Wireless implantable chip with integrated nitinol-based pump for radio-controlled local drug delivery

Implantable magnetically-actuated capsule for on-demand delivery

Many implantable drug delivery systems (IDDS) have been developed for long-term, pulsatile drug release. However, they are often limited by bulky size, complex electronic components, unpredictable drug delivery, as well as the need for battery replacement and consequent replacement surgery. Here, we develop an implantable magnetically-actuated capsule (IMAC) and its portable magnetic actuator (MA) for on-demand and robust drug delivery in a tether-free and battery-free manner. IMAC utilizes the bistable mechanism of two magnetic balls inside IMAC to trigger drug delivery under a strong magnetic field (|Ba| > 90 mT), ensuring precise and reproducible drug delivery (9.9 ± 0.17 μg per actuation, maximum actuation number: 180) and excellent anti-magnetic capability (critical trigger field intensity: ∼90 mT). IMAC as a tetherless robot can navigate to and anchor at the lesion sites driven by a gradient magnetic field (∇ Bg = 3 T/m, |Bg| < 60 mT), and on-demand release drug actuated by a uniform magnetic field (|Ba| = ∼100 mT) within the gastrointestinal tract. During a 15-day insulin administration in vivo, the diabetic rats treated with IMAC exhibited highly similar pharmacokinetic and pharmacodynamic profiles to those administrated via subcutaneous injection, demonstrating its robust and on-demand drug release performance. Moreover, IMAC is biocompatible, batter-free, refillable, miniature (only Φ 6.3 × 12.3 mm3), and lightweight (just 0.8 g), making it an ideal alternative for precise implantable drug delivery and friendly patient-centered drug administration.

Magnetic Shape-Memory Heuslers Turn to Bio: Cytocompatibility of Ni-Mn-Ga Films and Biomedical Perspective

Magnetic shape-memory (MSM) Heuslers have attracted great attention in recent years for both caloric and magnetomechanical applications. Thanks to their multifunctional properties, they are also promising for a vast variety of biomedical applications. However, this topic has been rarely investigated so far. In this communication, we present the first report on the absence of cytotoxicity of MSM Heuslers in Ni-Mn-Ga epitaxial thin films and the perspective toward bioapplications. Qualitative and quantitative biological characterizations reveal that Ni-Mn-Ga films can promote the adhesion and proliferation of human fibroblasts without eliciting any cytotoxic effect. Additionally, our findings show that the morphology, composition, microstructure, phase transformation, and magnetic characteristics of the films are well preserved after the biological treatments, making the material a promising candidate for further investigations.

Electronically powered drug delivery devices: considerations and challenges

INTRODUCTION

Electronically powered drug delivery devices enable a controlled drug release route for a more convenient and painless way with reduced side effects. The current advances in microfabrication and microelectronics have facilitated miniaturization and intelligence with the integration of sensors and wireless communication modules. These devices have become an essential component of commercialized on-demand drug delivery.

AREAS COVERED

This review aims to provide a concise overview of current progress in electronically powered drug devices, focusing on delivery strategies, manufacturing techniques, and control circuit design with specific examples.

EXPERT OPINION

The application of electronically powered drug delivery systems is now considered a feasible therapeutic approach with improved drug release efficiency and increased patient comfort. It is anticipated that these technologies will gradually fulfill clinical needs and resolve commercialization challenges in the future. This review discusses the current advances in electronic drug delivery devices, especially focusing on designing strategies to achieve an effective drug release, as well as the perspectives and challenges for future applications in clinical therapy.

Recent Development of Drug Delivery Systems through Microfluidics: From Synthesis to Evaluation

Conventional drug administration usually faces the problems of degradation and rapid excretion when crossing many biological barriers, leading to only a small amount of drugs arriving at pathological sites. Therapeutic drugs delivered by drug delivery systems to the target sites in a controlled manner greatly enhance drug efficacy, bioavailability, and pharmacokinetics with minimal side effects. Due to the distinct advantages of microfluidic techniques, microfluidic setups provide a powerful tool for controlled synthesis of drug delivery systems, precisely controlled drug release, and real-time observation of drug delivery to the desired location at the desired rate. In this review, we present an overview of recent advances in the preparation of nano drug delivery systems and carrier-free drug delivery microfluidic systems, as well as the construction of in vitro models on-a-chip for drug efficiency evaluation of drug delivery systems. We firstly introduce the synthesis of nano drug delivery systems, including liposomes, polymers, and inorganic compounds, followed by detailed descriptions of the carrier-free drug delivery system, including micro-reservoir and microneedle drug delivery systems. Finally, we discuss in vitro models developed on microfluidic devices for the evaluation of drug delivery systems, such as the blood–brain barrier model, vascular model, small intestine model, and so on. The opportunities and challenges of the applications of microfluidic platforms in drug delivery systems, as well as their clinical applications, are also discussed.

