngeal diseases. The passages 30 can typically be both in the upper range 61 (ie in the typical use mode palate-facing) as well as in the lower area 62 (that is tongue-facing in typical usage mode). Typically, in the upper area 61 as many passages 30 be provided as in the lower area 62 That is, typically two to fifty (2 to 50), more typically five to forty (5 to 40), even more typically ten to thirty (10 to 30), per range. Alternatively, the upper area 61 and the lower area 62 but also different numbers of passages 30 depending on the active ingredient used and indication. The provision of passages both in the upper and in the lower region allows a defined drug release of the first drug from the drug form, as well as a uniformly distributed throughout the mouth and throat area drug delivery, and thus an optimized effect of the first drug at the site of action. In particular, passages in the upper and lower portions of the teat allow saliva to flow from opposite teat sides into the central lumen and, due to the suction motion of the child, completely wet the dosage form. This regularly leads to a defined dissolution of the drug form, and thus to a defined drug release of the first drug from its drug form. At the same time, the reflux of the drug-enriched saliva over both areas 61 and 62 carried out, resulting in the above-mentioned evenly distributed drug delivery throughout the mouth and throat area. As a theoretical example, an erodible dosage form (such as. A throat tablet or a fruit gum) is mentioned, which is washed with saliva from all sides, which due to the defined contact surface between saliva and drug form to a uniform erosion of the dosage form and thereby to a defined drug release in leads the central cavity. The reflux of the drug-enriched saliva occurs over both areas 61 and 62 and thus ensures a uniformly distributed drug delivery throughout the mouth and throat area. One would only have the passages on one of the two areas 61 or 62 provide, it would - either using the same drug concentration - less active ingredient per unit time in the central cavity are released (risk of underdose), or you would have to increase the drug concentration in the dosage form, which can cause problems in the preparation on one hand (eg Lower dimensional stability, etc.), on the other hand, but also an altered composition of the dosage form can result. For example, a higher level of masking agent may be required to adequately mask the taste of the drug. Furthermore, the reflux of the drug-enriched saliva would only be via one of the two areas 61 and 62 take place, which leads adversely to the fact that the active ingredient is released either exclusively on the tongue side or exclusively on the palate side.

In embodiments, the passages 30 typically arranged at a generally uniform distance from one another. The passages 30 may typically have a generally circular cross-section. This show the passages 30 typically a uniform cross-sectional size, that is, all the passages have the same cross section. Alternatively, however, different cross-sectional sizes may be used, for example, depending on their location on the outer surface 25 are selected. The passages 30 can in principle have any shape. For example, they may be cylindrical, conical, cuboidal, cube-shaped, or combinations thereof (as a non-limiting enumeration). Furthermore, the passages may have a uniform shape, but alternatively, different shapes may be used. In particular embodiments, at least a portion of the passages 30 be cylindrically shaped. For example, all the passages 30 be cylindrically shaped. This simplifies the production of the nipple and thereby reduces the production costs. Alternatively, at least a portion of the passages 30 be conically shaped. For example, all the passages 30 be conical or only part of the passages 30 conical and the rest of the culverts 30 be cylindrically shaped. Conically shaped passages 30 mean that the proximal to the cavity 15 of the teat 10 located inner opening 31 the conically shaped passages 30 a diameter d1 which is smaller than the diameter d2 the distal to the cavity 15 of the teat 10 (ie outside) located outer opening 32 , see enlarged illustration in the 1 , The inner opening 31 the conical passages 30 has at least one 30 Percent smaller diameter d1 on as a diameter d2 the outside opening 32 more typically at least 50 percent smaller in diameter. The diameter d2 is typically 0.1 mm to 1 mm, more typically 0.2 mm to 0.8 mm, more typically 0.3 mm to 0.6 mm. The conical shaped passages allow to increase the contact surface with the oral mucosa. Depending on the active ingredient, its water solubility and the desired administered dose, this may be useful to achieve the application of the desired dose in an acceptable period of time at all. On the other hand, the conically shaped passages prevent - despite the large contact area with the oral mucus - too large fragments of the drug form, such as a tablet, undesirably get out of the cavity of the nipple into the child's mouth, resulting in an unwanted swallowing in extreme cases with the following breath disorder. This is particularly useful for those solid dosage forms that form particularly hard and sharp fragments during erosion, which is why even very small fragments of it can be a danger to the child. Typically, cylindrically shaped passages have a cross-sectional diameter of from 0.1 mm to 1 mm, more typically from 0.2 mm to 0.8 mm, more typically from 0.3 mm to 0.6 mm.

