Patent Publication Number: US-2003229308-A1

Title: Injector adapter and combination thereof

Description:
RELATED APPLICATIONS  
     [0001] This application claims the benefit of U.S. Provisional Application No. 60/385,622 filed on Jun. 5, 2002 entitled INJECTOR ADAPTER AND COMBINATION THEREOF and whose entire disclosure is incorporated by reference herein. 
    
    
     
       BACKGROUND OF THE INVENTION  
       [0002] The present invention relates to the administration of a drug solution and, more particularly, to the delivery of a viscous drug solution into a mammal.  
       [0003] Various devices have been developed for the delivery of medications into living organisms, including syringes in which a liquid is delivered from a chamber using pressure asserted by a manual plunger through a needle inserted under the skin. Improvements on these types of devices have led to needle-less injectors that apply a high pressure to the medication to create a jet that penetrates the skin without the need for a lumen.  
       [0004] However, the slowing down of injection rate is especially essential with the injection of viscous drug or other drugs that are difficult for tissue absorption. A level of pain usually follows injection due to the tissue&#39;s inability to quickly absorb the solution. Thus, a reduction of the injection rate is important for the injection of viscous drugs or other drugs that are difficult for tissue absorption because, in many cases, pain is the result of rate differences between the injection rate and the absorption rate. Other reasons for the reduced injection rate include the prevention of an adverse reaction due to rapid compound injection and the provision for lower injection forces needed for viscous compounds.  
       [0005] Where it is necessary to slow down the injection rate of an injector, it also necessary to hold and stabilize the injector in place during the injection process. This is not always easy to do and in fact can lead to increased pain when the attendant or patient tries to hold the injector steady but unconsciously or inadvertently moves the injector slightly during drug delivery. In addition, some of the drugs used by patients are for patients having limited dexterity. These patients are incapable of holding an injector in a stable orientation for a prolonged period of time. Thus, having to hold the injector throughout the injection process (e.g., 10 minutes) can be not simply tedious, but can be impossible for some patients. Moreover, having to hold the injector for a prolonged period of time can increase the pain to the patient as a result of movement. In addition, if a health care professional is administering, it diverts their attention from other tasks such as monitoring the patient&#39;s vital signs and/or taking appropriate actions (operating nearby equipment) necessary to stabilize/maintain the patient&#39;s health.  
       [0006] The prior art provides no solution to this problem. In the broad field of injection devices, the prior art does disclose needle “disposing” devices, such as those discussed in British Application No. 2205043, U.S. Pat. Nos. 4,836,373 (Goldman), 4,717,386 (Simmons); 4,737,149 (Gillian); 4,915,698 (Levenson); 5,334,173 (Armstrong et al.); 5,078,696 (Nedbaluk); 5,505,705 (Galpin et al.); 6,202,843 (Kelson et al.)); and needle/catheter “guiding” devices, such as those shown in U.S. Pat. Nos. 5,348,543 (Talley); 2,402,306 (Turkel); 2,295,849 (Kayden); 3,900,026 (Wagner); 4,755,173 (Konopa et al.); 4,318,401 (Zimmerman); 5,545,143 (Fischell)); 5,496,264 (Watson et al.); needle sheathing/handling devices, such as those shown in British Patent Application No.2205043 (Jones et al.) British Patent Application No. GB 2209470 (Calvert et al.); French Patent Application No. 2635686 (Fochesato et al.); and International Publication WO 91/00215 (Melker et al.); and needle guides for use with infusion devices such as that shown in U.S. Pat. No. 4,675,006 (Hrushesky).  
       [0007] PCT International Patent No. WO 96/24398 (Weston) discloses a needle-less injector that utilizes a pressure pad for evenly distributing the contact pressure of the injector when it is placed on the skin but also does not teach or suggest supporting the needle-less injector on its own for a prolonged period of time.  
       [0008] U.S. Pat. No. 6,332,875 (Inkpen et al.) discloses a hand-held injection device that facilitates the injection of manually-operated syringes or pens.  
       [0009] Thus, there remains a need for a device that permits an automatic injector to be applied to an injection site on a living being which can support itself for a prolonged period of time and automatically deliver a drug.  
