Multi-chamber sequential injection

Abstract

Disclosed and described herein are methods and systems for multi-chamber sequential injection of one or more substances, such as for intramuscular administration of medication. Certain embodiments of the present invention comprise a first chamber with a laterally disposed bypass flow channel, wherein sequential injection device houses separate chambers for segregated substances, bordered by plungers, as well as a bypass flow insert with an insert flow channel and at least one protruded feature ensuring a connecting space between the bypass flow channel and the insert flow channel.

Description

TITLE OF THE INVENTION: Multi-Chamber Sequential InjectionCROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of and priority to U.S. Provisional Application Serial No. 63 / 677,029, filed July 30, 2024, which is hereby incorporated by reference in its entirety for all that it contains (including all references therein) for all purposes as if restated and set forth fully herein to the maximum extent allowable by law.BACKGROUND OF THE INVENTION

[0002] The present invention relates to methods and systems for multi-chamber sequential injection of one or more drug substances, such as in the example of intramuscular (IM) or subcutaneous (SC or SQ) medication administration to a human or other animal. The present invention allows reliable preservation of different substances in separate chambers within the same system without mixing or other compromise, in a manner capable of withstanding distant transportation and long shelf-life durability, while preserving ease of administration for a user at time of sequential injection of contents of all chambers via a single injection. Methodologies and apparatuses described in the prior art lack such optimization and fail at one or more of these aspects, among other problems addressed by the present invention.

[0003] Other features of the present invention will be apparent to persons having ordinary skill in the art in light of this disclosure and description.BRIEF SUMMARY OF THE INVENTION

[0004] In certain embodiments of the present invention, a multi-chamber sequential injection system comprises a needle, a chamber that is proximate to the needle, and housing a bypass flow insert, and a plurality of plungers with an outer diameter, wherein the chamber further comprisesan inner diameter and a bypass flow channel with a bypass flow channel diameter, and the bypass flow insert comprises at least one protruded feature on its top side as well as an insert flow channel from its top side to its bottom side. The space between the bypass flow insert and its nearest plunger is a chamber, as is the space between each plunger thereafter, with circumferential seal along the inner diameter of the chamber with the outer diameters of the plungers and bypass flow insert. Each chamber can be filled with a different substance, which may be stored without mixing or leaking between contents of sequential chambers. When injection is desired, applying a force to the rearmost element translates all components within the chamber toward the needle. When the nearest plunger reaches and contacts the bypass flow insert, the protruded feature(s) results in preservation of a connecting space from the bypass flow channel to the flow channel. The substance in the next sequential chamber after the plunger then flows via the bypass flow channel, connecting space, and insert flow channel, to be injected through the needle. This pattern may repeat sequentially.

[0005] It shall be understood the systems described herein may comprise apparatuses, assemblies, and / or devices, and the present invention also includes methods, pertaining to the same.BRIEF DESCRIPTION OF THE DRAWINGS

[0006] For purpose of explanation, aspects of several embodiments are depicted in the following illustrative figures, wherein:

[0007] FIG. 1 represents an oblique partially transparent view of a multi-chamber sequential injection system according to the present invention;

[0008] FIG. 2A represents a long-axis partially transparent view of a multi-chamber sequential injection system according to the present invention;

[0009] FIG. 2B represents a long-axis internal view of a multi-chamber sequential injection system according to the present invention;

[0010] FIG. 2C represents an expanded component view of a multi-chamber sequential injection system according to the present invention;

[0011] FIG. 3 represents long-axis internal views of a chamber with a bypass flow channel;

[0012] FIG. 4A represents a top view of a bypass flow control insert;

[0013] FIG. 4B represents a side view of a bypass flow control insert;

[0014] FIG. 4C represents a bottom view of a bypass flow control insert;

[0015] FIG. 4D represents a longitudinally bisected view of a bypass flow control insert;

[0016] FIG. 4E represents an oblique bottom and side view of a bypass flow control insert;

[0017] FIG. 4F represents an oblique top and side view of a bypass flow control insert;

[0018] FIGS. 5A-E represent a method of sequentially injecting two substances via a dualchamber sequential injection system according to the present invention; and

[0019] FIGS. 6A-G represent a method of assembling a dual-chamber sequential injection system according to the present invention.DETAILED DESCRIPTION OF THE INVENTION

[0020] In the disclosure herein, details are set forth for purpose of description. However, a person having ordinary skill in the art will realize the invention may be practiced without all the specifics herein. The embodiments and explanations are intended, therefore, to be illustrative only, and not limiting. Similarly, where examples are used, they are not intended to be limiting unless the context clearly indicates otherwise. Accordingly, “for example” or “e.g.” should be read as “for example, and without limitation,” unless the context clearly indicates limitation is intended.

