Abstract: An extension set may include a clamp, which may include a housing and an actuator. The actuator may be movable between a raised position and a depressed position with respect to the housing. The actuator may include a bump profile. The extension set may include an extension tube, which may be disposed within the housing. The extension tube may include a loop. In response to movement of the actuator between the raised position and the depressed position with respect to the housing, the bump profile may progressively clamp the extension tube along the loop. The loop may facilitate an increased fluid volume flowing distally towards a catheter in response to actuating the clamp.

Abstract: A method for selecting a cleaning course includes one or more cleaning factors and any one of the one or more emotional factors, in which a cleaning weight of the one or more cleaning factors is preset for each of the one or more emotional factors.

Abstract: A toilet for administering a product to a user is disclosed. The toilet includes a bowl, a mechanism for administering the product to the user, a storage structure for storing the product, a sensor that detects a property of the product, and a processor. The bowl is adapted to receiving excreta from the user. The processor compares the detected property with a range of values indicating the suitability of the product for being applied to a user. The processor generates an alert when the detected property falls outside the range of values.

Abstract: A cord lock for cords with a snap part. The cord lock device has a movable top part that forms a button that is pressed to release tension on a cord. When the button is released, the cord is held. The button has a pressing surface which is pressed to bring cord passing surfaces on first and second parts into communication with one another, to release tension on the cord passing through the cord passing surfaces. The pressing surface has a socket for a snap on device, which can be a decorative or useful snap in device.

Abstract: An intermittent urinary catheter assembly (20) comprises a catheter tube (22) having a proximal insertion end (24) and a distal end (26) remote from the proximal insertion end and a lumen (28) which extends from at or near the proximal insertion end to the distal end for draining urine from a human bladder. The intermittent urinary catheter assembly includes a urine discharge sleeve (34) associated with the discharge opening (30) of the catheter tube, and the urine discharge sleeve has a compact stowed configuration and is extendable into a deployed configuration for directing urine flow. Alternatively, an adapter assembly (50?) comprises a fitting or nipple (52?) having a urine passageway for insertion into a funnel (40?) associated with a urine discharge end of an intermittent urinary catheter, and a discharge funnel (42?) associated with the fitting or nipple, and an extendable urine discharge sleeve (34?) within the discharge funnel.

Abstract: A device for managing fluid is provided. The device includes: a drip chamber including: an inlet; and outlet; a check valve positioned between the inlet and the outlet, the check valve configured for managing fluid flowing between the inlet and the outlet; and an elastic element. The combination of the check valve and the elastic element limits the extent to which the one way valve may be opened by brief transient pressures appearing at the outlet of the drip chamber. This limiting effect improves the accuracy of fluid delivery in setups such as ‘piggyback’ or Secondary Mode infusions of two fluids using a single pump.

Abstract: A method for producing a microneedle device having a coating on the microneedles comprises a step A of drying a precursor composition containing a biologically active substance and a first solvent to obtain -a freeze-dried composition, a step B of mixing the freeze-dried composition with a second solvent to obtain a coating composition, and a step C of applying the coating composition to the microneedles and drying the same, wherein the precursor composition further contains a thickener, or a thickener is added when the freeze-dried composition and the second solvent are mixed.

Abstract: A method for producing a microneedle device having a coating on the microneedles comprises a step A of drying a precursor composition containing a biologically active substance and a first solvent to obtain -a freeze-dried composition, a step B of mixing the freeze-dried composition with a second solvent to obtain a coating composition, and a step C of applying the coating composition to the microneedles and drying the same, wherein the precursor composition further contains a thickener, or a thickener is added when the freeze-dried composition and the second solvent are mixed.

Abstract: Described are inventions directed to methods of treating a cardiac dysfunction in a subject that includes administering an amount of probenecid effective to treat a symptom of cardiac dysfunction. The probenecid may be administered in at least one of an injection, orally, or transdermally. The amount of probenecid is sufficient to result in an improved performance on a standardized 6 minute walk test, an improved New York Heart Association (NYHA) classification, a lower diuretic dose requirement, a lower serum BNP levels, a normalization of serum sodium concentrations, and combinations thereof. In an embodiment, probenecid is administered over a period of about 8 hours to about 24 hours. Probenecid may be used for short term treatments, i.e., less than a week, or it may be administered in a long term manner, i.e., over a period of weeks, months, or even years.

