Methods and apparatus for the enhanced delivery of physiologic agents to tissue surfaces

Abstract

Apparatus and methods deliver vasoconstrictive agents simultaneously with capnic gases. The capnic gases can enhance the effectiveness of the vasoconstrictive agent, lower the dosage of drug or concentration of agent necessary to achieve a therapeutic result, or both. Exemplary capnic gases include carbon dioxide, nitric oxide, nitrous oxide, and dilute acid gases.

1 . A method for treating a patient, said method comprising: 
 administering a vasoconstrictive agent to the patient; and    delivering a capnic gas to a nasal, oral, auricular, or ocular membrane of the patient;    wherein the vasoconstrictive agent and capnic gas are administered and delivered simultaneously.    
   
   
       2 . A method as in  claim 1 , wherein the vasoconstrictive agent comprises a triptan.  
   
   
       3 . A method as in  claim 1 , wherein the vasoconstrictive agent comprises an ergotamine.  
   
   
       4 . A method as in  claim 1 , wherein the capnic gas is delivered to a nasal or oral mucosa while the patient refrains from inhaling the capnic gas.  
   
   
       5 . A method as in  claim 4 , wherein the capnic gas is infused through a nostril and exits through a nostril and/or the mouth.  
   
   
       6 . A method as in  claim 4 , wherein the capnic gas is infused through the mouth and exits through at least one nostril.  
   
   
       7 . A method as in any one of  claims 4  to  6 , wherein the capnic gas comprises carbon dioxide at a concentration of at least 50% by volume and is delivered at a controlled flow rate in the range from 0.5 cc/sec to 30 cc/sec.  
   
   
       8 . A method as in  claim 1 , wherein the gas is selected from the group consisting of carbon dioxide, nitric oxide, nitrous oxide, and dilute acid gases.  
   
   
       9 . A method as in  claim 8 , wherein the gas comprises carbon dioxide.  
   
   
       10 . A method as in  claim 9 , wherein the carbon dioxide is present at a concentration of at least 50% by volume.  
   
   
       11 . A method as in  claim 10 , wherein the carbon dioxide is substantially pure.  
   
   
       12 . A method for treating a patient for a migraine headache, said method comprising: 
 administering a systemic migraine medication to the patient; and    delivering a capnic gas to a nasal, oral, auricular, or optical membrane of the patient;    wherein the migraine medication and the capnic gas are administered and delivered within ______ minutes of each other.    
   
   
       13 . A method as in  claim 12 , wherein the migraine medication is selected from the group consisting of a 5-HT ligand, an alpha-adrenergic ligand, an anticonvulsant, a tricyclic antidepressant, a selective serotonin reuptake inhibitor, a monoamine oxidase (MAO) inhibitor, a calcium channel blocker, lithium carbonate, a corticosteroid, and a nasal decongestant.  
   
   
       14 . A method as in  claim 12 , wherein the migraine medication is a vasoconstrictive agent.  
   
   
       15 . A method as in  claim 14 , wherein the vasoconstrictive agent comprises a triptan or an ergotamine.  
   
   
       16 . A method as in  claim 12 , wherein the capnic gas is delivered to a nasal or oral mucosa while the patient refrains from inhaling the capnic gas.  
   
   
       17 . A method as in  claim 16 , wherein the capnic gas is infused through a nostril and exits through a nostril and/or the mouth.  
   
   
       18 . A method as in  claim 16 , wherein the capnic gas is infused through the mouth and exits through at least one nostril.  
   
   
       19 . A method as in any one of  claims 16  to  18 , wherein the capnic gas comprises carbon dioxide at a concentration of at least 50% by volume and is delivered at a controlled flow rate in the range from 0.5 cc/sec to 30 cc/sec.  
   
   
       20 . A method as in  claim 12 , wherein the capnic gas is selected from the group consisting of carbon dioxide, nitric oxide, nitrous oxide, and dilute acid gases.  
   
   
       21 . A method as in  claim 20 , wherein the gas comprises carbon dioxide.  
   
   
       22 . A method as in  claim 21 , wherein the carbon dioxide is present at a concentration of at least 50% by volume.  
   
   
       23 . A method as in  claim 22 , wherein the carbon dioxide is substantially pure.  
   
   
       24 . A method for treating a patient suffering from a migraine condition, said method comprising: 
 constricting cranial blood vessels; and    substantially simultaneously inhibiting the release of calcitonin gene-related peptide (CGRP).