[0021] The meaning of “substance” includes: active pharmaceutical ingredient, amalgam, analgesic, anesthetic, antibiotic, antidote, antifungal, antimicrobial, antiseptic, antitoxin, antiviral, biologic, drug, drug substance, elixir, matter, medicament, medication, medicine, mixture, ingredient, inoculation, pharmaceutical, prescription, reconstitution, serum, solute, solution, solvent, suspension, tincture, vaccination, and vaccine. It shall be understood that substance includes the foregoing across various modes of administration (e.g. intra-articular, intradural, intraluminal, intramuscular, intrathecal, parenchymal, subcutaneous, sublingual), purposes for use (e.g. analgesia, anesthesia, chemotherapy, sedation, sterilization), and recipients (e.g. a human of any age or any other mammal, animal, or creature), including regarding any specialty or discipline within healthcare or any similar field or art, and whether for diagnosis, inquiry, investigation, prevention, research, therapy, treatment, or any combination thereof. It shall also be understood that a substance may be the result of adding, combining, dissolving, mixing, reconstituting, suspending, and / or any other manner of uniting two or more component substances. It shall further be understood that a substance should be fluid but may comprise different states of matter.

[0022] Embodiments of the present invention may comprise certain drugs or combinations thereof, with examples provided herein. It shall be known that these examples are non-limiting, and extend to agents in identical or similar classes and / or with identical or similar mechanisms of action, and shall include equivalents with generic or other naming, all of which will be readily apparent to persons having ordinary skill in the art. Those of ordinary skill in the art will appreciate that the scope of the present invention encompasses and is directed to agents spanning various categories, including, for example, antibiotics, anticonvulsants, antidotes, antifungals, antihistamines, antiinflammatories, antimicrobials, antivirals, immunizations, vaccinations, and sympathetic and parasympathetic agonists and antagonists.

[0023] In certain embodiments, a drug may comprise at least one item selected from the group consisting of: acyclovir, albuterol, amoxicillin, amphotericin B, ampicillin, anidulafungin, artesunate, atropine, azithromycin, benzylpenicillin, brincidofovir, buprenorphine, caspofungin, cefazolin, cefepime, cefoperazone, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, cephalexin, cilastatin, clavulanate, clindamycin, clobazam, clonazepam, cloxacillin, cortisone, dantrolene, dexamethasone, diazepam, epinephrine, ertapenem, erythromycin, flumazenil, ganciclovir, hydrocortisone, imipenem, ketoconazole, lamotrigine, levetiracetam, meropenem, methylprednisolone, micafungin, midazolam, morphine, naloxone, naltrexone, norepinephrine, penicillin, pentamidine, perampanel, piperacillin, pralidoxime, prednisolone, prednisone, rufinamide, sulbactam, sulfamethoxazole, sumatriptan, tazobactam, topiramate, trimethoprim, valacyclovir, valproate, valproic acid, vancomycin, voriconazole, and zonisamide.

[0024] In exemplary embodiments, a drug may comprise the antiviral brincidofovir, offering utility in treating viral infection in geographical areas that may not be readily accessible, such as, for example, infection with a member of the Ebolavirus genus.

[0025] In exemplary embodiments, a drug may comprise a vaccination, such as those against influenza (flu), tuberculosis (TB), poxviridae, variola viral infection (e.g., smallpox), and varicella-zoster viral infection (e.g., chicken pox and / or shingles). In particular embodiments, a powder may comprise a polysaccharide conjugate vaccine. One example may comprise the Haemophilus influenzae type B (HIB) vaccine (which may be reconstituted, e.g., in 0.4% saline).

[0026] In exemplary embodiments, a drug may comprise antidotes for nerve gas or pesticide poisoning. In particular embodiments, a drug may comprise atropine, and the second drug may comprise pralidoxime. In particular embodiments, a drug may comprise atropine, and the seconddrug may comprise scopolamine. In other embodiments, a drug may comprise 2-pyridine aldoxime methyl chloride (2PAM).

