Multi-stage delivery system

A multi-stage drug delivery system having a cartridge and multiple plungers positioned in the cartridge and spaced apart from one another is provided. A first plunger, a second plunger, and the cartridge form a first chamber storing a first drug. The second plunger and the cartridge form a second chamber storing a second drug. A cannula pierces the first plunger to access the first drug. As the first plunger is driven toward the second plunger, the first drug is expelled from the first chamber for delivery to a patient through the cannula. After expelling the first liquid drug, the cannula can pierce the second plunger to access the second drug. As the first and second plungers are together driven toward a closed end of the cartridge, the second liquid drug is expelled from the second chamber for delivery to the patient through the cannula.

TECHNICAL FIELD

Embodiments generally relate to medication delivery. More particularly, embodiments relate to drug delivery systems for delivering multiple different drugs.

BACKGROUND

Many patients may be required to receive dosages of different drugs. Conventional drug delivery systems, such as many conventional wearable drug delivery devices, typically only provide a dosage of a single drug. Therefore, a patient may be required to use multiple conventional drug delivery devices to receive the different drug dosages. With each additional device, the patient is required to insert a new needle to facilitate delivery of each drug. Accordingly, what is needed is a drug delivery system that can deliver multiple different drugs and dosages in a less burdensome manner while reducing patient discomfort.

DETAILED DESCRIPTION

This disclosure presents various systems, components, and methods related to a drug delivery system. Each of the systems, components, and methods disclosed herein provides one or more advantages over conventional systems, components, and methods.

Various embodiments provide a multiple stage (multi-stage) drug delivery system and method of use. The multi-stage drug delivery system can include two or more chambers for storing liquid drugs. The multi-stage drug delivery system can deliver each drug to a user in succession. The multi-stage drug delivery system can include the same drugs or different drugs. The multi-stage drug delivery system can store and dispense the same amount of each drug or different amounts of each drug. Each drug can be delivered at a desired rate over a desired amount of time. The multi-stage drug delivery system can interface with a variety of different fluid delivery mechanisms to pass the stored drugs to the user. The multi-stage drug delivery system provides a simplified architecture for storing and dispending multiple different drugs to the user within the same container, enabling the user to use a same needle insertion to deliver the drugs. The multi-stage drug delivery device can be implemented within an on-body or wearable drug delivery device. Other embodiments are disclosed and described.

Various embodiments include a multi-stage drug delivery system having a cartridge, a first plunger positioned in the cartridge, and a second plunger positioned in the cartridge with the second plunger spaced apart from the first cartridge. The first plunger can be accessible through a first end of the cartridge. The first plunger, the second plunger, and the cartridge can form a first chamber configured to store a first liquid drug. The second plunger and the cartridge can form a second chamber configured to store a second liquid drug. A cannula can pierce the first plunger to access the first liquid drug. As the first plunger is driven toward the second plunger, the first liquid drug can be expelled from the first chamber for delivery to a patient through the cannula. After expelling the first liquid drug, the cannula can pierce the second plunger to access the second liquid drug. As the first and second plungers are together driven toward a closed end of the cartridge, the second liquid drug can be expelled from the second chamber for delivery to the patient through the cannula. The multi-stage drug delivery system allows two or more drugs to be delivered to a patient at different predetermined times, in different amounts, and according to different rates.

FIG. 1illustrates a multi-stage drug delivery system100. The multi-stage drug delivery system100can include a cartridge102, a first plunger104, and a second plunger106. The multi-stage drug delivery system100can further include a first drug108and a second drug110. The first and second drugs108and110can be any therapeutic agent including liquid drugs. The first and second drugs108and110can be different therapeutic agents or drugs. The multi-stage drug delivery system100can separately store and dispense the first and second drugs108and110using a common or shared drug delivery mechanism while enabling each drug to be dispensed at different times according to different customized schedules (e.g., different rates of delivery). The cartridge102can be of any size or shape. As an example, the cartridge102can be cylindrical with a circular cross-sectional shape.

