Inhaler with discrete motion interacting to lid motion. RU patent 2513154.

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine, and in particular to a medical dispenser comprising an outlet and closed compartments containing a drug that are used for sequential alignment with the above outlet and dispensing through the above outlet; the invention also relates to a method of digital motion of the medical dispenser. The drive motion leads to an accumulation of the mechanical energy, and then a release of the mechanical energy, and conversion it into the discrete motion of the compartments.

EFFECT: structural improvement.

14 cl, 11 dwg

THE TECHNICAL FIELD

The present invention relates to the medical device distribution containing outlet and closed departments containing medicinal product, which should be consistently combined with the specified discharge and the distribution of which must be made within a specified outlet. The invention also relates to a method of discrete move for medical device distribution.

BACKGROUND OF THE INVENTION

There are different kinds of medical devices distribution, such as packaging or device to make the distribution of tablets, ointments or inhaled substances, to name only a few. Some devices are hand made with one or more sealed compartments containing drug. Such offices may take the form of blisters, pockets or containing oral strips attached to the sealing strip, or other suitable form.

Taking into consideration the medical device distribution, made in the form of inhalers, on the market there are different types of devices of the hand. Dosing inhaler under pressure (pMDI) produces a fixed dose of a substance in the form of aerosol. Powder inhaler usually produces dose poroshkoobraznye substances, captured in the air stream. In powder inhaler powder remedy may be provided in the bulk container inhaler, which dose powder funds are to implement the deal. As an alternative volumetric container, powder inhalers may contain one branch or a large number of branches for the content of discrete dose powder.

Powder inhaler containing a large number of branches that contain discrete number of doses of the powder substances typically contain any indexing mechanism to move offices consistently in position for inhalation, as well as any opening mechanism to provide access to the substance contained in the offices. Although some inhalers provide short discrete move in the opposite direction, i.e. moving offices in the direction opposite to the normal direction of use, this may be undesirable in combination with certain types opening mechanisms, for example, because of the risk of interaction between a. Conventional discrete move forward in the inhaler, as a rule, can be initiated by any drive unit, such as an arm or cover outlet, which leads to move offices. If the actuator moves on the part of the distance, there is a risk of "half discrete movement", i.e. separation is not moved to the specified distance in full. This, in turn, can lead to the wrong dose. Besides the fact that these shortcomings are present in the inhalers, the disadvantages of reverse discrete move and half discrete move may also have other types of medical devices distribution. It would be desirable to provide medical device distribution and the method of discrete movement, in which you can avoid manifestations of inverse discrete move and/or half discrete move.

SUMMARY OF THE INVENTION

The aim of the present invention is to eliminate the disadvantages of medical devices distribution. This and other objectives, which will become apparent from the following description, achieved inhaler and in the manner defined in the appended claims.

The present invention also based on the understanding that the useful power created by the movement of the actuator, can be temporarily stored and used later. Choosing what time should be used retained power, achieved the required control. Thus, instead of complete discrete moving almost simultaneously with (direct drive) moving the drive specified discrete move could be delayed. For example, the output power created by the movement of the actuator may only be used when the drive is moved to the specified distance, in particular capacity can be used for the specified discrete move. Thus, if the user moves the drive only halfway, and then back, it will not happen discrete move that provides the ability to troubleshoot problems with discrete backward and a half. By delaying the use of effective power created by the movement of the drive, you can develop an indexing mechanism with two possible modes: mode without discrete move and full of discrete movement.

In accordance with the first aspect of the invention provides medical device distribution. The device distribution contains:

sealed compartment containing medicinal product intended for progressive alignment with the specified discharge and implementation of distribution after a specified outlet,

the drive is made with the possibility of moving between the first position and the second position,

this move actuator from the first position to the second position leads to the accumulation of mechanical energy, and when the drive second position accumulated mechanical energy is released and converted into a discrete moving offices.

Thus, although discrete moving functionally connected with the movement of the actuator, and is not essentially a parallel action, discreet movement is delayed until then, until the drive has moved at a distance. Although you could use the drive only for refueling indexing mechanism, and then manually use a separate component for release indexing mechanism, the present invention achieves delays automatically as the delay is controlled depending on the mounting position. Specified the second position can be properly positioned along the length of the travel drive. For example, by placing the specified second position at the end of the maximum permissible displacement drive, or near the discrete move will only happen if the user terminates or almost complete, affordable moving the drive. This can be useful in several ways. For example, if you move the drive also affects the opening of a branch of a mechanism, through the appropriate location specified the second position can be selected sequence according to which moved the various components.

The increase of mechanical energy can be envisaged as a continuous increase or accumulation of energy. Thus, until the actuator continues to move in the direction of the second situation, the energy accumulation continues. However, increasing mechanical energy can be as alternative, provided as initial growth energy during the first part of the move towards the second position of the drive, and then this energy is simply supported without increasing during the remaining part of the move towards the second position.

According to at least one illustrative option of carrying out the invention medical device distribution contains:

an indexing mechanism, designed for serial combining offices from the outlet and functionally connected with the drive, this mechanical energy is stored in indexing mechanism, and

opposing element with opposing position in which opposing element temporarily prevents the release of the specified mechanical energy, and releasing the position in which mechanical energy is released, resulting an indexing mechanism has the possibility to promote the separation forward,

while opposing element is functionally connected to the drive so that the opposing element reaches the specified releasing position, the actuator reaches the specified second position.

By providing a specified opposing element with releasing a position that is associated with the specified second position actuator is achieved visible and predictable release of mechanical energy. Although disclosed in this document opposing element provides certain advantages, possible alternatives for the release of mechanical energy. For example, there may be retarding element that sets the threshold force that must be overcome indexing mechanism. When the drive reaches its second position, indexing mechanism had had enough of power to force retarding element, which is greater than a specified threshold forces, resulting in a delay element misses an indexing mechanism, which allows discrete travel and accommodation next branch in combination with the outlet.

In this application, the expression "in combination with the outlet" should be understood as the location of the branch in the position to introduce contained drugs through the outlet. In the case when the medical device distribution is made in the form of a device, the expression "in combination with the outlet" should be understood as providing a branch in position for inhalation contained in the medicinal product from the outlet while the outlet can be a mouthpiece or nasal adapter.