In embodiments, the passages 30 be arranged in a variety of patterns. So can the passages 30 for example - without prejudice to their provision both in the upper range 61 as well as in the lower area 62 - in some parts of the outer surface 25 amplified, while in other parts of the outer surface no passages 30 available. In a particular embodiment, the sucker 10 in the part which rests on the so-called lip bow of the child, no passages 30 on. This prevents the active ingredient from being delivered to the lips of the sucking child, which, depending on the active substance, could lead to irritation, but at least loss of active substance to areas of the mouth which should not be treated at all. In a further particular embodiment, which can be combined with the aforementioned embodiment, the sucker 10 for example, a plurality of passages 30 at the throat-side end and the tip of the teat 10 on. That is, the passages 30 are located only on the throat-side end and the tip of the teat 10 while the rest of the nipple has none, or alternatively, fewer passages 30 having. In the latter case, therefore, at the atrial end or at the tip of the nipple 10 a larger number of passages 30 per outer surface unit of the teat 10 provided as in the remaining part of the nipple 10 , This leads to an increased release of active ingredient in the back of the oral cavity, that is in the transition from the hard palate to the soft palate or in the throat. These sections of the upper respiratory tract, for example, are affected by a so-called "acute pharyngitis" and can thus be treated efficiently and specifically. As an alternative to the aforementioned embodiments, the sucker 10 only in the part of the teat 10 , which rests on the so-called dental arch, a plurality of passages 30 exhibit. This can be used to bring appropriate active ingredients (such as the local anesthetic lidocaine) specifically to the so-called teething caused by gingivitis, without coming into contact with other areas in the mouth and throat.

Through a targeted combination of parameters such as size, shape, position, total number and area density of the culverts 30 on the outside surface 25 of the teat 10 Greater control over drug delivery of the first drug in the mouth and throat can be achieved. So may be dependent on the position and area density of the passages 30 In certain parts of the teat, the first active substance can be delivered in a targeted and concentrated manner at the desired site of action. So this is a kind of local "drug-targeting". One benefit of this is that those areas of the mouth and throat that are healthy and need no treatment do not even come into contact with the drug to cause any damage. On the other hand, the "diseased" areas of the mouth and throat (ie those areas that are reddened, swollen, attacked by bacteria, inflamed, etc.) are targeted and concentrated (ie treated with a high concentration of active ingredient at the site of action). The size and shape of the passages 30 On the other hand, it influences, among other things, the rate of dissolution of the (solid) pharmaceutical form and thus indirectly also the release of active ingredient of the first active substance from its drug form. For example, use passages 30 with generally circular cross-section having smaller diameters (eg, 0.1 mm), less saliva per unit time passes into the central cavity of the nipple 10 which leads to a slower dissolution of the (solid) dosage form and thus to a delayed release of the first drug from its drug form. At the same time, the reflux of drug-enriched saliva is slowed down by such "narrower" passages, which in turn results in delayed drug delivery to the site of action. The interaction of the aforementioned parameters thus allows a tailor-made treatment of diseases of the upper respiratory tract of infants (preferably of infants and young children), depending on the active ingredient, dosage form, indication, etc.

The sucker 10 according to embodiments is with a shield 20 combined, as in 4 shown. At the flat sign 20 which may have openings for better ventilation of the skin is the sucker 10 attached.

