DE102020121044A9 - nasal applicator - Google Patents

Abstract

The present invention relates to a nasal applicator (100) for the nasal administration of at least one medicinal substance (S), in particular an analgesic. The nasal applicator comprises a housing (2) which in turn has a substance reservoir (R) or is connected to one. Furthermore, the housing comprises a retrieval device (1) for actuation by the user with the aim of retrieving a next application dose (Dn) of the substance (S) or is connected to such. The housing also includes a dispensing dispenser and a blocking device (5) for temporarily blocking the dispensing dispenser (3) or is connected to such devices. Also on the housing is a dose detection device (7) for detecting the level of the application dose (D0, D1, D2, ..., Dn-1, Dn, Dn+1, ...), a electronic control device (9) and a data memory (M) comprises or the housing is connected to them. By means of a detection device (11), in cooperation with the control device (9) and the data memory (M), both a suitable point in time and a suitable dose for a subsequent application of a substance (S) can be determined by means of reading out, evaluating and/or predetermining.

Description

The present invention relates to a drug delivery device, in particular a nasal applicator, according to claim 1.

Nose applicators are known from practice, by means of which a patient can administer a medicament or an active ingredient nasally.

It is the object of the present invention to propose a further nasal applicator.

The object according to the invention is achieved by the nasal applicator having the features of claim 1.

According to the invention, a medication delivery device (for nasal, oral, buccal, sublingual, etc. delivery), in particular a nasal applicator for administering or nasally administering at least one substance, e.g. a medicinal or non-medicinal substance, e.g. B. a medicinal or non-medicinal active ingredient proposed. The medicinal substance can in particular be an analgesic. For this purpose, the drug delivery device or the nasal applicator has a housing.

The medication delivery device has or is connected to a substance reservoir for holding a quantity of the substance.

The medication delivery device is connected to or includes a retrieval device for actuation by the user/patient. The retrieval device is programmed or otherwise prepared so that the user of the drug delivery device can retrieve a next application dose of the substance by actuating the retrieval device. The purpose or aim of the retrieval device is therefore to be able to trigger an application dose.

The medication delivery device further includes or is connected to a delivery meter. The dispensing dispenser is provided for dispensing application doses upon actuation of the retrieval device. The delivery takes place, if it takes place, at a so-called delivery time.

The medication delivery device is also connected to or has a locking device. The blocking device is configured to temporarily block the dispensing doser during a blocking period, in particular a predefined blocking period. The blocking period begins, for example, after delivery of one, some or every application dose. Provision can thus be made for a blocking period to begin again at or after the respective delivery time of the delivered administration dose. The blocking period is defined by the start and end of the blocking period. Lockout periods applied by the locking device may have different durations or each may have the same duration.

In addition, the medication delivery device has or is connected to a dose detection device. The dose detection device is programmed to detect the amount (e.g. as an amount, in weight units, in volume units, in material units such as moles, etc.) of the application dose that is delivered by means of the delivery dispenser at the respective delivery time. It can also be programmed to record the level of an application dose referred to herein as the initial dose.

Furthermore, the drug delivery device is connected to an electronic control device or has one.

The drug delivery device may include or be connected to data storage for storage. He can at least the delivery times of one or more already delivered application doses, which z. B. before the next delivery time or in the past and / or store and / or have the heights of these application doses.

The drug delivery device may include, or be connected to, a sensing device that is programmed to sense operation of the retrieval device by the user. The actuation behavior can detect at least one actuation of the retrieval device by the user that has taken place or is taking place at a time of actuation and is preferably configured, programmed and/or provided accordingly. The aim of the actuation behavior is to trigger, deliver or have a next or future application dose applied and/or to check the circumstances for this, for example whether a previous delivery time was already a sufficiently long time ago.

The electronic control device is programmed to read data stored in the data memory. It is also programmed to evaluate the user's actuation behavior that was detected by the detection device. Next, it is programmed to a pre-determination time (or determination time), the level of the next application dose, z. B. from a variety of possible or definable application doses to predetermine or to be determined men, such as to select, calculate or specify which next, e.g. B. at a next delivery time, can be delivered to the user or can be delivered for a delivery to this user, should this outside of a blocking period, if such is set, actuate the retrieval device.

Such a predetermination time is at or after the actuation time. The step of predetermining takes place taking into account data read from the data memory. The data read out preferably include at least the delivery time of one or more of the application doses already delivered, or the time elapsed between the one or more delivery times of the application doses already delivered and the delivery time before or after the next actuation time. As an alternative or in addition, the data read out preferably include the level of one or more of the application doses that have already been dispensed, in particular by means of the medication dispensing device.

When reference is made herein to a user, this includes the patient who is self-medicating, the caregiver, the doctor, the patient's relatives and more, e.g. B. at the behest of the patient, the medication delivery device as described herein is used in the medication of the patient.

In all of the above and following statements, the use of the expression “can be” or “can have” etc. is to be understood synonymously with “is preferably” or “has preferably” etc. and is intended to explain an embodiment according to the invention.

Whenever numerical words are mentioned herein, the person skilled in the art understands them as indicating a numerical lower limit. Provided that this does not lead to a discernible contradiction for the person skilled in the art, the person skilled in the art always reads “at least one” or “at least one” when specifying “a” or “an”. This understanding is also encompassed by the present invention, as is the interpretation that a numerical word such as "a" can alternatively be meant as "exactly one" wherever this is clearly technically possible for a person skilled in the art. Both are encompassed by the present invention and apply to all numerals used herein.

Where "programmed," "provided," or "configured" is used herein, it is also disclosed to interchange these terms.

When reference is made herein to "programmed," "designated," or "configured" to perform a step or action, it is also disclosed that that step or action is optionally performed automatically, e.g. B. from the control device.

Advantageous further developments of the present invention are the subject matter of subclaims and embodiments.

Where reference is made herein to an embodiment, this represents an exemplary embodiment according to the invention.

If it is disclosed herein that the object according to the invention has one or more features in a specific embodiment, it is also disclosed herein that the object according to the invention expressly does not have this or these features in other embodiments that are also according to the invention, e.g. B. in the sense of a disclaimer. For each embodiment mentioned herein, the contrary embodiment, for example formulated as a negation, is also disclosed.

Embodiments according to the invention can have one or more of the features mentioned above and/or below in any technically possible combination.

Whenever a suitability, purpose, step or method step is recited herein, the present invention also encompasses corresponding programming or configuration of an apparatus or portion thereof suitable for achieving or carrying out.

Even if the present invention is not limited to a nasal applicator, but rather relates to drug delivery devices as such, the focus in the following is on nasal applicators.

The teachings, explanations, and advantages made of the nasal applicator apply without prejudice to drug delivery devices, and vice versa.

In some embodiments, the data store also includes pharmacological, pharmacodynamic and/or pharmacokinetic data, in particular relating to the substance that is or is to be administered. This data can be or include models, in particular PK models, or PK curves. They may have been recorded or compiled individually for each patient. Alternatively or additionally, others, the Sub stamp associated, data from the data storage includes or stored there.

The data can include, for example, the dose half-life and/or the elimination or terminal half-life of the substance.

The dose half-life is the time required for the concentration (e.g. in plasma, in blood, at the site of action (CNS, central nervous system), in adipose tissue, in the liver, etc.) to reach half the value (50%) of the administered dose is reduced.

The elimination or terminal half-life is the time required for the concentration present at pseudo-equilibrium to fall by half (50%).

The electronic control device is optionally programmed to also read out such data from the data memory.

Furthermore, the next or further application dose of the substance is pre-determined in this case, also taking into account the additionally read out data. The predetermination time, like optionally also the actuation time, can correspond to the delivery time of the next application dose, but it can also be before the delivery time.

The end of the blocking period of the blocking period can correspond to the point in time of the maximum concentration (this point in time is also referred to herein as: t _max ) between delivery of two successive application doses of the substance or be derived therefrom.

In certain embodiments, the blocking period can depend on the maximum concentration and accordingly on the doctor or other authorized persons or automatically on the medication delivery device, alternatively on a defined concentration, alternatively on the time until this defined concentration is undershot.

In some embodiments, the electronic control device is further programmed to cause the next or the further application dose to be dispensed at the predetermined level at the corresponding dispensing time by means of the dispensing dispenser. The electronic control device is also programmed to subsequently store or have stored in the data memory the level and/or a resulting concentration of the application dose, for example as quantity information or volume information etc. of the substance, of the next application dose delivered. Furthermore, the control device is preferably programmed in order, for example at the same time as or subsequent to the dispensing of the application dose, to cause the blocking device to temporarily block the dispensing dispenser for a specific blocking period.

The blocking period begins, for example, from or after the delivery time of this next application dose and is defined by a blocking period start and/or a blocking period end, which can also apply to any other blocking periods mentioned herein.

The delivery time of the next application dose delivered can be stored in the data memory, and the control device can be programmed for this.

In some embodiments, the electronic control device is further programmed to execute or initiate the sequence of the other steps mentioned above also in connection with one or more of the dispensing of further application doses following the next application dose, which are chronologically after the next application dose.

In some embodiments, the electronic control device is programmed to read out data from the data memory which z. B. include PK curves and / or PK models, and which depict a time course of the concentration of the substance in the body, in particular in the blood of the patient. Based on these curves or models, the electronic controller can calculate a next maximum concentration. The next maximum may be the maximum that the concentration has between immediately consecutive dispensing times. It may be the result of accumulated application doses.

In certain embodiments, this maximum concentration is calculated and used to determine the blocking period. When determining the blocking period, the point in time at which this maximum is achieved can be taken into account.

In some embodiments, the electronic control device is further programmed to determine the next application dose in such a way that the next maximum concentration will not exceed a predetermined maximum value or a predetermined maximum. In these embodiments, the application dose is determined on the basis of data stored in the data store, in particular PK curves or models, and a therapeutic maximum stored in the data store. The therapeutic The maximum can be the maximum of a single application dose or the maximum of a sum of several applications.

In some embodiments, the evaluation of the recorded activation behavior of the user includes determining the activation time at which the user would like to call up the next or the further application dose. Alternatively, the evaluation of the usage behavior includes the period of time that lies between this actuation time and the end of the blocking period of the last elapsed blocking period.

In this case, the predetermination includes taking into account the determined next actuation time or taking into account the determined period of time.

In some embodiments, the drug delivery device or nasal applicator further includes a feedback device. It is used by the user to provide feedback, e.g. B. to his well-being, his pain condition or the like. The feedback device, which can be a switch, a touch surface, etc., can e.g. B. be provided to be operated by the user when, or as long as he is painless or can make a statement about the effect of the substance in his body in any other way. So it can be agreed that the user presses the feedback device for the first time, e.g. B. presses when the pain is first felt to be tolerable after the last application dose applied to the user. It can also be agreed that the user no longer actuates the feedback device from the point in time at which he feels pain again for the first time (due to the decreasing concentration of the substance in the body).

The feedback device can be identical to the retrieval device, e.g. B. with its own switch evaluation, for example by being operated longer, shorter, more often or in some other way than the retrieval device, alternatively it can be a separate device for operation by the user.

In this case, the detection device is programmed to detect that the feedback device has been actuated by the user at least at one, preferably a first, feedback point in time.

Furthermore, the control device is programmed to determine the concentration of the substance present in the body or in the blood of the user at the at least one feedback point in time.

A determination here can always be a calculation, reading out and/or reading.

In addition, the control device is programmed to set a target concentration or its maximum value to a value below, above or equal to the determined concentration.

Whenever a "target concentration" is mentioned herein, it can be the concentration that produces a desired therapeutic effect.

In some embodiments, the detection device is further programmed to detect at least one actuation of the retrieval device by the user at different actuation times, in particular after the blocking period. Alternatively or additionally, the detection device is programmed to detect a feedback point in time, preferably a last feedback point in time, after which there are no further actuations of the feedback device by the user, at least until the point in time at which the next application dose is dispensed. Optionally, the present invention also includes storing these feedback times.

The control device can also be programmed to determine concentrations of the substance in the body, in particular in the blood, for example based on the data read out, such as e.g. B. PK curves, PK models, etc. Here, for example, both the concentration at, preferably the first, feedback time and the concentration at the, preferably first, actuation time (e.g. since the end of the last blocking period) or at the last feedback time is relevant . These concentrations can be or will be assigned to the respective points in time.

Furthermore, the control device can also be programmed to determine or select a concentration curve over time from a group of concentration curves over time. When determining the concentration curve over time, both the concentration at the preferably first feedback time and the concentration at the preferably first actuation time or the last feedback time are taken into account.

When reference is made herein to a "set of concentration courses over time", this is a set of concentration courses that relate to or are derived from the same dose (e.g. 50 µg fentanyl). In particular, the concentration profiles include those that show the time profile of the concentration for the mean value of all patients examined using this dose values of a collective, or the plus/minus of one or more standard deviations. A large number of such courses or data can be stored in the data memory. From this, the group of the observed time curves can be selected.

Furthermore, the control device can be programmed to take into account the individual concentration profile over time determined in this way when predetermining the level of one or more of the subsequent application doses, in particular to take into account the determined individual PK curve.

In some embodiments of the nasal applicator, the control device is further programmed to take into account the set target concentration or its maximum value when predetermining the level of the next application dose. Alternatively or additionally, it can be provided that the determined individual concentration profile over time, in particular the determined individual PK curve, is taken into account during the predetermination.

In some embodiments, the controller is further programmed to, after delivery of an initial or loading dose at an earlier time, at a first (or referred to herein as "initial") time of actuation of the retrieval device by the user (preferably after expiry of an the blocking period following delivery of the initial dose, during which no application dose is administered to the user when the retrieval device is actuated), to determine a concentration assigned to this point in time of actuation, specifically for each of the concentration curves (stored in the data memory) of the/a group or of these derive. This first time of actuation is after the delivery time of the initial dose. The control device is also programmed to define the concentrations determined in this way as the estimated target concentration of the associated concentration profile over time. If, to put it simply, there was an initial dose and the user wanted to call up another application dose after the blocking period that followed had expired, then the point in time at which the user attempted to call up the further application dose is shown for each of the concentration curves considered over time assigned a concentration. Since the concentration so assigned has been determined by calculation and is the result of a hypothesis which still requires testing and confirmation, the concentration so determined is referred to herein as the estimated target concentration. If the group of time courses considered has three elements (courses), then three estimated target concentration values are obtained. In other words, three hypotheses are put forward. They indicate how high the concentration in the body would have to be if the first, second or third concentration course in the group applied to the user under consideration.

An initial dose can also be referred to herein as a first or preceding application dose, which was delivered at a delivery time, which can correspondingly be the first delivery time. The initial dose may actually be the very first application using the drug delivery device.

The control device can also be programmed to apply the first application dose following the initial dose in response to actuation of the retrieval device at the first actuation time.

Furthermore, the control device can determine a point in time at which, after the application of this first application dose, the concentration in the body, in particular in the blood, will or should have fallen again to the estimated target concentration of the associated concentration profile over time. This time is also referred to herein as the calculated target concentration time. In order to calculate it in each case (i.e. for each concentration profile from the group), the same temporal concentration profiles of the group are used again for which a calculated target concentration time point has already been defined. It should be noted that differences between the level of the initial dose and the subsequent, first application dose are taken into account here. For example, if the initial dose was 50 µg fentanyl, the three selected concentration curves over time in the group indicated how this 50 µg fentanyl could be detected in the body. A first of the three concentration curves could e.g. B. assume that the course will behave as observed in a collective on average. A second can For example, suppose the gradient behaves like the first gradient by plus one standard deviation, plus 10%, and so on. A third can For example, assume that the gradient behaves like the first gradient by minus one standard deviation, minus 10%, and so on. However, if the subsequent, first application dose is not 50 µg, for example, but only 30 µg fentanyl, then the same three selected concentration curves over time for the group are assumed. They are just no longer calculated for 50 µg, but for 30 µg of fentanyl.

The control device can also be used to directly or indirectly detect or determine the second actuation time for retrieving a second or the subsequent, first application dose in turn subsequent, z. B. second application dose to be programmed.

In addition, the control device can be programmed to determine a concentration profile over time from the group as an individual concentration profile over time, in particular as an individual PK curve. In this case, the respective difference between the calculated target concentration time of each concentration profile over time from the group and the second actuation time is taken into account. In particular, that concentration profile over time that has the smallest difference between its calculated target concentration time and the second actuation time comes into consideration as an individual concentration profile over time.

The control device can also be programmed to take into account the determined individual concentration profile over time when predetermining the level of one or more of the subsequent application doses, which can in particular be an individual PK curve or an individual PK model.

In some embodiments, the control device is further programmed to determine the concentration of the substance present in the body or in the blood of the user. The determination takes place at at least one considered actuation point in time or at least one considered predetermination point in time. Furthermore, the controller is programmed to set this concentration as the target concentration.