Mechanical energy can be accumulated in various types of structures, such as construction, containing a piezoelectric components or roaming hard components, such as levers. According to at least one illustrative option perform indexing mechanism contains the spring, in which is stored the specified mechanical energy. The term "spring" should be understood in a broad sense. Thus, it includes any elastic object that is designed to store and provide energy in different ways. Spring can be made from any right of elastic material, e.g. metal, such as steel alloys, or rubber or plastics, etc. to name just a few possible alternatives, the spring can be a torsional spring, coil spring, leaf spring, compression spring, the spring tension, etc. but it can also be a piece of rubber that is compressed, and then when you release of stored energy affects other part is an indexing mechanism.

According to at least one illustrative option perform specified indexing mechanism contains the actuator, which is made with the possibility of interaction with branches or design, support Department, with the actuator connected to the spring so that when the counter reaches the specified element releasing provisions, accumulated in the spring of mechanical energy is transferred with the help of the driving element in the Department. Spring can either be attached to the drive element at the time of the release of mechanical energy, or it can be in constant contact with a driving element. In the latter case, when the spring becomes cocked, the actuator will be more and more force to move forward Department, but the strength of opposing element will interfere with such moves. Thus, the Department or the specified design supporting departments, will tend to move forward in the direction of discrete move. Although the use of driving element was discussed in detail above, the alternative would be to have a spring in direct contact with branches or design, support Department, without intermediate driving element.

According to at least one illustrative option execution when opposing element is specified opposing position, he is also in fixing contact with one or more branches or with a design supporting departments. Thus, opposing element directly prevents discrete moving offices. The alternative would be to have opposing element in the fixture contact either with a driving element, or spring, indirectly preventing discrete moving offices.

According to at least one illustrative option perform medical device distribution contains a rotatable disk, holding these offices, and in the specified opposing position opposing element interacts with the drive to prevent it from turning. It should be understood that opposing element can also be applied in other movable structures that carry the drug, such as strips, blister packs, etc. Similarly, although a circular disk provides certain advantages, opposing element can be applied for construction of any form, for example rectangular, cylindrical, etc.

According to at least one illustrative option perform medical device the distribution contains the guide, which moves together with the actuator, and counter element contains the brake, designed to prevent the movement of branches, and witness element, which is connected with brake and move along this guide in response to move the drive, and when the witness item reaches the point of release attached brake is released. The guide can be performed in various ways, for example, on a movable wall or pasting within the medical device distribution, the actuator is connected with moving wall or insert. The guide can be made in the form of a long groove that fits in the mating part witness element. Alternatively, the guide can be a long rail that has coupled the part of the witness of the element.

Although the above option is performing contains the guide, which interacts with opposing element, moving opposing element of its counter position in releasing his position can be achieved in other ways. For example, when the actuator reaches the second position, it can interact with lever or switch that operates on counteracting item to move it to the unlock position.

In order to reduce the risk of slippage, that is moving offices at once by more than one step to wards (approximately equal to the distance between adjacent units), may provide the means, which limit the freedom of movement. This is reflected in at least one illustrative embodiment, in accordance with which the locking element that during the specified discrete movements made with the possibility of interaction with branches or with the design, support Department, in order to limit specified move. The locking element may contain a dog or any other suitable component. Thus, while opposing the item is moved to releasing their position, thus providing the ability to convert stored mechanical energy in discrete moving, locking element will limit the degree of discrete move.

Drives can contain any suitable type of control by the user of the medical device distribution, such as a button, lever, handle or the like. However, some medical devices distribution equipped with a cap outlet, which is made with the possibility of opening and closing the outlet of the device hand. Although there may also be provided and a separate drive, cap outlet can be properly included in the actuator. Thus, either the opening or closing movement can be used to create the specified mechanical energy, which must be converted to a discrete move. This is reflected in at least one illustrative embodiment, in accordance with which drive contains the cover outlet, made with the possibility of opening and closing the outlet.

According to at least one illustrative option to run a specified move actuator from the first position to the second situation involves moving cover outlet in direction close outlet. It should be noted that the second position actuator does not run with a fully closed with outlet with the help cover outlet. The second regulation actually can be achieved before the outlet will be closed with a lid and discharge. None less in the specified case the execution of the direction of movement is such that moving cover outlet in direction close is to accumulate the specified mechanical energy and then on the way to the closing (or the full closure) that created the mechanical energy is to escape. It can be named as "discrete move on close". Alternatively, you can also provide that instead used "discrete move when you open". This will mean that the cover outlet has moved in the direction from closed to open position to create the specified mechanical energy (for example, the first position is fully closed the outlet, and the second position reflects, at least partially, vent opening).

According to at least one illustrative option perform medical device distribution represents an inhaler for inhalation substances. The inhaler may appropriately be a powder inhaler with discrete doses of inhaled medicines in the specified branches. The outlet can be made as a mouthpiece or nasal adapter.

(ii) antagonists chemokines: WH (monohydrochloride (2R)-1-|[2-[(aminocarbonyl)amino]-4-chlorophenoxy]acetyl]-4-[(4-torfanil)methyl]-2-metilpiperazina), SSH, N-{2-[((23)-3-{[1-(4-Chlorobenzyl)piperidine-4-yl]amino}-2-hydroxy-2-methylpropyl)oxy]-4-hydroxyphenyl}ndimethylacetamide (see WO 2003/051839) and 2-{2-chloro-5-{[(28)-3-(5-chloro-1 N, 3H-Spiro[1-benzofuran-2,4'-piperidine]-1'-yl)-2-hydroxypropyl]oxy}-4-[(methylamino)carbonyl]fenoxi}-2-methylpropanol acid (see WO 2008/010765), 656933 (N-(2-bromophenyl)-N'-(4-cyano-1 N-1,2,3-benzotriazole-7-yl)urea), 766994 (4-({[({[(2R)-4-(3,4-dichlorobenzyl)morpholine-2-yl]methyl}amino)carbonyl]-amino}methyl)benzamide), MHS-282, MHS-915, cyanovirin N, E-921, INCB-003284, INCB-9471, maraviroc, MLN-3701, MLN-3897, T-487 (N-{1-[3-(4-metoxifenil)-4-oxo-3,4-dihydropyrido[2,3-d]pyrimidine-2-yl]ethyl}-N-(pyridine-3-ylmethyl)-2-[4-(cryptonetx)phenyl]ndimethylacetamide) and vicriviroc;