According to the invention, the above pacifier is 1 of the 4 with a replaceable cartridge 70 be provided. This is schematically as an exploded view in 5 shown, with the cartridge 70 here as an example two openings 71 having. The cartouche 70 comprises a second active ingredient 18 that has at least one opening 71 can be delivered. The cartridge is in a holding element 75 held or provided, which s.der the sucker 10 opposite side of the shield 20 is appropriate. The holding element 75 is designed so that the opening (s) 71 the cartouche 70 in use state of the pacifier 1 exposed to the nose of the toddler (infant or infant). For this purpose, the holding element may have a recess on a part of its circumference as in 6 shown. In this way, located in the cartridge second active ingredient 18 , as evidenced by evaporation or evaporation in the direction of the nose. The cartouche 70 has a closure to be removed before use 72 the openings 71 on, which may be designed as a tear-off foil (non-limiting), or as a cap as in 5 shown schematically. Other possible closure forms are known to those skilled in the art and are considered to be within the scope of the disclosure. Furthermore, the opening (s) can (can) 71 the cartouche 70 be designed so that no liquid can escape from the cartridge (ie can escape in liquid form). This may typically be achieved by a corresponding orifice size (eg, a corresponding diameter for a circular opening cross-section) at which the liquid is retained by the surface tension. Alternatively, a polymer can be used to "seal" the opening (s) 71 be provided, which is gas permeable and liquid impermeable. Such polymers are known to those skilled in the art and are considered to be part of the disclosure.

As in 5 and 6 illustrated, includes the pacifier 1 in embodiments a preferably cap-shaped conclusion 80 , This is for interacting with the retaining element 75 designed so that the cartridge 70 is kept stable between. In particular, the degree may 80 a fixing mechanism on the cartridge 70 produce. This is the conclusion 80 typically for engagement with the retaining element 75 designed. The conclusion 80 can with the holding element 75 through a bayonet lock 85 be releasably connectable. The bayonet lock 85 is typically occlusable and releasable by rotation through an angle of a few degrees, say 5 degrees to 30 degrees. To stabilize the closure, in the cap-shaped closure 80 a feather 90 and a pressure ring 95 be provided. These generate a compressive force that causes a twist of the conclusion 80 inhibits. This also reduces the risk of unintentional release. In addition, the closure is not operable by infants and babies and thus represents a child safety.

According to embodiments, the pacifier 1 with a sucker 10 , as in 1 shown, equipped, as well as with the cartridge 70 as described above. In other embodiments, a pacifier with a conventional nipple, that is, without passages 30 , with the cartouche 70 and the holding system according to the invention. In other embodiments, such as in 5 shown, the sucker are the 1 and the cartridge or its holding system combined.

For use with the nipple 10 of the 1 Thus, a solid dosage form is typically provided which comprises a first active ingredient. The dosage form is typically provided in a lozenge-like dosage form. It thus serves as a refillable element with a first active ingredient in a nipple 10 for a pacifier 1 can be used, such as in 1 shown. The second active ingredient 18 is for use in the cartridge 70 (see also 7 ) intended. He is chosen to achieve a soothing effect for cold symptoms of the nose by evaporation. Typical would be here about essential oils. For example, in infants and infants, black cumin oil (Nigella sativa), chamomile oil (matricaria chamomilla), pine needle oil (picea abies) and eucalyptus oil (oleum eucalypti) are used. For example, a commercially available oil mixture for infants and toddlers is Babix®, a blend of pine needle and eucalyptus oil.

The cartouche 70 can be refillable, or typically designed as a replaceable disposable cartridge. The cartridge is preferred 70 designed as a replaceable disposable cartridge. This is because: The use of essential oils in infants and toddlers is not without controversy. Thus, not every essential oil is suitable for every age and every child. For example, the use of 1.8 cineole (eg in eucalyptus oil) is controversial in infants under 6 months, as this ingredient dissolves the tough respiratory mucus, but can not reliably kill off infants under the age of 6 months. In addition, due to hyperemia, the sensitive bronchial mucosa of infants may swell, which can lead to a life-threatening respiratory distress, depending on the "sensitivity" of the infant.