[0027] In exemplary embodiments, a drug may comprise epinephrine in solution. Epinephrine in solution may be sensitive to container material or interaction with a second drug substance, imposing restrictions on storage, transportation, and shelf-life. The possibility of epinephrine in solution, with the advent of the inventive features of the present invention, allows for a more forgiving and durable product, with improved shelflife and drug stability, including across a wider range of container materials (e.g., plastic) and housed in the same autoinjector device with a second drug in separate chambers without mixing.

[0028] The meaning of “chamber” includes cartridge, module, container, reservoir, vial, receptacle, or any component designed to hold a substance. It shall be understood that chamber includes the foregoing across various modes of administration (e.g. intra-articular, intradural, intraluminal, intramuscular, intrathecal, parenchymal, subcutaneous, sublingual), purposes for use (e.g. analgesia, anesthesia, chemotherapy, sedation, sterilization), and recipients (e.g. a human of any age or any other mammal, animal, or creature), including regarding any specialty or discipline within healthcare or any similar field or art, and whether for diagnosis, inquiry, investigation, prevention, research, therapy, treatment, or any combination thereof.

[0029] The meaning of other terms may be defined herein explicitly or otherwise and / or will be apparent to persons having ordinary skill in the art.

[0030] FIG. 1 depicts a multi-chamber sequential injection system 100 comprising two chambers having a distal end 100a and a proximal end 100b. While embodiments discussed in detail herein may be dual-chambered, the invention is not limited to two chambers.

[0031] FIGS. 2A-C show three different views of the dual-chamber sequential injection system 100. FIG. 2A shows a view of the exterior of the system 100, which includes a chamber 102 and a needle cap cover 101. As shown in FIG. 2B, a chamber proximate to the needle 102 houses bypass flow insert 105, first plunger 107, and second plunger 109. The space between bypass flow insert 105 and first plunger 107 creates a first chamber 106 where a first substance may reside. Similarly, the space between first plunger 107 and second plunger 109 creates a second chamber 108 where a second substance may reside. The bypass flow insert 105 is configured to be in fluid communication with the needle 103 via an insert flow channel 112, which is included in bypass flow insert 105. In the embodiment of system 100, the needle 103 is a hollow needle with a distal tip 111 and proximal base 114. Also, in the embodiment of system 100, the needle cap cover 101 is only removable via selective unlocking of a needle cap seal 104, to help prevent unintentional or otherwise undesired penetration injury from the needle 103, for the safety of the user(s) and / or injection subject(s).

[0032] The first chamber 102 has a chamber inner diameter 113 along the portions of chamber 102 not comprising bypass flow channel 115; and chamber 102 comprises bypass flow channel115 and bypass flow channel diameter 116 along the portion 117 of chamber 102 comprising bypass flow channel 115. In system 100, the bypass flow channel diameter 116 is greater than the chamber inner diameter 113, e.g. along that certain portion 117 of the length of chamber 102. Also, as shown in FIG. 2C, the bypass flow channel 115 in system 100 and bypass flow channel diameter116 encompass a limited circumference extending only for a specific arc 118 of the circumference of chamber 102. In certain embodiments of the invention, the bypass flow channel diameter 116 may vary over the specific arc 118 of the circumference of the chamber 102 and portion 117 of thelength of the chamber 102. Regardless of such variability, the bypass flow channel diameter 116 is always greater than the chamber inner diameter 113.

[0033] In system 100, as shown for example in FIGS. 2A-2C, other than at the bypass flow channel 115 of chamber 102, there is circumferential sealing between chamber 102 and the first plunger 107 and second plunger 109. This specific design of the circumferential sealing in system 100 means that a substance in first chamber 106 and substance in second chamber 108 cannot mix during storage of the system 100 because fluid in first chamber 106 and second chamber 108 cannot pass the edge of first plunger 107 along the portions of chamber 102 comprising chamber inner diameter 113. In embodiments of the invention, such as system 100, the outer diameter 119 of first plunger 107 is such that the first plunger 107 is in friction contact (with circumferential sealing) with the first chamber 102 other than when first plunger 107 is moved into a position where it abuts the portion of the length 117 of the first chamber and specific arc 118 of the first 102 that define the bypass flow channel 115 - i.e., at the position where the bypass flow channel diameter 116 is greater than the first plunger 107 outer diameter 119. The surface of first plunger 107 that is in friction contact with the surface of the first chamber 102 is configured such that it can be moved within the first chamber 102 in the proximal to distal (or distal to proximal) direction of the system 100 with the application of force. Similarly, the outer diameter 120 of the second plunger 109 is such that the second plunger 109 is in friction contact (with circumferential sealing) with the first chamber 102 other than when second plunger 109 is moved into a position where it abuts the portion of the length 117 of the first chamber 102 and specific arc 118 of the first chamber 102 that define the bypass flow channel 115 - i.e., at the position where the bypass flow channel diameter 116 is greater than the second plunger 109 outer diameter 120. The surface of second plunger 109 that is in friction contact with the surface of the first chamber 102 is configured suchthat it can be moved within the first chamber 102 in the proximal to distal (or distal to proximal) direction of the system 100 with the application of force.