       SUMMARY OF THE INVENTION  
       [0010] An apparatus for use with an automatic injector (e.g., any injector that automatically delivers a solution to a living being including automatic syringes, automatic needle-less injectors, etc.,) for injecting a solution into a living being. The apparatus comprises: an injector-receiving member (e.g., a collar or sleeve) for receiving a portion of a housing of the automatic injector; and a living being-engaging member (e.g., a substantially flat base surface) forming one end of the injector-receiving member and including releasable coupling means (e.g., a biocompatible adhesive layer) for releasably coupling the apparatus to the living being, and wherein the living being-engaging member comprises an aperture for permitting passage of the solution from the automatic injector, when activated, into the skin of the living being.  
       [0011] A method for delivering a solution to a living being using an automatic injector (e.g., any injector that automatically delivers a solution to a living being including automatic syringes, automatic needle-less injectors, etc.,) having an output for dispensing the solution. The method comprises the steps of: coupling a rigid structure (e.g., a substantially flat base portion having a collar or sleeve member forming a part thereof) to the skin of the living being, and wherein the rigid structure has an aperture in a portion thereof (e.g., in the substantially flat base portion) that couples to the skin of the living being; coupling the automatic injector to the rigid structure; and activating the automatic injector to cause the solution to pass from the output, through the aperture and into the skin.  
       [0012] An apparatus for automatically delivering a solution to a living being. The apparatus comprises: an automatic injector (e.g., any injector that automatically delivers a solution to a living being including automatic syringes, automatic needle-less injectors, etc.,) having a housing with a proximal and distal end, wherein the proximal end comprises a skin-engaging surface and a hole for permitting the solution to pass therethrough; the skin-engaging surface comprises releasable coupling means for releasably coupling the apparatus to the living being; and wherein the apparatus delivers the solution, when activated, through the skin of the living being without the need for a person to hold the apparatus during solution delivery.  
       [0013] A method for automatically injecting a solution into a living being. The method comprising the steps of: coupling a proximal end of an automatic injector (e.g., any injector that automatically delivers a solution to a living being including automatic syringes, automatic needle-less injectors, etc.,) to the skin of the living being, wherein the automatic injector has an aperture in the proximal end that is coupled to the skin of the living being; and activating the automatic injector to cause the solution to pass through the hole and into the skin and without the need for a person to hold the automatic injector during solution delivery. 
     
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
     [0014]FIG. 1 is an isometric view of the injector adapter of the present invention;  
     [0015]FIG. 2 is an isometric view of the injector adapter including an exploded view of a preferred adhesion system that is coupled to the base portion of the injector adapter for releasably coupling the injector adapter to the skin of a living being;  
     [0016]FIG. 2A is an isometric view of the preferred adhesion system of FIG. 2;  
     [0017]FIG. 3 is an exploded view showing an automatic injector and the injector adapter, with the injector adapter already applied to the skin of a living being;  
     [0018]FIG. 4 depicts the automatic injector engaged with injector adapter, shown in cross-section, and with the automatic injector being activated to make the injection into the skin;  
     [0019]FIG. 5 depicts the automatic injector engaged with another embodiment of the injector adapter having a shortened injector-receiving portion, shown in cross-section, and with the automatic injector being activated to make the injection into the skin;  
     [0020]FIG. 6 is an isometric view of another embodiment of the injector adapter using the shortened injector-receiving portion, showing a release sheet tab projecting from the base of the adapter;  
     [0021]FIG. 7 is an exploded view showing another automatic injector and the injector adapter of FIG. 6 before the adapter is applied to the skin;  
     [0022]FIG. 8 depicts the automatic injector engaged with injector adapter of FIG. 6 but with the release sheet still covering the base of the adapter;  
     [0023]FIG. 9 depicts a bottom isometric view of the injector adapter using the shortened injector-receiving portion of FIGS.  5 - 8  and including the preferred adhesion system;  
     [0024]FIG. 10 is a side elevation view of an integrated injector adapter of the present invention;  
     [0025]FIG. 11 is a top view of the integrated injector adapter;  
     [0026]FIG. 12 is a partial cross-sectional view of the lower portion of the integrated injector adapter taken along line  12 - 12  of FIG. 11;  
     [0027]FIG. 13 a  is a top view of the clip of the integrated injector adapter;  
     [0028]FIG. 13 b  is a bottom view of the clip the integrated injector adapter;  
     [0029]FIG. 14 is a partial cross-sectional view of one snap of the clip engaged with the body-engaging portion of the integrated injector adapter taken along line  14 - 14  of FIG. 13 a;    
     [0030]FIG. 15 is a top view of the release liner of the integrated injector adapter; and  
     [0031]FIG. 16 is a partial isometric and cross-sectional view of the upper portion of the clip of the integrated injector adaptor illustrating how a tab of the release liner is secured to the clip.  