For the above reasons, there is a great deal of uncertainty among many parents as to which essential oils are suitable in which concentration and duration of use, for which age groups and which indication. Therefore, the use of essential oils is often completely dispensed with. Even those parents who are open to treatment with essential oils often do not know what dosage of a given oil will fit which age group. Commercially available oil mixtures can not provide any assistance, since they usually give no such recommendations. Even if parents were advised on the correct dosage of a particular oil mixture (with medical help, etc.), the dripping of the oil on a carrier medium, for example, the child's clothing with many disadvantages. So it can happen, especially at night, and under stress, that despite advice wrong dosage. In addition, the clothing of the child is dirty, or it requires an additional carrier medium for the oil, for example. A Wattebauschs. After opening the bottle, the oil has only a limited shelf life. The child's clothing and pacifier components in contact with the oil must be cleaned in one additional step. These and other disadvantages are eliminated by providing a replaceable disposable cartridge.

Thus, in a further aspect, there is provided the use of a disposable replaceable cartridge in a pacifier in accordance with the present invention. After consumption of the second active ingredient 18 in the cartouche 70 can the cartridge 70 thus against a new, filled cartridge 70 be replaced. This has, among other things, the advantage that - for certain indications and age groups - tailored single doses can be provided.

The change of the cartridge 70 can, for example, through the bayonet lock 85 , be made even if the pacifier 1 is in the child's mouth. A twist lock with safety stopper is an alternative push-turn closure and is considered to be part of the disclosure. Other types of closure or variants of the holder of the cartridge 70 are also possible and are considered to be part of the revelation. It should be noted, however, that, for example, the bayonet lock is a parental lock, as it is in principle not possible for infants and toddlers to perform the relatively complicated pressure and rotational movement. This also applies mutatis mutandis to the screw cap with safety stopper. In contrast to the aforementioned closure variants would be a simple screw between the cap-shaped closure 80 and the holding element 75 pose a risk. For example, infants of nearly 2 years could easily open such a screw cap. The reliability of a screw cap depends heavily on the force and angle at which the thread is twisted. Especially at night, and under stress, it may happen that the screw is incorrectly twisted (ie with too little force or a slightly offset angle). This could lead to an opening of the closure by the child, whereby items of the closure or the cartridge itself could get into the child's mouth and be swallowed. It is important to avoid this.

Thus, in light of the foregoing, embodiments pertain to the use of a pacifier for delivery of active ingredient to the upper respiratory tract (typically the mouth, throat and nose) of infants and children Infants (children aged 0 to 2 years). In other words, embodiments relate to a pacifier for use in the treatment of upper respiratory tract (typically the mouth, throat and nose) disorders of infants and infants (children aged 0 to 2 years). The pacifier according to the invention makes it possible to deliver active substances both to the nose and to the mouth / throat. This can be done simultaneously or sequentially as needed.

Furthermore, embodiments relate to a pacifier according to the present invention which comprises a drug-loadable nipple and a medicament form erodible (ie dissolvable) with the aid of liquid (in particular saliva). The dosage form is provided in the form of a dosage form suitable for sucking (for example in the form of a lozenge), and comprises a first active substance. The drug form is designed so that it can be introduced as a refillable element in the nipple. That is, the dosage form has the dimensions and properties required to be inserted into the nipple of the pacifier. The required dimensions and properties of the drug form depend essentially on the particular configuration of the nipple, and in particular of the respective mechanism for introducing the pharmaceutical form. For example, in the nipple of the present invention, the passage passage 50 the course, whether a dosage form in the teat 10 can be introduced or not. The dosage form further constitutes a composition for use in the treatment of diseases of infants and infants, and more particularly for topical (local) treatment of upper respiratory tract disorders in infants and infants. Typically, the dosage form is a solid dosage form selected from the group consisting of lozenge, chewable tablet, dragee, sublingual tablet, buccal tablet, candy (hard candy and soft candy), (gum) lozenge, fruit gum and gum drop. Typically, the dosage form is not in the form of homeopathic globules or as a coating on the teat wall.