The control device is further programmed to set the level of the next application dose at the next predetermined time such that the concentration in the body or in the blood of the user will only drop to the target concentration again after a predetermined period of time has elapsed. This period of time can be set, for example by the attending physician, and begins at the point in time at which the next application dose is dispensed.

For this purpose, as described above, the unchanging individual concentration curve over time, ie the PK curve of the user, can be taken as a basis and/or taken into account.

In some embodiments, the electronic control device is further programmed to take into account data read from the data memory in the step of predetermining the level of the next application dose. These data include both the delivery time of one or more of the application doses already delivered on the one hand and the amount of one or more of the application doses already delivered on the other hand. It is covered by the present invention that here, as an alternative to the delivery time, the time period elapsed between the one or more delivery times of the application doses already delivered and the delivery time after the next actuation time can be considered.

In some embodiments, the evaluation of the activation behavior of the user, which is recorded by means of the detection device, includes the detection of activations of the retrieval device by the user at activation times within a blocking period. This can be in any, a specific, i. h, in the first and/or in the second, etc., or in each period of suspension. In certain embodiments, this actuation behavior can optionally also be stored in or on a device suitable for this purpose, e.g. B. the data storage mentioned herein provided.

The control device is also programmed to determine a concentration of the substance in the body, in particular in the blood, which is or can be associated with the respective actuation times within one of the blocking periods.

The controller is further programmed to set a target concentration or its minimum value to a value above, below or equal to the associated concentration, respectively.

In certain embodiments, the procedure outlined above may be repeated multiple times, e.g. H. in loop, to be executed. The target concentration so approximated, or the minimum value so approximated, may optionally be reset to zero (0) after any or each lockout period.

In some embodiments, the detection device of the nasal applicator according to the invention is further programmed to detect and optionally store at least one actuation of the retrieval device by the user at least one time of actuation after the blocking period.

In this case, the control device is further programmed to determine a concentration in the body, in particular in the blood, which is associated with the actuation time after the blocking period.

The control device is also programmed to determine a concentration profile of the group over time. Here, both at least one, preferably the last actuation time within the (any) blocking period as well as at least one, preferably the first, actuation point in time after the blocking period is taken into account.

The control device is also programmed to take into account the determined individual concentration profile over time, in particular the determined individual PK curve, when predetermining the level of one or more of the following application doses.

In some embodiments of the nasal applicator, the control device is further programmed to take into account the set target concentration or its minimum value and/or the determined individual concentration profile over time, in particular the determined individual PK curve, when predetermining the level of the next application dose.

In some embodiments, the evaluation of the actuation behavior of the user, which is detected by means of the detection device, comprises the evaluation of actuations of the retrieval device by the user at actuation times within one of the blocking periods. This can be in any, a specific, i. h, in the first and/or in the second, etc., or in each period of suspension. In certain specific embodiments, this actuation behavior can optionally also be stored in or on a device suitable for this purpose.

Furthermore, the control device can be programmed to determine an increase in the time intervals between successive actuation times within one of the (considered) locking periods, alternatively the absence of further actuation times within the considered locking period. In addition, the control device can be programmed to specify a point in time from which the extent of the increase or the absence of it satisfies predetermined criteria.

Criteria can be specified, for example, that as soon as z. B. 50%-75% of the blocking period T_vain _n have elapsed, one may assume that the actuation times are in a predetermined manner much further apart than before, and / or if for a z. B. predetermined period of time has not been actuated, it is assumed that the effect of the therapeutic effect has become noticeable / noticeable and / or the target concentration has been reached.

For some embodiments it can be specified that if arithmetically z. B. 80% or another predetermined proportion of the calculated maximum concentration has been reached and there are still unsuccessful retrieval attempts, i.e. the desired therapeutic effect has not yet been achieved, the end of the current blocking period is brought forward, since the remaining z. B. 20% of the concentration will not be sufficient to bring the user to the target concentration (C _ED ) with the currently applied regime.

For some embodiments it can be specified that if arithmetically z. B. 80% of the calculated maximum concentration has been reached and there are still unsuccessful retrieval attempts, i.e. the desired therapeutic effect has not yet been achieved, the next predetermination time is brought forward in the knowledge that the user will probably attempt retrieval at the end of the blocking period.

As these time intervals increase, it means that the desired therapeutic effect is beginning to set in, perhaps slowly, but definitely. Thus, in the event that an actuation by the user takes place after the end of the blocking period, the dose can turn out to be smaller or be calculated as if there were no therapeutic effect.

Furthermore, the control device can be programmed to determine a concentration of the substance in the body, in particular in the blood, which is associated with the point in time.

The controller may be further programmed to set the target concentration or its minimum value to a value above, below or equal to the assigned concentration, respectively.

In some embodiments, the electronic control device is further programmed to evaluate at least one actuation of the retrieval device by the user at at least one actuation time which is after the blocking period. Optionally, storing the actuation in or on a device suitable for this purpose is also covered by the present invention.

In this case, the control device is further programmed to determine a concentration in the body, in particular in the blood, for the actuation time or times after the blocking period.

The control device can be further programmed to determine a concentration profile over time for the/a group, taking into account both one, preferably the last, actuation time within the blocking period and one, preferably the first, actuation point after the blocking period.

In addition, the control device can be programmed to take into account the determined individual concentration profile over time, in particular the determined individual PK curve, when predetermining the level of one or more of the subsequent application doses.

In some embodiments, the nasal applicator controller is further programmed to take into account the set target concentration or its minimum value when predetermining the level of the next application dose. Alternatively or additionally, the control device can take into account the determined individual concentration profile over time, in particular the determined individual PK curve.

In some embodiments, the control device is further programmed to limit the level of the next application dose and/or to limit the resulting concentration.

Alternatively or additionally, the control device is programmed to limit the cumulative level of all application doses delivered within a predetermined period of time and/or to limit the concentrations resulting therefrom.

Again alternatively or additionally, the control device is programmed to limit the cumulative level of all application doses delivered and/or to limit the resulting concentrations.

For this purpose, the control device optionally accesses data relating to the substance stored in the data memory.

In some embodiments, the nasal applicator according to the invention is suitable for the nasal administration of an application dose of substances which are or have medicinal active ingredients in particular.

In other embodiments, the inventions relate to a drug delivery device that is not a nasal applicator. What is stated herein for the nasal applicator therefore also applies without restriction to a drug delivery device as a nasal applicator, especially if this is portable and can be used by the user, e.g. B. a patient is operable alone and is usually operated without outside help or special knowledge.

In particular, a drug delivery device is suitable for other types of administration, for example for further transmucosal administrations, in particular via the oral mucosa, for example in the cheek pouch (buccal) or under the tongue (sublingual), or also for inhalative administration.

In some embodiments, the delivery dispenser is or includes a particle or droplet generator, such as a vortex chamber, spray head, nozzle, cannula, dropper, perforated plate, baffle, porous membrane or the like.

In some embodiments, the delivery doser includes an energizing mechanism and/or a delivery mechanism. This can be designed mechanically and/or electronically, e.g. B. as a micropump, piston pump, rotary pump, peristaltic pump, centrifugal pump or the like.

In some embodiments, the dispensing doser includes an analog, in particular stepless, and/or a digital (0 or 1) control for dosing. This can be part of the electronic control device of the nasal applicator. In particular, an application dose or release quantity of the substance corresponds to a quantity in the range between 1 μl and 300 μl per actuation.

In some embodiments, a high level of reproducibility and accuracy in the delivery of the amount by a user-independent operation (alternatively: triggering) by always the same trigger parameters such. B. release speed, release force, etc., pressure, rotation, stroke, etc. must be guaranteed.

In some embodiments, the nasal applicator includes a metering valve.

In certain embodiments, the nasal applicator comprises an elastomer ring, in particular a removable one, for sliding onto the nasal dip. The elastomer ring serves to seal off the nostril as airtight as possible from the outside.

In some embodiments, the nasal applicator, e.g. B. commercial or conventional nasal spray cartridges that have an integrated conveyor or pumping device. By means of this integrated conveying or pumping device, different dosing sizes can be delivered after venting (priming), for example by lengthening or shortening the stroke of this device.

In some embodiments, a delivery or pumping device is triggered mechanically, ie by hand, by the user/patient. For this purpose, for example, a spring-loaded manually or externally charged, adjusted and triggered.

In some embodiments, the dose detection device of the nasal applicator comprises a sensor configured to detect the substance delivered or the amount of active ingredient thereof. The dose can be detected, for example, by means of direct measurement, e.g. B. by means of a flow sensor, etc.) and / or by means of derived measurement. In the case of a derived measurement, the dose is calculated or derived. This can be done, for example, by measuring revolutions (min ^-1 ), angle, stroke distance, distance, number of strokes, time, valve actuations (number and/or time), etc.

In some embodiments, the dose detection device can be integrated into the control device of the nasal applicator, for example. In other embodiments, it is separate.

In some embodiments, the dose can be measured using a flow sensor, a flow sensor, or using a droplet distribution measurement and/or particle distribution measurement.

In some embodiments, the droplet distribution and/or particle size distribution can be measured to determine the dose.

In some embodiments, by means of the triggering parameters, such as e.g. B. triggering speed, triggering force, etc., the droplet size distribution and / or particle size distribution can be set or adapted or adjusted. This is intended in particular to adapt the droplet distribution and/or particle size distribution to different active ingredients in a simple manner.

In some embodiments, the data memory of the nasal applicator comprises at least one internal memory component which is not volatile and can be overwritten or written to multiple times and/or an external memory component which can be exchanged in particular (e.g. SSD memory card, USB memory, HDD, Etc.). Alternatively or additionally, a network or the Internet can also be considered as external storage.

In some embodiments, e.g. B. as a final step of the method triggered by the control device, at the end of the treatment or therapy without or after an automatic data backup in or on a (further) internal or external storage device suitable for this purpose, the personal data and / or individual control data from the Clear data memory of the nasal applicator and/or reset the nasal applicator to the factory settings. The nasal applicator or parts thereof can thus advantageously be passed on to other patients after the patient's therapy has ended, without data protection concerns having to oppose this.

In some embodiments, the data memory, in particular the external data memory, can be implemented as a digital pain ID card and used by the user/patient to provide evidence to the attending physicians and/or controllers, for example when traveling or during checks.

In some embodiments, the user/patient interacting with the nasal applicator can be viewed as a pre-programmed, self-regulating system, eliminating the need for programming and potential sources of error. The same is known from the use of IV-PCA smart pumps for the administration of opiates. The pre-programmed, self-regulating system includes certain dose limits (e.g. dose limits, concentration limits, time limits, limits based on a therapeutic effect, i.e. e.g. a lower dose for a low pain score). These dose limits may be dose limits per time, a specific number of actuations or actuations, a single dose limit, a daily dose limit, a concentration limit, and/or the like. When the dose limits are reached, two consequences can occur: the delivery of further application doses can either be paused or the dose can be reduced in such a way that a therapeutic effect can no longer occur. In particular, however, a placebo effect is made possible here.

In some embodiments, the user/patient can be viewed as a control circuit and the triggering behavior of the nasal applicator can be adapted based on the recorded or determined pharmacological data in accordance with the user/patient reaction in terms of dose and therapy. On the one hand, direct measured values (actual values), e.g. B. the blood sugar level or the opioid concentration in the blood, or on the other hand indirect measured values (derived and/or estimated values), e.g. B. Pharmacokinetic ("PK") curves of a (reference) population. Direct measured values are preferably used to adapt the triggering behavior.

In some embodiments, the electronic control device is further programmed in order to be able to predetermine a predetermination time of an application dose of the substance, with subjective therapeutic observations a patient-specific therapeutic effect, such as B. pain, to be considered. These observations may be or include the patient's pain level (pain score), pain type, pain duration, pain intensity and/or pain frequency.

• - eine numerische Ratingskala (NRS, beispielsweise von 1 (= schmerzfrei) bis 10 (= stärkste Intensität)),
• - eine verbale Ratingskala (VRS, mit Beschreibungen der Schmerzintensität, beispielsweise „keine“, „mäßig“, „mittel“, „schwer“, „sehr schwer“, oder auch Beschreibungen des zeitlichen Auftretens, beispielsweise „nie“, „selten“, „manchmal“, „häufig“, „immer“),
• - visuelle Analogskala (VAS, beispielsweise als Linie, deren Endpunkte extreme Zustände darstellen, wie z. B. „kein Schmerz“ und „unerträglicher Schmerz“, auf welcher der Benutzer/Patient sein subjektives Schmerzempfinden markiert, ohne eine entsprechende Skalierung wahrzunehmen), oder eine
• - Functional Activity Scale (FAS, beispielsweis mit den Einteilungen „keine Einschränkung“ (no limitation), wenn der Benutzer eine bestimmte Aktivität ohne Einschränkung (z. B. aufgrund von Schmerzen) ausführen kann, „leichte Einschränkung“ (mild limitation), wenn die Aktivität nur eingeschränkt ausgeführt werden kann (z. B. aufgrund von Schmerzen) und „erhebliche Einschränkung“ (significant limitation), wenn die Aktivität nicht ausgeführt werden kann (z. B. aufgrund von Schmerzen oder aufgrund von Nebenwirkungen einer Schmerztherapie).

This means that the user/patient determines what is still bearable for him/her or how much pain he/she feels. This can e.g. B. by manual entry on a one-dimensional rating scale to determine the pain intensity. Such scales can be, for example:

• - a numerical rating scale (NRS, for example from 1 (= pain-free) to 10 (= strongest intensity)),
• - a verbal rating scale (VRS, with descriptions of the pain intensity, e.g. "none", "moderate", "moderate", "severe", "very severe", or also descriptions of the time of occurrence, e.g. "never", "rarely", "sometimes", "often", "always"),
• - visual analogue scale (VAS, e.g. as a line whose endpoints represent extreme conditions, such as “no pain” and “unbearable pain”, on which the user/patient marks their subjective pain perception without perceiving a corresponding scaling), or one
• - Functional Activity Scale (FAS, for example with the classifications "no limitation" (no limitation) if the user can perform a certain activity without limitation (e.g. due to pain), "mild limitation" (mild limitation) if the activity can only be performed to a limited extent (e.g. due to pain) and “significant limitation” if the activity cannot be performed (e.g. due to pain or due to side effects of pain therapy).

• - Vitalwerte (wie Blutdruck, Herzfrequenz, Temperatur etc.),
• - Pupillenreaktion,
• - Delirium
• - Halluzinationen
• - Schwindel
• - Toleranz
• - Abhängigkeit
• - gesteigerte Schmerzempfindlichkeit (Hyperalgesie)
• - Sedation,
• - Nebenwirkungen (wie Juckreiz (Itching), Übelkeit (Nausea), Erbrechen (Vomiting) etc.),
• - physiologische Beobachtungen,
• - Gesamtdosis/Volumen und/oder Gesamtkonzentration der Substanz/des Wirkstoffs,
• - verbleibende Füllmenge im Behältnis.

In some embodiments, objective and/or subjective observations may be considered. These can e.g. B. include:

• - Vital signs (such as blood pressure, heart rate, temperature, etc.),
• - pupil reaction,
• - delirium
• - Hallucinations
• - Dizziness
• - tolerance
• - dependency
• - Increased sensitivity to pain (hyperalgesia)
• - sedation,
• - Side effects (such as itching, nausea, vomiting (vomiting) etc.),
• - physiological observations,
• - total dose/volume and/or total concentration of the substance/active substance,
• - Remaining capacity in the container.

In some embodiments, the present invention can be counted towards so-called personalized medicine, in which the user/patient is viewed as a pre-programmed, self-regulating system and with dose limits (absolute) and/or dose limits per time, concentration limits or quantity limits and/or limitation of the number of activations and/or limitations for a single dose and/or daily dose, etc. as well as the alternatives listed and explained below, a therapy that is as individual as possible is sought. The more input or information about the status of the user/patient is available, the more individually the therapy can be designed. If concentration limits are considered here, different high doses can result in certain embodiments.

• - Daten aus der (elektronischen) Patientenakte,
• - Daten der individuellen Anamnese,
• - Daten aus einem voroperativen Aufklärungsgespräch (Pre-OP),
• - Daten die während einer Operation erhoben wurden (beispielsweise während einer Anästhesie),
• - Daten, die in einem PACU (Post Anaesthesia Care Unit, Aufwachraum etc.) erhoben wurden und/oder
• - individuellen anthropometrischen Patientendaten (beispielsweise Gewicht, Alter, Größe, Geschlecht etc.)