[0034] Embodiments of the invention may include a plurality of protrusions on a bypass flow insert. For example, in system 100, the bypass flow insert 105 includes protrusions 121.

[0035] FIG. 3 shows a closer look at the first chamber 102 and specifically its bypass flow channel 115. The needle 103 is seen at the distal end of the system 100, and the bypass flow channel 115 forms a portion of the first chamber 102.

[0036] FIGS. 4A-F illustrate the details of an embodiment of a bypass flow insert 400 that can be used in embodiments of the invention, such as, for example system 100. Bypass flow insert 400 comprises a top side 401 and bottom side 402, an insert flow channel 403 extending through the bypass flow insert 400 from the top side 401 to the bottom side 402, and protrusions 405 on the top side 401. Bypass flow insert 400 has an outer diameter 406 and a height 407. Protrusions 405 have a height 408. In an exemplary embodiment of system 100, for example, bypass flow insert 105 may comprise bypass flow insert 400 wherein insert flow channel 112 comprises insert flow channel 403 and protrusions 121 comprise protrusions 405.

[0037] The figures herein show generally rounded components. It will be understood that components may be of any other shape as necessary, warranted, appropriate, and / or desired. Further, FIGS. 4A-4F herein show a bypass flow insert 400 comprising three equidistant rounded protrusions 405 with height 408. Embodiments of the invention may comprise bypass flow inserts with other dimensions, quantities, configurations, and shapes of protruded feature(s).

[0038] FIGS. 5A-E show a method of sequential injection using an embodiment of a dualchamber sequential injection system 500. FIG. 5A depicts the system 500 as it would be in storage with first chamber filled with first substance 506 and second chamber filled with second substance508. FIG. 5B depicts an application of a force 510 in a proximal to distal direction at second plunger 509, which moves second plunger 509 in the proximal to distal direction, which therefore pushes, and causes distal translation of, the serially apposing second substance 508, first plunger 507, and first substance 506. As a result of each of these movements caused by the force 510, the first substance 506 moves through the bypass flow insert 505 and needle 503 and results in the start of the injection of first substance 506. It shall be understood that forces described herein, such as force 510, may comprise an energy, force, strength, and / or work that is the direct or indirect result of a human or non-human. In certain embodiments, force 510 is manual and exerted by a human user (e.g., in administration to oneself or another person). However, automation, and machine generated forces, among others, are also included in the present invention.

[0039] FIG. 5C depicts further application of force 510 to the second plunger 509 in the proximal to distal direction causing further movement of the second substance 508, first plunger 507, and first substance 506. At the specific point in shown in FIG. 5C, the first plunger 507 has come into contact with the protruded features of bypass flow insert 505 that prevent complete apposition of first plunger 507 along the entire top side of bypass flow insert 505. The protrusions of bypass flow insert 505 preserve a connecting space that allows for fluid communication between the bypass flow channel 515 to the insert flow channel 512 of bypass flow insert 505. Further, in certain embodiments, generally some amount of the first substance 506 may remain in the bypass flow channel 515, connecting space, insert flow channel 512, and / or needle 503 at the point illustrated in FIG. 5C. The second substance 508 is then at a point where it can enter the bypass flow channel 515 and with further application of force 510 can bypass first plunger 507 and proceed towards the needle 503 and injection site.

[0040] FIG. 5D depicts further application of feree 510 to the second plunger 509 in the proximal to distal direction causing further movement of the second substance 508 from the second chamber into the bypass flow channel 515 and through the insert flow channel 512 and ultimately out through needle 503 for injection of the second substance 508. At or before this point, the full amount of first substance 506 that was filled in the first chamber has been injected through the needle 503 in the embodiment illustrated in FIG. 5D.