In the pacifier according to the invention, therefore, a dosage form can be used in a suitable for sucking dosage form for use in the treatment of diseases of infants and young children, in particular for the topical (local) treatment of upper respiratory diseases of infants and toddlers. The dosage form is typically a solid dosage form (typically liquid, especially saliva), especially for prolonged oral cavity residence for use in the treatment of infants and infants. In other words, the dosage form is a dosage form dissolvable by sucking (with the aid of saliva). Typically, the dosage form is therefore intended for the treatment of children in the 1st and 2nd year of life (i.e., for the treatment of children up to and including 2 years). By "length of stay in the oral cavity" is meant the time required to completely dissolve the dosage form in the oral cavity, typically by sucking with the aid of saliva. Typically, the time to completely dissolve the dosage form in the oral cavity is about 1 to about 30 minutes, more typically about 2 to about 25 minutes, more typically about 5 to about 15 minutes. The residence time in the oral cavity can be determined by reference to corresponding dissolution tests described in pharmacopoeias.

The dosage form is intended for use in the treatment of diseases of infants and infants. Typically, the dosage form is a dosage form suitable for the topical treatment of upper respiratory tract disorders. Upper respiratory tract disorders are typically cough, catarrh, mucosal irritation in the upper airways, and / or inflammatory diseases of the oropharynx, i. Oral and pharyngeal inflammation, such as sore throat, throat scratching, hoarseness, dry throat and / or gingivitis. These diseases often occur as a concomitant of cold and flu infections, but also as independent diseases. Non-limiting examples of such inflammatory diseases of the cervical area are throat inflammation, especially angina, laryngitis, pharyngitis, and tonsillitis. Such diseases of the throat / throat are often accompanied by dysphagia. Also inflammations in the area of the oral cavity, such as Stomatitis, gingivitis, oral mucosal lesions, inflammation caused by teething and the like, have a very unpleasant symptoms for children and are included in the invention.

The dosage form typically contains a first active ingredient. The first active ingredient is typically selected from the group consisting of topical antibiotics, local anesthetics, antiseptics, expectorants, anticariogenic agents, mucous drugs and their extracts, tanning drugs or their extracts, and combinations thereof. Other possible drug classes for the drug are antitussives, anti-inflammatory drugs, analgesics, and glucocorticoids. An exemplary local antibiotic is tyrotricin, preferably used in combination with lactoferrin and lysozyme. Non-limiting examples of local anesthetics are Benzocaine or lidocaine. Non-limiting examples of local antiseptics are octenidine, chlorhexidine, triclosan, dequalinium chloride, cetylpyridinium chloride, hexamidine diisethionate, amylmetacresol, 2,4-dichlorobenzyl alcohol, benzalkonium chloride. Expectorants are medicines that liquefy the mucus in diseases with tough mucus formation, promote the removal of the mucus or facilitate expectoration. Non-limiting examples of expectorants are bromhexine and its metabolites ambroxol, acetlycysteine carbocysteine, and / or guaifenesin. Non-limiting examples of slime drugs are ribwort plantain (Plantago lanceolata L), Icelandic moss (Lichen islandicus), marshmallow (Althaea officinalis L.), mallow (Malva sylvestris L. and M. neglecta TRUE), boxhorn clover (Trigonella foenum-graecum L.) , Salep and quince (Cydonia oblonga MILL.) And their combinations, preferably plantain (Plantago lanceolata L.). Non-limiting examples of tanning agent drugs are pelargonium, blackberry (Rubus fructiosus), oak (Quercus rubor and / or Quercus petraea), goose fingerwort (Potentilla anserina), cloves (Szygium aromaticum), blueberry (Vaccinium myrtillus), myrrh (Commiphora myrrha), Ratanhia (Krameria triandra), sage (Salvia triloba), blackthorn (Prunus spinosa), nettle (Lamium album), tormentil (Potentilla erecta), strawberry (Fragaria vesca), agrimony (Agrimonla eupatoria), lady's mantle (Alchemilla xanthochlora), rose ( Rosa gallica), meadow button (Sanguisorba officinalis) and their combinations. An exemplary anticariogenic agent is xylitol. Also, the ingredients of drug drugs such as ivy, peppermint, thyme, primrose, fennel, anise, ginger, or combination thereof may be used as the active ingredient.