In some embodiments, the electronic control device is further programmed in order to be able to predetermine a predetermination time of an application dose of the substance, patient-specific setup data being entered and/or taken into account as an alternative or in addition. For example, this setup data may include or result from:

• - Data from the (electronic) patient file,
• - data of the individual anamnesis,
• - Data from a pre-operative consultation (Pre-OP),
• - Data collected during an operation (e.g. during anesthesia),
• - Data collected in a PACU (Post Anesthesia Care Unit, recovery room, etc.) and/or
• - Individual anthropometric patient data (e.g. weight, age, height, gender etc.)

In some embodiments, alternatively or additionally, subjective therapeutic observations, e.g. by means of a pain score as described herein, and taken into account.

• - Herzfrequenz (HR),
• - HRV,
• - (partielle) Sauerstoffsättigung im Blut (SpO₂),
• - Blutdruck,
• - Blood pressure trending (BPT),
• - elektrochemische Hautreaktionen,
• - Temperatur,
• - Photoplethysmogramm (PPG),
• - Elektrokardiogramm (EKG),
• - Atemfrequenz,
• - Blutzuckerspiegel,
• - Stress.

In some embodiments, the electronic control device is further programmed in order to be able to predetermine a predetermination time of an application dose of the substance by alternatively or additionally taking into account objective therapeutic observations. These observations can be compared, preferably automatically, using sensor data for vital signs. The vital data can include, for example:

• - heart rate (HR),
• - HRV,
• - (partial) oxygen saturation in the blood (SpO ₂ ),
• - blood pressure,
• - blood pressure trending (BPT),
• - electrochemical skin reactions,
• - temperature,
• - Photoplethysmogram (PPG),
• - electrocardiogram (ECG),
• - respiratory rate,
• - blood sugar level,
• - stress.

In some embodiments, there is the possibility of personalizing, adapting, modifying, etc. the method initiated by the control device. This can be done using a user interface, management software and/or peripheral devices.

In some embodiments, the method initiated by the control device creates value tables for controlling the nasal applicator.

In some embodiments, the method initiated by the control device calculates different triggering parameters for the nasal applicator, depending on the position of the device.

In some embodiments, the circadian, ultradian, and/or infradian rhythm of the user/patient may be taken into account.

In some embodiments, the nasal applicator transmits the data from the data memory in a wired and/or wireless manner using appropriate protocols, e.g. B. Wi-Fi, Bluetooth, WLAN, GPS, RFID, NFC, barcode, QR code, ZigBee, Wibree, WiMAX, IrDA etc. and / or is in signal connection with the data memory.

If a signal or communication connection between two or more components is discussed here, this can be understood to mean a connection that exists during use. This can also be understood to mean that there is a preparation for such a (wired, wireless or implemented in some other way) signal communication, for example by coupling both components, for example by means of pairing, etc.

Pairing is a process of creating a link between electronic units for the purpose of communication. One of the best-known examples of this is the establishment of a Bluetooth connection, by means of which various devices (e.g. smartphones, headphones) are connected to one another. Pairing is also sometimes referred to as bonding.

In some embodiments, the data listed here is transmitted via an interface between the smart device and the computer.

In some embodiments, the data presented herein is transmitted web-based, i. H. no software installation is necessary.

In some embodiments, the data listed herein is transmitted using an encrypted data transmission.

In some embodiments, the data listed herein is preferably transmitted over an adjustable range.

In some embodiments, low-energy solutions are preferably provided for the nasal applicator and the devices connected thereto in order to consume as little electricity as possible.

In some embodiments, fleet management is provided for the nasal applicator and associated devices; H. managing, scheduling, controlling and monitoring multiple nasal applicators with the connected devices.

In some embodiments, the nasal applicator, including the devices connected thereto, can be integrated into an existing IT infrastructure. Interfaces, e.g. B. with clinical devices and / or with other medical products and / or with diagnostic devices and / or with a laboratory etc. can be provided.

In some embodiments, interfaces to electronic medical records and/or to hospital quality reports and/or to national, European and international data collection initiatives. Thus, on data from z. B. internal and external research, internal and external survey data (e.g. patient satisfaction, side effects, etc.) can be accessed. Within the European Union, for example, the international statistical classification of diseases and related health problems (ICD-10) is of interest, within Germany the diagnosis-related case groups (Diagnosis Related Groups (DGRG)) and quality improvement in postoperative pain therapy (QUIPS) provide comparative data and in the USA the Risk Evaluation and Mitigation Strategies (REMS) programs.

In some embodiments, there is a modular/expandable dock or docking station for the electronic control unit and/or other peripherals. The dock or docking station is used to store and/or manage the nasal applicator and/or peripherals. The dock or docking station is suitable for storing and/or managing the applicator and/or peripherals. The dock can e.g. B. for loading, for software updates, pairing, hardware checks and / or releases, etc. may be provided. In some embodiments, the dock or docking station is implemented as a standalone IT infrastructure, e.g. B. in the intranet (via hub/router/switch). Alternatively or additionally, the dock can be integrated into an existing IT infrastructure via appropriate interfaces.

In some embodiments of the present invention, the data interfaces are wired, e.g. E.g. designed as USB, USB-C, Thunderbolt, etc.

In some embodiments it can be provided by means of z. B. IBM Watson to create access to outsourced system intelligence and thus provide connection to existing hospital information systems (HIS/PACS) via common interfaces such as HL7 and DICOM. For example, a technician can thus have access to the nasal applicator, to the devices connected to the nasal applicator, to interfaces and/or to the software.

In some embodiments, a central server is provided.

In some embodiments, the nasal applicator, in particular its electronic control device, comprises an energy storage device, in particular a rechargeable accumulator or a battery.

In some embodiments, the energy storage device can have an application-related and/or indication-related battery design. In these embodiments, depending on the indication, a differently dimensioned energy storage device can be provided, in particular energy storage devices with different service lives or different running times. For example, an energy supply of three days may be sufficient postoperatively, while a longer energy supply (e.g. over two weeks) may be advantageous in the treatment of migraine.

In some embodiments, wireless charging of the energy store can be provided, for example by means of pins (e.g. in a charging cradle) or without pins (e.g. Qi, by means of inductive energy transmission).

In some embodiments, wired charging of the energy store can be provided, for example by means of a power pack.

In some embodiments, batteries can be provided for changing as the energy storage device, e.g. B. Disposable batteries (button cells, AA, AAA, AAAA, block batteries, etc.), rechargeable batteries, rechargeable battery packs, etc.

In some embodiments, an external power connection can be provided as the energy store.

In some embodiments, the substance reservoir of the nasal applicator is provided integrally, in other embodiments not integrally, in particular co-packed, i. H. packaged with the nasal applicator and/or an associated component. Both in the integral and in the non-integral embodiments, the substance reservoir can be (re)filled, in particular from the outside.

In some embodiments, the substance reservoir is an already prefilled disposable container and/or a disposable container that can be filled on site, e.g. B. made of glass, plastic, metal, non-ferrous metal, composite materials, etc. or a combination of these materials.

In some embodiments, the substance reservoir is provided with a position-independent triggering device, ie triggering can take place with a triggering functionality in all axes and degrees of freedom. This can be done, for example, by a collapsible and/or an energy acted upon container and / or the like can be realized.

In some embodiments, the substance reservoir has a fixed filling volume, in other embodiments it has a variable filling volume.

In some embodiments, the substance reservoir can be free of preservatives, in other embodiments it can be filled with substances containing preservatives and/or be suitable for this purpose.

In some embodiments, the substance reservoir is provided with at least one connection device, which is used to connect the substance reservoir to the dispensing dispenser, in particular in a detachable manner. This can be done by means of a Luer connection, a needle, a screw cap, a plug connection, a click connection, by means of compression or the like. Furthermore, mechanical pins and/or a form fit can also be included in the present invention for the connection.

In some embodiments, a device, in particular a barcode and/or an RFID device, can be provided on the substance reservoir for recording and/or storing information that can be output for the traceability of one or more applications. These can also z. B. a label, a QR code, a chip, an RFID / NFC tag, an image recording, which can each be scanned, etc. or a combination thereof. Applications are, for example, information about the substance such as name, expiry date, pharmacological data, concentration, etc.

In some embodiments, technical solutions can be used on the substance reservoir to avoid errors in the sense of the poka-yoke or key-and-lock principle. For this purpose, for example, an inscription, a QR code, a barcode, a chip, an RFID/NFC tag, an image recording, which can each be scanned, etc. or a combination thereof can be provided on the substance reservoir. Corresponding control and/or computing devices with suitable software can also be included in the present invention for this purpose. This allows u. advantageously improper handling and/or the insertion of an incorrect substance reservoir into the nasal applicator can be avoided. Mechanical pins and/or a corresponding form fit can also serve this purpose and are therefore also covered by the present invention.

In some embodiments, the substance reservoir is a non-integral, pre-filled, disposable container, e.g. B. made of glass, plastic, metal, non-ferrous metal, composite materials, etc. or any combination thereof, which is stored separately from the nasal applicator, in particular from its dispensing dispenser. In particular, this avoids compatibility problems between the material(s) of the substance reservoir of the substance. Separate storage can reduce or even avoid the risk of extractables or leachables migrating into the substance.

In some embodiments, the substance reservoir is a refillable, integrated reusable container with a filter, in other embodiments without a filter.

In some embodiments, the substance reservoir is an external reusable container with a filter, in other embodiments without a filter.

In some embodiments, the nasal applicator includes an additional substance reservoir, in particular a liquid reservoir, in which another substance can be accommodated. The further substance preferably differs from the first substance. The further substance may be medicinal or non-medicinal, e.g. B. hyaluronic acid, ectoine, aloe vera, etc.

In some embodiments, the substance reservoir of the nasal applicator includes multiple chambers. In such embodiments, the nasal applicator may be capable of delivering multiple therapies, e.g. B. painkillers or cannabinoids on the one hand and z. B. and insulin on the other hand to support. In certain embodiments it can be provided that the substance in the first chamber and/or reservoir is neutralized or destroyed with a substance in the second chamber and/or reservoir. This can be particularly useful in the event of theft or misuse.

In some embodiments, the nasal applicator includes a cooling device suitable for cooling one, several or all substance reservoir(s), in particular its content.

In some embodiments, the control device may be provided as a disposable device, in other embodiments as a reusable electronic control device. Hybrid embodiments, in which part of the control device is reusable and part is provided as a disposable component, are also encompassed by the present invention.

In some embodiments, the control device collects, stores, monitors, processes, calculates, simulates, regulates and/or controls one, several or all functionalities of the nasal applicator.

In some embodiments, the nasal applicator is controlled by the control device using an algorithm (embedded software) that is loaded onto the nasal applicator.

In some embodiments, the dispensing doser can be controlled separately by the control device or together with the dose detection device.

In some embodiments, the dose detection device can be controlled separately by the control device or together with the dispensing doser.

In some embodiments, the nasal applicator is controlled by the control device using a decentrally stored algorithm, e.g. B. web-based, via a ward computer or smart devices (non-embedded software).

• - Vorrichtungen zur Patientenauthentifizierung,
• - Armbänder,
• - Sensoranordnungen,
• - Docking Stations,
• - Rechner (PC),
• - Smartgeräte,
• - Drucker,
• - andere medizinische Geräte,
• - Vorrichtungen in einem Rechenzentrum,
• - Hub, Router, Accesspoint,
• - (Cloud)Server.

In some embodiments, the control device is in wireless or wired signal communication with other devices, for example in order to be able to interact with peripheral devices. Peripherals may include:

• - Devices for patient authentication,
• - Bracelet,
• - sensor arrays,
• - docking station,
• - calculator (PC),
• - smart devices,
• - Printer,
• - other medical devices,
• - devices in a data center,
• - hub, router, access point,
• - (Cloud) servers.

In some embodiments, peripheral devices of the nose applicator function as radio cells for a positioning system or for generating a geofence.

In some embodiments, the electronics of the control device can be designed redundantly, e.g. B. two-channel, by monitoring system / watchdog, etc. This can contribute in a particularly advantageous way to ensure safe operation, thus increasing safety and to meet the various risk classes in medical technology.

In some embodiments, the nasal applicator retrieval device includes a triggering mechanism, which in turn includes at least one of the features described below.

Thus, the triggering mechanism can work purely or essentially mechanically, e.g. B. similar to an insulin pen or a Respimat® soft mist inhaler.

Alternatively, the trigger mechanism can be a combination of mechanics (trigger mechanism), e.g. heart curve, actuator and/or jump and electronics (actuator).

In some embodiments, the triggering mechanism may be or include a unidirectional, bidirectional, multidirectional, rotary, stepper, and/or encoder controlled, and/or infinitely variable piston and/or actuator, etc.

In addition to this, an opposing dosing adjustment mechanism (cf. insulin pen) can be provided in some embodiments. Alternatively, electronic dosing (cf. electronic insulin pen) is also covered by the present invention.

In some embodiments, the triggering mechanism includes a pump, e.g. B. a micropump, piston pump, rotary pump, peristaltic pump, centrifugal pump, centrifugal pump or the like.

In some embodiments, the triggering mechanism is based on a bi-directional two-stroke (suck/push) principle, e.g. B. according to the functional principle of the Respimat®.

In some embodiments, the triggering mechanism may induce microdosing, e.g. B. in the range of 1 ul to 300 ul.

In some embodiments, a delivered amount (application dose) can be easily and/or accurately reproduced since the amount or scope of the application dose is independent of user/patient manipulation by means of the present invention.

A high level of reproducibility and accuracy of the dispensed quantity through user-independent triggering with always the same triggering parameters, e.g. e.g. force, speed, stroke/displacement, General energy input can make a beneficial contribution to patient safety.

In some embodiments, the triggering mechanism may cause triggering by a mechanical or electronic trigger. In these embodiments, no force is required in the system.

In some embodiments, the application dose of the substance is adjustable, in particular variable, in particular by means of configurations of the triggering mechanism, as described herein.

In some embodiments, the triggering mechanism includes a metering valve that remains open as long as it is held depressed, for example. A dosing valve with a dosing chamber, a time-controlled valve, or a flow-controlled valve, etc. is also encompassed by the present invention.

In some embodiments, the triggering mechanism further includes a reversible pumping (suction) direction. This can be provided in particular, e.g. for the disposal and/or neutralization of the substance or active ingredient in the event of misuse and/or theft.

In some embodiments, the housing of the nasal applicator functions as a retrieval device for actuating the trigger mechanism.

In some embodiments, the nasal applicator is suitable and/or adapted for operation by right-handed people, in others for operation by left-handed people. In certain embodiments, it is suitable and/or adapted for both left-handed and right-handed operation.

In some embodiments, the triggering of the triggering mechanism and/or the level of the administration dose caused thereby are independent of an actuation by the user/patient.

In some embodiments of the nasal applicator it is provided that the user/patient sets the amount of an application dose to be delivered himself. This can be done, for example, based on calculations or instructions from a doctor. These can be communicated to the user/patient in different ways, for example via a smartphone or the like. In certain embodiments, software, in particular an application (app), for example for a smartphone, can be included in the present invention for this purpose.

• - einen integrierten Auslöseknopf, beispielsweise ausgestaltet als Softtouch-Knopf, als Druckknopf, als Schalter, als Bereich (Button) auf einem Touchscreen, als Sensor oder dergleichen;
• - eine integrierte Eingabevorrichtung, beispielsweise eine Tastatur, ein Touchscreen, ein Drehknopf (oder mehrere), ein integrierter Sensor oder eine Kamera zum Erfassen von biometrischen Daten, beispielsweise Fingerabdruck, Gesicht oder Sprache, eines Codes, oder dergleichen;
• - eine externe Eingabevorrichtung, die, vorzugsweise drahtlos, mit dem Nasenapplikator, insbesondere dessen Abrufvorrichtung verbunden ist, beispielsweise eine Applikation (App), eine Fernbedienung, Eingabe mittels Web oder Cloud, Rechner, Smart Device oder dergleichen.

In some embodiments, the retrieval device for activating the trigger mechanism comprises or is designed as at least one of the following devices:

• - An integrated release button, for example designed as a soft-touch button, as a push button, as a switch, as an area (button) on a touch screen, as a sensor or the like;
• - an integrated input device, e.g. a keyboard, a touch screen, a rotary knob (or more), an integrated sensor or a camera for capturing biometric data, e.g. fingerprint, face or voice, a code, or the like;
• - An external input device, which is preferably wirelessly connected to the nasal applicator, in particular its retrieval device, for example an application (app), a remote control, input via web or cloud, computer, smart device or the like.

In certain embodiments, the external input device can be configured analogously to the examples of the implementation of the integrated input device mentioned herein.

In some embodiments, certain user/patient behavior may control or affect the retrieval device. For example, pressing twice for a trigger can cause the nasal applicator to "wake up" with the first press, possibly combined with a system check, a check of authorization, etc., a calculation of the application dose and provision of the same, while the second press finally triggers the application dose causes.

