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  Drug delivery apparatus and method for automatically reducing drug dosageRelated Patent Categories: Surgery, Controlled Release Therapeutic Device Or SystemDrug delivery apparatus and method for automatically reducing drug dosage description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20060047270, Drug delivery apparatus and method for automatically reducing drug dosage. Brief Patent Description - Full Patent Description - Patent Application Claims
RELATED APPLICATIONS [0001] This application is a CIP of U.S. application Ser. No. 11/069,573 filed on 28 Feb. 2005 which is incorporated herein by reference. This application claims the benefit of U.S. Provisional Application 60/604,999 filed on 27 Aug. 2004 which is incorporated herein by reference. FIELD OF THE INVENTION [0002] This invention relates generally to medical devices for delivering a medication, or drug, to a body site at flow rates and times specified by a stored drug delivery profile. More particularly, this invention relates to such devices which can operate to automatically gradually modify rates of drug delivery to achieve a desired target dosage. BACKGROUND OF THE INVENTION [0003] Various implantable drug delivery devices are known in the art which can be programmed to deliver a drug to a body site for infusion at flow rates and times dictated by a stored drug delivery profile. Such delivery devices typically include a refillable reservoir for storing a fluid drug and a controllable fluid transfer device (e.g., a pump or valve) for transferring fluid from the reservoir to a catheter for delivery to the body site. The drug delivery profile comprises a data set specifying a schedule of flow rates for a periodic cycle, or period, of a certain duration. For example, the duration of a period can be twelve hours, twenty four hours, or one week, etc. The particular profile used to control drug delivery is typically specified by the patient's clinician and depends upon several factors including the particular drug formulation being delivered, the patients condition, the therapy being administered, etc. [0004] The delivery profile is typically stored in the medical device at the time of implanting and can thereafter be modified by a clinician (using an external controller or programmer) when the patient periodically visits for a refill/checkup, e.g., once per month. [0005] In the course of certain drug therapies, it may be desirable to increase or reduce the drug dosage delivered to the patient. For example, in some situations, it may be helpful to reduce or terminate drug administration for a limited period in order to increase the patient's sensitivity to the drug. In still other situations, it may be desirable to terminate delivery of a drug as an initial step in preparation for changing the drug formulation. [0006] For illustrative purposes, in situations where a therapeutic decision has been made to reduce or eliminate delivery of a certain drug, it is generally desirable to reduce the drug dosage gradually. This gradual reduction, which is sometimes referred to as a detoxification procedure, is relatively easy to administer if the patient is available to the clinician on a frequent basis, e.g., daily. However, in the use of implanted drug delivery devices, patients typically visit their clinicians infrequently, e.g., once per month, and it has therefore been inconvenient and impractical to administer a drug modification program. The present invention is directed to an implantable drug delivery apparatus and method of operation which facilitates the automatic gradual modification, e.g., reduction of drug delivery over an extended interval, e.g., many days. SUMMARY OF THE INVENTION [0007] The present invention relates to a drug delivery device which includes a fluid drug reservoir, a catheter, a controllable fluid transfer device, e.g., a pump or valve mechanism, and a drug delivery controller. The controller, e.g., a microprocessor, is operable in accordance with the invention, to automatically gradually reduce the rate of drug delivery specified by a stored delivery profile from a current dosage value to a targeted final dosage value. [0008] In accordance with a preferred embodiment, dosage reduction is achieved over an interval comprised of multiple periods, where a period may, for example, comprise 4, 12, or 24 hours. An initial delivery profile specifies an initial delivery rate (or rates). Delivery rates for each subsequent period within the reduction interval are determined by applying a calculated reduction rate (typically a percentage) to the delivery profile for the preceding period. In this manner, the initial delivery profile is incrementally reduced in steps to ultimately achieve a delivery profile specifying the desired final dosage value. [0009] For example, in a preferred embodiment, a clinician may specify a final dosage value and the duration of the reduction interval (which can be expressed in number of periods). Based on this information and the initial dosage information contained in the stored initial delivery profile, a system in accordance with the invention operates to calculate a reduction rate which is then used to periodically reduce the delivery rates until the rates appropriate to the final dosage value are reached. [0010] The preferred embodiment also enables the clinician to alternatively specify a periodic (e.g., daily) dosage reduction rate thus enabling the system to then calculate the duration of the reduction interval (e.g., number of days). [0011] Although in many applications, it suffices to calculate and reduce delivery rates on a daily basis, it is recognized that for more rapid dosage reduction, or detoxification, delivery rates can be reduced more frequently by partitioning the 24 hour daily period into subperiods of, for example, 2 hours, 4 hours, or 8 hours. BRIEF DESCRIPTION OF THE FIGURES [0012] FIG. 1 is a block diagram of an exemplary medical system comprised of an implantable medical device, e.g., a drug delivery device, and an external communication device, or programmer; [0013] FIG. 2 is a schematic diagram of an exemplary implantable drug delivery device; [0014] FIG. 3A shows an exemplary initial drug delivery profile for a 24 hour period and successive reductions of said profile in accordance with the invention; [0015] FIG. 3B plots the daily dosage delivered to the patient with respect to FIG. 3A over the full reduction interval showing a reduction of delivery rate occurring once every 24 hours; [0016] FIG. 3C is similar to FIG. 3B but depicts the full reduction of delivery rate occurring once every four hours rather than once per day; [0017] FIG. 4 is a flow chart depicting an algorithm executable by an external programmer for producing data for an implanted drug delivery device to enable the device to gradually reduce the dosage, i.e., rate of drug delivery, to the patient; and [0018] FIG. 5 is a flow chart executable by the implanted drug delivery device. 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