[0041] FIG. 5E depicts further application of force 510 in the proximal to distal direction causing further movement of the second plunger 509 until it comes into contact with the first plunger 507, and movement of the remainder of second substance 508 from the second chamber into the bypass flow channel 515 and ultimately out through the needle 503. In certain embodiments, at this point in the injection process, a small amount of the second substance 508 may remain in the bypass flow channel 515, connecting space, insert flow channel 512, and / or needle 503. In certain embodiments, further force application may cause further movement and injection of remaining second substance 508.

[0042] In certain embodiments of the invention, application of force to the second plunger can be combined with proximal to distal translation of the system (e.g., moving the needle deeper into the injection site), possibly with specific timing of the force and translation such that injection of the second substance occurs when the needle is at a deeper target(s) in the injection site (such as, e.g., a different tissue level) than at the target(s) for injection of the first substance, allowing for selective administration.

[0043] Finally, FIGS. 6A-G show methods for assembly of inventive systems such as those of the foregoing figures. An insertion rod 622 and insertion tube 623 can be utilized to, respectively, push and guide a bypass flow insert 605 (FIGS. 6A, 6B), first plunger 607 (FIG. 6D), and secondplunger 609 (FIG. 6F) into position within the first chamber 602, with intervening filling of first substance 606 (FIG. 6C) and second substance 608 (FIG. 6E) into their desired chambers. More specifically, in FIGS. 6A-6B first insertion rod 622 pushes bypass flow insert 605 through insertion tube 623 to the distal end inside the first chamber 602. In FIG. 6C, first substance 606 is added to the first chamber 602. In FIG. 6D, insertion rod 622 pushes first plunger 607 through insertion tube 613 into the first chamber 602 until first plunger 607 apposes first substance 606. In FIG. 6E, second substance 608 is added in the second chamber 602. In FIG. 6F, insertion rod 612 pushes second plunger 609 through insertion tube 613 into the chamber 602 until second plunger 609 apposes second substance 608. In FIG. 6G, the inventive system has been assembled with first substance 606 and second substance 608 filled in the system and ready for injection.

[0044] Components of the present invention can comprise commonly used materials in the ail, such as plastic, rubber, glass, polymeric materials, metals, and / or alloys. In some embodiments, the chamber comprises one or more items selected from the group consisting of: medical grade plastic, glass, stainless steel, and aluminum. In some embodiments, the plungers comprise industry standard medical plungers and / or pistons, and / or may comprise one or more items selected from the group consisting of: polytetrafluoroethylene, polyethylene, polypropylene, and polyisoprene.

[0045] The foregoing pertains to certain embodiments only. Persons having ordinary skill in the art will readily detect improvements or variations that may apply to other embodiments within the scope of this invention in light of this disclosure. The disclosure herein provides description of the present invention and elements thereof. It will be understood that such specifics are for illustrative and exemplary purposes only and are not intended to be limiting. The invention described herein is not intended to be limited to the embodiments discussed in the detailed description or shown in the figures.

Claims

CLAIMSWhat is claimed is:

1. A dual-chamber sequential injection device, with proximal and distal ends, comprising a hollow needle, comprising a base and a tip, a first chamber, comprising a bypass flow channel and bypass flow channel diameter along a limited arc and length of the chamber and an inner diameter along the remaining arc and length of the chamber, a bypass flow insert, with top and bottom sides, comprising an outer diameter, an insert flow channel from its top side to its bottom side, and at least one protruded feature on its top side, a first plunger, comprising an outer diameter, and a second plunger, comprising an outer diameter, operably assembled wherein the needle tip is at the distal end, the needle base aligns with the flow channel at the bottom side of the bypass flow insert, the first plunger is proximal to the bypass flow insert, the second plunger is proximal to the first plunger, the outer diameters of the bypass flow insert, first plunger, and second plunger approximate the inner diameter of the first chamber diameter wherein the first plunger and second plunger are movable from the proximal end toward the distal end,circumferential sealing prevents fluid from bypassing the second plunger, at all points along the first chamber other than the bypass flow channel, circumferential sealing prevents fluid from bypassing the first plunger, circumferential sealing prevents fluid from bypassing the bypass flow insert other than through the insert flow channel, and the one or more protruded features obstruct complete apposition of the first plunger against the top of the bypass flow insert, further wherein patency is maintained of a connecting space between the bypass flow channel to the insert flow channel.