(iii) corticosteroids: alklometazon dose, aminometano, beclomethasone, budesonide, BootExecute propionate, ciclesonide, clobetasol propionate, diisobutylamine, adiprene delloutlet, fluoqinolona acetonide, fluticasone furoate, fluticasone propionate, loteprednol etabonate (for local use) and mometasone furoate;

(iv) antagonists DP1: L888839 and MC;

(v) inductors discontinueties: ADC4022, aminophylline, methylxanthines, or theophylline;

(vi) IKK2 inhibitor: 2-{[2-(2-methylamino-pyrimidine-4-yl)-1H-indole-5-carbonyl]-amino}-3-(phenyl-pyridine-2-yl-amino)-propionic acid;

(vii) inhibitors SOKH: celecoxib, diclofenac sodium, etodolac, ibuprofen, indometacin, meloxicam, nimesulide, OS, OS, OS, OS, OCD9101, parecoxib sodium, piceatannol, piroxicam, rofecoksib, valdecoxib;

(viii) lipoxygenase inhibitors: Agalakova acid, Albuferon, terbutaline mesilate, dexibuprofen-lysine (monohydrate), atalii sodium, licofelone, linetest, manapalan, misoprostol, MN-001, tepoxalin, UCB-35440, valivedon, ZD-2138, ZD-4007 and zileuton ((+or -)- 1-(1-benzo[b]Tien-2-ileti)-1-hydroxyurea);

(ix) antagonists leukotriene receptor: alucast, isalocal (CGP A), montelukast, montelukast sodium, antitrust, pranlukast, pranlukast hydrate (monosodium salt), berlukas (MK-679) and zafirlukast;

(x) inhibitors lros: derived hydroxamic acid (M-(4-chloro-2-methyl-phenyl)-4-phenyl-4-[[(4-propan-2-elpanel)sulfanilamida]methyl]-piperidine-1-carboxamide), piceatannol and resveratrol;

(xi) agonists beta2-adrenergic receptors: metaproterenol, isoproterenol, izoprenalin, albuterol, salbutamol (for example, in the form of sulfate), formoterol (for example, in the form of fumarata), salmeterol (for example, in the form of xinafoate), terbutaline, ortsiprenalin, bitolterol (for example, in the form of nelfinavir), pirbuterol, indacaterol, salmeterol (for example, in the form of xinafoate), bambuterol (for example, in the form of hydrochloride), carbatrol, indacaterol (CAS number 312753-06-3; QAB-149), derivatives formanilide, such as 3-(4-{[6-({(2K)-2-[3-(formylamino)-4-hydroxyphenyl]-2-hydroxyethyl}-amino)hexyl]oxy}-butyl)-benzosulphate; 3-(4-{[6-({(2K)-2-gidroksi-2-[4-hydroxy-3-(hydroxy methyl)phenyl]ethyl}amino)hexyl]oxy}butyl)-benzosulphate; GSK 159797, GSK 159802, GSK 597901, GSK 642444, GSK 678007; and compound selected from N-[2-(diethylamino)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-3-[2-(1-naphthyl)etoxi]propanamide, N-[2-(diethylamino)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-3-[2-(3-chlorophenyl)-etoxi]propanamide, 7-[(1R)-2-({2-[(3-{[2-(2-chlorophenyl)ethyl]amino}propyl)thio]-ethyl}amino)-1-hydroxyethyl]-4-hydroxy-1,3-benzothiazole-2(3H)-she and N-cyclohexyl-N 3 -[2-(3-torfanil)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-b-laninabina, or its pharmaceutically acceptable salt (for example, where the counterion represents hydrochloride (for example, monohydrochloride or dihydrochloride), hydrobromide (for example, monogidrohlorida or dihydrobromide), fumarate, methanesulfonate, econsultant, benzosulphate, 2,5-dihlorbenzolovy, para-eluasemefond, napadenie (naphthalene-1,5-disulfonate or naphthalene-1-(sulfonic acid)-5-sulfonate), Etisalat (ethane-1,2-disulfonate or ethane-1-(sulfonic acid)-2-sulfonate), D-mandelate, L-mandelate, cinnamal or benzoate);

(xii) muscarinic antagonists: acridine bromide, glycopyrrolate (such as R,R, R,S, S,R - or S,S-glycopyrronium bromide), oxytrope bromide, pirenzepin, taenzerin, Tiotropium bromide, 3(R)-1-phenethyl-3-(N-xanthene-9-carbonyloxy)-1-isolabella[2.2.2]octane bromide, (3R)-3-[(2S)-2-cyclopentyl-2-hydroxy-2-Tien-2-racetaxi]-1-(2-phenoxyethyl)-1-isolabella[2.2.2]octane bromide, Quaternary salt (such as [2-(R)-cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-(3-phenoxy-propyl)-ammonium salt, [2-(4-chloro-benzyloxy)-ethyl]-[2-(P-cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-ammonium salts and salt (R)-1-[2-(4-fluoro-phenyl)-ethyl]-3-(S)-2-phenyl-2-piperidine-1-yl-propenyloxy)-1 Azania-bicyclo[2.2.2]octane, where the counterion is, for example, chloride, bromide, sulphate, methanesulfonate, benzosulphate (besilat), eluasemefond (toilet), naphthalenesulfonate (napadenie or Hemi-napadenie)phosphate, acetate, citrate, lactate, tartrate, mesilate, malate, fumarate, or succinate);