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
     [0032] As discussed earlier, reduction of the injection rate is important for the injection of viscose drugs or other drugs that are difficult for tissue absorption because, in many cases, pain is the result of rate differences between the injection rate and the absorption rate. Thus, as will be discussed below in detail, the injector adapter  20  permits the automatic injector to be attached to the skin of the living being, without the need for the patient or an attendant (hereinafter “user”) to hold the injector, for the required duration of the slow injection. Furthermore, it is within the broadest scope of this invention that the injector adapter  20  be universal. That is, the injector adapter  20  can be applied to a range of conventional automatic injectors where the delivery of a highly viscous drug is required, and/or where the time of drug delivery is longer than a conventional automatic injector delivering a bolus and/or where manual injection by the patient is not possible and assistance is needed in the form of the adapter  20 . The high viscosity of some drug solutions substantially increases the injection time. Injection time is the result of the level of pressure applied to the drug volume, the physical attributes of the drug including viscosity, and the fluid path geometry such as the needle&#39;s inner diameter and length, as well as delivery volume. Injection time, in most cases, is a device control parameter though in some cases the tissue also affects it by creating significant backpressure. Alternatively, for some low viscosity drugs, a modified device would be used to slow down the delivery rate and to increase the delivery time. The injection time could reach into tens of minutes. It is not possible for the patient to reliably keep an injector pressed against the skin for an extended time. The injector adapter  20  solves this problem.  
     [0033] Referring now in detail to the various figures of the application wherein like reference characters refer to like parts, there is shown at  20  in FIG. 1 an injector adapter that couples to the skin of a living being and permits an automatic injector to be coupled thereto without the need for an attendant to hold the automatic injector during drug delivery to the living being; especially in cases where the injection of the drug solution must be delivered slowly over a long period of time (e.g., approximately 10 minutes).  
     [0034] In particular, the injector adapter  20  basically comprises a base portion  22  and an injector receiving portion  24 . As shown most clearly in FIG. 3, the base portion  22  couples to the skin  26  of a living being and an automatic injector  10  is releasably coupled to the injector receiving portion  24 . Examples of automatic injectors that can be used with the injector adapter  20  are those disclosed in U.S.A.S. No. 60/334,294 filed on Nov. 30, 2001 entitled AUTOMATIC INJECTOR and whose entire disclosure is incorporated by reference herein. It should be understood that it is within the broadest scope of this invention to have the injector adapter  20  be used with any automatic injector and that the examples cited in No. 60/334,294 do not limit the use of the injector adapter  20  to only those automatic injectors. Moreover, the term “automatic injector” as used throughout this Specification is meant to include any injector that automatically delivers a material to a living being and therefore includes automatic injectors that do not automatically retract an injection needle (also referred to as “automatic syringes”) and also includes automatic needle-less injectors.  
     [0035] The preferred embodiment of the injector adapter  20  comprises a unitized base portion  22  and injector receiving portion  24  that can be formed using any well-known rigid material (e.g., plastic), although it is within the broadest scope of the invention  20  to have the base portion  22  and the injector-receiving portion  24  be two separate pieces that can be assembled into the injector adapter  20 . The injector adapter  20  forms a disposable unit, as do the automatic injectors that are used with the injector adapter  20 .  
     [0036] The base portion  22  forms a substantially flat surface and comprises a hole  28  (FIGS.  4 - 5 ) that permits a needle  12  (FIG. 4) to pass through the base portion  22  and into the skin  26  for the injection; alternatively, when a needle-less automatic injector (not shown) is used, the hole  28  permits the passage of the drug solution from the output of the needle-less automatic injector, through the base portion  22  and into the skin  26 . The base portion  22  is circular in shape (e.g., 60 mm diameter) and, in the preferred embodiment, adheres to the skin  26  of the living being using, preferably, an adhesive system  27  (FIGS.  2 - 2 A) applied to the underside of the base portion  22  to maintain the automatic injector  10  pressed against the skin  26  of the living being for an extended time.  