2. The device of claim 1, further comprising a removable covering of the needle.

3. A dual-chamber sequential injection system, comprising the device of claim 1, further wherein a first substance is housed in a first chamber between the bypass flow insert and the first plunger, a second substance is housed in a second chamber between the first and second plungers, and application of a proximal to distal force on the second plunger sequentially results in: injection of the first substance through the insert flow channel and needle, distal translation of the first plunger until it apposes at least one protruded feature of the bypass flow control insert, and injection of the second substance through the bypass flow channel, connecting space, insert flow channel, and needle.

4. A dual-chamber sequential injection assembling apparatus, comprising an insertion rod and an insertion tube, whereinthe insertion tube is deployable within the first chamber and operable to guide selective distal translation of a bypass flow insert, first plunger, and second plunger within the first chamber, and the insertion rod is operable to effect the selective distal translation of the bypass flow insert, first plunger, and second plunger within the first chamber.

5. A method of assembling a dual-chamber sequential injection system comprising: placing the insertion tube of the apparatus of claim 4 within the first chamber; using the insertion rod to apply a distal translation force to the bypass flow insert through the insertion tube until the bypass flow insert bottom side apposes a distal end of the first chamber; inputting a first substance into the first chamber; using the insertion rod to apply a distal translation force to the first plunger through the insertion tube until the first plunger apposes the first substance; inputting a second substance into the first chamber; using the insertion rod to apply a distal translation force to the second plunger through the insertion tube until the second plunger apposes the second substance; and removing the insertion rod and insertion tube.

6. A dual-chamber sequential injection device, with a proximal end and a distal end, comprising: a hollow needle, comprising a tip at the distal end and a base more proximally; a first chamber, proximal to and apposing the needle base, comprising a bypass flow channel and at least one bypass flow channel diameter along a partial arc and partiallength of the first chamber, and the first chamber inner diameter along the remaining arc and length of the chamber; a bypass flow insert, housed in the first chamber at its distal end, with a bottom side apposed to the needle base and a top side more proximally with at least one protruded feature, comprising an insert outer diameter in mobile frictional contact with the first chamber inner diameter in circumferential seal wherein fluid can only pass the bypass flow insert through an insert flow channel, which extends from the top side to the bottom side and is in fluid communication with the needle base at the bottom side; a first plunger, housed in the first chamber proximal to the bypass flow insert and in a first position proximal to the bypass flow channel, comprising a first plunger outer diameter in mobile frictional contact with the first chamber inner diameter in circumferential seal wherein fluid can only pass the first plunger if the first plunger is moved distally to a second position at the level of the bypass flow channel, wherein the first plunger is obstructed from complete apposition against the top of the bypass flow insert by the at least one protruded feature, further wherein patency is maintained of a connecting space between the bypass flow channel to the insert flow channel; and a second plunger, housed in the first chamber proximal to the first plunger, comprising a second plunger outer diameter in mobile frictional contact with the first chamber inner diameter in circumferential seal.

7. A dual-chamber sequential injection system, comprising the device of claim 6, a first substance housed in a first chamber between the bypass flow insert and the first plunger, and asecond substance housed in a second chamber between the first plunger and the second plunger, wherein application of a proximal to distal force on the second plunger sequentially results in injection of the first substance through the insert flow channel and the needle, distal moved of the first plunger to the second position, and injection of the second substance through the bypass flow channel, the connecting space, the insert flow channel, and the needle.

8. A method of using the system of claim 7, comprising translating the system distally with the application of the proximal to distal force.

9. The method of claim 8, wherein the first substance and the second substance are injected at different depths in an injection site.

10. The dual-chamber sequential injection device of claim 1, wherein the substance in one chamber comprises atropine, and the substance in the other chamber comprises pralidoxime.

11. The dual-chamber sequential injection device of claim 1, wherein the substance in one chamber comprises atropine, and the substance in the other chamber comprises scopolamine.

12. The dual-chamber sequential injection device of claim 4, wherein the substance in the first chamber comprises atropine.

13. The dual-chamber sequential injection device of claim 4, wherein the substance in the first chamber comprises pralidoxime.

14. The dual-chamber sequential injection device of claim 4, wherein the substance in the first chamber comprises scopolamine.

15. The dual-chamber sequential injection device of claim 6, wherein the substance in one chamber comprises atropine, and the substance in the other chamber comprises pralidoxime.

16. The dual-chamber sequential injection device of claim 6, wherein the substance in one chamber comprises atropine, and the substance in the other chamber comprises scopolamine.

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