(xiv) inhibitors PDE: 256066, aerofillin (3-(4-chlorophenyl)was 3.7-dihydro-1-propyl-1H-purine-2,6-dione), AWD 12-281 (N-(3,5-dichloro-4-pyridinyl)-1-[(4-torfanil)methyl]-5-hydroxy-alpha-oxo-1H-indole-3-ndimethylacetamide), BAY19-8004 (Bayer), CDC-801 (Calgene), the connection Celgene ((βR)b-(3,4-acid)-1,3-dihydro-1-oxo-2H-isoindole-2-propanone), cilomilast (CIS-4-cyano-4-[3-(cyclopentyloxy)-4-methoxyphenyl]-ciclohexencarboxilic acid, 2-(3,5-dichloro-4-pyridinyl)-1-(7 metasepia[1,3-benzodioxol-2,1'-cyclopentane]-4-yl)Etalon (CAS number 185406-34-2)), (2-(3,4-diference)-5-fluoro-N-[CIS-4-[(2-hydroxy-5-methylbenzoyl)amino]cyclohexyl])-3-pyridinecarboxylic), (2-(3,4-diference)-5-fluoro-N-[CIS-4-[[2-hydroxy-5-(hydroxymethyl)benzoyl]-amino]cyclohexyl]-3-pyridinecarboxylic), ST, GPD-1116, ibudilast, 1C 485, KF 31334, KW-4490, liimist ([2-(2,4-dichlorobenzoyl)-6-[(methylsulphonyl)oxy]-3-benzofuranyl])-urea), (N-cyclopropyl-1,4-dihydro-4-oxo-1-[3-(3-pyridinylmethyl)phenyl])-1,8-naphthiridine-3-carboxamide), (N-(3,5-dichloro-4-pyridinyl)-4-(deformitate)is 8-[(methylsulphonyl)amino])-1-dibenzofuranes), ON06126, ORG 20241 (4-(3,4-acid)-N-hydroxy)-2-diazocarbonyl), PD 189659/PD168787 (Parke-Davis), pentoxifylline (3,7-dihydro-3,7-dimethyl-1-(5-oxohexyl))-1 N-purine-2,6-dione), connection (5-fluoro-M-[4-[(2-hydroxy-4-methyl-benzoyl)amino]cyclohexyl]-2-(Tian-4-yloxy)pyridine-3-carboxamide), pikemalt (3-(cyclopentyloxy)-M-(3,5-dichloro-4-pyridinyl)-4-methoxy-Bensaid), PLX-369 (WO 2006026754), roflumilast (3-(cyclopropylmethoxy)-N-(3,5-dichloro-4-pyridinyl)-4-(deformitate)benzamide), SCH 351591 (N-(3,5-dichloro-1-oxide-4-pyridinyl)-8-methoxy-2-(trifluoromethyl)-5-hinolincarbonova), SelCID(TM) CC-10004 (Calgene), T-440 (Tanabe), tecomelt (6-[2-(3,4-dioxyphenyl)-4-thiazolyl]-2-piridinkarbonovaya acid), topkill (9-cyclopentyl-7-ethyl-6,9-dihydro-3-(2-thienyl)-5H-pyrazolo[3,4-C]-1,2,4-triazolo[4,3-a]pyridine), TPI 1100, UCB 101333-3 (N,2-dicyclopropyl-6-(hexahydro-1H-asain-1-yl)-5-methyl-4-pyrimidinone), V-A (Napp), VM554/VM565 (Vernalis and sardarin (6-[4-(deformitate)-3-methoxyphenyl]-3(2H)-pyridazinone);

(xv) PDE5 inhibitors: gamma-glutamyl[s-(2-iogansen)cysteinyl]glycine, tadalafil, vardenafil, sildenafil, 4-phenyl-methylamino-6-chloro-2-(1-imidazolyl)-chinazoline, 4-phenyl-methylamino-6-chloro-2-(3-pyridyl)-chinazoline, 1,3-dimethyl-6-(2-propoxy-5-methanesulfonamide)-1,5-dihydropyrazolo[3,4-d]pyrimidine-4-one and 1-cyclopentyl-3-ethyl-6-(3-ethoxy-4-pyridyl)-pyrazolo[3,4-d]pyrimidine-4-one;

(xvi) agonists PPARγ: pioglitazone, pioglitazone hydrochloride, rosiglitazone maleate, rosiglitazone maleate ((-)-enantiomer, free base), rosiglitazone maleate/Metformin hydrochloride and tesaglitazar;

(xvii) the protease inhibitors: a inhibitor Alfa-anticipating, EPI-HNE4, UT-77, ZD-0892, DPC-333, Sch-709156 and doxycycline;

(xviii) statins: atorvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin;

(xix) antagonists thromboxane: remateran and stratatest;

(xx) vasoconstrictor agents: A-306552, ambrisentan, avosentan, BMS-248360, BMS-346567, BMS-465149, BMS-509701, bosentan, BSF-302146 (ambrisentan), a peptide that is linked with the gene of calcitonin, dellutil, darusentan, potassium fundamental, fasudil, iloprost, KS-12615 (dellutil), COP-12792 AV (dellutil), liposomal treprostinil, PS-433540, sitaxentan sodium, Ferula sodium, FA-11241 (sitaxentan), FA-3214 (N-(2-acetyl-4,6-dimetilfenil)-3-[[(4-chloro-3-methyl-5-isoxazol)amino]sulfonyl]-2-thiophencarboxamide), FA-3711, trapidil, treprostinil of diethanolamin and treprostinil sodium;

(xxi) ENAC: amiloride, benzagel, triamteren, 552-02, PSA14984, PSA25569, PSA23682 and AER002.

The inhaler may contain a combination of two or greater number of active ingredients, such as a combination of two or more specific active ingredients listed above in (i)-(xxi).

In one embodiment, the inhaler contains the active ingredient selected from mometasone, ipratropium bromide, Tiotropium and its salts, salmeterola, fluticasone propionate, beclomethasone dipropionate, reproterol, clenbuterol, rofleponide and salts, nedocromil, sodium kromoglikatom, flunisolide, budesonide, formoterol fumarata dihydrate, terbutalina, terbutalina sulfate, salbutamol the grounds and sulfate, fenoterola, 3-[2-(4-hydroxy-2-oxo-3H-1,3-benzothiazole-7-yl)ethylamino]-N-[2-[2-(4-(were)etoxi]ethyl]propanesulfinamide hydrochloride, indacaterol, acridine bromide, N-[2-(diethylamino)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-3-[2-(1-naphthyl)etoxi]propanamide or pharmaceutically acceptable salts (for example, dihydrobromide); N-cyclohexyl-N 3 -[2-(3-torfanil)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-b-laninabina or pharmaceutically acceptable salts (e.g., di-D-mandelate); salt [2-(4-chloro-benzyloxy)-ethyl]-[2-(R)-cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-ammonium (for example, Hemi-naphthalene-1,5-disulfonate); salts (R)-1-[2-(4-fluoro-phenyl)-ethyl]-3-(S)-2-phenyl-2-piperidine-1-yl-propenyloxy)-1 Azania-bicyclo[2.2.2]octane (for example, bromide or toluensulfonate); or a combination of any two or more of these ingredients.