     [0037] In order to couple the injector adapter  20  to the skin  26 , it is necessary to allow an element of flexibility for the skin  26  relative to the rigid nature of the injector adapter  20  and injector  10 . A similar adhesive mechanism has been developed and is the subject of PCT Application No. IE99/00046 entitled IMPROVED ADHESIVE SYSTEM FOR MEDICAL DEVICES and whose entire disclosure is incorporated by reference herein. The adhesive system  27  improves the ability to attach a rigid body, i.e., the injector adapter  20 , to a flexible one, i.e., the skin  26  of a living being. In particular, as shown in FIG. 2, the adhesive system  27  comprises a double-sided adhesion layer  27 A, a biocompatible single-side adhesion layer  27 B and a liner  27 C. The double-sided adhesion layer  27 A (e.g., Avery Dennison FT-1115) has one side  27 A 1  (FIG. 2A) that is secured against the base portion  22 ; a hole  28 A is provided in the layer  27 A that aligns with the hole  28  in the base portion  22  for allowing passage of the drug or needle (not shown). The non-adhesive side  27 B 1  (a portion of which is shown in FIG. 2A) of the biocompatible single-side adhesion layer  27 B (e.g., Kendall FM100) is secured against the other side  27 A 2  of the double-sided adhesion layer  27 A; similarly, the biocompatible single-side adhesion layer  27 B also comprises a hole  28 B that aligns with holes  28 / 28 A to permit passage of the drug or needle (not shown). Finally, the liner  27 C having a pull tab  32  is releasably coupled to biocompatible adhesive side  27 B 2  to cover side  27 B 2  until that side  27 B 2  is ready to be coupled to the skin  26 . As can be seen from FIGS.  2 - 2 A, the biocompatible single-side adhesion layer  27 B is larger than the double-sided adhesion layer  27 A, thereby forming a “skirt” or “ring”  30  that is not adhered to the base portion  22 . As a result, this provides the element of flexibility mentioned earlier. During assembly, the adhesive system  27  (FIG. 2A) is applied to the base portion  22  and is ready for use as shown in FIG. 1. When the injector adapter  20  is ready to be applied, the user seizes the tab  32  on the liner  27 C and pulls it away from the base portion  22 , thereby exposing the biocompatible adhesive side  27 B 2 . Once the liner  27 C is removed, the injector adapter  20  can then be adhered to the injection site on the skin  26 . Tests conducted using the adhesive system  27  with the injector adapter  20  with an automatic injector  10  coupled thereto indicated that it is important to thoroughly wipe the injection site with alcohol before the injector adapter  20  is applied to the area. This wiping procedure apparently reduces the levels of oil and particulate matter in the site area which enhances the ability of the biocompatible adhesive side  27 B 2  to hold the injector adapter  20  in place for a long period of time (e.g., 10 minutes).  
     [0038] The injector receiving portion  24  of the injector adapter  20 , in the preferred embodiment, basically comprises a collar or neck that receives the working end  14  of the automatic injector  10 . In particular, the collar/sleeve is circular in shape (e.g., inside diameter 24 mm) in order to correspond with the circular shaped working end  14  of the injector  10 . It should be noted that the collar/sleeve may be a non-circular shape (e.g., oval) so long as it corresponds in shape with the working end of the injector  10 . Depending on the type of automatic injector  10  used, it is within the broadest scope of the injector adapter  20  to have the injector receiving portion  24  include means for engaging and disengaging. For example, if the injector adapter  20  is to be a non-disposable unit and therefore used again, disengagement from the automatic injector  10  is then required. Thus, the working end  14  of the injector  10  may include tabs, undercuts, and cutouts in the collar/sleeve to permit unobstructed operation of any injector triggers or visual access to any drug windows when the injector  10  is engaged with the injector adapter  20 . Thus, the injector adapter  20  can have design features that match a selected automatic injector design.  