As shown inFIG. 1, the first drug108can be stored in a first chamber114defined by the first plunger104, the second plunger106, and the cartridge102. The storage and use of the first drug108in the first chamber114can represent a first stage of the multi-stage drug delivery system100. The second drug110can be stored in a second chamber116defined by the second plunger106and the cartridge102. The storage and use of the second drug110in the second chamber116can represent a second stage of the multi-stage drug delivery system100.

The first and second drugs108and110can be hermetically separated and sealed by the cartridge102and the first and second plungers104and106as shown inFIG. 1. The first and second plungers104and106can be elastomeric plungers. The first and second drugs108and110can be provided in a common device (e.g., the cartridge102) while ensuring the first and second drugs108and110are separately stored and dispensed. The first and second plungers104and106can be positioned anywhere along an interior portion of the cartridge102.

The multi-stage drug delivery system100can be used in a drug delivery device that provides the first and second drugs108and110to a user. For example, the multi-stage drug delivery system100can be part of a bolus device and/or a wearable drug delivery device. The multi-stage drug delivery system100can include the same or different amounts of the first and second drugs108and110(e.g., the dosages of the first and second drugs108and110can be the same or different). The first drug108can be dispensed first over a first amount of time at a first rate of delivery with the second drug110dispensed over a second amount of time at a second rate of delivery, after the first drug108is dispensed. The multi-stage drug delivery system100enables the first and second drugs108and110to be provided to the user using the same fluid path to the user. Consequently, a single needle insertion can be used to deliver the first and second drugs108and110.

The multi-stage drug delivery system100can dispense the second drug110immediately after the first drug108has been dispensed or can deliver the second drug110after a delay. Accordingly, the first and second drugs108and110can be delivered relatively close together in time or can be delivered at separate times after a desired delay. Further, the delivery of the first and second drugs108and110can be customized in terms of the rate at which each drug is delivered. For example, the first drug108can be delivered over a first amount of time while the second drug can be delivered over a second, different amount of time. The first and second amounts of time can be varied as desired to dispense the first and second drugs108and110at different desired rates of delivery, respectively. In this way, a customized delivery of the first and second drugs108and110can be provided with the dosages (e.g., how much drug to dispense in total), delivery times (e.g., when to dispense a drug), and delivery schedules (e.g., how quickly or slowly to dispense the dosage) for each drug being largely independent of each another.

FIG. 1shows the multi-stage drug delivery system100in an initial state. Specifically, no mechanical energy or force is introduced or applied to the multi-stage drug delivery system100as shown inFIG. 1. A cannula112is shown in relatively close proximity to the multi-stage drug delivery system100. The cannula112can be a hard cannula112that is sterilized. The cannula112can be positioned adjacent to the cartridge102or within an open area of the cartridge102yet still displaced from the first plunger104. The cannula112can initially be positioned entirely outside of the cartridge102.FIG. 1can represent the multi-stage drug delivery system100before activation (e.g., before activation of a wearable drug delivery device in which the multi-stage drug delivery system100operates).

As shown inFIG. 1, the cannula112can be positioned adjacent to a first end of the cartridge102. In particular, the cannula112is positioned in proximity to a first surface118of the first plunger104. The first surface118can be adjacent to an open end of the cartridge102which allows the cannula112to enter the cartridge102. The first plunger104can further include a second surface120. The second surface120can be adjacent to the first drug108. The second plunger106can also include a first surface122and a second surface124. The first surface122can be adjacent to the first drug108and the second surface124can be adjacent to the second drug110as shown.

FIG. 2illustrates insertion of the cannula112into the first stage of the multi-stage drug delivery system100(e.g., into the first chamber114). As shown inFIG. 2, indicator202indicates application of a force applied to the cannula112. The application of the force202to the cannula112can cause the cannula112to pierce and pass through the first plunger104. The force202can be such that the cannula112pierces through the first plunger104to enter the first stage (e.g., the first chamber114) holding the first drug108. The force202can cause the cannula to enter the first chamber114at a desired depth. For example, the cannula112can pierce the first plunger104and enter the first stage at a depth so as to maximize extraction of the first drug108stored in the first chamber114. In various embodiments, the body of the first plunger104may be counter-bored to facilitate piercing by the cannula112.