Specific combinations of active ingredients that can be included in the inhaler include:

(a) formoterol (for example, in the form of fumarata) and budesonide;

(b) formoterol (for example, in the form of fumarata) and fluticasone;

(g) N-[2-(diethylamino)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-3-[2-(1-naphthyl)etoxi]propanamide or pharmaceutically acceptable salt (for example, dihydrobromide) and g (R)-1-[2-(4-fluoro-phenyl)-ethyl]-3-((S)-2-phenyl-2-piperidine-1-yl-propenyloxy)-1 Azania-bicyclo[2.2.2]octane (for example, bromide or eluasemefond);

(e) N-cyclohexyl-N 3 -[2-(3-torfanil)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-beta-alanine or pharmaceutically acceptable salt (e.g., di-D-Mandela) and salt [2-(4-chloro-benzyloxy)-ethyl]-[2-(R)-cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-ammonium (for example, Hemi-naphthalene-1,5-disulfonate);

(e) N-cyclohexyl-N 3 -[2-(3-torfanil)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-beta-alanine or pharmaceutically acceptable salt (e.g., di-D-Mandela) and g (R)-1-[2-(4-fluoro-phenyl)-ethyl]-3-(S)-2-phenyl-2-piperidine-1-yl-propenyloxy)-1 Azania-bicyclo[2.2.2]octane (for example, bromide or eluasemefond).

In accordance with the second aspect of the invention is offered the method of discrete move to the medical device distribution containing the containing the drug Department, the method includes a continuous build-up of mechanical energy, interruption of continuous increase by liberating the specified mechanical energy and convert the specified released mechanical energy in discrete move these offices.

In accordance with the third aspect of the invention is offered the method of discrete move for medical device distribution containing the containing the drug Department and the drive, and the method includes move the specified drive that consistently leads to the build-up of mechanical power, then release and transformation of mechanical energy in discrete moving offices.

It should be understood that the methods of the second and third aspects of the invention cover and can be implemented with any variant of execution or from any signs described in connection with the medical device distribution in accordance with the first aspect of the invention, if these options make or symptoms compatible with the methods of the second and third aspects.

BRIEF DESCRIPTION OF DRAWINGS

Figure 1 is a medical device distribution, made in the form of an inhaler, unassembled in accordance with at least one illustrative option of carrying out the invention.

Figure 2 represents the context of individual parts of the nebulizer.

Figure 3 represents the context of individual parts of the nebulizer during the distribution of medicines from the nebulizer.

Figure 4-8, and 11 represent the views of different parts of the nebulizer, including details associated with the discrete move.

Figure 9 represents the context of individual parts of the inhaler before performing the discrete move.

Figure 10 represents the context of individual parts of the nebulizer after performing a discrete move.

A DETAILED DESCRIPTION OF THE DRAWINGS

Before a detailed description of the different parts illustrated medical device distribution provides a brief introduction focused on inventive concept in relation illustrated illustrative scenarios. Accordingly, medical device distribution, made in the form of an inhaler 2, contains the final hole, made in the form of a tip of 10 (see Figure 1). The basis of 14 has a large number sealed the offices located in the form of sealed cavities 16, which are consistent with the possibility of combining with a mouthpiece 10 and with possibility hand over the mouthpiece 10. Drive, in this embodiment, the containing cover 12 mouthpiece and insert 38, made with the possibility of moving between the first position (mouthpiece 10 is not closed) and the second position (mouthpiece 10 closed or nearly closed). The closing movement covers 12 mouthpiece also moves the insertion 38. Box 38 connected with an indexing mechanism containing the spring 52 torsion in which mechanical energy is accumulated in the result of closing movement covers 12 mouthpiece. Spring 52 torsion is connected with a drive item 54 for discrete move cavity 16 (see Fig-10). Opposing element, made in the form brakes 74, is opposing position, preventing discreet movement. Brake 74 contains the witness item 78, which moves along the guide 80 mobile insert 38 (see 11). When the witness item 78 reaches the point of release guide 80, brake 74 will move in releasing its position, which is achieved simultaneously with the achievement of the drive specified the second position. Mechanical energy thus released, and the actuator 54 can perform discrete move. Next will be given a more detailed description of the medical device distribution.

Figure 1 depicts the medical device distribution, made in the form of an inhaler 2, unassembled in accordance with at least one illustrative option of carrying out the invention. Inhaler 2 contains a node 4 distribution of doses that have on the whole disk configuration, the upper part 6 of the casing, the lower part 8 casing outlet presented in this embodiment in the form of a tip of 10, and the cover 12 outlet. In addition to performing the function of alternate opening and closing outlet cover 12 also performs the function of an actuator for accumulation of mechanical energy, as will be explained next.

Site 4 distribution dose contains all the base 14, which has a large number of cavities 16, consistently along all of continuing basis. Cavity 16 may contain drug, for example, in the form of powder and sealed foil 18, thus providing a tightly closed departments. Thus, the basis of 14 forms design to maintenance departments. Foil 18 is either part of one overall foil, or provided as separate segments. In the example shown to limit foil 18 and to facilitate the separation from the Foundation of the 14 provides perforation. Above each cavity 16 relevant United with her dividing element 20 attached to the top of the foil 18. Separators 20 are connected using any suitable type of connection, welding, gluing, etc. to the relevant parts of foil 18. Upward movement or lifting the separation of item 20 causes attached foil 18 becomes separated from the cavity 16.

Ring guide structure 22 is located above the dividing elements 20. Guide structure 22 contains a large number of guides sections 24, divided vertically through the walls, with each guide section 24 connected to the dividing element 20. When dividing element 20 raised from holding cavity Foundation 14, appropriate directing section 24 will guide move the dividing element 20. Each rail section 24 supplied neutralizing element, such as plate spring 26. After dividing element 20 was raised, and the medicinal product in open cavity 16 were involved in inhaled air flow, and the separator item 20 returned to the base 14, plate spring 26 raised will support the separator item 20 in contact with the ground from 14 to close cavity 16. This will complicate the output of any remaining powder coated used cavity 16, thus reducing the risk of fluctuations in doses that could occur if such remaining powder would be involved in the follow inhalation. It also reduces the risk of remaining powder from the cavity 16 and jamming of the mechanical components in the inhaler or the risk of creating a dividing element noticeable noise, which is undesirable for the user. Vertical walls that separate guide ring structure on 22 guides section 24, act as elements that restrict lateral flow path. Thus, inhalation, the air stream has no deviations to the side as soon as it reaches the area of cavities Foundation 14, and will be redirected to the mouthpiece 10. An alternative would be doing more short vertical walls, and in this case the neighbouring separation elements 20 could perform the functions of the elements that restrict lateral flow path.