Abstract: An applicator and method for applying a microneedle device to a skin surface. The applicator can include a first portion comprising a microneedle array, and a second portion coupled to the first portion via a connector. The connector can be configured to yield or fracture by changing from a first state in which the connector is intact to a second state in which the connector is yielded or fractured when a threshold application force is applied to at least one of the first portion and the second portion in a direction substantially perpendicular with respect to the first portion. The method can include pressing the applicator in a direction substantially perpendicular to the first portion to press the microneedle array into the skin surface until the threshold application force is met or exceeded and the connector is changed to its second state.

Abstract: Presented herein are implantable systems and methods for long-term delivery of treatment substance to the ear of a recipient of an implantable auditory prosthesis.

Abstract: Described are implantable therapeutic devices, systems and methods to treat a patient. The device includes a hollow refillable housing for implantation within the posterior segment of an eye through a penetration in the sclera including a proximal retention structure protruding outward from a proximal end region of the housing, an access portion opening, and a penetrable barrier positioned at least in part within the access portion opening, the penetrable barrier configured to be repeatedly penetrated. A rigid porous structure is positioned within a region of the housing away from the access portion opening into a reservoir chamber extends along an axis between the penetrable barrier and the porous structure includes a volume sized to deliver therapeutic amounts of a therapeutic agent to the eye for an extended period of time. A cover is coupled to at least an upper surface of the proximal retention structure.

Abstract: Described herein include embodiments of devices, systems and methods for measuring drill depth, such as drill depths in bone material. For example, embodiments of drill depth measuring systems and associated methods are described. Some drill depth measuring systems can utilize at least resistance, capacitance, optical and/or acoustic sensing features for assisting the drill depth measuring system with determining drill depths and types of tissue being drilled into. Various other related features, devices and methods are also described.

Abstract: Catheter cannula, catheter, and catheterization method, for administering a fluid or/and substance to, or for draining a fluid or/and substance from, a treatment space of a body vessel, duct, or cavity. In some embodiments the cannula includes: an elongated flexible tube mountable on a needle, and having an invasive section and a non-invasive section; and at least one anchoring element protruding from, a surface of the invasive section in a manner such that an operative configuration of each anchoring element increases outer circumferential diameter of the cannula to an extent less than lumen diameter of the body vessel, duct, or cavity, at the treatment space, thereby anchoring the invasive section to inside the body vessel, duct, or cavity, at the treatment space. The catheter includes a needle and the cannula mounted thereupon.

Abstract: An access port for providing subcutaneous access to a patient is disclosed. The access port includes a septum including palpable identification indicia thereon. In particular, the access port in one embodiment includes a body that defines a fluid cavity and a needle-penetrable septum covering the fluid cavity for providing access thereto. The septum defines an outer periphery. One or more palpation features are included on the septum. The palpation features each include a portion that extends in a radial direction beyond the outer periphery of the septum. The palpation features are therefore disposed relatively farther away from each other, simplifying palpation and identification thereof after the port has been subcutaneously implanted into a patient. The palpation features can be indicative of an attribute of the port, such as its ability to withstand fluid pressures and flow rates associated with power injection, for instance.

Abstract: A drug delivery device or patch-like delivery device which employs a spring force and an inclined surface to apply pressure on a fluid reservoir, thereby delivering medicament to a user's body. The slope of the inclined surface may be engineered to control the drug delivery rate. The device may be low profile and wearable, for example in the form of a patch. A visual indicator of the amount of medicament delivered or remaining may be incorporated, for example via a transparent window that shows the progression of an inclined surface as it presses on the reservoir. The device may incorporate mechanisms for automatic extension and retraction of a cannula at the beginning and end of drug delivery. Drug delivery rate may be limited with flow restrictors, and by using a two-reservoir system with a viscous liquid displacing a reservoir containing the medicament.

Abstract: An applicator (100) for applying a microneedle device to a skin surface comprising a first portion (102) comprising a microneedle array (107), and a second portion (104) coupled to the first portion via a connector (106). The connector can be configured to yield or fracture by changing from a first state in which the connector is intact to a second state in which the connector is yielded or fractured when a threshold application force is applied to at least one of the first portion and the second portion in a direction substantially perpendicular with respect to the first portion. A method can include pressing the applicator in a direction substantially perpendicular to the first portion to press the microneedle array into the skin surface until the threshold application force is met or exceeded and the connector is changed to its second state.