In some embodiments, the nasal applicator can generate output information, in particular by means of one of its devices, preferably automatically, preferably after a substance dose has been dispensed. This output information can be or can include a log file of the treatment. Each detectable signal or each detectable interaction, in particular each actuation, can be logged. Alternatively or additionally, the output information can be or include the creation of a standardized and/or personalized report related to the user/patient. The output information can be provided using a digital (online) dashboard, using print functions (e.g. for the narcotics book (BtM)), using exports, etc. to a device that is suitable for this purpose, preferably wire los, in some embodiments also wired and / or with contact pins.

In some embodiments, the delivery dose triggering mechanism may be activated in other ways, such as breath-activated or nose-activated, i. H. the triggering mechanism is automatically activated by means of a negative pressure sensor, for example, when the nasal applicator is inserted into the nose and inhaled through the nose. A mechanical implementation of this triggering mechanism is also covered by the present invention.

In some embodiments, an optical system is integrated into the nose applicator, for example for capturing biometric data such as a fingerprint or face, for capturing a QR code, a barcode or the like.

In some embodiments, the output information may be or may include an indication of the amount of time (countdown/timer) until the next release. The display or the end of this period of time can, for example, be optical (e.g. by means of a colored display, an LED or a push message), acoustically (e.g. by means of an alarm), tactile (e.g. by means of vibration) or in an analog manner and way. A colored display can include, for example, the nasal applicator or a section thereof changing color to signal its status, for example changing to “green” if a new application is allowed to take place.

In some embodiments, the output information can be or include an output of step-by-step instructions (e.g. for a setup or further operation or the like) by means of a visual and/or acoustic medium, for example a smartphone or the like.

In some embodiments, step-by-step instructions are provided on the nasal applicator and/or on corresponding peripheral devices and/or on smart devices.

In some embodiments of the present invention, input and/or output options can each be provided in a barrier-free manner. This includes e.g. B. inputs and / or outputs in Braille, optical, acoustic or tactile inputs and outputs, z. B. vibration, sound, etc. This is particularly advantageous for the use of the present invention in poor visibility conditions and / or at night. These input and/or output options can in particular be or include contactless input and/or output options.

In some embodiments, the nasal applicator includes a QR code reader. This can be used to scan the UDI (“Unique Device Identification”) of the disposable cartridge, to identify the disposable housing, the applicator electronics, a disposable wristband and/or its wristband electronics, and/or for automated reading in a docking station.

In some embodiments, printer functionality is also encompassed by the present invention. This can include serve to create a report, to make stickers (e.g. for the BtM book and/or the patient file), etc.

In some embodiments of the present invention, data access is provided directly by means of a dedicated input and readout display. Alternatively or in addition, data access can be provided indirectly using “digital online management software”, for example using a smartphone, tablet and/or computer and/or using other interfaces.

In some embodiments, the nasal applicator and/or at least one of its devices includes touch-sensitive surfaces.

In some embodiments, the present invention may include a microphone integrated into the nasal applicator and/or a smartphone microphone. This microphone can be used to z. B. to record a pain diary.

In certain embodiments, the present invention may include a shake to wake function. Devices suitable for this purpose, for example an acceleration sensor, a gyroscope, an angle sensor, a position sensor and/or the like are also covered by the present invention.

In some embodiments, the present invention may include a camera integrated into the nasal applicator and/or a smartphone camera. This camera can be used, for example, to be able to look into the nose, ears, etc., to have a diagnosis made after transmission to a doctor, and the like (digital health diagnostics). It can also be used to identify the degree of sedation, for example by recording a pupil reaction of the eye.

Patient authentication means that only the authorized user/patient can operate the device. A user can e.g must be a doctor, nurse and/or other authorized person.

In some embodiments, the nose applicator has an integrated authentication module for this purpose, in other embodiments the authentication module is provided externally, in certain embodiments partially integrated. In this case, the authentication mechanism on which the authentication module is based is preferably coupled to exactly one single, specific device. Signal transmissions required for this purpose can e.g. e.g. be provided and take place as disclosed herein. Appropriate configurations of the signal transmission partners involved can be provided.

In some embodiments, an integrated authentication module, i.e. provided on or in the nose applicator, can have an optical effect, e.g. B. by means of QR code readers or by means of devices for recognizing and comparing biometric data, in other embodiments it can have an acoustic effect, e.g. B. by voice recognition, in other embodiments tactile, z. B. by entering a PIN or a password. In this case, the authentication module comprises the sensor arrangement that is suitable in each case for authentication and an evaluation device.

In some embodiments, the authentication module may be provided to be compatible with other devices, devices, devices.

Provision can be made in certain embodiments for authentication to be carried out by means of vibration (for example by means of a specific vibration pattern) or by means of speech or voice recognition. In further embodiments, an area in which the device is activated can be defined via the GPS location of the nose applicator and/or by means of a geofencing function.

In some embodiments, a partially integrated or external authentication module can be provided on the patient, in other embodiments it is not provided on the patient. For example, with partially integrated or external authentication modules, the authentication mechanism can be based on tokens, wireless authentication. The authentication module can be a wristwatch, an RFID bracelet, a barcode, a chain, a ring, a smartphone, a smartwatch, a tablet, or additional software for the aforementioned modules (e.g. an app), etc. or include. In this case, the authentication module comprises the sensor arrangement and/or evaluation device suitable for the authentication in each case, analogously to that described above.

In some embodiments, the authentication module is compatible with or can be integrated into standard hospital patient identification tools (e.g. into a patient bracelet).

In some embodiments, it may be necessary to use the authentication module to authenticate an administrator and/or a user group in order to put the nasal applicator into operation or trigger an application dose or make adjustments to the nasal applicator.

In some embodiments, the authentication module is provided to additionally authenticate technicians and/or system administrators and grant them access to the software of the nose applicator, in particular its control device.

In some embodiments, it may be necessary to use the authentication module to authenticate an administrator and/or a user group in order to operate the nasal applicator control device by remote control or remote control (remote) and/or to overwrite data on it (override function). This can e.g. B. be necessary to cause an extra drug delivery. The authentication can be carried out using one of the devices and/or modes of action mentioned herein.

In some embodiments, the range of the authentication module is variable and/or adjustable, preferably continuously.

In some embodiments, the authentication module can be integrated in so-called smart textiles, for example in glasses, in shoes, in a patient gown, in a pillow and/or in a pillow case and/or in a duvet cover and/or mattress, in a work coat or the like .

In some embodiments, the authentication module is an in-ear wearable device or the like.

In some embodiments, the authentication module is or comprises a subcutaneous implant for authentication and a sensor arrangement suitable for reading the same.

In some embodiments, the authentication module is or includes a dental crown or dental splint for authentication and a sensor arrangement suitable for reading the same.

In some embodiments, the authentication module is or includes a camera integrated into the nose applicator and/or a smartphone camera to capture data, for example biometric data, alternatively or additionally a microphone, integrated or external, for the purpose of voice recognition.

In some embodiments, the nasal applicator comprises a monitoring/surveillance system, with monitoring being or comprising observing the patient and monitoring also observing his surroundings. By means of the system, for example, the so-called adherence to therapy, i. H. the extent to which the patient's behavior is in accordance with the agreed recommendations/prescriptions of a doctor (compliance/adherence) are monitored.

In some embodiments, the monitoring/surveillance system includes real-time automated drug monitoring. This can e.g. B. record a used amount, a remaining amount, the number of remaining applications, etc., and store it internally or externally using a storage device suitable for this purpose.

In some embodiments, the monitoring/surveillance system includes automated real-time therapy monitoring. This can e.g. B. application times and application quantities, attempted (unsuccessful) applications during a blocking interval, etc. and store them internally or externally using a suitable storage device.

In some embodiments, the monitoring/surveillance system includes automated real-time therapy log keeping. This can e.g. B. patient-specific side effects, emotional states and / or the strength, duration and / or frequency of symptoms etc. and store them internally or externally using a suitable storage device.

In some embodiments, the monitoring/surveillance system can be designed to create a mobility log.

In some embodiments, the nasal applicator monitoring system includes a combination of the aforementioned real-time monitors.

Real-time monitoring by means of the monitoring and/or surveillance system of the nasal applicator advantageously enables simple and/or precise logging of the therapy

In some embodiments, the control device of the nasal applicator includes integrated, visual and/or acoustic status and/or alarm displays, for example LED(s), buzzer, beep(s) and/or a display, to display the status or the alarm, in particular by means of a error code or the like.

In some embodiments, the control device of the nasal applicator includes external, optical and/or acoustic status and/or alarm displays, for example in or on peripheral devices, smart devices and/or ward computers. The external status and/or alarm displays can also include LED(s), buzzer, beep(s) and/or a display, and they can also be provided as a software dashboard (app), push message or the like.

In some embodiments, the nasal applicator is configured to send automatic notifications, in particular a call for help and/or an alarm to third parties, e.g. B. to certain groups of people, doctors, nursing staff, rescue control center or the like. This can be the case, in particular, with unusual behavior, for example constantly retrieving medication, exceeding the maximum permitted amount of medication (dosing limit) or the like, and/or when the vital signs of the user/patient are outside predetermined limits. Alternatively or in addition, such a message can be provided by the user/patient actively pressing an “emergency button”.

In some embodiments, a "safe" state of the nasal applicator is provided. This is particularly the case in the "off" state. In the “safe” state, the system will not deliver a dose under any circumstance.

In some embodiments, the nasal applicator includes patient monitoring sensors. The sensors are suitable for recording patient-specific data. This data can include objective data such as position, movement and/or vital signs (e.g. HR, HRV, SpO ₂ , blood pressure, electrochemical skin reaction, temperature, photoplethysmogram (PPG), electrocardiogram (ECG), blood pressure trending (BPT), respiratory rate, stress , etc.) or subjective data collected via patient feedback as described herein.

Such monitoring systems can advantageously increase or optimize therapy adherence and thus the therapeutic effect (e.g. through reminders, supporting information, value coupons, etc., status queries, suggestions, activity trackers, notification of relatives/acquaintances, etc.).

In some embodiments, the nose applicator can be provided with additional functions, such as reminders, further supporting information, gamification (e.g. collecting points, collecting TV minutes, value coupons, etc.), status queries, suggestions, activity trackers, notification of relatives/ acquaintances, etc. to add.

In some embodiments, the nose applicator can be provided to enable so-called social monitoring and communication, i. H. to provide a means of communication, preferably bi-directional, to family, friends and caregivers, etc.

In some embodiments, the nasal applicator can have an antidote in addition to the medical substance in a further substance reservoir, suitable for e.g. B. to reduce or prevent side effects or to avoid an overdose or the like.

In some embodiments, the nasal applicator is configured to perform respiratory gas analysis, e.g. g. a capnography, and to display the result of the analysis, for example, to transmit it to a peripheral device and/or to store it in a storage device suitable for this purpose.

In some embodiments, the nose applicator can be connected to sensor arrangements and/or evaluation devices, by means of which the position of the user/patient can be recorded and stored. The position can capture the positioning of the patient, whether he/she is standing up, has fallen, and/or the like. These sensor arrays can be provided internally or externally, preferably as detailed herein, for example integrated into smart textiles with integrated sensors. The nasal applicator can also have suitable actuators etc. for this purpose. A mobility protocol etc. can be created in this way, for example.

In some embodiments, the patient monitoring sensors or parts thereof can be implanted. In other embodiments, it or parts thereof can be integrated into a dental crown or splint or into an earring or ear clip.

In some embodiments, the patient monitoring sensor system or parts thereof can detect or make measurable sensitivities or states of the user/patient, such as pain. This can be determined via body reactions such as skin electroplating, blood pressure change, heart rate change and/or pupil dilation.

In some embodiments, the nasal applicator includes a nasal applicator locating system. The nasal applicator locating system can be configured to locate the nasal applicator, to locate the substance and/or to locate the user/patient. An integrated real-time (real-time) positioning system z. B. a fleet management or the like by means of wireless connectivity (e.g. via Wi-Fi, Bluetooth, WLAN, GPS, RFID, NFC, barcode, QR code, ZigBee, Wibree, WiMAX and / or IrDA etc.) can be used. The nasal applicator locator system advantageously serves the purpose of facilitating device management and increasing patient safety.

In some embodiments, setting up virtual zones or areas can simplify the position determination.

In some embodiments, the nasal applicator includes an anti-abuse system and/or an anti-theft system.

In some embodiments, the housing of the nasal applicator is designed to be inaccessible, such that access to the or each substance is prevented. This can be realized, for example, by means of a disposable housing that would be destroyed when opened.

In some embodiments, the nasal applicator includes a device for physically fixing it. This can be designed, for example, by means of a Kensington® lock, a security cable or cable, cable lock, etc.

In some embodiments, the nasal applicator is provided with a predetermined geofence. In these embodiments, the present invention encompasses the possibility of influencing the functionality of the nasal applicator outside of a predefined area, for example by preventing triggering or by neutralizing the active substance of the substance. This can be realized using a software solution and/or wireless connectivity. As herein already performed, peripheral devices can serve as a radio cell.

In some embodiments, the nasal applicator can be designed to be childproof. The childproofing can be implemented, for example, by means of hardware (e.g. cover, lock and/or safe) and/or by means of software (e.g. patient authentication etc.).

In some embodiments, peripheral devices of the nasal applicator can be provided with a safety lock and/or protection against manipulation, e.g. B. a bracelet with inserted steel wire, Kevlar, etc.), in particular, peripheral devices can be infinitely adjustable and thus be individually adjustable to the user / patient.

In some embodiments, real-time location (real-time), in particular geofencing, can be used for fleet management and/or locking/unlocking the nasal applicator and/or for triggering neutralization of the active substance in the substance.

In some embodiments, the active ingredient in the substance, for example, by a liquid and / or solid and / or gaseous additive, such as. B. a base, acid, antagonist, plaster, cement and / or cold (N ₂ O ≙ -89 ° C or CO ₂ ≙ -78.5 ° C) etc. neutralized or destroyed.

In some embodiments, the nasal applicator may be configured to be reprocessed between treatments for two different patients, for example. A reprocessing can e.g. B. be or include programming or reprogramming, (re)charging or replacing batteries or other energy storage devices as described herein, (re)filling the substance reservoir(s) and/or inserting a new cartridge. Furthermore, the reprocessing can be or include checking, for example in the form of a system check, complete or partial disposal of the nasal applicator and/or substance, hygiene measures such as cleaning and/or disinfecting, and/or maintenance, which can also include a system update . The controller may optionally be programmed to perform reprocessing steps such as B. to delete the deletion of patient data automatically or on request, such as after selecting a corresponding menu item in the control menu of the storage device.

In some embodiments, the nasal applicator is a completely disposable product that must be completely disposed of in accordance with applicable regulations. The nasal applicator, the substance(s) and/or any peripheral device may have to be disposed of individually.

In some embodiments, the nasal applicator is partially disposable and includes, for example, reusable electronics, disposable components that have come into contact with the substance and/or the user/patient (e.g., a disposable electronics housing, a disposable nasal dip, a disposable pump, or the like.

In some embodiments, the nasal applicator may be configured to include automated and/or logged disposal of the residual amount of the substance. This can be done, for example, by pumping into hazardous waste or into a special container or a separate container for medication disposal, suction and neutralization, etc.

In some embodiments, the nose applicator includes a modular, preferably expandable, docking station for the electronic control device and/or other peripheral devices. For example, the docking station may be configured to charge the energy storage device, push software updates to the nasal applicator and/or peripherals, pair any two devices included in the nasal applicator, perform hardware verification, implement enables on the nasal applicator/peripheral, etc .

In some embodiments, the nasal applicator is configured for automatic (re)ordering of the substance(s).

In some embodiments, the nasal applicator protective cap contains antibacterial agents to keep the nasal dip clean.

In some embodiments, the nasal applicator includes a rinsing device for the nasal dip, since otherwise the volume of substance in the nasal dip would “stand still” until the next release, which could promote colonization with microorganisms. This can preferably be provided in the substance in the case of sensitive active substances.

In some embodiments, a priming process may be provided during which e.g. B. the substance is returned to the substance reservoir and automatically collected. In some embodiments it can be provided that the nasal applicator blocks a triggering if the priming process is not completed.

In some embodiments, data evaluation via software (e.g. data export, dashboard, reports, e-mails, notifications, screen, app, etc.) can be provided inside and/or outside of the nasal applicator.

In some embodiments, the data evaluation can provide for data encryption to be used. This can be or include an encryption key, blockchain, password, passphrase, token, biometrics and/or dongle, etc., for example.