Each separator item 20 is covering the ground of part 28, which is in alignment with the corresponding cavity 16 at the base. In addition, each separator item 20 is protruding in the Central part 30. Also includes the opening mechanism, containing raising item 32 for lifting the separation of 20 items. Raising element in this embodiment, the presents in the form of the turning lever is equipped with a grip 34 to capture serving Central part 30 dividing elements 20. Raising item 32 has cocked position (Figure 2 and 6), in which the capture 34 is in the down position, and after turning around a rotary axis 36 not filled the position (Fig 3 and 7), which capture 34 is in the raised position. Raising item 32 with his capture 34 made with the possibility of rotation around the horizontal axis 36 and, thus, still facing the mouthpiece 12 during operation inhaler 2.

Returning to Figure 1, box 38, with an overall the form of a disk, provided under the upper part 6 of the casing. The upper side of the insert 38 has two 40 pin. Pins 40 pass up through the appropriate arched openings 42, made in the upper part 6 cover, and connect with cover 12. When the cover 12 turns, 40 pins through the arched openings 42 will inform moving box 38, which also will turn around. Bottom insert 38 is equipped with the first transmission of force element, which in this scenario is shown in the form of Cam 44 (see Figure 4), which converts the rotary movement in straightforward the force acting on the capture 34 raising item 32 to return raising item 32 of its nezapravlennaya position in his cocked position. When Cam 44 comes into contact with capture 34 raising item 32 (see Figure 5)raising item 32 begins to move in the radial direction separation item 20 and also starts to rotate around its rotary axis 36. In addition, capture 34 falls tucked in, or cocked position raises item 32 (see Figure 2). Lowering capture 34 will be done against force coil springs 46, which pojata to raise capture 34 in nezapravlennaya position. Spiral spring 46 wrapped around 48 hours, going up from the bottom of part 8 of the casing.

As shown in figure 4, 6 and 7, the lower side of the insert 38 also provided speakers second transmitting force element 50, which is made with the possibility of interaction with the end of the spring 52 torsion located under a heavy spring 46 and wound up on the same rack 48. Spring 52 torsion is connected with a drive item 54 for the implementation of the rotary promotion cavities 16 at a time in one step so that every time lead to a closed cavity in combination with the mouthpiece 10. The actuator is best shown in Fig, 9, 10 and 11.

To keep raising element in the cocked position provides the latch 56, which is clearly seen in figure 2. The latch 56 contains the first element, made in the form of elongated pillars 58, and the second element, made in the form valve 60. Ottoman extension 58 is the first end part 62, which is made with the possibility of rotation around the first horizontal axis 64 near the end of lifting item 32, which is located distal relatively mouthpiece 10 (capture 34 is proximally relatively mouthpiece 10). Ottoman extension 58 has a second terminal part 66, made with the possibility of maintaining valve 60. Valve 60 made with the possibility of rotation around the second horizontal axis 68. The valve closes a number of intakes 70 (Fig.1-3), provided in the lower part 8 of the casing. This permits the admission of air in a nebulizer 2 through these intakes 70, when the user performs breathe through a mouthpiece 10 (outlet).

In another embodiment, the (not shown on the drawings) item 72 may be replaced by a spring located in box 38. This spring can be a steel spring, installed, for example, on a small ledge above the supports 58, for preload bearing in basically the same as the item 72.

Thus, in order to enter the dose, the user performs breath, creating sufficient air flow for lifting valve 60 against actions clamped forces. This is illustrated in Figure 3. When the valve is 60 rises air flow and rotates around the second axis 68 (clockwise figure 3), involving the valve to 60, located on the other side of the axis, is lowered, resulting in a second terminal part 66 support 58 losing support. This leads to the fact that relying 58 rotates around the first axis 64 (counterclockwise figure 3) and "roll out" of the adjacent parts of the valve 60. The latch 56 is now in its second position in which he provides the ability to move raises item 32 specified in nezapravlennaya position. Thus, the accumulated energy spiral springs 46 moves released currently raising item 32. Raising item 32 will be rotated around its axis 36, with the capture of 34 will rise, resulting geared dividing element 20 rises from the base 14. Foil 18 remains attached to a separating element 20, thus opening the cavity 16, containing the drug. Figure 1 using the dotted line shows the separator item 20, raised capture 34 raising item 32.

It should be understood that the design of illustrative inhaler 2 involves the use of a phenomenon called principle cavity, which is driven by the shift during disaggregation of powder in the cavity 16 and empty the powder from this cavity. Cavity driven shift, is a model for flow in a cavity in which the upper bound is moved in the desired direction of flow and thereby causes a rotation in the cavity. Figure 2 illustrates the cavity 16 containing a powder of medicinal product that has appropriate free space above the powder. Figure 3 inhalation, the air flow is shown passing specified free space along the field flat surface, with the specified flat area on the surface contains a hole in the cavity 16, containing the powder. Horizontal passage inhalation of air flow leads to the accumulation of a vortex flow of air in the cavity 16, leading to the disaggregation of powder and removal of the powder from the cavity 16. Cavity 16, as a rule has the form of bricks, and the hole cavity has the edge on which side of the cavity outside the flat area of a surface in a flow passage. Accordingly, the air flow with the passage past a cavity in flow passage preferably runs parallel to the plane, which coincides with the edge of the hole cavity in flow passage.

Though, after it was carried out the distribution of dose, valve 60 may come back in the down position, capture 34 raising item 32 will remain in nezapravlennaya position (see, for example, 7), until you fill up the inhaler to effect the distribution of the next dose.

Although inhaler refill 2 can be connected either by opening or closing the lid 12, in this illustrative embodiment assumes that the lid is closed 12 runs inhaler 2. Thus, when the user has been inhalation dose (Fig 3 and 7), he closes the lid 12 to close the mouthpiece 10 (Figure 1). Although the cover 12 can be done in different ways closing, such as linear or manual way, in this illustrative embodiment, the cover 12 turns to close the mouthpiece 10. At the time of such closing the lid 12 attached insert 38 with your speakers delivering force element 50 and Cam 44 causes lowering of seizure 34 raising item 32, counteracting force coil springs 46 (Figure 5), and rotate the base 14, thereby following a closed cavity 16 to capture 34. Box 38 helped by clicking on supporting the position of the item 72 supports 58, leading to the return of the lock 56 to his first position, which prevents the lifting lifting item 32 capture 34. After that, when the user opens the lid 12 to take the next dose, box 38 will go around the other side without affecting fixed and cocked raising item 32. Inhaler 2 now dressed (cocked and ready to be activated when the user performs breathe through a mouthpiece 10, allowing initiated by the breath of raising foil 18 of the cavity 16.