Acoustofluidic Based Wireless Micropump for Portable Drug Delivery Applications. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021;2021:1276-1279. [PMID: 34891518 DOI: 10.1109/embc46164.2021.9629811]

In this study, an acoustofluidic based wireless micropump for drug delivery was proposed and fabricated. The key actuator of this micropump is a small gigahertz piezoelectric resonator, which could induce strong fluidic streaming at low applied power. This acoustofluidic micropump has stable and accurate dosage resolution (7.0 μL), and sufficient flow rate (1.34 mL/min). The miniaturized size and wireless controlled operation prove it as a portable drug delivery system.Clinical Relevance- The acoustofluidic based micropump could apply for the drug administration in a safe, effective and stable form. It has potential to integrate with miniaturized sensors and electronic circuit to form portable drug delivery systems, realizing smart on-demand drug delivery.

Thermally induced silane dehydrocoupling on porous silicon nanoparticles for ultra-long-acting drug release

Here, we report an ultra-long-acting drug release nano-formulation based on porous silicon nanoparticles (pSiNPs) that are prepared by thermally induced silane dehydrocoupling and lipid-coating. This robust formulation offers the ability to release an anticancer drug, for up to 2 weeks, in various biological environments; pH 7.4 buffer, cancer cells, and tumor xenograft model.

Shape memory materials and 4D printing in pharmaceutics

Shape memory materials (SMMs), including alloys and polymers, can be programmed into a temporary configuration and then recover the original shape in which they were processed in response to a triggering external stimulus (e.g. change in temperature or pH, contact with water). For this behavior, SMMs are currently raising a lot of attention in the pharmaceutical field where they could bring about important innovations in the current treatments. 4D printing involves processing of SMMs by 3D printing, thus adding shape evolution over time to the already numerous customization possibilities of this new manufacturing technology. SMM-based drug delivery systems (DDSs) proposed in the scientific literature were here reviewed and classified according to the target pursued through the shape recovery process. Administration route, therapeutic goal, temporary and original shape, triggering stimulus, main innovation features and possible room for improvement of the DDSs were especially highlighted.

Platform for micro-invasive membrane-free biochemical sampling of brain interstitial fluid

Neurochemical dysregulation underlies many pathologies and can be monitored by measuring the composition of brain interstitial fluid (ISF). Existing in vivo tools for sampling ISF do not enable measuring large rare molecules, such as proteins and neuropeptides, and thus cannot generate a complete picture of the neurochemical connectome. Our micro-invasive platform, composed of a nanofluidic pump coupled to a membrane-free probe, enables sampling multiple neural biomarkers in parallel. This platform outperforms the state of the art in low-flow pumps by offering low volume control (single stroke volumes, <3 nl) and bidirectional fluid flow (<100 nl/min) with negligible dead volume (<30 nl) and has been validated in vitro, ex vivo, and in vivo in rodents. ISF samples (<1.5 μL) can be processed via liquid chromatography-tandem mass spectrometry. These label-free liquid biopsies of the brain could yield a deeper understanding of the onset, mechanism, and progression of diverse neural pathologies.

Large-Scale Flow in Micro Electrokinetic Turbulent Mixer

In the present work, we studied the three-dimensional (3D) mean flow field in a micro electrokinetic (μEK) turbulence based micromixer by micro particle imaging velocimetry (μPIV) with stereoscopic method. A large-scale solenoid-type 3D mean flow field has been observed. The extraordinarily fast mixing process of the μEK turbulent mixer can be primarily attributed to two steps. First, under the strong velocity fluctuations generated by μEK mechanism, the two fluids with different conductivity are highly mixed near the entrance, primarily at the low electric conductivity sides and bias to the bottom wall. Then, the well-mixed fluid in the local region convects to the rest regions of the micromixer by the large-scale solenoid-type 3D mean flow. The mechanism of the large-scale 3D mean flow could be attributed to the unbalanced electroosmotic flows (EOFs) due to the high and low electric conductivity on both the bottom and top surface.

Polymer Nanocomposite Microactuators for On-Demand Chemical Release via High-Frequency Magnetic Field Excitation

On-demand delivery of substances has been demonstrated for various applications in the fields of chemistry and biomedical engineering. Single-pulse release profile has been shown previously for micro/nanoparticles in different form factors. However, to obtain a sustained release, a pulsatile release profile is needed. Here, we demonstrate such a release profile from polymer magnetic nanocomposite microspheres loaded with chemicals. By exciting the microactuators with AC magnetic fields, we could achieve up to 61% cumulative release over a five-day period. One of the main advantages of using a magnetic stimulus is that the properties of the environment (e.g., transparency, density, and depth) in which the particles are located do not affect the performance. The operating magnitude of the magnetic field used in this work is safe and does not interact with any nonmetallic materials. The proposed approach can potentially be used in microchemistry, drug delivery, lab-on-chip, and microrobots for drug delivery.