In some embodiments of the nasal applicator, further functionalities can be switched on, for example a dashboard (control center) from which the devices of the nasal applicator can be controlled, monitored, etc. centrally, for therapy and/or further devices and/or the application of further substances and/or functions patient management and/or the like.

In some embodiments, the nasal applicator may be provided or programmed to conduct internal and/or external surveys, e.g. B. patient satisfaction, side effects or the like. These surveys can be standardized, for example according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10, EU) or according to Diagnosis Related Groups (DGRG) and/or according to the Quality Improvement in Postoperative Pain Therapy (QUIPS)(Germany) and or according to the Risk Evaluation and Mitigation Strategies (REMS) programs (USA).

In some embodiments, the nasal applicator includes a QIUPS interface (questionnaire, information material, etc.) for determining the user/patient's acute and chronic pain perception.

In some embodiments, the nasal applicator includes patient education (online and/or offline) for training and/or aftercare of the user/patient, or an opportunity to do so. This can be done, for example, by means of an online video consultation, using a virtual assistant, using instructions for use, a package leaflet, information on side effects, FAQs, operations and/or product information, forms, surveys, a therapy diary, electronic patient files, etc.

In some embodiments, the nasal applicator includes a training function (online and/or offline) for doctors and/or nursing staff, e.g. B. by means of reminders, new training courses, studies, device updates, new functionalities, substances, etc.

In some embodiments, customized reports can be created using the present invention to meet the unique needs of hospitals or other facilities and/or regulations. This can include, for example, the regulations of the Food and Drug Administration (FDA) in the USA, the regulations of the Federal Institute for Drugs and Medical Devices (BfArM) in Germany or the regulations of the European Medicines Agency (EMA) in Europe, etc .

In some embodiments, the nose applicator is intended to support IoT (Internet of Things), for example by means of healthcare tracking, identification/authentication, data collection/data mining and/or sensing. For this purpose, provision can be made for the individual devices and peripheral devices of the nasal applicator to be provided with unique identifiers so that the individual devices and peripheral devices can recognize one another in a network. Data can then be transmitted over the network by means of communication devices suitable for this purpose, in particular without human intervention.

In some embodiments, the nose dip of the nasal applicator can be configured to measure temperature, humidity, airflow, negative pressure, and so on.

In some embodiments of the nasal applicator, it can be configured to record the sleep rhythm and, based on this record, to adjust the further dosing (dosing schedule) before/during/after sleep, etc.

In some embodiments of the nasal applicator, its housing surface can have a beading effect (lotus effect), i. H. it can be self-cleaning, antibacterial, etc.

In some embodiments of the nasal applicator, the housing of the nasal applicator can be coolable, e.g. B. for insulin. A cooling device can be provided, as well as thermally insulating materials or provisions.

In some embodiments of the nasal applicator, the housing of the nasal applicator can have insulation against cold, heat, moisture and/or liquid.

In some embodiments of the nasal applicator, additional modules can be clickable on these. Appropriate brackets, before directions etc. may be present on the nasal applicator.

In some embodiments of the nose applicator, it can be connected to a smartphone, in particular to the smartphone of the user/patient, via the AUX or Lightning socket. In these embodiments, the smartphone becomes the electronics and the corresponding app becomes the necessary software for the nose applicator.

In certain embodiments, the nasal applicator and/or one of the peripheral devices are programmed to be able to emit a position signal, a stand-up signal, a fall signal, etc. Smart textiles with integrated sensors, actuators, haptics, etc., mobility protocol, etc. can be provided for this purpose.

The nasal applicator and/or one of the peripheral devices can be provided and configured to perform these functionalities. They can be used to send a signal to third parties (e.g. to a control center, to the ward room, etc. after a fall of the user), but they can also be used to predetermine the height of one or more subsequent application doses. For example, provision can be made to make the delivery of an application dose and/or the amount dependent on the user standing up in the meantime, ie z. B. has at least left the bed for fewer steps or some physical activity.

In some embodiments, the nasal applicator is configured to itself, in particular automatically, mix a concentration of the substance and/or fill the internal substance reservoir and/or dilute it with a substance from a second substance reservoir, e.g. B. Dilute 100 µg/100 µL to 50 µg/100 µL.

In some embodiments, the nasal applicator is suitable for energy harvesting, i. H. for energy production e.g. B. by one or more rotation (s) on the case back. A hybrid system between mechanical and electronic systems can thus be created, with the required energy being generated as required.

• Die Arzneitherapie wird durch die Tatsache erschwert, dass Patienten auf dieselbe Dosis derselben Substanz sehr unterschiedlich reagieren. Es finden sich Unterschiede in der Wirksamkeit, sowie im Spektrum und Schweregrad von unerwünschten Wirkungen und Nebenwirkungen.

One or more of the advantages set forth herein may be achievable by some embodiments of the invention, including:

• Drug therapy is complicated by the fact that patients respond very differently to the same dose of the same substance. There are differences in effectiveness, as well as in the spectrum and severity of undesirable effects and side effects.

A significant proportion of the inter-individual variability (i.e. differences between different patients) of individual drugs can be attributed to the patient's genetic make-up (pharmacogenetics). An identical dosage in different patients leads to very different concentration-time curves (pharmacokinetics) and thus to very different effects (pharmacodynamics) and dose individualization is therefore advantageous. In addition to the inter-individual variability, the intra-individual variability d. H. Consider differences in an individual patient in drug therapy. The present invention can contribute to this.

The cumulative effect (accumulation or enrichment of the substance) through the administration of several consecutive application doses must be taken into account, particularly in the case of multiple administration of substances with a narrow therapeutic range, a long elimination phase and side effects. The present invention can allow application of one or more such application doses to be carried out by the user himself, which is safe for the user.

The latter applies in particular to older people, for whom a correct or individually adapted dosage plays a decisive role. The present invention can contribute to this.

The careful "titration" (which takes place in a determination or discovery phase) to a substance concentration and the adjustment of the different application doses or the therapeutic effect while avoiding "overshooting" and the associated avoidance of undesirable side effects can represent a further advantage.

For this purpose, controlling to the target concentration (C _ED ) can be advantageous. In the case of pain therapy, reaching the target concentration represents a state in which the patient is satisfied with his pain therapy. A concentration that exceeds the target concentration no longer contributes to the therapeutic effect, but only increases the side effects to be avoided.

The present invention can allow application-related problems of nasal applicators, such as the different nasal anatomy, the nasal condition, the application angle, such as deep that the individual user usually introduces the nasal attachment and the like: a preset level of the application dose, the effect of which on the body depends on the aforementioned and other factors, is not required according to the invention. The present invention is suitable for dealing with such, above all inter-individual, peculiarities when predetermining the level of the application doses. In this way, the desired therapeutic effect can be assured.

If the substance, as also encompassed by the invention, is applied nasally, ie non-invasively, the disadvantages of other forms of application can be avoided. In the case of oral administration, for example, the substance must first be metabolized via the liver (first-pass effect) before it can develop its effect. Other disadvantages are the relatively slow onset of action and the difficulty in administering individual doses. Symptoms such as dysphagia and dry mouth make oral administration more difficult. In the case of sublingual administration, for example, the relatively small absorption area and accidental swallowing are problematic. The effect is also affected by drinking, eating or speaking too soon after sublingual application.

Intranasal administration by means of the nasal applicator according to the invention is painless, easy to self-administer and has a rapid effect.

The substance-related blocking of further applications during a blocking period, which is also variable and can be set according to the invention by the blocking device in terms of start and duration, can allow the target concentration to be found early and can advantageously prevent an excessive administration of the substance. The locking device ensures that the applied dose can establish its full effect and the effect can thus be evaluated by the user.

According to the invention, a self-regulating system is thus advantageously proposed which, after a "titration phase" (which is a determination or finding phase) based on already dispensed application doses, the user's actuation behavior and the past time intervals, individualized or personalized application doses, in the case of multiple dosing, and emits, which causes the needs of the user, according to or the desired therapeutic effect.

According to the invention, the user's body is used as a control loop or controlled system, since only the user's body reflects what the substance does to the body (pharmacodynamics) and the respective application dose is determined and applied individually to the user on request/need.

According to the invention, the user can also be categorized using the properties of the pharmacokinetics and the course of the concentration in the body over time can be tracked. After an initial "titration phase" you can assign the corresponding user whether he is within e.g. B. the group of pharmacokinetics tends towards the mean or “-SD” or “+SD” and/or define its individual concentration-time curve. Since the target concentration at which the desired therapeutic effect occurs can also be determined according to the invention, the present invention advantageously makes a contribution to the further development of personalized medicine.

Inter-individual variability (e.g. age, previous illnesses, consumption of medication) and intra-individual variability (e.g. manipulation, mobilization, circadian course, improvement in the state of illness or state of recovery) can advantageously be taken into account by the control device.

Advantageously, there is no need for the doctor or other authorized personnel to intervene, which saves time and resources.

Finally, the present invention can contribute to the fact that a smaller amount of substance is advantageously required to achieve the same effect.

"Intercepting" the remaining medication, e.g. B. from the OP, which may have been delivered as an initial or initial dose, is also advantageously possible according to the invention.

• 1 zeigt einen Nasenapplikator als Beispiel einer Medikamentenapplikationsvorrichtung einer ersten exemplarischen Ausführungsform;
• 2 zeigt schematisch und exemplarisch einen möglichen zeitlichen Verlauf einer Nutzung des erfindungsgemäßen Nasenapplikators als Beispiel einer Medikamentenapplikationsvorrichtung;
• 3 zeigt schematisch und exemplarisch die Höhe kumulierter Dosen verschiedener Applikationen einer Substanz an den Benutzer;
• 4 zeigt schematisch und exemplarisch das Ergebnis einer Vorbestimmung der Höhe der verschiedenen Applikationsdosen;
• 5a zeigt schematisch anhand dreier exemplarisch ausgewählten zeitlichen Konzentrationsverläufe das Ermitteln eines individuellen Konzentrationsverlaufs für einen betrachteten Benutzer der erfindungsgemäßen Nasenapplikators; und
• 5b zeigt eine Fortführung des Gedankens der 5a.

The invention is described below using exemplary embodiments thereof with reference to the attached drawing. In the figures:

• 1 Figure 12 shows a nasal applicator as an example of a drug delivery device of a first exemplary embodiment;
• 2 shows schematically and by way of example a possible course over time of use of the nasal applicator according to the invention as an example of a medication application device;
• 3 shows schematically and by way of example the amount of cumulative doses of different applications of a substance to the user;
• 4 shows schematically and by way of example the result of a predetermination of the level of the different application doses;
• 5a shows schematically the determination of an individual concentration profile for a user of the nasal applicator according to the invention, based on three examples of selected concentration profiles over time; and
• 5b shows a continuation of the idea of 5a .

1 shows a nasal applicator 100 of a first exemplary embodiment in a schematically simplified representation.

As 1 shows, the nasal applicator 100 has a housing 2 in or on which optionally one, all or more of the devices or components mentioned below can be arranged independently of one another. In other embodiments, one or more of these components can also be present externally, ie not inside the housing 2, in any combination.

The nasal applicator 100 has a retrieval device 1 which the user has to actuate in order to obtain a dose D (see FIG 2 or 3 ) to be able to apply a substance S from a substance reservoir R. Substance S can be a medicinal or non-medicinal active substance, in particular a painkiller. At the same time, the retrieval device 1 can be or have an optionally provided feedback device 8 . The feedback device 8, if present, can alternatively be a stand-alone device.

If the user has actuated the retrieval device 1, which can be a switch, a button, a slot or the like, and thus triggered an actuation signal, a dispensing dispenser 3 can release a quantity of the substance S that it has dosed, i.e. determined in terms of quantity or volume. It can flow from the reservoir R via the lumen of a nasal attachment 4 to be inserted into a nostril (into the user's nose, inject or the like. Alternatively, it can be applied from the reservoir R via a drop generator into the nose, which is part of the nasal attachment 4 or another device of the nasal applicator 100 can be.

For this purpose, the reservoir R can optionally be acted upon by means of an energy application mechanism. This can act by means of pressure, force, speed, oscillation, vibration, rotation, electrical/magnetic forces, etc. The droplet generator, which can for example be part of the dispensing dispenser 3 or the nosepiece 4, can thus be, for example, a pressurization mechanism acting on the substance S; e.g. B. a piston pushes into the reservoir R, or a pump pulls out of the reservoir R and applies pressure, force, speed, etc. to the substance S and pushes it through the droplet generator.

The optional droplet generator can function mechanically and/or electrically. He can e.g. B. be designed as a nozzle, evaporator, piezo element, etc., or have the like. It can preferably produce a spray or a cloud of droplets or a cloud of particles.

Since such a release by the dispenser 3 should not be possible at any time and not due to each actuation of the retrieval device 1 and/or not at any time, a blocking device 5 is provided. It is configured, preferably in a time-controlled manner, to release or dispense by means of the dispensing dispenser 3 during a blocking period defined according to predetermined criteria with regard to its duration and/or the time of its beginning and/or end (see e.g. T_vain _n in 2 ) to prevent, disallow, etc. even if the retrieval device 1 should be operated during the lockout period. During the blocking period, which is of fixed or unchangeable duration in some embodiments, while it is variable or changeable in others, an actuation of the retrieval device 1 does not lead in principle or generally to an application, whereas this does not have to be the case for an actuation after the blocking period has expired or not applicable.

The amount or volume of that part of the substance S which is contained in individual starting or application doses (Do, D ₁ , D ₂ , ..., D _n , ... in 2 or in 3 ) as explained below, is and/or was delivered at different delivery times tA ₀ , tA ₁ , tA ₂ , ..., tA _n , ... is detected by means of a dose detection device 7 . The dose detection device 7 can be configured to record the individual starting or application doses D ₀ , D ₁ , D ₂ , . . . D _n , , to measure, to determine, to store, to sum up etc.

The dose detection device 7 can, for example, measure an amount, a volume or another parameter which allows a direct statement to be made about the respective application dose. The dose detection device 7 can additionally or alternatively measure or determine a parameter that provides indirect information about the respective application dose allows, for example, a flow per time, a number of strokes of a pump, a number of revolutions of a pump, or the like.

Dose limits and/or concentration limits, which one, e.g. B. based on a unit of time limited or predetermined, limit total dose and / or total concentration can optionally be provided.

The dose detection device 7 can additionally or alternatively be programmed to record a point in time at which one or more specific application doses were or are being administered by means of the nasal applicator 100 . The dose detection device 7 can additionally or alternatively be programmed to detect a period of time, for example between two or more delivery times tA ₀ , tA ₁ , tA ₂ ,..., tA _n ,... (see FIG 2 or 3 ) administered initial or application doses D ₀ , D ₁ , D ₂ ,..., D _n , .... Further periods of time between any points in time mentioned herein can also be recorded (such as tA ₁ -/"minus" T_vain _{1_E} , tA ₁ - (especially last) tB _{_v} , tB _{1_v1} - tA ₀ , tB _{_v} (especially the last one, so tB _{_v-1} ) - tA ₀ , T_vain _{1_E} - last tB _{_v} , T_vain _{1_E} - tB _{1_v1} , which whose parameters are explained below.

An electronic control device 9 may be provided to control the function of the nasal applicator 100 or some, any or all of those referred to in FIG 1 to control, regulate and/or monitor said device or components. As stated above, it can be provided in the housing 2 or outside. It can be the recipient of information about initial or application doses D ₀ , D ₁ , D ₂ , ..., D _n , ..., which have been predetermined externally. Corresponding wired or wireless signal connections can be provided, unidirectionally or bidirectionally or multidirectionally, between the control device 9 and the component or components of the nose applicator 100 .

A detection device 11 can be provided in order to detect whether and/or when the user, who may be a user, operator or patient herein, attempted or initiated a further application dose by actuating the retrieval device 1 .

The substance reservoir R can be optionally exchangeable in each embodiment, for example as a single-shot reservoir, as a reservoir with sufficient substance S for a large number of application processes, etc.

The substance reservoir R can, for example, be prefilled, self-fillable, integrated, exchangeable, designed for single application and/or for multiple applications.

The substance reservoir R can be arranged inside the housing 2 or externally thereto.

The substance can be in any physical state (liquid, gaseous, solid, etc.).

A data memory M for storing data, or with data stored therein, can be arranged inside the housing 2 or externally thereto.

This data can relate to the previous use of the nasal applicator 100 by the user, as well as information on the times or durations mentioned herein (synonym: time intervals), etc.; they can be the result of an evaluation by the control device 9, etc. or optionally data for pharmacological, pharmacodynamic and/or pharmacokinetic data relating to substance S; they can be substance-related and/or specified by the doctor or other authorized persons, e.g. a t _max value of substance S, a so-called “overruled” t _max value corrected by the doctor, e.g. B. the time or the end of the time interval after application, at or in which the maximum concentration or blood concentration occurs, the half-life, the terminal half-life, a value adjusted by the doctor or other authorized persons, etc.