As shown inFIG. 2, to enter the first chamber114holding the first drug108, the cannula112can be caused to pierce the first surface118and the second surface120of the first plunger104and to extend through the first plunger104. A tip or end or the cannula112can be sharp or pointed to facilitate piercing of the first plunger104. To obtain access to the first chamber114, the cannula112can be caused to move in a lateral direction toward a far end of the cartridge102as shown. The tip or end of the cannula112can be positioned near to the second surface120of the first plunger104once access to the first chamber114is provided. The cannula112can be positioned at a center of the first plunger104but is not so limited. In various embodiments, the first plunger114can be inserted along any portion of the first surface118of the first plunger104for example.

Once the cannula112is inserted into the first stage of the multi-stage drug delivery system100at a desired depth, the first drug108can be introduced into the fluid delivery mechanism coupled to the cannula112. As an example, the cannula112can be coupled to a fluid delivery mechanism that delivers the first drug108to a user or patient. A variety of fluid delivery mechanisms can be used. For example, the fluid delivery mechanism can include one or more components for coupling the cannula112to the patient. In various embodiments, the components can include tubing (e.g., plastic and/or stainless steel tubing) coupled to the cannula as well as a needle or cannula (e.g., coupled to the tubing) for accessing a site on the patient. Overall, the fluid delivery mechanism198can be or can provide a fluid path178from the cannula to the user of the multi-stage drug delivery system100. Accordingly, when the cannula112is coupled to a liquid drug, then the fluid path can be used to deliver the liquid drug to the user. In various embodiments, the cannula112can be part of the fluid delivery mechanism198or can be coupled to it. In various embodiments, the cannula112can be coupled via the fluid path178to the patient.

The fluid delivery mechanism198can further be used to apply the force202. As an example, the fluid delivery mechanism198can include a cannula insertion component188for driving the cannula112in a direction indicated by the applied force202to pierce the first plunger104. The cannula insertion component188can be coupled to the cannula112and can be triggered to cause the cannula112to advance toward the first plunger104to pierce the first plunger104. In various embodiments, the cannula insertion component188can comprise a mechanical system or an electromechanical system for manipulating the cannula112. In various embodiments, the cannula insertion component188can include one or more springs such as, for example, an expansion spring, a compression spring, and/or a torsion spring. The cannula insertion component188can be triggered to pierce the cannula112through the first plunger104based on a user input or action that indicates a desire to activate delivery of the first drug108(e.g., by a user pressing a button on a wearable drug delivery device to activate the device).

Further, the fluid delivery mechanism198can include a drive component, such as168, to apply a force204on the first plunger104to force the first drug108out of the first stage of the multi-stage drug delivery system100. For example, after the cannula112pierces the first plunger104and is positioned at a desired depth within the first chamber114, a second force can be applied to the first plunger104as indicated by indicators204. The force204can be applied to any portion of the first surface118of the first plunger104(e.g., at one or more positions along the first surface118). The force204can drive the first drug108out of the first chamber114, through the fluid delivery mechanism198(e.g., the cannula112and any other components coupling the cannula to the patient), and on to the user. The force204can cause the first plunger104to move towards the stationary second plunger106. The drive component168can be coupled to the first plunger104. In various embodiments, the drive component168can comprise a mechanical system or an electromechanical system for driving the first plunger104toward the far end of the cartridge102. In various embodiments, the drive component168can include one or more springs such as, for example, an expansion spring, a compression spring, and/or a torsion spring.