Abstract: A dispensing device and the method of making same for dispensing medicaments to a patient that includes a housing, a first assembly connected to the first end of the housing that includes a body portion, and a penetrating sub-assembly. The first assembly also includes a rate control chip of novel construction that is connected to the penetrating sub-assembly and functions to control the rate of flow of medicinal fluid to the patient. Disposed within the housing is a second assembly that includes a shuttle, a collapsible container carried by the shuttle and a plurality of variable force springs that function to thrust the collapsible container into penetrating engagement with the penetrating member of the penetrating assembly and then to collapse the collapsible container to deliver the medicinal fluid to the patient. Connected to the second end of the housing is a novel third assembly that includes an operating member that functions to controllably move the shuttle forwardly of the housing.

Abstract: A user-initiated fluid pathway connection includes: a connection hub, a piercing member, a sterile sleeve, and a drug container having a cap, a pierceable seal, a barrel, and a plunger seal, wherein the piercing member is initially retained within the sterile sleeve between the connection hub and the pierceable seal of the drug container. The connection hub may include an internal aperture within the connection hub which functions as a flow restrictor and wherein a piercing member is connected to one end of the internal aperture and a fluid conduit is connected to another end of the internal aperture. A drug delivery pump with integrated sterility maintenance features includes a housing, upon which an activation mechanism, an insertion mechanism, a fluid pathway connection as described above, a power and control system, and a drive mechanism connected to a drug container are mounted. Methods of assembly and operation are also provided.

Abstract: A low cost transdermal patch comprises water soluble microneedles and has good performance. A transdermal patch comprises a microneedle sheet, which comprises a plurality of water soluble microneedles, moisture permeable sheet, wherethrough water vapor passes, and a reinforcing film. The reinforcing film is adhered, by an adhesive layer having an adhesive strength less than that of an adhesive layer, onto an outer surface of the moisture permeable sheet, which is the side opposite the skin opposing surface. The reinforcing film includes a water vapor barrier sheet, which blocks the passage of water vapor through at least a first area, and a removable portion around the water vapor barrier sheet. The removable portion is configured such that it can be separated from and peeled off the water vapor barrier sheet.

Abstract: An intercostal-pump based fluid management system, as described herein, comprises an intercostal pump that is, generally, a resiliently flexible bulb having an inlet and an outlet. The inlet is attached to a first tube that extends from the intercostal pump to a first area of a patient's body, for example, the patient's pleural cavity. The outlet is connected to a second tube that extends from the intercostal pump to a second area of a patient's body, for example, the patient's peritoneal cavity. Upon operation of the intercostal pump, fluid is transferred from the first area of the patient's body to the second area. In use, the intercostal pump is placed between a first rib and a second rib in a patient. The intercostal pump operates by being successively compressed and decompressed between the first and second ribs as the patient breaths. As the patient inhales, the patient's rib cage expands and the intercostal pump is decompressed.

Abstract: A hand operated medical pump is described including: at least one fluid inlet; at least one fluid outlet; a flexible pump bulb defining a pumping chamber which forms at least part of a pumping flow pathway; at least one directional valve which allows flow of fluid in a direction from the at least one inlet to the at least one outlet, but inhibits flow of fluid in a direction from the at least one outlet to the at least one inlet; and a bypass flow pathway from the at least one inlet to the at least one outlet which by-passes the at least one directional valve; and wherein the bypass flow pathway extends through the pump bulb.

Abstract: A liquid medicine self-administration device including a flexible reservoir, an operating member, a pushing member to move with respect to the operating member and to induce pressure deformation of the reservoir, and engaging means engages the operating member. With the operating member engaged by the engaging means, the pushing member is relatively moved to the operating member based on restoring force of a spring member to push the reservoir by the pushing member. By disengaging means moving in unison with the pushing member, the engaging means is released from an engaged state with respect to the operating member, when the pushing member has moved to a predetermined location while pushing the reservoir.

Abstract: An auto-injector apparatus includes a flexible container containing a liquid medicant, a needle communicated with a container, a housing with a container being received in the housing, a pump disposed in the housing and positioned to engage the flexible container and expel the medicant from the container through the needle upon relative movement between the pump and the container, and a main drive spring operably associated with the needle to extend the needle from a first needle position wherein the needle is completely received in the housing to a second needle position wherein the needle protrudes from the housing. The pump may be a roller.