The data can be objective and/or subjective.

The data can be objective values (sensor values), e.g. B. Blood sugar level, blood pressure, heart rate, respiratory rate, oxygen saturation, etc.

The data can be subjective values (“effect values”) that cannot be measured directly. They are derived from collected values such as e.g. e.g. pain score, sedation score, side effects etc.) and/or measured values (e.g. SpO ₂ , HR, HRV etc.)

The data can be or include the recommended concentration, contraindications, side effects, expiry date and/or package insert, professional information, patient information, Summary of Product Characteristics (SmPC), assembly instructions, disassembly instructions, operating instructions/operating instructions etc.

In addition to pharmacological and/or pharmacokinetic data, the data can optionally include user-related data such as e.g. B. weight, age, gender, BMI, medical history, comedications, comorbidities, allergies, etc. Generally include user and/or treatment history (e.g., data on previous interventions, procedures, diagnostics, medical history, tests, medications received/prescribed, anesthetics received, muscle relaxants, antiemetics, etc.).

Such and other data can help the control device 9 to calculate more precise dosages or to increase the safety of the therapy.

The data memory M can be a hardware memory component, a flash memory or an external data memory, for example arranged in a cloud, in a mobile device or the like and/or via Wi-Fi/Bluetooth etc. with other components of the nasal applicator 100 in signal connection.

The blocking device 5 and/or the detection device 11 are preferably electronic, e.g. B. by means of the control device 9 realized components.

A timer or timer, such as a clock, may be provided. The individual components, as mentioned above, can fall back on them. In some embodiments, it can be provided to inform the user about the end of the current blocking period, for example optically or acoustically or haptically, for example by means of vibration.

2 shows schematically and by way of example a possible course of use over time of the nasal applicator 100 according to the invention.

If the user activates the retrieval device 1, for example in order to apply an application dose D _n referred to herein as the "next" application dose, the electronic control device 9 or its detection device 11 is used to determine whether this point in time at which the user requests this next application dose D _n wants to apply, may or may not fall within a blocking period T_vain _n that is still ongoing.

If this point in time, at which the retrieval device 1 is actuated, falls within the blocking period T_vain _n , no application dose D _n is administered to the user at this point in time. Such times are passing 2 with reference to an earlier blocking time T_vain ₁ exemplarily as times tB _{1_v1} and tB _{2_v1} with reference to further blocking times z. B. as tB _{1_v2} , and are optionally included in the pre-determination.

On the other hand, if the time at which the retrieval device 1 is actuated does not fall within the blocking period T_vain _n , but is after the expiration or end T_vain _{n_E} of the blocking period T_vain _n as in the example 2 shown based on the actuation time tB _n , then the next application dose D _n is applied to the patient at a time referred to herein as the next delivery time tA _n .

The level of the next application dose D _n is specified or predetermined at a predetermination time tV _n referred to herein as the next prior to its application by the electronic control device 9, which may have carried out the corresponding calculations itself or adopted the results of such calculations.

The predetermination of the amount of the next application dose D _n is from the nasal applicator 100 or its 1 mentioned components, such as the control device 9, regardless of whether they are included in the housing 2 of the nasal applicator 100 or are external to it.

The first predetermination time tV _n , like the actuation time tB _n , can be at or before the first delivery time tA _n ; it can therefore coincide with the first delivery time tA _n , at least within the scope of what is technically possible, so that between the first predetermination time tV _n and next delivery time tA _n there is sufficient time to actually predetermine or calculate the level of the next application dose D _n and time for the corresponding devices or components to respond, which must be informed of the predetermined level before application by signal or in some other way.

When predetermining the amount of the next application dose D _n , which is an example of the variable dose D, i.e. it is not or not exclusively preset unchangeably by a doctor or other authorized persons, manufacturers or the like for the nasal applicator 100, data can be read out of the data memory M Data and/or data obtained from the in 1 mentioned components of the nasal applicator 100 were determined, are taken into account.

This data preferably already includes an initial time tA ₀ before the successful actuation time tB _n , at which the user may have been administered an initial dose D ₀ before delivery of the first application dose D ₁ , whether by means of the nasal applicator 100 according to the invention, or by medical means staff, e.g. B. still in a recovery room postoperatively (post-op), etc. Next can If this data includes the level of this optional starting dose D ₀ .

In the present case it is assumed that an initial dose D ₀ was delivered to the user at an initial time tA ₀ .

These data preferably include each initial point in time tA ₀ , tA ₁ , tA ₂ , tA _{n -1} which is before the successful actuation point in time tB n and at which the user has already received an initial or application dose D ₀ , D ₁ , D ₂ , D _{n 1} was administered or he had dosed himself. Alternatively or additionally, the time that has elapsed since then and preferably also the respective amount of the above-mentioned doses are also included.

If one considers the planned delivery of the next application dose D _n , these data include, for example, at least the level of the previous application dose D _n-1 and, optionally, its delivery time tA _n-1 or the time that has elapsed since then.

The predetermination, which takes place at the first predetermination time tV _n , thus results in the level of the next application dose D _n . The amount is determined at the next predetermination time tV _n , which is after the next actuation time tB _n and is not preset by a doctor or other authorized persons, manufacturer or the like, which can also apply to all or some of the other application doses mentioned herein. The predetermination of the next predetermination time tV _n takes place taking into account data read out of the data memory M.

After the application of the next application dose D _n has taken place, preferably at the release time tA _n of the next application D _n , a blocking period T_vain _n is again set and/or started. It may be the same length as previous or subsequent suspension periods, or different. The length of each lock period can be predetermined and / or z. B. have been set by the doctor or other authorized persons. When scheduling the next blocking period, a logic or an algorithm can be followed for which(n) tV _n can also be calculated at each predetermination time.

As 2 can be seen, what was described above for this figure can be repeated.

When predetermining the level of an application dose D _n+1 after the next, however, it is now possible, optionally, in addition to the levels and/or the delivery times of the above-mentioned application doses and possibly also the initial dose D ₀ , for the first time to also include the level and/or the application time t _At the here referred to as the next application dose, but then already applied application dose D _n are taken into account, which in the meantime can be recorded as data and also stored in the data memory M.

Predetermining the level of the next but one application dose D _n+1 , which takes place at the predetermination time tV _n+1 , can therefore now also include the length of the time period between the next but one delivery time tA _n+1 and the next delivery time tA _n as well as the lengths of the time periods , which lie between the second delivery time tA _n+1 and the starting time tA ₀ or earlier delivery times tA ₁ , tA ₂ .

3 shows schematically and as an example the applied individual doses D ₀ , D ₁ , D ₂ , ..., D _n-1 , D _n , D _n+1 , ... and the doses of substance S accumulated over time t, their levels and/or delivery times tA ₀ , tA ₁ , tA ₂ , ..., tA _n-1 , tA _n , tA _n+1 , ...etc. can be included in the pre-determination of later application doses. The time axis t and its scaling correspond to that in 2 used or are to be assumed to be identical. The time tA ₁ and the time tA ₂ thus correspond to the in 2 absolute times tA ₁ and tA ₂ shown.

4 describes, schematically and by way of example, the phase in the supply of the user with the substance S, also referred to herein as the “titration phase” (which is a determination or finding phase), in which the target concentration causing the therapeutic effect desired by the user is determined. The amount of the following application doses can then be determined on it and/or an individual, dose- or concentration-based treatment plan can be set up in a time-controlled manner.

4 shows schematically and by way of example the result of a predetermination of the level of the different application doses D ₁ , D ₂ and others, each of which can be an example for the respective next application dose D _n , as used herein.

In order to predetermine the respective application dose D ₁ , D ₂ , and others, in the embodiment discussed here, recourse is had to data from the data store M, which includes pharmacological, pharmacodynamic and/or pharmacokinetic data. The data can be models, in particular PK models, as well as PK curves. They are preferably patient-specific.

In the example, these pharmacological, pharmacodynamic and/or pharmacokinetic data or models include 4 here referred to as PK curves of concentrations of substance S in the body of the user over time after the respectively applied doses. The curves shown reflect the course over time of the concentration of a specific substance S, which results from the applied dose, and the level of the applied doses. The curves also reflect the processes of absorption, distribution, metabolism and elimination in the body. Such pharmacokinetic models follow statistical distributions z. B. taking into account with mean and standard deviation and are mostly patient-specific, ie they can run differently from patient A to patient B, which is why they can be stored in the data memory M for different users or user collectives according to different statistical distributions. Since the course of such PK curves depends on the route of application and the dose, the two are in 4 PK curves provided with reference symbols are referred to once as PK50 for the intranasal administration of 50 μg fentanyl and once as PK25 for the intranasal administration of 25 μg fentanyl.

Pharmacological, pharmacodynamic and/or pharmacokinetic data, as they can be stored in the data memory M, include in the example 4 optionally also information on the substance S such as t _max , which can indicate the point in time at which the highest concentration C(t) in the body, for example in the blood, is present after application of a dose D. The duration of t _max can be used as the blocking duration, at least initially or subsequent to a first dose, here the starting dose D ₀ . Likewise, the blocking period can be based on t _max by the blocking period z. B. is only 90% of t _max , or a number of minutes shorter or longer than t _max can be determined, etc. Values over 100% of t _max are also possible, z. B. 110% of t _max , which is after t _max , if you want to include a delay in which the administered substance gets from the blood to the site of action, or if t _max is 13 minutes, but the blocking period is limited to e.g . B. 10 minutes is to be set.

The electronic control device 9 can thus be programmed to also read out such data relating to the substance S stored in the data memory M and to take this into account when predetermining the next application dose D _n of the substance S.

As in 4 shown schematically and as an example, the user was initially administered an initial dose D ₀ of 50 μg intranasal fentanyl at the initial time tA ₀ . The concentration rises up to a first maximum C _1max , which is why the end of the blocking period T_vain _{1_E} of the first blocking period T_vain ₁ is also fixed for this point in time, the blocking period start of which T_vain _{1_S is} at tA ₀ .

If only the initial dose D ₀ were applied to the user, the concentration C(t) would decrease over time and, assuming the in 4 broken PK curve PK50 will have halved after about 30 minutes.

However, since such a halving obviously does not meet the needs of the user who actuated the retrieval device 1 at actuation time tB ₁ , a first application dose D ₁ of, for example, 25 μg fentanyl is administered to him at the first delivery time tA ₁ . Predetermining this level at the predetermination time t _V1 has shown that 25 µg fentanyl, given the course of the PK50 curve, is sufficient to achieve a concentration in the interplay between decreasing effect or concentration of the initial dose D ₀ with simultaneously increasing effect or concentration of the first application dose D ₁ can be achieved, which on the one hand is not above the initial dose D ₀ of 50 μg fentanyl, which was initially classified as sufficient, and on the other hand is not below a concentration C _ED of about 45 μg fentanyl that causes the desired therapeutic effect.

The control device 9 recognizes the concentration C _ED of about 45 μg of fentanyl that produces the therapeutic effect desired by the user in that the user obviously missed the desired therapeutic effect from the actuation time tB ₁ , which is only shortly before the first delivery time tA ₁ , which caused him to actuate the retrieval device 1.

As 4 shows, the user tries to request two more applications during the blocking period T_vain ₁ (at the times tB _{1_v1} and tB _{2_v1} ), since the desired therapeutic effect has apparently not occurred or has not yet occurred. These applications are refused because the concentration of the initial dose D ₀ has not yet reached its maximum, but in any case the blocking period T_vain ₁ has not yet ended. It will only reach its maximum towards the end of the blocking period T_vain _{1_E} . Since it can now be seen that the actuation time tB ₁ only occurs some time after the end of the blocking period _{T_vain 1_E} , the system can use the PK curve to derive a concentration in which the desired therapeutic effect occurs. In this case, a starting dose D ₀ of 50 µg fentanyl results in a therapeutic one Time slot of 8 minutes (from minute 7 to minute 15).

you can in 4 also recognize that the concentration for the desired therapeutic effect is already reached at minute 7. This can be seen from the fact that from this point in time there are no more unnecessary actuation times tB _{m_vn} during the blocking period T_vain ₁ . As can be seen, however, the maximum concentration of the initial dose D ₀ has not yet reached its maximum. The concentration that prevails at the last futile actuation time tB _{3_v1} can be used for verification by comparing this prevailing concentration with the expected actuation time after T_vain _{1_E} .

Knowing the concentration C _ED causing the desired therapeutic effect from the first actuation point in time tB ₁ , the control device 9 can now independently predetermine the level of the first application dose D ₁ . She can predetermine a level of 25 µg fentanyl, knowing that the decay of the concentration C(t) due to the initial dose D ₀ and the simultaneous rise in the concentration C(t) due to the first application dose D ₁ lead to a second maximum C _2max which will not be above a therapeutically acceptable maximum.

Using the pharmacokinetic models (PK curves), the control device 9 can optionally calculate a time in which the concentration of the dose D ₁ will fall below the desired therapeutic effect. In 4 this takes place after another 19 minutes or 34 minutes since tA ₀ .

If the concentration C _ED causing the desired therapeutic effect and/or the respective next maximum C _{nmax is} known from the above considerations, knowing the point in time at which the concentration C _ED or the respective next maximum C _nmax will occur or will be reached , the next blocking period are calculated. For example, the blocking period T_vain ₁ can be taken from the data memory M in connection with the level of the initial dose D ₀ . By contrast, the end T_vain _{2_E} of the following, second blocking period T_vain ₂ can be obtained from knowledge of the point in time of C _2max , the two can be identical to one another. Alternatively, at the point in time tA ₁ at which the concentration C _ED is achieved, the point in time at which the concentration C(t) will again have fallen to the concentration C _ED can optionally be calculated. Half of the difference between these two points in time, as well as another portion thereof (e.g. 40%, 35%, etc.), can be set as the duration of the next blocking period.

Alternative approaches are also included. In general, the calculated time for the next drop below C _ED could also be selected as the blocking period, or shortly before. This would be in 4 at 58 minutes from tA ₀ . Thus, at tA ₂ , in this case tV ₂ , the control device 9 could set the blocking period for the next target concentration C _ED (at minute 58 in 4 ) put.

The heights of the other application doses such. B. D ₂ (in this exemplary case 25 μg fentanyl each) would be predetermined following similar considerations as for D ₁ : they were determined taking into account the level of application doses already administered and the time elapsed since their application; for the second application dose D ₂ a residual concentration was used, which is due to the initial dose D ₀ and the first application dose D ₁ , for the third application dose, not shown here, the residual concentration, which is based on the initial dose D ₀ , the first application dose D ₁ and the second application dose D ₂ is due to be turned off or turned off. A residual dose is also determined by the amount of the previous application and the time that has passed since its application.

The amount of the next application dose D _n can be predetermined such that the concentration in the body, especially in the blood, of the user only after a predetermined period of time, adjustable z. B. by the doctor or other authorized persons, starting from the delivery time tA _n of the next application dose D _n , will fall again to the target concentration C _ED .

As 4 shows, the user actuates the retrieval device 1 at actuation times _{tB 1_v1} , tB _{2_v1} and tB _{3_v1} during the blocking period T_vain ₁ . However, since these three operations are within the blocking period T_vain ₁ , the user cannot obtain an application dose D with them. Nevertheless, the control device 9 registers the three unsuccessful attempts at actuation and the times at which they were actuated. They are in the example of 4 at minute 2 (tB _{1_v1} ) or at minute 4 (tB _{2_v1} ) or at minute 7 (tB _{3_v1} ), and can optionally be stored in the data memory M. If the unsuccessful attempts at exercise are analyzed to determine how far apart they are, when they stop, etc., the concentration C _ED desired by the user and causing the intended therapeutic effect can be identified or determined as a first but sufficient approximation.

In 4 feedback times tF _{1_1} , tF _{1_2} , tF _{1_3} and tF _{1_4} are given. They stand for moments in which the user activates a feedback device 8 in order to indicate by means of feedback that he is satisfied or not satisfied with the effect he felt of the concentration present at the time of the feedback. He can thus z. B. signaling that he is currently pain free, that he would not prefer a higher concentration in the body, etc.

In 4 you can see in the PK50 _D0 curve that from about 45 minutes there is a "straight line", i.e. the gradient remains constant (pseudo-equilibrium "lambda").

The elimination half-time is now the time in which the prevailing concentration at minute 45 halves.

According to the literature, the elimination half-time of fentanyl ranges from 3 to 12 hours, depending on habituation.