The concentration of the first drug in the dosage form can vary widely, depending on the drug and age of the child. In general, the dosage form contains the first active ingredient in a therapeutically effective amount, in particular from 0.05 to 30% by weight, typically from 0.1 to 20% by weight, more typically from 0.2 to 10% by weight typical 0.5 to 5 wt .-%, based on the total weight of the dosage form. Nevertheless, depending on the application, it may be advantageous or necessary to deviate from the aforementioned quantities. The respective quantities of a particular active substance are known to the person skilled in the art from, for example, relevant textbooks (for example Dietmar Wigger et al., Medicament in Paediatrics, Elsevier Urban and Fischer, Munich 4th edition, 2013).

The active ingredient is typically embedded in a matrix in the dosage form. In particular, the active substance is incorporated in a solid matrix which is soluble, in particular, in the case of sucking and / or salivary action. The matrix is typically in the dosage form in amounts of 70 to 99.05 wt .-%, more typically 80 to 99.9 wt .-%, still typically 90 to 99.8 wt .-%, more typically 95 to 99.5 wt .-%, based on the total weight of the dosage form.

The matrix may have elastic and / or plastic properties. In this case, the matrix has elastic properties when they change their shape under the action of force and can return to the original form when the acting force ceases. The matrix has plastic properties when it is irreversibly deformed under the action of force when it exceeds a yield point and retains this shape after exposure. Typically, the matrix may exhibit non-linear elastic behavior, in particular rubber elasticity.

The matrix may comprise a hydrocolloid, especially those selected from the group consisting of starch, cellulose, pectins, gum arabic, galactomannans, carubin, agar, carrageenan, alginates, gelatin, caseinates, xanthan, dextrans, scleroglucan, and combinations from that. The hydrocolloids give the pharmaceutical form their characteristic properties, for example their rubber-elastic consistency. Because of its elastic and / or plastic properties, the dosage form is optimally suitable for use in a teat of a pacifier which can be loaded with active substance. Thus, the dosage form can optimally compensate for the pressure caused by the child's sucking and chewing movement without it being disturbing for the child. This is particularly advantageous, as compared to conventional lozenges, which are rigid and therefore perceived during the suction movement as a disturbing foreign body. As a result of the child's sucking and chewing movements, the dosage form slowly dissolves with the help of saliva and thus releases the active substance to the oral cavity. The dosage form differs on the basis of its matrix of commercially available tablets for infants, such as vitamin D3 Tablets, etc., which should dissolve in contact with liquid within a few seconds. It also differs from traditional fruit gums in that it is tailor-made for infants and toddlers. Thus, the dosage forms on the age-appropriate drug dose for the respective indication and can be used by the parents stress-free and without extensive research regarding dosage / application, etc. The drug forms represent a previously unknown dosage form that they are tailor made for children up to 2 years. To date, according to the inventors, there are no comparable pharmaceutical forms for this particular group of patients, as drug forms are indicated in a suitable for suckling dosage form for children earliest from an age of well over two years (for example, from 4 years) (see for example Isla® moss for children from 4 years). The reason for this is that infants and very young children easily swallow such lozenges, which in the worst case can lead to a reflec- tive cardiovascular arrest. However, it is often difficult for parents to estimate when their child has the ability to hold a tablet or similar. to suck, without swallowing. Furthermore, approved and commercially available dosage forms for older children (eg for children from the age of 4) may contain concentrations of active substance that are not compatible with children up to 2 years of age. This uncertainty leads to the fact that drug forms for sucking are generally not administered to children ≤ 2 years. The present invention overcomes this technical prejudice.

In addition to the active ingredient in the appropriate dosage, the dosage form can also contain customary auxiliaries (fillers, masking agents, etc.), depending on the type of dosage form. These are widely known to those skilled in the pharmaceutical art and can be suitably used. For example, in a fruit gum in addition to active ingredient and hydrocolloid sweeteners, acids, fruit and vegetable extracts, flavors, water, and sequestering agents may be included. As a sweetener, for example, sugar, glucose syrup, fructose and sugar alcohols are used. Typically, the dosage form has no disintegrant.

The dosage form can therefore be used, in particular as a refillable element, in a teat-laden nipple of a pacifier according to the invention.

The dosage form may be provided in a variety of child-friendly forms, such as animal figures, and may be further packaged as a single dose.

Exemplary embodiments of the pharmaceutical form:

embodiment 1 : The embodiment 1 refers to a drug form in the form of fruit gums with the active ingredients 2,4-diclorobenzyl alcohol and amylmetacresol, and their preparation.