In order to reduce the risk of fixing raising item 32 in the cocked position without having to combine unopened cavity 16, prevented the return of the lock 56 in the first locked position until the next cavity combined with a mouthpiece 10. In addition, in order to reduce the risk of slippage, i.e. the passage of a fluid past 16 mouthpiece 10 without opening cavity 16, provides an indexing mechanism for consistent alignment of cavities with a mouthpiece 10, and the indexing mechanism is made with the possibility of combining the following cavity with 16 mouthpiece 10 after raising item 32 was moved from nezapravlennaya provisions in the cocked position.

Thus, in the illustrated illustrative embodiment, after it was carried out the distribution of the dose, the user closes the lid 12. As described above, rotate the cover 12 rotate the insert 38, performed generally in the form of a disk. Through the rotation of the insert 38 stipulated Cam 44 will be forced to move raises the element 32 (see Figure 5) to his cocked position. Thus, engagement 34 raising item 32 will move from elevated nezapravlennaya the positions shown in figure 3 and 7, omitted in the cocked position, shown in figure 2 and 6.

Almost simultaneously with the Cam 44, who forcibly moves raising item 32, through the rotation of the insert 38 ledge second transmitting power of the item 50 will be through an indexing mechanism to forcibly bring the following cavity 16 in combination with the mouthpiece 10. In particular, as shown in Fig.6, the speaker item 50 will increase the mechanical energy in the spring 52 torsion, which is connected with a drive item 54 (see Fig). Cocked spring 52 torsion will be forced to turn connected to the actuator 54 around the Central axis, provide stable 48 (see 1) to interact with base 14 and thereby lead to the rotation base 14, to bring the following cavity 16 in combination with a mouthpiece.

However, the force acting on the actuator 54, provide speakers element 50 through the spring 52 torsion, temporarily protivodeistviya, at least until lifting item 32 has not reached its cocked position (and the drive is not reached its second position). If the capture 34 raising item 32 will not be lowered in front of discrete movement, the next in turn the separator item 20 may hit capture 34 during discrete move.

Opposing element contains the brake 74, designed to prevent the movement of branches. Brake 74 attached to the side of the rack 75, protruding from the lower part 8 of the housing (see Figure 1). Brake contains brake pad 76, which is pressed against the outer covering the surface of 14 (see Figure 9), thus preventing the turn of the basis 14. Opposing element also contains a witness item 78 (see Figure 1 and 11), which is connected with brake 74 and which moves along the guide 80 executed on the bottom of the insert 38, with an overall the form of a disk. Guide 80 best visible in figure 4, 5 and 11, and on 11 shows how the witness item 78 moves along the guide 80. Thus, when the witness item 78 moves along the guide 80, it will follow the wrong path, and when it reaches the point of release (conformed to the achievement drive second position), attached brake 74 releases the basis of 14 (Figure 10). Now the mechanical energy is released and the actuator 54 may exercise discreet movement. Thus, the basis of 14 can be rotated by driving element 54, which operates spring 52 torsion, as explained previously. Thus, the above illustrative mechanical step sequence provides an alternative cocked opener (here illustrated as raising item 32 with capture) and discrete transfer offices (here illustrated how tightly closed cavity in base 16 14).

As shown in Figure 9, before the brake 74 remitted, the end part of driving element 54 interacts with one of teeth 82 the basis 14. The stopper 84 lever form is connected with a drive item 54 and can even be done with a driving element 54 as one part. The stopper 84 is preventing the position in which he prevents the holding of the first element (supports 58) release 56 the second element (valve 60) release 56. Thus, in this state inhaler raises the element may not be recorded in the cocked position. Thus, the risk of a re-start from the same cavity 16 decreases.

The actuator 54 and the stopper 84 attached to the total cylinder 88 (best seen figure 11), which rotates around the Central reception Desk, 48 (1), coming up from the lower part 8 of the casing. When the actuator 54 turns the basis of 14, the stopper 84 deleted from preventing position, as shown in Figure 10, thus providing the ability to support 58 valve 60, and fix cocked drive. The inhaler is now filled.

As described earlier, in particular in connection with 2 and 3, when the user opens the lid 12 and performs breathe through a mouthpiece 10, valve 60 rises so that the bearing 58 departs from the valve 60, Opera, thereby raising the item 32. Raising item 32, cocked spiral spring 46, rises so that the grip 34 raising item 32 removes the separator item 20 and foil 18 of the cavity 16, which currently are combined with the mouthpiece 10. As you can see from 11, mobile pulling the lever 90 connects the actuator 54 with lifting item 32. When lifting item 32 and capture 34 raised, pulling the lever 90 follows this move, resulting in the other end of traction lever 90 the actuator 54 drawn from seasoned status, shown in Figure 10, in the activated state shown in Figure 9. The stopper will be 84, therefore, returned back to its preventing the position shown in Figure 9. Then, when the user closes the lid 12, the inhaler again becomes filled.

If a user for some reason not enough will close the lid 12, the witness item 78, moving along the guide 80, will not reach the point of release and, therefore, the brake 74 is released. This, in turn, means that there will be discrete move. In addition, while raising item 32 is in his cocked position, it will not be fixed, because fixation can occur only in connection with discrete movement, as described above. Thus, if the user then opens the lid 12, which was not completely closed, raising item 32 just returns to its nezapravlennaya position.

Described in this document indexing mechanism provides the ability to limit the rotation base 14 one direction. Thus, it is possible to prevent the failure of discrete turn. This can be advantageous in connection with other types opening mechanisms or dividing elements.

It should be noted that in this application, terms such as "top", "bottom", "above", "below" were used for illustrative purposes only, to describe the internal relationships between the elements of a device, regardless of how inhaler is focused in the surrounding space. For example, for illustrative embodiment of the drawings, the cavity of 16 are considered to be placed "below" foil 18 and separation elements 20 are located "above" foil 18, regardless of how inhaler 2 as a whole is held or is rotated by the user. Similarly, the term "horizontal" means a direction in the plane of the foil 18 or of any plane parallel to the plane foil 18, and "vertical" means any direction perpendicular to this plane. Thus, the vertical line can cross cavity 16, foil 18 and separation elements 20.