5a shows an example and a schematic representation using three example PK curves PK50 _{D0_+SD} , PK50 _{D0_M} and PK50 _{D0_-SD} of the statistical distribution (mean value and standard deviation) of the possible concentration curves in the user's body after administration of 50 µg intranasal fentanyl, which at a sufficient large population were obtained. There may be more than three curves between the boundaries shown, ie appropriate study of the collective/population may have resulted in more than three distinguishable PK curves. All of them, or the models on which they are based, can be stored in the data memory M and/or can be taken into account by the control device 9 . For the sake of simplicity only three PK curves are shown and discussed here.

In general, the same high doses of a substance can lead to different concentrations C(t) in the body of the individual patient. This is influenced by various factors, such as pharmacogenetics, intra-individuality, age, weight, gender, previous medication, previous illnesses, etc. Furthermore, different nasal anatomy, the nasal condition, the application angle, how deep the nose attachment is inserted and how the manually triggered nasal spray is operated play a role in the course of the respective PK curve, which influences the concentration C(t) over time in the body.

Using population pharmacokinetic models such as that in 5a The PK50 _{D0_+SD} (mean value plus one standard deviation), PK50 _{D0_M} (mean value) and PK50 _{D0_-SD} (mean value minus one standard deviation) curves shown here can be used to depict such differences.

As can be seen, the same dose of 50 µg intranasal fentanyl leads to three different concentration maxima C _{1max_-SD} , C _{1max_M} and C _{1max_+SD} for these three curves selected as examples. A large number of other curves could also be displayed. They would in turn have other concentration maxima. However, the point in time up to the maximum concentration does not differ in the three curves shown and also in those not shown from the large number of curves, or if so only marginally. The end T_vain _{1_E} of the blocking period T_vain ₁ , which is based on the point in time at which the concentration maximum C _{1max_-SD} , C _{1max_M} and C _{1max_+SD} is reached, ends for each of the three curves of 5a at the same time.

If it is assumed that the starting dose D ₀ (D ₀ =50 μg) is applied at the time tA ₀ , the control device 9 can calculate the maximum concentrations C _{1max_-SD} , C _{1max_M} and C _{1max_+SD} ( and many more). However, since the time until these maximum concentrations are reached is the same for all variants, control device 9 sets the first blocking period (T_vain ₁ , see 5a) for all three PK curves the same as the time to reach the maximum concentration, which in this case is set to 10 minutes as an example. Reaching the maximum concentration can take place in one area. In the present case of intranasal fentanyl, this is between 10 and 12.8 minutes. Since the increase in concentration in the range from 10 to 12.8 minutes is only very small, the time is rounded off to a practicable amount such as e.g. B. 10 minutes. You could of course also choose 11, 12 or 13 minutes. Thus, if the initial dose D ₀ (D ₀ =50 µg) is applied at t _A0 , the resulting maximum concentration is calculated, the flooding time until the maximum concentration C _{1max_-SD} , C _{1max_M} or C _{1max_+SD} is reached is calculated Length of the blocking period T_vain ₁ (here 10 min) calculated and T_vain _{1_S} and T_vain _{1_E} set.

According to the different courses of the three PK curves PK50 _{D0_+SD} , PK50 _{D0_M} and PK50 _{D0_-SD} , at the first actuation time tB ₁ , at which concentration falls below the therapeutic effect desired by the user, concentration falls, at which the patient can request (points in time relating to the operation by the patient, the predetermination, etc. are not shown here for reasons of simplification or fall on the first delivery time, which is actually the case in practice can be) the first application dose D ₁ would be received, calculate a different concentration C _{ED1_+SD} , C _{ED1_M} , C _{ED1_-SD} (or with a view to the as in 5a plotted PK curves), which causes the desired therapeutic effect. This concentration is also referred to herein as the target concentration or C _ED . Their value is based, among other things, on pharmacodynamics.

It should be noted that actuation time tB _n may correspond to predicted time tV _n and/or release time tA ₁ . So it can z. For example: tB ₁ =tV ₁ =tA ₁ .

5a it can be seen that the concentration C _{ED1_+SD} , C _{ED1_M} , C _{ED1_-SD} was already present before the delivery time t _A1 as C' _{ED1_+SD} , C' _{ED1_M} , C' _{ED_-SD} at 5, 6 or 8 min had. This can also be derived from the missing tB _{_v} 's.

The above statements are the basis for an embodiment, which in relation to 5b is discussed, and in which the nasal applicator 100 takes into account the actuation behavior of the user in a concrete way.

when you get in 5b If you draw a line (straight through two points) starting from t _A0 to the corresponding concentrations C _{1max_-SD} , C _{1max_M} and C _{1max_+SD} , you get three straight lines, each with a different slope. If you now look at the increase in concentration based on the time intervals, you could already make an assessment of which curve the user could possibly be assigned to, because the PK50 _{D0_+SD} curve has the greatest increase in concentration in the same time interval and the PK50 _{D0_-SD} curve has the lowest . Since the desired therapeutic effect depends on the concentration, an initial assessment can be made.

5b shows schematically the exemplary procedure for determining, selecting and/or defining an individual PK curve PK _Ind which reflects the course of the active ingredient concentration of 50 μg intranasal fentanyl of a specific, individual user. It should be noted at this point that the goal when determining an individual concentration profile over time, as used herein, does not always have to be an individual PK curve of the user. It may also be sufficient according to the invention if z. B. based on the statistical mean curve PK50 _{D0_M} or or limit curves such. B. the curve "mean plus standard deviation" or the curve "mean minus standard deviation" or others and knows in which range the user is moving.

5b includes the presentation of 5a , but supplements this from the first delivery time tA ₁ with the administration of a first application dose D ₁ in the amount of 30 µg fentanyl, for example.

From the first delivery time tA ₁ , the PK curves PK30 _{D1_+SD} , PK30 _{D1_M} and PK30 _{D1_-SD} assumed before this time are applied. Starting from the in 5b determined target concentrations C _{ED1_+SD} , C _{ED1_M} , C _{ED1_-SD} , the control device 9 or the algorithm determines a large number of possible doses and concentrations C(t) derived therefrom, which allow an assessment/categorization, i.e. when the expected times of the next Actuation to retrieve a further application dose would have to occur. In this case, the system has set 30 µg and the system cumulates the previous curves and, based on the determined target concentrations C _{ED1_+SD} , C _{ED1_M} , C _{ED1_-SD} , projects the respective curve progressions into the future. It is determined at which point in time the target concentrations C _{ED2_+SD} , C _{ED2_M} , C _{ED2_-SD} should mathematically be undershot again. In the example of 5b they are marked with tB _{2_+SD} , tB _{2_M} and tB _{2_-SD} . Based on this check, the control device 9 can determine in which area or on which curve the user is located. The user can be better classified via these and further iterations.

• Fall 1: Trifft auf die Konzentrationsveränderung im Körper des Benutzers die Populations-Pharmakokinetik Kurve PK30_{D1_M} (Mittelwert) zu, so liegt er gute 24 Minuten oberhalb der erwünschten therapeutischen Effekt-Konzentration, nämlich von Minute 18 bis Minute 42. Er würde erst bei Minute 42 zum Zeitpunkt tB_{2_M} eine Betätigung abgeben, was nach einer Vorbestimmung schließlich zu einer erneuten Abgabe einer (zweiten) von ihm angeforderte Applikationsdosis D_{2_M} zum Applikationszeitpunkt tA_{2_M} führt.
• Fall 2: Trifft auf die Konzentrationsveränderung im Körper des Benutzers die Populations-Pharmakokinetik Kurve PK30_{D1_+SD} (Mittelwert zuzüglich einer Standardabweichung) zu, so liegt er gute 20 Minuten oberhalb der erwünschten therapeutischen Effekt-Konzentration, nämlich von Minute 18 bis Minute 38. Er würde erst bei Minute 38 zum Zeitpunkt tB_{2_+sD} eine Betätigung abgeben, was nach einer Vorbestimmung schließlich zu einer erneuten Abgabe einer (zweiten) von ihm angeforderte Applikationsdosis D_{2_+SD} zum Applikationszeitpunkt tA_{2_+SD} führt.
• Fall 3: Trifft auf die Konzentrationsveränderung im Körper des Benutzers die Populations-Pharmakokinetik Kurve PK30_{D1_-SD} (Mittelwert abzüglich einer Standardabweichung) zu, so liegt er gute 27 Minuten oberhalb der erwünschten therapeutischen Effekt-Konzentration, nämlich von Minute 18 bis Minute 45. Er würde erst bei Minute 45 zum Zeitpunkt tB_{2_-SD} eine Betätigung abgeben, was nach einer Vorbestimmung schließlich zu einer erneuten Abgabe einer (zweiten) von ihm angeforderten Applikationsdosis D_{2_-SD} zum Applikationszeitpunkt tA_{2_-SD} führt.

Three possible cases are considered below:

• Case 1: If the population pharmacokinetic curve PK30 _{D1_M} (mean value) applies to the change in concentration in the user's body, it is a good 24 minutes above the desired therapeutic effect concentration, namely from minute 18 to minute 42. It would only be at minute 42 release an actuation at the time tB _{2_M} , which, after a predetermination, finally leads to a renewed release of a (second) application dose D _{2_M} requested by him at the application time tA _{2_M} .
• Case 2: If the population pharmacokinetic curve PK30 _{D1_+SD} (mean value plus one standard deviation) applies to the change in concentration in the user's body, it is a good 20 minutes above the desired therapeutic effect concentration, namely from minute 18 to minute 38. He would not release an actuation until minute 38 at the time tB _{2_+sD} , which, after a predetermination, finally leads to a renewed delivery of a (second) application dose D _{2_+SD} requested by him at the application time tA _{2_+SD} .
• Case 3: Meets the population Phar on the concentration change in the user's body If the macokinetics curve PK30 _{D1_-SD} (mean value minus one standard deviation) is good, it is a good 27 minutes above the desired therapeutic effect concentration, namely from minute 18 to minute 45. It would only be activated at minute 45 at the time tB _{2_-SD} deliver, which, according to a predetermination, finally leads to a renewed delivery of a (second) application dose D _{2_-SD} requested by him at the application time tA _{2_-SD} .

The control device 9 recognizes from the actuation times tB _{2_+SD} , tB _{2_M} , or tB _{2_-SD} whether the individual PK curve of the user is now the PK curve PK30 _{D1_+SD} , the PK curve PK30 _{D1_M} or the PK -curve PK30 _D1-SD (or one of the countless other PK curves which the control device 9 can also consider). If the retrieval time is at tA _{2_+SD} , the PK curve PK30 _D1+SD applies. If the retrieval time is at tA _{2_M} , the PK curve PK30 _{D1_M applies} .

If the retrieval time is at tA _{2_-SD} , the PK curve PK30 _{D1_-SD} applies.

If an initial direct association between a time profile and the user under consideration is not possible, the control device 9 nevertheless approaches the target by means of an exclusion method and categorizes/determines for the specific user based on his/her actuation behavior which concentration profile over time or which curve best reflects him/her. After the "titration phase" (which is a determination or finding phase), which in 5b shown and found out about the in 5b can possibly extend further times, a categorization or classification of the user can take place. The level of the following application doses can then be determined and/or an individual, dose- or concentration-based treatment plan can be set up in a time-controlled manner.

If one follows the procedure above, by postulating one or any number of PK curves as a possible, individual PK curve of the user a priori or as a large number of hypotheses (such as: the PK curve PK30 _{D1_+SD} applies to the user, or the PK curve PK30 _{D1_M applies} to the user, or the PK curve PK30 _{D1_-SD} applies to the user) already following a first starting or application dose D ₀ , D ₁ , D ₂ , etc. or the correctness of the applicable hypotheses set up can be checked quite generally for a next application dose D _n . This leads to an individual pharmacokinetic model for the user, which can be used as a basis for future application doses. In the example of 5b the PK curve PK30 _{D1_+SD} is defined as the PK curve PK _Ind at the time of actuation tB _{2_+SD} and used as a basis for the necessary calculations in future preliminary determinations of application doses.

A check that the individual pharmacokinetic model determined in this way actually applies can optionally be carried out at any time in the course of the further treatment and in connection with further application doses D _n , D _n+1 , etc.

Reference List

100

nasal applicator

1

retrieval device

2

Housing

3

dispensing doser

4

nose attachment

5

locking device

7

dose detection device

8th

feedback device

9

Electronic control device

11

detection device

CED1

Target concentration, concentration required for the desired effect/effect at actuation time tB ₁

CED2

Target concentration, concentration required for the desired effect/effect at actuation time tB ₂

CED3

Target concentration, concentration required for the desired effect/effect at actuation time tB ₃

CED1_+SD

First specified target concentration, concentration required for the desired effect/effect on the PK curve PK50 _{D0_+SD} at actuation time tB ₁

CED1_M

First specified target concentration, concentration required for the desired effect/effect on the PK curve PK50 _{D0_M} at the actuation time tB ₁

CED1_-SD

First specified target concentration, concentration required for the desired effect/effect on the PK curve PK50 _{D0_-SD} at actuation time tB ₁

CED2_+SD

Second set or first estimated target concentration, concentration required for the desired effect/response on the PK curve PK30 _{D1_+SD} at actuation time tB ₂

CED2_M

Second set or first estimated target concentration, concentration required for the desired effect/response on the PK curve PK30 _{D1_M} at actuation time tB ₂

CED2_-SD

Second set or first estimated target concentration, concentration required for the desired effect/response on the PK curve PK30 _{D1_-SD} at actuation time tB ₂

C'ED1

First target concentration determined before the delivery time tB ₁ , concentration required for the desired effect/effect on the PK curve PK50 _D0

C'ED1_+SD

First target concentration determined before the delivery time tB ₁ , concentration on the PK curve required for the desired effect/effect PK50 _{D0_+SD}

C'ED1_M

First target concentration determined before delivery time tB ₁ for which

C'ED1_-SD

Desired effect/effect Required concentration on the PK curve PK50 _{D0_M} First target concentration determined before the dispensing time tB ₁ , concentration required for the desired effect/effect on the PK curve PK50 _{D0_-SD}

C(t)

concentration at time t

Cnmax

maximum concentration

C1 max

First maximum on the PK curve PK50 _D0

C2max

Second maximum on the PK curve PK25 _D1

C3 max

Third maximum on the PK curve PK25 _D2

C1max_+SD

First concentration maximum on the PK curve PK50 _{D0_+SD}

C1max_M

First concentration maximum on the PK curve PK50 _{D0_M}

C1max_-SD

First concentration maximum on the PK curve PK50 _{D0_-SD}

C2max_+SD

Second concentration maximum on the PK curve PK30 _{D1_+SD}

C2max_M

Second concentration maximum on the PK curve PK30 _{D1_M}

C2max_-SD

Second concentration maximum on the PK curve PK30 _{D1_-SD}

D

dose

D0

starting dose; loading dose

D1

First application dose, previous application dose

D2

Second application dose, subsequent application dose

D3

Third application dose

Dn-1

The application dose preceding the next application dose

Dn

Next application dose

Dn+1

The application dose following the next application dose or the one after that

M

data storage

PK25

PK curve for 25 µg fentanyl single dose

PK50

PK curve for 50 µg fentanyl single dose

PK25Dn

PK curve for 25 µg fentanyl multiple dose

PK50Dn

PK curve for 50 µg fentanyl multiple dose

PK50+SD

PK curve for a single dose of 50 µg fentanyl, mean value for all individuals in the collective considered plus one standard deviation

PK50M

PK curve for a single dose of 50 µg fentanyl, mean value over all individuals of the collective considered

PK50-SD

PK curve for a single dose of 50 µg fentanyl, mean value across all individuals of the collective considered minus one standard deviation

PK50Dn_+SD

PK curve for multiple doses of 50 µg fentanyl, mean value for all individuals in the collective considered plus one standard deviation

PK50Dn_M

PK curve for multiple doses of 50 µg fentanyl, mean value over all observed individuals of the collective

PK50Dn_-SD

PK curve for multiple doses of 50 µg fentanyl, mean value across all observed individuals of the collective minus one standard deviation

PK30Dn_+SD

PK curve for multiple doses of 30 µg fentanyl, mean value for all individuals in the collective considered plus one standard deviation

PK30Dn_M

PK curve for multiple doses of 30 µg fentanyl, mean value over all observed individuals of the collective

PK30Dn_-SD

PK curve for multiple doses of 30 µg fentanyl, mean value across all observed individuals of the collective minus one standard deviation