The applied force204can be constant or varied and can be used to deliver the first drug108to the user over a desired amount of time (e.g., at a desired rate of delivery). For example, a relatively strong force204can be applied to rapidly provide the first drug108to the user. Alternatively, a relatively weak force204can be applied to slowly provide the first drug108to the user. In general, any delivery schedule and rate of delivery of the first drug108can be provided by using and varying the force204.

FIG. 2also shows a stroke206of the multi-stage drug delivery system100—that is, the distance the first plunger104travels to expel all or approximately all of the first drug108from the first chamber114of the multi-stage drug delivery system100(e.g., the stroke206can represent the amount of the first drug108that can be stored and provided to a user). As discussed above, the stroke206can be varied by the amount of the first drug108included in the multi-stage drug delivery system100and the magnitude and timing of the force204applied to the first plunger104can determine how the amount of the first drug108is provided to the user.FIG. 2can represent a state of the multi-stage drug delivery system100when the first drug108is initially accessed (e.g., when the cannula112is first introduced into the first chamber114).FIG. 2can represent the multi-stage drug delivery system100after activation and as delivery of the first drug108to the user first begins.

FIG. 3illustrates extraction of the first drug108from the multi-stage drug delivery system100. Specifically,FIG. 3shows the first plunger104being driven towards the second plunger106. The second plunger106can be in a fixed position. As a result, the first drug108can be forced out of the first chamber114of the multi-stage drug delivery system100, through the cannula112, and on to the fluid delivery mechanism198coupled to the cannula112for delivery to the user. As shown inFIG. 3, indicator302represents the first liquid drug108from the first chamber114being expelled out of the first chamber114through the cannula112. The first liquid drug108can flow out of the cartridge102in a direction that is substantially opposite to the direction of the movement of the first plunger104towards the second plunger106which causes the first liquid drug108to be expelled out of the first chamber114.

As shown inFIG. 3, the force204can be applied to the first plunger104to drive it towards the second plunger106. The inserted position of the cannula112can remain in relatively the same position with respect to the first plunger104to ensure maximize extraction of the first drug108. A reduction in stroke304is also shown for reference inFIG. 3. The reduction in stroke304can indicate that the size of the first chamber114of the multi-stage drug delivery system100has been reduced and that a corresponding amount of the first drug108has exited the multi-stage drug delivery system100through the cannula112for delivery to the user.FIG. 3can represent a state of the multi-stage drug delivery system100when the first drug108is being extracted.

FIG. 4illustrates the multi-stage drug delivery system100after depletion of the first drug108. That is,FIG. 4shows the multi-stage drug delivery system100after all or approximately all of the first drug108has been extracted from the first chamber114of the multi-stage drug delivery system100. As shown inFIG. 4, the first plunger104is in close proximity to the second plunger106(e.g., adjacent such that no portion of the first drug108remains between the first and second plungers104and106). The second surface120of the first plunger104can be adjacent to or pressed against the first surface122of the second plunger106.

The force204applied to the first plunger104can drive the first plunger104to the position shown inFIG. 4. As the first drug108is being depleted and as the first plunger104is forced against the second plunger106, the cannula112can be introduced into the second plunger106. As shown inFIG. 4, a portion of the end of the cannula112can pierce a portion of the second plunger106. The cannula112can pierce the first surface122of the second plunger106and can be partially inserted into the second plunger106. The state of the multi-stage drug delivery system100as shown inFIG. 4can be a state following depletion of the first drug108and prior to extraction of the second drug110.

FIG. 5illustrates insertion of the cannula112through the second plunger106of the multi-stage drug delivery system100and into the second chamber116. As shown inFIG. 5, a second force502can be applied to the cannula112to drive the cannula112through the second plunger106. The end of the cannula112can extend into the second chamber116of the multi-stage drug delivery system100a desired amount to ensure maximum extraction of the second drug110. The cannula112can extend beyond the second surface124of the second plunger to be coupled to the second liquid drug110stored in the second chamber116.