     [0039] For example, as shown most clearly in FIG. 3, where an automatic injector  10  comprises a slidable injection trigger  16  along the working end  14 , the injector receiving portion  24  comprises a cutout  34  (or opening, aperture, gap, etc.) to allow the attendant to operate the trigger  16  once the working end  14  is coupled to the injector adapter  20 . FIG. 4 shows the trigger  16  being in a downward position, thereby extending the needle  12  downward, through the hole  28  and into the skin  26 . Furthermore, where the automatic injector  10  comprises a slit/cavity  17  (see FIGS.  3 - 4 ) at the working end  14 , a corresponding catch  36  (FIG. 4) inside the collar/sleeve releasably engages the slit/cavity  17  to releasably couple the injector  10  to the injector adapter  20 . In addition, where a drug window  19  (FIGS.  4 - 5 ) is included within the working end  14  of the injector  10 , a corresponding cutout  34 A (FIG. 1, or other cutout, opening, aperture, gap, etc.) in the injector receiving portion  24  provides visual access to the user during the injection process to permit the user to know the level of drug still within the injector  10 ; the injector receiving portion  24  may include other cutouts  34 B (FIG. 1) that permit visual access to other portions of the working end  14  of the injector  10  when it is engaged in the injector receiving portion  24 . It should also be noted that where the automatic injector  10  comprises a body sensing element  11  that normally retracts when the injector  10  is directly pressed against the skin of the living being, this retraction is not obstructed when the injector  10  is coupled to the injector adapter  20 . In particular, during engagement of the working end  14  of the injector  10  within the injector adapter  20 , the base portion  22  provides the body sensing element  11  with a firm surface to push against; in addition, this retraction action of the body element  11  operates to cause a snap cooperation of the slit/cavity  17  and the catches  36  to support the engagement/disengagement of the working end  14  within the injector receiving portion  24 . Furthermore, this snap cooperation also aligns the retracted injection needle  12  with the hole  28  (as well as holes  28 A- 28 B in the adhesion system  27 ) in preparation for injection. Once engaged with the injector adapter  20 , it should be understood that the automatic injector  10  can then be used in its normal operation (i.e., needle penetration, drug delivery, needle retraction by the end of delivery) as if it were placed directly against the skin, but without the need to hold the injector  10  in place during injection.  
     [0040] It should be noted that although it is preferred to have the automatic injector  10  be vertically oriented during the injection process (as shown in FIG. 4), e.g., the living being can be in a prone position, it is not required. If the living being is a human, the patient can be in a sitting, reclining or even in an upright position. Furthermore, the preferred embodiment of the injector adapter  20  has the injector receiving portion  24  perpendicular to the base portion  22 , thereby creating an injection that is normal to the skin surface. It is within the broadest scope of the invention  20  though, to include other angular orientations of the injection to the skin using the injector adapter  20 . Thus, the key feature of the present invention  20  is that it provides a secure coupling of the automatic injector  10  to the living being during injection without the need for an attendant to hold the injector  10  during injection, thereby preventing any needle movements in the tissue during injection.  
     [0041] An alternative embodiment of the injector adapter  20  is shown in FIG. 5 whereby the injector receiving portion  24 ′ of the injector adapter  20  is shortened in height. This shortened height  38  facilitates packaging and storing of the injector adapter  20 . It also alleviates the need to provide a cutout  34  (or opening, aperture, gap, etc.) in the collar/sleeve as discussed earlier. And although the neck/collar is shortened, the injector-receiving portion  24  still operates to couple a smaller sized working end of the injector  10  using the snap cooperation of the slit/cavity  17  and the catches  36 . FIGS.  6 - 8  show the use of the injector adapter  20  using another type of shortened injector receiving portion  24 ″ with a different type of automatic injector  10 ′. The release sheet  27 C also comprises a slightly-modified tab  32 ′ which includes a grasping hole  33 . FIG. 9 shows the injector adapter  20  using either of the shortened injector receiving portions  24 ′ or  24 ″ and the adhesive system  27  coupled to the base portion  22 , with the liner  27 C already removed.  