Abstract: A drug delivery device is provided. The drug delivery device includes a drug reservoir in fluid communication with a microneedle array. The drug delivery device has a sliding actuation mechanism that may be activated by a button or lever. Actuation of the drug delivery device inserts the microneedle array into the skin of a subject and causes a piston to compress the drug reservoir, thereby delivering the drug through the microneedle array to the subject.

Abstract: Devices for delivery of medical compositions in either liquid or powder form include a piercing device for piercing a flexible sheet material in which when contained in a flexible blister dosage form, the piercing device serves as a delivery channel for compositions contained in the blister. The device is configured to reduce or inhibit puncture flap interference with the delivered spray or mist by forming a substantial non-contact drape in the material prior to puncture.

Abstract: The invention relates to a medicament container for a liquid medicament, the medicament container comprising a bag with an outlet, the bag being compressible or shrinkable by subjection of at least a part of the medicament container to an energy source.

Abstract: An apparatus for percutaneous delivery of a sealant comprising: at least two fluid reservoirs, an introducer needle having a distal tip that is in fluid communication with at least one reservoir, a fluid delivery tube that is in fluid communication with a second reservoir, wherein the fluid delivery tube has a tip and wherein the fluid delivery tube is configured so that the tip of the fluid delivery tube does not extend past the distal tip of the introducer needle during use.

Abstract: A syringe comprises a barrel with a plunger in slidable and sealing engagement therein, and a needle attached to one end of the barrel. The barrel has an aspiration device in the form of manually-operable resilient portions, which can be operated to cause a pressure differential in the barrel, the pressure differential then being used to perform aspiration. The resilient portions are preferably formed by localized reductions of wall thickness in the external surface of the barrel.

Abstract: The present invention relates to an assembly for a drug delivery device comprising a dispensing container and a reservoir container for holding a fluid medicinal product, wherein the dispensing container and the reservoir container are connected to one another and are in fluid communication, and wherein the dispensing container is squeezable for dispensing a dose of the fluid medicinal product from the dispensing container, the dispensing container being refillable with the fluid medicinal product from the reservoir container.

Abstract: A safety needle device and method of supplying fluid to a vascular access port is described. The device may include a base member, a handle member, and a compressible member positioned between the handle member and a compression plate. The compressible member is coupled to a proximal end of a needle. Following the delivery of fluid to a vascular access port, the needle is removed by moving the handle member away from the base member, which collapses the compressible member, flushing fluid into the vascular access port to substantially replace a volume of the needle.

Abstract: Disclosed therein is a medicinal liquid supply apparatus, which includes a fixed-type medicinal liquid supply volume controller adapted to supply medicinal liquid only as much as a paramedic sets and fixes and an arbitrary medicinal liquid supply volume controller adapted to allow a patient or the third party to arbitrarily supply the medicinal liquid as occasion demands during the paramedic's absence, thereby effectively supplying the medicinal liquid according to the patient's disease and pain conditions.

Abstract: The present invention provides a percutaneous absorption system and a percutaneous absorption method, which have a simple constitution and can realize the easy and continuous percutaneous absorption of medicine even when the medicine is formed of a water-soluble oligomer solution or a high-molecular solution. In the percutaneous absorption system comprising a medicine reservoir portion having a medicine holding portion which holds medicine therein and a support portion for supporting the medicine reservoir portion, the support portion including an adhesive layer and a substrate having medicine non-permeating property, the system is provided with an elastic member for applying pressure to the medicine held in the inside of the medicine reservoir portion, and by breaking the substrate having medicine non-permeating property in the support portion using a mechanical stimulus such as an injection needle or the like, the medicine is released (delivered) at a fixed rate.

Abstract: A liquid medicine self-administration device including a flexible reservoir, an operating member, a pushing member to move with respect to the operating member and to induce pressure deformation of the reservoir, and engaging means engages the operating member. With the operating member engaged by the engaging means, the pushing member is relatively moved to the operating member based on restoring force of a spring member to push the reservoir by the pushing member. By disengaging means moving in unison with the pushing member, the engaging means is released from an engaged state with respect to the operating member, when the pushing member has moved to a predetermined location while pushing the reservoir.