Wireless Power Transfer for Implanted Medical Application: A Review

With ever-increasing concerns on health and environmental safety, there is a fast-growing interest in new technologies for medical devices and applications. Particularly, wireless power transfer (WPT) technology provides reliable and convenient power charging for implant medical devices without additional surgery. For those WPT medical systems, the width of the human body restricts the charging distance, while the specific absorption rate (SAR) standard limits the intensity of the electromagnetic field. In order to develop a high-efficient charging strategy for medical implants, the key factors of transmission distance, coil structure, resonant frequency, etc. are paid special attention. In this paper, a comprehensive overview of near-field WPT technologies in medical devices is presented and discussed. Also, future development is discussed for the prediction of different devices when embedded in various locations of the human body. Moreover, the key issues including power transfer efficiency and output power are addressed and analyzed. All concerning characteristics of WPT links for medical usage are elaborated and discussed. Thus, this review provides an in-depth investigation and the whole map for WPT technologies applied in medical applications.

Nitinol actuated soft structures towards transnasal drug delivery: a pilot cadaver study

Sudden hearing loss can be treated noninvasively by administering drugs to the middle ear (≈1 ml) via the eustachian tube. The nasopharyngeal cavity requires high dexterity manipulation as it is restricted by the nasal vestibule, and precise drug delivery through the small cavity can allow previously unreachable areas to be reconsidered for localized delivery. Nitinol has shape memory capabilities and can be used for distal actuation accessed from small lumen and a tortuous path. The drug delivery device (DDD) is a soft and needle-sized (2 mm) and comprises of Nitinol, ribbon spring, and a drug delivery tube. By controlling the input voltage to the Nitinol, bending of the device at different angles could be achieved, and the ribbon spring works antagonistically to the Nitinol to revert to the initial position once deactivated. The actuation of the device and its corresponding bending are calculated in vitro and found to have a bending angle ranging between 36.2 and 66.8° for applied voltages of 1.2-2.0 V, with surface temperature of 45.6-154 °C. The DDD is able to actuate 200 cycles with ≈91-76% retention of bending performance, with a temperature increase of ≈8.5-9% when 1.2-2.0 V is applied. Addition of soft insulating material shows ≈34-62% reduction in the surface temperature in the first cycle and ≈37-59% over 200 cycles when actuated at 1.2-2.0 V. The active steering and navigation capabilities of the DDD are demonstrated in simulated environments (based on the eustachian tube dimensions of adult and infant). Preclinical testing in human cadavers is demonstrated and suggests the developed DDD controlled by varying the input voltages for bending, and mechanically varied drug delivery may be a feasible option for localized drug delivery in eustachian tube. Graphical abstract.

Microfluidics for interrogating live intact tissues

The intricate microarchitecture of tissues - the "tissue microenvironment" - is a strong determinant of tissue function. Microfluidics offers an invaluable tool to precisely stimulate, manipulate, and analyze the tissue microenvironment in live tissues and engineer mass transport around and into small tissue volumes. Such control is critical in clinical studies, especially where tissue samples are scarce, in analytical sensors, where testing smaller amounts of analytes results in faster, more portable sensors, and in biological experiments, where accurate control of the cellular microenvironment is needed. Microfluidics also provides inexpensive multiplexing strategies to address the pressing need to test large quantities of drugs and reagents on a single biopsy specimen, increasing testing accuracy, relevance, and speed while reducing overall diagnostic cost. Here, we review the use of microfluidics to study the physiology and pathophysiology of intact live tissues at sub-millimeter scales. We categorize uses as either in vitro studies - where a piece of an organism must be excised and introduced into the microfluidic device - or in vivo studies - where whole organisms are small enough to be introduced into microchannels or where a microfluidic device is interfaced with a live tissue surface (e.g. the skin or inside an internal organ or tumor) that forms part of an animal larger than the device. These microfluidic systems promise to deliver functional measurements obtained directly on intact tissue - such as the response of tissue to drugs or the analysis of tissue secretions - that cannot be obtained otherwise.