When the cannula112is inserted through the second plunger106and into the second chamber116of the multi-stage drug delivery system100, the second drug110can be introduced into the fluid path coupled to the user (e.g., a fluid path coupled to the cannula112). Specifically, the second drug110can be provided to the delivery mechanism coupled to the cannula112so that the second drug110may be passed on to the user. As shown, the force204can be applied to the first plunger104to move both the first plunger104and the second plunger106toward the end of the cartridge102. That is, by applying the force204to the first plunger104, the second plunger106is forced to move toward an end of the cartridge102. In turn, the volume or size of the second chamber116is reduced which forces the second drug110through the cannula112and on to the fluid delivery mechanism.

FIG. 5also shows a stroke504for the second chamber116of the multi-stage drug delivery system100—that is, the distance the second plunger106travels to expel all or approximately all of the second drug110from the second chamber116of the multi-stage drug delivery system100(e.g., the amount of the second drug110that can be stored and provided to a user). As discussed above, the stroke504can be varied by the amount of the second drug110included in the multi-stage drug delivery system100and the magnitude and timing of the force204applied to the first plunger104(and the second plunger106) can determine how the amount of the second drug110is provided to the user.FIG. 5can represent a state of the multi-stage drug delivery system100when the second drug110is initially accessed (e.g., when the cannula112is first introduced into the second chamber).

FIG. 6illustrates extraction of the second drug110from the multi-stage drug delivery system100. Specifically,FIG. 6shows the first plunger104and the second plunger106together being driven toward the end of the cartridge102. As a result, the second drug110can be forced out of the second chamber116of the multi-stage drug delivery system100, through the cannula112, and on to the fluid delivery mechanism coupled to the cannula112for delivery to the user. As shown inFIG. 6, the force204can be applied to the first plunger104(and to the second plunger106indirectly) to drive both the first and second plungers104and106towards the end of the cartridge102. The inserted position of the cannula112can remain in relatively the same position with respect to the second plunger106to ensure maximize extraction of the second drug110.

As shown inFIG. 6, indicator602represents the second liquid drug110from the second chamber116being expelled out of the second chamber116through the cannula112. The second liquid drug110can flow out of the cartridge102in a direction that is substantially opposite to the direction of the movement of the first plunger104and the second plunger106towards the end of the cartridge102which causes the second liquid drug110to be expelled out of the second chamber116.

A reduction in stroke604is also shown for reference inFIG. 6—for example, to indicate the second chamber116of the multi-stage drug delivery system100has been reduced and that a corresponding amount of the second drug110has exited the multi-stage drug delivery system100for delivery to the user.

FIG. 6illustrates the multi-stage drug delivery system100in a state of delivering the second drug110to a user. That is,FIG. 6can represent a state after the cannula112has pierced through the second plunger106and the second drug110is being delivered to the user but prior to all of the second drug110being extracted.

In various embodiments, the force502can generally be applied to drive the cannula112through the plungers104and106. The force502can then be removed or stopped and the force204can be applied or reapplied to drive the first plunger104(and the second plunger106when appropriate) towards the end (e.g., a closed end) of the cartridge102. That is, the force502may not be used to drive the plungers104and106to the end of the cartridge102. The force204can be applied along any portion of the first plunger104(e.g., including one or more positions along any portion of the first plunger104).

FIG. 7illustrates the multi-stage drug delivery system100after depletion of the second drug110. That is,FIG. 7shows the multi-stage drug delivery system100after all or approximately all of the second drug110has been extracted from the second chamber116of the multi-stage drug delivery system100. As shown inFIG. 7, the first and second plungers104and106are positioned against the end of the cartridge102(e.g., adjacent to the end of the cartridge102such that no portion of the second drug108remains between the second plunger106and the end of the cartridge102).

As shown inFIG. 7, the second plunger106has met the end of stroke. Accordingly, the delivery of the dosage of the second drug110is substantially complete (e.g., all of the second drug110has been forced out of the second chamber116).FIG. 7can represent a state of the multi-stage drug delivery system100after both the first and second drugs108and110have been delivered to the user. The multi-stage drug delivery system100can be re-used (e.g., re-filled) or can be discarded.