Abstract: A safety needle device and method of supplying fluid to a vascular access port is described. The device may include a base member, a handle member, and a compressible member positioned between the handle member and a compression plate. The compressible member is coupled to a proximal end of a needle. Following the delivery of fluid to a vascular access port, the needle is removed by moving the handle member away from the base member, which collapses the compressible member, flushing fluid into the vascular access port to substantially replace a volume of the needle.

Abstract: A cartridge assembly apparatus for an auto-injector includes a flexible container containing a liquid medicant. A needle hub is connected to the flexible container. A needle is attached to the needle hub and extends proximally from the needle hub. A frame is connected to the needle hub and includes a frame proximal end extending proximally beyond a proximal end of the needle. The needle hub and the needle are displaceable relative to the frame in a proximal direction to insert the needle into a patient.

Abstract: A catheter having a drug delivery unit at the distal end thereof. The drug delivery unit includes an actuator capable of assuming an activated and an inactivated configuration. The drug delivery unit also includes a receptacle capable of accepting a therapeutic agent. The actuator and receptacle are in communication with each other such that the actuator transmits force to the receptacle and the receptacle accepts force from the actuator in an activated configuration of the actuator. Also provided is a method of delivering a therapeutic agent to a target site using the catheter of the present invention.

Abstract: An intravenous catheter introducing device includes a needle hub slidably inserted into a barrel and holding a needle cannula, a biasing member disposed to bias the needle hub to a rear position so as to retract the needle cannula in the barrel, and an easy release unit including an engaging wall segment which is attached to an outer surface of the barrel, two flexible squeezed wall segments which extend from the engaging wall segment and which is squeezable so as to move two latch members to steer clear of a retained end of the needle hub through an access hole in the barrel, thereby permitting the biasing member to bias the needle hub towards the rear position.

Abstract: A device for delivering fluid to a person including a reservoir for containing a fluid to be delivered to the person, a fluid transport device for dispensing fluid from said reservoir to the person, said fluid transport device including a proximal end in fluid communication with said reservoir and a distal end having a penetrating member for piercing the skin of the person to facilitate the delivery of fluid to the person through the fluid transport device, a housing containing said reservoir and said fluid transport device, said housing including an exit port for receiving said distal end of said fluid transport device upon injection of said distal end into said person and means for securing a first wall of said housing to the skin of the person, a injection activation device including a driving mechanism contacting said fluid transport device for driving said penetrating member from a first position within said housing, through said exit port to a second position, external to said housing and into the skin

Abstract: A compact fluid dispenser for use in controllably dispensing fluid medicaments, such as antibiotics, blood clotting agents, analgesics, and like medicinal agents from collapsible containers at a uniform rate. The dispenser includes a novel stored energy source that is provided in the form of a compressible-expandable member that functions to continuously and uniformly expel fluid from the device reservoir. The apparatus further includes a novel fluid flow control assembly that precisely controls the flow of the medicament solutions from the device reservoir to the patient.

Abstract: A compact fluid dispenser for use in controllably dispensing fluid medicaments, such as antibiotics, blood clotting agents, analgesics, and like medicinal agents from collapsible containers at a uniform rate. The dispenser includes a novel stored energy source that is provided in the form of a compressible-expandable member that functions to continuously and uniformly expel fluid from the apparatus reservoir. The apparatus further includes a novel fluid flow control assembly that precisely controls the flow of the medicament solutions from the apparatus reservoir to the patient.

Abstract: The present invention relates to an apparatus and method for intradermally administering a pharmaceutical composition or other substance into and through the skin of a mammalian body in a manner that avoids or eliminates excess pain and discomfort normally caused as a result of the microabraders or microneedles entering the epithelial layers beneath the stratum corneum. In a preferred embodiment, the apparatus is a microdevice with an array of microabraders or microneedles with a manipulating member.

Abstract: The present invention provides a system and method for irrigating and collecting tissue from a body cavity in a patient. The system includes an irrigation and collection device for injecting an irrigation fluid into the body cavity. The irrigation device injects fluid into the body cavity by creating a positive pressure within the device to expel the irrigation fluid from the device into the body cavity. The irrigation fluid is evacuated from the body cavity by the resulting negative pressure within the device, drawing the irrigation fluid and any loose tissue or particulate material into the device. The irrigation fluid is filtered, collecting the evacuated tissue and particulate material in a collection receptacle thereby isolating the evacuated tissue and particulate material within the irrigation fluid.