     [0042] Another variation of the injector adapter  20  is an integrated injector/adapter configuration as shown in FIG. 10 using the reference number  120 , whereby the adapter is incorporated into the automatic injector itself at its proximal end. The integrated injector adapter  120  reduces the number of steps and simplifies the injection process. This is of critical importance for patients with limited dexterity, including rheumatoid arthritis (RA) and multiple sclerosis (MS) patients. In the embodiments of the injector adapter  20  discussed previously, the user would remove the injector adapter  20  from its package and the automatic injector  10  from its package. The user would then normally apply the injector adapter  20  to the injection site (after thoroughly wiping the site with alcohol, as discussed earlier) by pulling the tab  32  of the release sheet  27 C and applying the injector adapter  20  at the site. Next, the user would prepare the automatic injector  10  in accordance with the accompanying instructions of that particular injector  10  (e.g., inserting a drug cartridge, removing any needle protector means, etc.). Once the injector  10  is ready for use, the user would then insert the working end  14  of the injector  10 , as discussed previously. In contrast, using the integrated injector adapter  120 , the user would remove the combined automatic injector/adapter  120  from a single package. Furthermore, the removal of the release sheet  27 C from the base portion  22  of the integrated injector adapter  120  simultaneously removes the needle protector means. Because the automatic injector  10  already comprises the base portion  22 , the step of inserting the automatic injector  10  into the adapter is omitted.  
     [0043] As shown most clearly in FIGS.  10 - 11 , the integrated injector adapter  120  comprises an injector  122 , a trigger button  124 , a safety tab  126 , an observation window  128 , the body-engaging portion  130 , a liner  132  and a clip  134 . A form or bond line  129  is shown between the injector  122  housing and the body-engaging portion  130 . As will be discussed in detail later, the clip  134  is pulled away from the body-engaging portion  130  when the device  120  is ready to be applied to the skin  126  of the living being. When the clip  134  is pulled away, a flat base surface  125  (FIG. 12) is exposed for engaging the skin  126  of the living being.  
     [0044] In particular, as shown most clearly in FIG. 12, the injector  122  contains a pre-filled syringe  121  (e.g., a pre-filled HYPAK® syringe, such as a 1 ml “short” version),having a needle  136  attached thereto and a removable needle protector  138  (e.g., a rubber sterility protector) covering the needle  136 . When the integrated injector adapter  120  is assembled, the needle  136  and protector  138  are positioned to pass through an opening  140  in the flat base surface  125 . The forward end  142  of the needle protector  138  is lodged into latches  144  located within an opening  145  (FIG. 13 a ) in the top surface  147  of the clip  134 . Thus, upon removal of the clip  134 , the needle protector  138  is also pulled away from the needle  136 , while the needle  136  remains retracted within the body-engaging portion  130 , in preparation for the injection.  
     [0045]FIG. 13 a  provides a top view of the clip  134  (removed from the integrated injector adapter  120 ) showing the opening  145  containing the latches  144  therein. A pair of snaps  146 A/ 146 B on opposing sides of the clip  134  releasably engage corresponding recesses in the lower portion of the body engaging portion  130 , as shown most clearly in FIG. 14 which shows only one of the snaps  146 B/corresponding recess  148 B, it being understood that the other snap  146 A releasably engages into a corresponding recess on the opposite side of the body engaging portion  130 . The clip  134  has a gripping surface  135  (FIG. 13 a ) which helps an RA or MS patient seize the clip  134  in order to remove it.  
     [0046]FIG. 15 provides a top view of the release liner  132  which covers the flat base surface  125  before use of the integrated injector adapter  120 . During assembly of the integrated injector adapter  120 , an adhesive system, similar to adhesive system  27 , is applied to the underside surface of the flattened base surface  125  and includes a biocompatible single-side adhesion layer (similar to layer  27 B discussed earlier) that is covered with the release liner  132 . A hole  150  is provided in the release liner  132  to permit the removal of the needle protector  138  when the clip  134  is pulled away. In addition, the release liner  132  comprises holes  152  on opposite sides of the release liner  132  which are connected to clip  134  via respective pins  154  (only one of which is shown in FIG. 16) which are on opposite sides of the clip  134 . Thus, when the user pulls the clip  134  away from the integrated injector adapter  120 , the release liner  132  is also pulled away in a symmetrical manner that will not cause any side forces on the protector  138  or on the needle  136  that might otherwise bend or deform either the protector  138  or the needle  136 . This removal of the clip  134  exposes the adhesion biocompatible single-side adhesion layer  27 B 2  in preparation for application of the integrated injector adapter  120  to the skin  26 .  