FIGS. 1-7illustrate the multi-stage drug delivery system100having two chambers (e.g., chambers114and116) but is not so limited. That is, the multi-stage drug delivery system100can include any number of chambers (and corresponding number of plungers) to store and subsequently dispense any number of different drugs, in any amount, according to any desired delivery schedule in accordance with the techniques described herein.FIGS. 1-7can represent cross-sectional side views of the multi-stage drug delivery system100during various stages of operation as described herein.

FIG. 8illustrates a method800for delivering multiple liquid drugs to a patient using a multi-stage delivery system such as, for example, the multi-stage delivery system100. The method800is described in relation to delivering two liquid drugs to the patient from the multi-stage delivery system but is not so limited. The method800is applicable to the delivery of any number of liquid drugs from a multi-stage delivery system configured to store a corresponding number of liquid drugs as will be appreciated by a person of ordinary skill in the art. Further, the method800is applicable to the delivery of different liquid drugs, to the delivery of different amounts of each liquid drug, and to the delivery of each liquid drug at different times and rates as will be appreciated by a person of ordinary skill in the art.

At802, a container configured to store a first drug in a first chamber and configured to store a second drug in a second, different chamber can be provided. The first and second drugs can be liquid drugs. The first and second drugs can be any type of liquid drugs. The first and second liquid drugs can be the same or different drugs. The first and second chambers can be of the same size or can be configured to store different amounts of the first and second drugs, respectively.

The first and second drugs can be sealed and separated from each other. A first plunger positioned in the container, a second plunger positioned in the container and spaced apart from the first plunger, and the container can form the first chamber. The second plunger and the container can form the second chamber.

At804, a cannula can pierce the first plunger. The cannula can be positioned at a center of the first plunger. The cannula can extend through the first plunger and into the first chamber. The cannula can extend into the first chamber by a desired amount or depth and can be coupled to the first drug.

The cannula can be coupled to the patient. Accordingly, when the cannula accesses the first drug stored in the first chamber the cannula can couple the first drug to the patient.

At806, the first plunger is driven toward an end of the container. The first plunger is advanced further into the container toward the second plunger. The cannula can remain positioned in the first plunger as the first plunger is advanced. The second plunger can remain stationary. As a result of the first plunger moving further into the container, the first drug is expelled from the first chamber (e.g., as the size or volume of the first chamber is reduced). The expelled first drug can flow into and through the cannula and on to the patient.

The first plunger can be advanced to expel substantially all of the first drug. When substantially all of the first drug is expelled, the first plunger can be positioned against the second plunger.

At808, the second plunger can be pierced by the cannula. The cannula can extend through the second plunger (and through the first plunger) and into the second chamber. The cannula can extend into the second chamber by a desired amount or depth and can be coupled to the second drug. Accordingly, when the cannula accesses the second drug stored in the second chamber the cannula can couple the second drug to the patient.

At810, the first plunger and second plungers are driven toward the end of the container. The first and second plungers are advanced further into the container toward a closed end of the container. The cannula can remain positioned in the first and second plungers as the first and second plungers are advanced. As a result of the first and second plungers moving further into the container, the second drug is expelled from the second chamber (e.g., as the size or volume of the second chamber is reduced). The expelled second drug can flow into and through the cannula and on to the patient.

The first and second plungers can be advanced to expel substantially all of the second drug. When substantially all of the second drug is expelled, the second plunger can be positioned against the closed end of the container with the first plunger positioned against the second plunger.

The following examples pertain to additional further embodiments:

Example 1 is a multiple stage drug delivery system, comprising a cartridge, a first plunger positioned in the cartridge, and a second plunger positioned in the cartridge, wherein the first plunger, the second plunger, and the cartridge form a first chamber configured to store a first liquid drug, and the second plunger and the cartridge form a second chamber configured to store a second liquid drug.