PKInd

Individual PK curve

R

substance reservoir

S

Medicinal substance

T_vainn

blocking periods

T_vainn_S

Beginning of the lockdown

T_vainn_E

end of the lockdown

tA0

starting time; time of delivery of the starting dose; loading dose

tA1,..., tAn, tAn+1

Submission time 1 to n+1

tA2_+SD

Time of submission Mean value for all individuals considered in the collective plus one standard deviation

tA2_M

Time of submission Mean value across all observed individuals of the collective

tA2_-SD

Time of submission Mean value of all observed individuals of the collective Mean value minus one standard deviation

tB1, ..., tBn, tBn+1

Actuation time 1 to n+1

tB2_+SD, tB2_M, tB2_-SD

Calculated target concentration time

tB1_v1, tB2_v1

Futile actuation times during the blocking period T_vain ₁

tB1_v2, tB2_v2

Futile actuation times during the blocking period T_vain ₂

tBm_vn

Futile actuation times during the blocking period T_vain _n

tFn_1

First feedback time

tFn_2, tFn_3

feedback times

tFn_4

Last feedback time

tV1, ..., tVn, tVn+1

Predetermination time 1 to n+1

Claims (19)

Nasal applicator (100) for nasally administering at least one medical substance (S), in particular an analgesic, with a housing (2), having or connected to - a substance reservoir (R) for holding a quantity of the substance (S); - A retrieval device (1) for actuation by the user with the aim of retrieving a next application dose (D _n ) of the substance (S); - A dispensing dispenser (3) for dispensing application doses (D ₀ , D ₁ , D ₂ , ..., D _n-1 , D _n , D _n+1 , ...) upon actuation of the retrieval device (1). at a delivery time (tA ₀ , tA ₁ , tA ₂ , ..., tA _n-1 , tA _n , tA _n+1 , ...); - A blocking device (5) for temporarily blocking the dispensing dispenser (3) during or after the respective dispensing time (tA ₀ , tA ₁ , tA ₂ , ..., tA _n-1 , tA _n , tA _n+1 , . ..) the delivered application dose (D ₀ , D ₁ , D ₂ , ..., D _n-1 , D _n , D _n+1 , ...) re-starting blocking period (T_vain ₁ , T_vain ₂ , ... , T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) with a blocking period beginning (T_vain _{1_S} , T_vain _{2_S} , ..., T_vain _{n-1_S} , T_vain _{n_S} , T_vain _{n+1_S} , ...) and a lock duration end (T_vain _{1_E} , T_vain _{2_E} , ..., T_vain _{n-1_E} , T_vain _{n_E} , T_vain _{n+1_E} , ...) ; - A dose detection device (7) for detecting the level of the dose by means of the dispensing dispenser (3) at the dispensing time (tA ₀ , tA ₁ , tA ₂ , ..., tA _n-1 , tA _n , tA _n+1 , ...) respectively delivered application dose (D ₀ , D ₁ , D ₂ , ..., D _n-1 , D _n , D _n+1 , ...): - an electronic control device (9); - A data memory (M) for storing at least the delivery times (tA ₀ , tA ₁ , tA ₂ , ..., tA _n-1 ) of one or more already delivered application doses (D ₀ , D ₁ , D ₂ , ..., D _n-1 ) and/or the heights of these application doses (D ₀ , D ₁ , D ₂ , ..., D _n-1 ); characterized by - a detection device (11) at least for detecting an activation behavior of the user at an activation time (tB _n ) relating to the retrieval device (1) with the aim of applying a next or further application dose (D _n ); and in that the electronic control device (9) is programmed to - read out data stored in the data memory (M); - Evaluation of the means of the detection device (11) detected actuation behavior of the user; - Predetermine, at a predetermination time (tV _n ), the amount of the next or the further application dose (D _n ) which the user in the event that it actuates the retrieval device (1) outside of a blocking period (T_vain _n ), can be released at a next delivery time (tA _n ), the predetermination time (tV _n ) being at or after the actuation time (tB _n ), and wherein the predetermination takes place taking into account the data read from the data memory (M), these data at least a) the delivery time (tA ₀ , tA ₁ , tA ₂ , ..., tA _n-1 ) of one or more of the application doses already delivered _{( D 0 , D 1} , _{D 2} , _{Application doses} (D ₀ , _{D 1} , D ₂ , of the application doses already delivered (D ₀ , D ₁ , D ₂ , . . . , D _n-1 ) on the other hand. nose applicator (100) after claim 1 , wherein - the data memory (M) further comprises pharmacological, pharmacodynamic and/or pharmacokinetic data relating to the substance (S) or other data associated with the substance, wherein - the electronic control device (9) is further programmed to additionally read out data stored in the data memory (M ) stored data relating to the substance (S) or data associated with the substance, and wherein - the next application dose (D _n ) of the substance (S) is pre-determined taking into account the additionally read data. nose applicator (100) after claim 1 or 2 , wherein the electronic control device (9) is further programmed to initiate the further steps: - dispensing the next application dose (D _n ) in the predetermined amount at the corresponding dispensing time (tA _n ) by means of the dispensing dispenser (3); and subsequently - storing the level and/or a resulting concentration of the application dose of the next application dose (D _n ) delivered in the data memory (M) and causing the blocking device (5) to temporarily block the dispensing dispenser (3) for a period from or after the dispensing time (tA _n ) of this next application dose (D _n ) beginning blocking period (T_vain _{n + 1} ) with a blocking period beginning (T_vain _{n + 1_S} ) and blocking period end (T_vain _{n + 1_E} ) and / or storing the delivery time (tA _n ) of the next delivered Application dose (D _n ) in the data memory (M). nose applicator (100) after claim 3 , wherein the electronic control device (9) is further programmed, the sequence of the further steps of claim 3 also in connection with one or more of the dispensing of further application doses (D _n+1 ) following the next application dose (D _n ). nose applicator (100) after claim 4 , wherein the electronic control device (9) is also programmed to read data from the data memory (M) which z. B. PK curves (PK25, PK50) and/or models, and which depict a time course between concentration (C(t)) in the body, in particular blood, of the patient, and based on this, a next maximum (C _1max ,C _2max , C _nmax ) of the concentration (C(t)). nose applicator (100) after claim 5 , wherein the electronic control device (9) is further programmed to predetermine the next application dose (D _n ) based on data stored in the data memory (M), in particular PK curves (PK25, PK50) or models, and a data memory (M) to determine the amount of the next application dose (D _n ) in such a way that the next maximum (C _{1max ,} C _2max , C _nmax ) will not exceed the predetermined maximum based on the therapeutic maximum. Nose applicator (100) according to one of the preceding claims, wherein - the evaluation of the detected actuation behavior of the user, the determination of the actuation time (tB _n ) for calling up the next application dose (D _n ), or between this actuation time (tB _n ) and the end of the blocking period ( T_vain _{n_E} ) of the most recently elapsed blocking period (T_vain _n ); - the predetermination includes taking into account the determined next actuation time (t _Bn ) or the determined period of time. A nasal applicator (100) according to any one of the preceding claims, further comprising - a feedback device (8) for actuation by the user; wherein the detection device (11) is programmed to detect an actuation of the feedback device (8) that occurred at least at one, preferably first, feedback time (tF _{n_1} ); wherein the control device (9) is programmed to determine the concentration of the substance (S) present in the body or in the blood of the user at the at least one feedback time (tF _{n_1} ), and to set a target concentration (C _ED ) or its maximum value to a value in each case below the determined concentration. nose applicator (100) after claim 8 , wherein the detection device (11) further per is programmed to detect at least one actuation of the retrieval device (1) by the user at actuation times (tB ₁ , tB ₂ , ..., tB _n-1 , tB _n , tB _n+1 , ...) after the blocking period ( T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) and/or for detecting a, preferably last, feedback time (tF _{n_4} ) from which further actuations of the feedback device ( 8) failure by the user, preferably the user's most recent failure to operate; wherein the control device (9) is further programmed - to determine both a preferably first feedback point in time (tF _{n_1} ) and a preferably first actuation point in time (tB ₁ , tB ₂ , ..., tB _n-1 , tB _{n ,} tB _n+1 , ...) or the concentration (C(t)) in the body, in particular in the blood, respectively associated with the last feedback time (tF _{n_4} ); - for determining a concentration curve over time from a group of concentration curves over time associated with the same dose, in particular models or PK curves (PK50 _+SD , PK50 _M and PK50 _-SD ), from a large number of time curves stored in the data memory (M) and associated with the same dose Concentration courses, in particular PK models or PK curves, taking into account both the preferably first feedback time (tF _{n_1} ) and one of the preferably first actuation times (tB ₁ , tB ₂ , ..., tB _n-1 , tB _n , tB _n+1 , ...) or the last feedback time (tF _{n_4} ) ordered concentration; and - to take into account the individual concentration profile determined over time, in particular the individual PK curve (PK _Ind ) determined, when predetermining the level of one or more of the subsequent application doses (D ₃ , D _n , D _n+1 , ...). nose applicator (100) after claim 8 or 9 , wherein the control device (9) is further programmed, - when predetermining the level of the next application dose (D _n ), the set target concentration (C _ED ) or its maximum value and/or the determined individual concentration profile over time, in particular the determined individual PK curve ( PK _Ind ) to be considered. Nose applicator (100) according to one of the preceding claims, wherein the control device (9) is further programmed - to determine, after delivery has taken place, an initial dose (D ₀ ), which was delivered at a delivery time (tA ₀ ), at or for a first Actuation time (tB ₁ ), which is after the delivery time (tA ₀ ) of the initial dose (D ₀ ), for a group of concentration courses over time associated with the same dose, in particular models or PK curves (PK50 _+SD , PK50 _M and PK50 _-SD ) , from a large number of concentration courses over time stored in the data memory (M) and assigned to the same dose, in particular PK models or PK curves, a concentration (C _{ED1_+SD} , C _{ED1_M} , C _{ED1_-} ) assigned to the first actuation time point (t _B1 ) _SD ), and for setting the concentrations determined in this way (C _{ED1_+SD} , C _{ED1_M} , C _{ED1_-SD} ) in each case as an estimated target concentration of the associated concentration curve over time; - for applying the initial dose (D ₀ ) following the first application dose (D ₁ ) in response to the actuation of the retrieval device (1) at the first actuation time (tB ₁ ); - to determine for the temporal concentration curves of the group, at which point in time after the application of the first application dose (D ₁ ), the concentration in the body, in particular in the blood, will have fallen again to the estimated target concentration of the associated concentration curve over time, and to determine, each time for the concentration curves of the group, the time determined as the calculated target concentration time (tB _{2_+SD} , tB _{2_M} , tB _{2_-SD} ) - for recording or determining the second actuation time (tB ₂ ) for calling up a second or subsequent application dose (D ₂ ); - to determine a concentration curve over time from the group as an individual concentration curve over time, in particular as an individual PK curve (PK _Ind ), taking into account the respective difference between the calculated target concentration time (tB _{2_+SD} , tB _{2_M} , tB _{2_-SD} ) of each concentration curve over time from the group and the second activation time (tB ₂ ), in particular the concentration curve over time which has the smallest difference between its calculated target concentration time (tB _{2_+SD} , tB _{2_M} , tB _{2_-SD} ) and the second activation time (tB ₂ ). ; and - to take into account the determined individual concentration profile over time, in particular the determined individual PK curve (PK _Ind ), when predetermining the level of one or more of the subsequent application doses (D ₃ , D _n , D _n+1 , ...). Nose applicator (100) according to one of the preceding claims, wherein the control device (9) is further programmed - to determine the at least one considered actuation time (tB _n-1 ) or at least one considered predetermination time (tV _n-1 ) in the body or in the the user's blood concentration of the substance (S), and setting this concentration as the target concentration (C _ED ); and wherein the control device (9) is further programmed to - at the next predetermination time (t _Vn ) the amount of the next application dose (D _n ) such to determine that the concentration in the body or in the blood of the user will only drop to the target concentration (C _ED ) again after a predetermined period of time, starting from the delivery time (tA _n ) of the next application dose (D _n ). Nose applicator (100) according to one of the preceding claims, wherein - the evaluation of the user's actuation behavior detected by means of the detection device (11) includes the detection of actuations of the retrieval device (1) by the user at actuation times (tB _{1_v1} , tB _{2_v1} , tB _{1_v2} , tB _{2_v2} ) within one of the blocking periods (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...); - The control device (9) is further programmed to determine one of the actuation times (tB _{1_v1} , tB _{2_v1} , tB _{1_v2} , tB _{2_v2} ) within one of the blocking periods (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) associated concentration (C(t)) in the body, in particular in the blood; - Set the target concentration (C _ED ) or its minimum value to a value above the assigned concentration (C(t)). nose applicator (100) after Claim 13 , wherein the detection device (11) is further programmed to detect at least one actuation of the retrieval device (1) by the user at actuation times (t _B1 , t _B2 , ..., t _Bn-1 , t _Bn , t _Bn+1 , ...) after the blocking period (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) ; wherein the control device (9) is further programmed - to determine an actuation time (tB ₁ , tB ₂ , ..., tB _n-1 , tB _n, tB _n+1 , ...) after the blocking period (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) associated concentration (C(t)) in the body, in particular in the blood; - To determine a concentration profile of the group over time, taking into account at least one, preferably the last, actuation time (tB _{1_v1} , tB _{2_v1} , tB _{1_v2} , tB _{2_v2} ) within the blocking period (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) and at least one, preferably the first, actuation time (tB ₁ , tB ₂ , ..., tB _n-1 , tB _n, tB _n+1 , ... ) after the blocking period (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) ; and - to take into account the determined individual concentration profile over time, in particular the determined individual PK curve (PK _Ind ), when predetermining the level of one or more of the subsequent application doses (D ₃ , D _n , D _n+1 , ...). nose applicator (100) after Claim 13 or 14 , wherein the control device (9) is further programmed, - when predetermining the level of the next application dose (D _n ), the set target concentration (C _ED ) or its minimum value and/or the determined individual concentration profile over time, in particular the determined individual PK curve ( PK _Ind ) to be considered. Nose applicator (100) according to one of the preceding claims, wherein - the evaluation of the user's actuation behavior detected by means of the detection device (11) includes the evaluation of actuations of the retrieval device (1) by the user at actuation times (tB _{1_v1} , tB _{2_v1} , tB _{1_v2} , tB _{2_v2} ) within one of the blocking periods (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...); - The control device (9) is further programmed to determine an increase in the time intervals between successive actuation times (tB _{1_v1} , tB _{2_v1} , tB _{1_v2} , tB _{2_v2} ) within one of the blocking periods (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) or the absence of further actuation times (tB _{1_v1} , tB _{2_v1} , tB _{1_v2} , tB _{2_v2} ) within the blocking period (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...), and for determining a point in time from which the degree of increase or lack of it satisfies predetermined criteria; - the control device (9) is further programmed to determine a time-associated concentration (C(t)) in the body, in particular in the blood; - Set the target concentration (C _ED ) or its minimum value to a value above the assigned concentration (C(t)). nose applicator (100) after Claim 16 , wherein the control device (9) is further programmed to evaluate at least one detected actuation of the retrieval device (1) by the user at actuation times (tB ₁ , tB ₂ , ..., tB _n-1 , tB _n , tB _n+1 , ...) after the blocking period (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) ; wherein the control device (9) is further programmed - to determine an actuation time (tB ₁ , tB ₂ , ..., tB _n-1 , tB _n, tB _n+1 , ...) after the blocking period (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) associated concentration (C(t)) in the body, in particular in the blood; - To determine a concentration profile of the group over time, taking into account both one, preferably the last, actuation time (tB _{1_v1} , tB _{2_v1} , tB _{1_v2} , tB _{2_v2} ) within the blocking period (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , _{T_vain n , T_vain n+ 1 ,} the lock duration (T_vain ₁ , T_vain ₂ , ..., T_vain _n-1 , T_vain _n , T_vain _n+1 , ...) ; and - to take into account the determined individual concentration profile over time, in particular the determined individual PK curve (PK _Ind ), when predetermining the level of one or more of the following application doses (D ₃ , D _n , D _n+1 , ...). nose applicator (100) after Claim 16 or 17 , wherein the control device (9) is further programmed, - when predetermining the level of the next application dose (D _n ), the set target concentration (C _ED ) or its minimum value and/or the determined individual concentration profile over time, in particular the determined individual PK curve ( PK _Ind ) to be considered. Nose applicator (100) according to one of the preceding claims, wherein the control device (9) is further programmed to - limit the level of the next application dose (D _n ) and/or the concentration resulting therefrom; - Limiting the cumulative level of all application doses delivered within a predetermined period of time (D ₀ , D ₁ , D ₂ , ..., D _n-1 , D _n , D _n+1 , ...) and/or the resulting concentrations ; and/or - limiting the cumulative amount of all delivered application doses (D ₀ , D ₁ , D ₂ , ..., D _n-1 , D _n , D _n+1 , ...) the resulting concentration, the control device (9) optionally accesses data relating to the substance (S) stored in the data memory (M).

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