     [0047] During assembly, the pre-filled syringe  121 , including the needle  136  and needle protector  138 , is positioned within the injector  122  housing and positioned through the hole  140  in the body-engaging portion  130 . The release liner  132  is installed on the flat base surface  125  and the clip  134  is coupled to the body-engaging portion  130 . When the integrated injector adapter  120  is to be used for injection, the user wipes the injection site thoroughly with alcohol. The user then seizes the gripping surface  135  of the clip  134  and pulls the clip  134  away from the integrated injector adapter  120 , which exposes the biocompatible single-side adhesion layer (similar to layer  27 B discussed earlier). The user then presses the flat base surface  125  against the injection site to cause the integrated injector adapter  120  to adhere to the injection site. The user then removes the safety tab  126 ; the safety tab  126  prevents false activation of the integrated injector adapter  120 . As discussed earlier with respect to the injector adapter  20 , some automatic injectors  10  use a body-sensing element  11  (FIG. 3) as a method to prevent false activation. Where the integrated injector adapter  120  is used, such a body-sensing element is replaced by the safety tab  126 . Next, the user then activates the trigger  124  to effect the automatic injection: needle penetration and drug delivery for the prolonged period (e.g., 10 minutes) which is then followed by automatic needle retraction. The user can also confirm completion of the drug delivery by sensing the automatic needle retraction and/or viewing the empty syringe body which is visible through the drug window  128 . The integrated injector adapter  120  is then removed from the injection site and ready for safe disposal.  
     [0048] It should be understood that both the injector adapter  20  and the integrated injector adapter  120  can be used for extended bolus as well as by patients not capable of keeping the automatic injector steady against the injection site for the time required for conventional automatic injections (e.g., a few seconds).  
     [0049] It is also within the broadest scope of the invention to include the use of an injector adapter for conventional hypodermic needles that are manually-operated by an attendant.  
     [0050] It is further appreciated that the present invention may be used to deliver a number of drugs. The term “drug” used herein includes but is not limited to peptides or proteins (and mimetic thereof), antigens, vaccines, hormones, analgesics, anti-migraine agents, anti-coagulant agents, medications directed to the treatment of diseases and conditions of the central nervous system, narcotic antagonists, immunosuppressants, agents used in the treatment of AIDS, chelating agents, anti-anginal agents, chemotherapy agents, sedatives, anti-neoplastics, prostaglandins, antidiuretic agents and DNA or DNA/RNA molecules to support gene therapy.  
     [0051] Typical drugs include peptides, proteins or hormones (or any mimetic or analogues or any thereof) such as insulin, calcitonin, calcitonin gene regulating protein, atrial natriuretic protein, colony stimulating factor, betaseron, erythropoietin (EPO), interferons such as α, β or γ interferon, somatropin, somatotropin, somastostatin, insulin-like growth factor (somatomedins), luteinizing hormone releasing hormone (LHRH), tissue plasminogen activator (TPA), growth hormone releasing hormone (GHRH), oxytocin, estradiol, growth hormones, leuprolide acetate, factor VIII, interleukins such as interleukin-2, and analogues or antagonists thereof, such as IL-1ra; analgesics such as fentanyl, sufentanil, butorphanol, buprenorphine, levorphanol, morphine, hydromorphone, hydrocodone, oxymorphone, methadone, lidocaine, bupivacaine, diclofenac, naproxen, paverin, and analogues thereof; anti-migraine agents such as sumatriptan, ergot alkaloids, and analogues thereof; anti-coagulant agents such as heparin, hirudin, and analogues thereof; anti-emetic agents such as scopolamine, ondansetron, domperidone, metoclopramide, and analogues thereof; cardiovacular agents, anti-hypertensive agents and vasodilators such as diltiazem, clonidine, nifedipine, verapamil, isosorbide-5-monotritate, organic nitrates, agents used in treatment of heart disorders, and analogues thereof; sedatives such as benzodiazepines, phenothiazines, and analogues thereof; chelating agents such as defroxanune, and analogues thereof; anti-diuretic agents such as desmopressin, vasopressin, and analogues thereof; anti-anginal agents such as fluorouracil, bleomycin, and analogues thereof; anti-neoplastics such as fluorouracil, bleomycin, and analogues thereof; prostaglandins and analogues thereof; and chemotherapy agents such as vincristine, and analogues thereof, treatments for attention deficit disorder, methylphenidate, fluvoxamine, bisoprolol, tacrolimus, sacrolimus and cyclosporin.  
     [0052] While this invention has been particularly shown and described with references to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.