Most components of the inhaler 2, such as cover 12, 14 basis, dividing elements 20 lifting item 32, box 38, the actuator 54 and lock 56 accordingly made of plastic, such as a polymer, but alternatively can be used, and other materials such as metal or ceramic.

Inhaler 2 can properly support the design, which provides protection from moisture, such as, for example, desiccant, described in the international patent document # 2006/000758, or any other suitable alternative for inclusion in the drying material.

It should be noted that, although the drawings were illustrated in connection with powder inhaler with disk sealed cavity, inventive concept also covers and can be applied to other types of inhalers. Thus, the creation and release of mechanical energy and its transformation into discrete moving can be implemented in devices with offices with stripes, or in blister packs or in any other construction with doses that can discretely to move. Therefore, inventive concept can be used with other types opening mechanisms, such as the mechanisms that pierce or cut the Department to gain access to the drug. In addition, inventive concept is not limited inhalers, but also includes other types of medical devices distribution, such as packages containing pills or capsules, which are available at the outlet.

In the next version of the runtime (not shown on the drawings), cover 12 can be replaced on the cover, which is for the most part of the casing. Cover in this case, made with the possibility of rotation about casing between open the configuration in which the mouthpiece opened and closed configuration in which the mouthpiece, and a large part of the casing made in the cover. The cover can be made on the inner surface Cam surface 44, 50, 80, which in previous versions of the were associated with inserting 38. Hole in the casing can also be provided through which some or all of a Cam surface, such as the Cam surface 50, may act in order to interact with the relevant parts of the mechanism inside the enclosure (e.g., spring 52 discrete move).

1. Medical device distribution containing: the outlet, sealed compartment containing medicinal product intended for progressive alignment with the specified discharge and implementation of distribution after a specified outlet opening mechanism for opening a sealed units; drive, made with the possibility of moving between the first position and the second position, move the actuator from the first position to the second position leads to the accumulation of mechanical energy, and when the second position actuator accumulated mechanical energy is released and converted into a discrete moving offices.

2. Medical device distribution according to claim 1, comprising: an indexing mechanism, designed for serial combining offices from the outlet and functionally connected with the drive this mechanical energy is stored in an indexing mechanism, and opposing element with opposing position in which opposing element temporarily prevents the release of the specified mechanical energy, and releasing the position in which mechanical energy is released, resulting in an indexing mechanism is provided the possibility to promote the separation forward, while the opposing element is functionally connected to the drive so that the opposing element reaches the specified releasing position, the actuator reaches specified the second position.

3. Medical device distribution according to claim 2, in which an indexing mechanism contains the spring, in which is stored the specified mechanical energy.

4. Medical device distribution according to paragraph 3, where an indexing mechanism contains the actuator, which is made interoperable with branches or design, support Department, with the actuator connected to the spring so that when the counter reaches the specified element releasing provisions, accumulated in the spring of mechanical energy is transferred with the help of a drive item offices.

5. Medical device distribution according to claim 2, in which the specified opposing position opposing the item is in the fixture contact with one or more branches or with a design supporting departments.

6. Medical device distribution according to claim 2, containing the rotary disc holding these offices, and in the specified opposing position opposing element interacts with the drive to prevent rotation.

7. Medical device distribution according to claim 2, containing the guide, which moves together with the actuator, and counter element contains the brake, designed to prevent the movement of branches, and witness element, which is connected with brake and which moves at a specified guide in response to movement of the actuator, moreover, when the witness item reaches the point of release attached brake is released.

8. Medical device distribution according to claim 1, containing the locking element that during the specified discrete movements made with the possibility of interaction with branches or with the design, support Department, with the provision limiting the move.

9. Medical device distribution according to claim 1, wherein said the drive contains a cover of the outlet, which is made with the possibility of opening and closing the outlet.

10. Medical device distribution of claim 9, in which the indicated move actuator from the first position to the second situation involves moving cover outlet in direction close outlet.

11. Medical device distribution on any one of claims 1 to 10, which is a nebulizer.

12. Medical device distribution in paragraph 11, in which medicine contains the active ingredient selected from mometasone, ipratropium bromide, Tiotropium and its salts, salmeterola, fluticasone propionate, beclomethasone dipropionate, reproterol, clenbuterol, rofleponide and salts, nedocromil, sodium kromoglikatom, flunisolide, budesonide, formoterol fumarata dihydrate, terbutalina, terbutalina sulfate, salbutamol base and sulfate, fenoterola, 3-[2-(4-hydroxy-2-oxo-3H-1,3-benzothiazole-7-yl)ethylamino]-N-[2-[2-(4-were)etoxi]ethyl]propanesulfinamide hydrochloride, indacaterol, acridine bromide, N-[2-(diethylamino)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-3-[2-(1-naphthyl)etoxi]propanamide or pharmaceutically acceptable salts (for example, dihydrobromide); N-cyclohexyl-N 3 -[2-(3-torfanil)ethyl]-N-(2-{[2-(4-hydroxy-2-oxo-2,3-dihydro-1,3-benzothiazole-7-yl)ethyl]amino}ethyl)-b-laninabina or pharmaceutically acceptable salts (e.g., di-D-mandelate); salt [2-(4-chloro-benzyloxy)-ethyl]-[2-(R)-cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-ammonium (for example, Hemi-naphthalene-1,5-disulfonate); salts (R)-1-[2-(4-fluoro-phenyl)-ethyl]-3-(S)-2-phenyl-2-piperidine-1-yl-propenyloxy)-1 Azania-bicyclo[2.2.2]octane (for example, bromide or toluensulfonate); or a combination of any two or more of these ingredients.

13. The method of discrete move to the medical device distribution that has containing drug Department, including continuous accumulation of mechanical energy, interruption of continuous accumulation by the release of the specified mechanical energy and convert the specified released mechanical energy in discrete move these offices.

14. The method of discrete move for medical device distribution that has containing medicine Department and the actuator, including moving the specified drive, and move the actuator consistently leads to the accumulation of mechanical power, then release and transformation of mechanical energy in discrete moving offices.