Abstract: A device for delivering fluid to a person includes a reservoir for containing a fluid to be delivered to the person; a fluid transport device for dispensing fluid from the reservoir to the person, the fluid transport device including a proximal end in fluid communication with the reservoir and a distal end having a penetrating member for piercing the skin of the person to facilitate the delivery of fluid to the person through the fluid transport device; a housing containing the reservoir and the fluid transport device, the housing including an exit port for receiving the distal end of the fluid transport device upon injection of the distal end into the person and means for securing a first wall of the housing to the skin of the person; and an injection activation device including a driving mechanism contacting the fluid transport device for driving the penetrating member from a first position within the housing, through the exit port to a second position, external to the housing and into the skin of the perso

Abstract: A needleless dosage transfer system for filing medicating devices such as syringes or needleless cannulas to minimize the likelihood of an unwanted needle stick and to avoid the initial cost of a needle as well as the disposal cost of the needle. A vial has a body portion 20 formed with flexibly deformable walls and defines a blind bore. An opening of the vial includes a tapered section adapted to frictionally fit over a taper of a male luer-type fitting commonly found on syringes and needleless cannulas. By deforming the walls of the vial, fluid is forced from the vial into a syringe. The opening of the vial 10 is protected with a cap and includes a scoreline which, when fractured, defines the opening. The cap to be removed from the vial prior to its use is fabricated as one piece with the vial in order to assure sterile conditions during manufacture and filling. A tab is associated with the cap which lists the ingredients within the vial. The vial also supports an area which lists the vial's contents.

Abstract: A portable colon irrigator is provided. The colon irrigator includes a manually operated pump, a first hose connecting the manually operated pump and a water source, a water ejector having an ejector body and an irrigating nozzle attached to the ejector body for being inserted into the anus of a user, a second hose connecting the manually operated pump and the ejector body, and two wings attached to the ejector body. The manually operated pump provides pressure to eject water from the irrigating nozzle and prevents backflow from the second hose, and the wings rest on a toilet. The colon irrigator may further include a branching valve and spraying nozzles so that it may also used as a bidet.

Abstract: A device for delivering a substance into the skin of a patient includes a housing and a plurality of microneedles for penetrating the skin. The housing includes a bottom wall with a plurality of apertures for supplying the substance to the microneedles. The housing also includes a flexible top cover member enclosing a bladder containing the substance to be delivered. The bottom wall of the housing has at least one cannula facing the bladder. Pressing on the top cover member causes the cannula to puncture the bladder and deliver the substance to the microneedles for delivery to the patient. In one embodiment, the cannula is surrounded by a flexible member to prevent piercing of the bladder until sufficient pressure is applied to the cover member to depress the flexible member.

Abstract: The present invention provides a unitary syringe having a mounted needle surrounded by a sheath having a break-zone. The fluid medicament to be injected is contained within a blister cavity formed between upper and lower polymeric layers. Accidental needle sticks are reduced by optional guard fingers surrounding the needle. These fingers extend past the and bracket the sharpened end of the needle.

Abstract: A device for delivering a beneficial agent within a body cavity such as the ear canal. The device preferably includes a soft resilient casing that can be compressed to fit at least partially within the ear canal. Once inserted in the ear canal, the casing expands to form a seal between a boundary defining the ear canal and the device. The soft casing preferably encapsulates the beneficial agent within a reservoir formed inside the soft casing. As the device is squeezed, the beneficial agent is ejected through a release point. The device then maintains the beneficial agent within the ear canal until the beneficial agent has had time to take effect.

Abstract: A medicament-dispensing system includes a cartridge for housing and actuating an accordion-like vial-dispenser for dispensing a calibrated amount of medicament by means of a single actuation motion which sequentially loads the vial-dispenser and dispenses the loaded medicament. The vial-dispenser has a front bellows portion, a rear bellows portion, an internal piston mechanism, a medicament storage chamber and a dosage cavity. The cartridge has a trigger mechanism which acts in concert with a notched lever and a wedge-shaped arm internally located in the cartridge to sequentially load the dosage cavity with medicament and discharge it. Depression of the trigger mechanism simultaneously extends, by means of the notched lever, the front bellows portion and compresses the rear bellows portion to load the dosage cavity with medicament.