Starting materials: kind Amount in mg syrup glucose 420.0 granulated sugar 420.0 modified starch 124 pectin 30.4 citric acid 2.0 2,4-dichlorobenzyl 2.4 amylmetacresol 1.2 Total 1000.0

The starting materials glucose syrup, sugar, modified starch and pectin are boiled with the addition of water. Then citric acid and, if necessary, flavors and coloring fruit and vegetable extracts are added and mixed. Thereafter, the hot mass is cooled to about 60 ° C and the antiseptic active ingredients 2,4-diclorobenzyl alcohol and amylmetacresol homogeneously stirred therein. The still warm mass is poured into powder-filled and embossed molds. The fruit gum mass solidifies by cooling, whereby the drug form is formed. The solidified Fruchtgummikörper be formed and dried in an air-conditioned room at a drying temperature between 45 and 55 ° C over a drying period of 36 to 96 hours. Then the fruit gums are freed from adhering powder thickness, surrounded with a thin film of a release agent and packed in single doses.

embodiment 2 : The embodiment 2 refers to a drug form in the form of a lozenge with the drug ambroxol hydrochloride, and their preparation.

Starting materials: kind Amount in mg Carbopol 71 G NF polymer 35.5 ambroxol hydrochloride 7.5 carrageenan 1 Mannitol (Pearlitol SD 200) 122 Sodium bicarbonate fine 11.25 Citric acid wfr. FeinGr. 11.75 Macrogol 6000 (polyethylene glycol 6000) 12.5 Sucralose micro. 1.0 Cherry Aroma F & L (P0605760) 10.0 Potassium monohydrogen phosphate 2.5 zinc stearate 3.75 silica 1.25 Sorbitol (Parteck SI400) 27.5 Xanthan gum 2.5 Total: 250.00

The starting materials are mixed in a conventional manner, granulated, pressed and then packed in single doses.

Claims (10)

Pacifier (1) comprising: - a sucker, a flat plate (20) to which the sucker is attached, - A replaceable cartridge (70) having an active substance (18), with at least one opening (71) through which the active substance (18) can be discharged; and - A holding element (75) for receiving the cartridge (70), wherein the holding element (75) on the suction (10) facing away from the shield (20) is mounted and designed so that the at least one opening (71) of the Cartridge (70) in the use state of the pacifier (1) is exposed on the nose of the child so that the active ingredient (18) can be delivered in the direction of the nose, wherein the cartridge (70) to be removed before use, a closure (72) the openings (71). Pacifier (1) after Claim 1 , further comprising a, preferably cap-shaped, end (80), which is designed to engage with the holding element (75), so that the cartridge (70) between the holding element (75) and closure (80) is supported. Pacifier (1) after Claim 2 wherein the termination (80) is releasably connectable to the retention member (75) by a closure mechanism (85) which requires a combination of at least two simultaneous or sequential movements; Pacifier (1) after one of the Claims 2 and 3 wherein in the conclusion (80), a spring (90) and a pressure ring (95) are provided. Pacifier (1) after one of the Claims 3 and 4 wherein the shutter mechanism (85) is a bayonet lock. A pacifier (1) according to any one of the preceding claims, wherein the retaining member (75) has a recess on a portion of its periphery so that the agent (18) contained in the cartridge (70) can be delivered by evaporation or evaporation towards the nose , A pacifier (1) according to any preceding claim, wherein the sheet shield (20) is releasably connected to the nipple (10). A pacifier (1) according to any one of the preceding claims, wherein the cartridge (70) constitutes a disposable cartridge. A pacifier (1) according to any one of the preceding claims, wherein the nipple (10) comprises a rubbery material, and wherein the nipple (10) has a central cavity (15) for receiving a second active agent and in at least part of its outer surface (25 ) having a plurality of passages (30) connecting the cavity (15) with an outer space (35) around the pacifier (1), so that the passages (30) in the use state of the pacifier (1) with the cavity (15) connect to the mouth of a child. Use of a dosage form in a pacifier (1) according to one of Claims 1 - 9 ,

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