Example 2 is an extension of Example 1 or any other example disclosed herein, further comprising a cannula configured to pierce the first plunger to access the first liquid drug stored in the first chamber.

Example 3 is an extension of Example 2 or any other example disclosed herein, further comprising a cannula insertion component coupled to the cannula.

Example 4 is an extension of Example 3 or any other example disclosed herein, wherein the cannula insertion component comprises one or more springs.

Example 5 is an extension of Example 3 or any other example disclosed herein, wherein the cannula is coupled to a patient, wherein the cannula couples the first liquid drug stored in the first chamber to the patient when the cannula accesses the first chamber.

Example 6 is an extension of Example 5 or any other example disclosed herein, further comprising a drive component configured to advance the first plunger toward the second plunger, thereby extracting the first liquid drug from the first chamber for delivery to the patient through the cannula.

Example 7 is an extension of Example 6 or any other example disclosed herein, wherein the drive component comprises one or more springs.

Example 8 is an extension of Example 6 or any other example disclosed herein, wherein the drive component comprises an electromechanical system.

Example 9 is an extension of Example 6 or any other example disclosed herein, wherein the cannula is configured to pierce the second plunger to access the second liquid drug stored in the second chamber after the first liquid drug is extracted from the first chamber.

Example 10 is an extension of Example 9 or any other example disclosed herein, wherein the cannula couples the second liquid drug stored in the second chamber to the patient when the cannula accesses the second chamber.

Example 11 is an extension of Example 9 or any other example disclosed herein, wherein the first plunger is positioned adjacent to the second plunger after the first drug is extracted from the first chamber.

Example 12 is an extension of Example 11 or any other example disclosed herein, wherein the drive component is configured to advance the first plunger and the second plunger toward an end of the cartridge, thereby extracting the second liquid drug from the second chamber for delivery to the user through the cannula.

Example 13 is an extension of Example 12 or any other example disclosed herein, wherein the first drug is dispensed over a first amount of time at a first rate and the second drug is dispensed over a second amount of time at a second rate.

Example 14 is an extension of Example 13 or any other example disclosed herein, wherein the first amount of time and the second amount of time are non-overlapping.

Example 15 is an extension of Example 13 or any other example disclosed herein, wherein the first and second rates are different.

Example 16 is an extension of Example 1 or any other example disclosed herein, wherein the first and second plungers are elastomeric plungers.

Example 17 is an extension of Example 1 or any other example disclosed herein, wherein the first and second liquid drugs are different drugs.

Example 18 is an extension of Example 1 or any other example disclosed herein, wherein the first chamber and the second chamber have different volumes.

Example 19 is an extension of Example 1 or any other example disclosed herein, wherein the cartridge comprises glass.

Example 20 is a method, comprising providing a container configured to store a first liquid drug in a first chamber and a second liquid drug in a second chamber, piercing a first plunger with a cannula to couple the cannula to the first liquid drug, driving the first plunger toward an end of the container to extract the first liquid drug from the first chamber through the cannula, piercing a second plunger with the cannula to couple the cannula to the second liquid drug, and driving the first and second plungers toward the end of the container to extract the second liquid drug from the second chamber through the cannula.

Example 21 is an extension of Example 21 or any other example disclosed herein, further comprising piercing the second plunger after substantially all of the first liquid drug is extracted from the first chamber.

Example 22 is an extension of Example 21 or any other example disclosed herein, further comprising piercing the second plunger after a predetermined delay.

Example 23 is an extension of Example 22 or any other example disclosed herein, further comprising extracting the first liquid drug from the first chamber at a first rate and extracting the second liquid drug from the second chamber at a second, different rate.

Example 24 is an extension of Example 23 or any other example disclosed herein, wherein the first and second liquid drugs are different liquid drugs.

Example 25 is an extension of Example 20 or any other example disclosed herein, further comprising sealing the first chamber with the container and the first and second plungers and sealing the second chamber with the container and the second plunger.