Acoustofluidic stick-and-play micropump built on foil for single-cell trapping

The majority of microfluidic devices nowadays are built on rigid or bulky substrates such as glass slides and polydimethylsiloxane (PDMS) slabs, and heavily rely on external equipment such as syringe pumps. Although a variety of micropumps have been developed in the past, few of them are suitable for flexible microfluidics or lab-on-a-foil systems. In this paper, stick-and-play acoustic micropump is built on thin and flexible plastic film by printing microstructures termed defended oscillating membrane equipped structures (DOMES) using two-photon polymerization. Specifically, this new micropump induces rectified flow upon the actuation of acoustic waves, and the flow patterns agree with simulation results very well. More importantly, the developed micropump has the capabilities to generate adjustable flow rates as high as 420 nL min-1, and does not suffer from problems such as bubble instability, gas dissolution, and undesired bubble-trapping that commonly occur in other forms of acoustic micropumps. Since the micropump works in stick-and-play mode, it is reusable after cleaning thanks to the easy separation of covers and substrates. Lastly, the developed micropump is applied for creating a self-pumped single-cell trapping device. The excellent trapping capability of the integrated device proves its potential for long-term studies of biological behaviors of individual cells for biomedical applications.

Graphene Oxide-Enabled Synthesis of Metal Oxide Origamis for Soft Robotics

Origami structures have been widely applied in various technologies especially in the fields of soft robotics. Metal oxides (MOs) have recently emerged as unconventional backbone materials for constructing complex origamis with distinct functionalities. However, the MO origami structures reported in the literature were rigid and not deformable, thus limiting their applications to soft robotics. Herein, we reported a graphene oxide (GO)-enabled templating synthesis to produce complex MO origami structures from their paper origami templates with high structural replication. The MO origami structures were next stabilized with elastomer, and the MO-elastomer origamis were able to be adapted into multiple actuation systems (including magnetic fields, shape-memory alloys, and pneumatics) for the fabrication of MO origami robots. Compared with conventional paper origami robots, the MO robots were lightweight, mechanically compliant, fire-retardant, magnetic responsive, and power efficient. We further demonstrated the legendary phoenix-fire-reborn concept in the soft robotics fields: a paper origami robot sacrificed itself in a fire scene and transformed itself into a downsized Al₂O₃ robot; the Al₂O₃ robot was able to crawl through a narrow tunnel where the original paper robot was unfit. These MO reconfigurable origamis provide an expanded material library for building soft robotics, and the functionalities of MO robots can be systematically engineered via the intercalation of various metal ions during the GO-enabled synthesis.

Wirelessly activated device with an integrated ionic polymer metal composite (IPMC) cantilever valve for targeted drug delivery

This paper reports a wirelessly powered ionic polymer-metal composite (IPMC) soft actuator operated by external radio frequency (RF) magnetic fields for targeted drug delivery. A 183 μm thick IPMC cantilever valve was fitted with an embedded LC resonant circuit to wirelessly control the actuator when the field frequency is tuned to its resonant frequency of approximately 25 MHz. Experimental characterization of the fabricated actuator showed a cumulative cantilever deflection of 160 μm for three repeated RF ON-OFF cycles at 0.6 W input power. The device was loaded with a dye solution and immersed in DI water to demonstrate wireless drug release. The qualitative result shows the successful release of the dye solution from the device reservoir. The release rate can be controlled by tuning the RF input power. We achieved a maximum average release rate of ∼0.1 μl s-1. We further conducted an in vitro study with human tumor cells (HeLa) to demonstrate the proof of concept of the developed device. The experiments show promising results towards the intended drug delivery application.

Design of a remote-control drug delivery implantable chip for cancer local on demand therapy using ionic polymer metal composite actuator

Since the local, on demand, cancer therapy is a challenging clinical issue today, this paper presents the design, fabrication and characterization of a remotely controlled single reservoir drug delivery chip using Ionic Polymer Metal Composite (IPMC) actuator. Here, Drug release was externally programmed and controlled wirelessly on demand by a communication circuit. The transmitter and receiver circuits were designed to control the release/sealed status remotely even from 7 cm distance while the transmitter and receiver were coupled magnetically. IPMC here was used as the moving cap of the reservoir, that in release mode, lets the drug out on demand with a low received power of 20 mW. The novel simple design could release the whole content of the drug which is remarkable in comparison with the designs which need complicated optimizations of diffuser, nuzzle and IPMC diaphragm pump, leading to an incomplete release. To make sure that there is no leakage in the sealed mode, IPMC was attached to a polydimethylsiloxane (PDMS) support film. Biocompatibility of all the components of the chip were tested by 3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide (MTT) assay.

Recent advances of controlled drug delivery using microfluidic platforms

Conventional systematically-administered drugs distribute evenly throughout the body, get degraded and excreted rapidly while crossing many biological barriers, leaving minimum amounts of the drugs at pathological sites. Controlled drug delivery aims to deliver drugs to the target sites at desired rates and time, thus enhancing the drug efficacy, pharmacokinetics, and bioavailability while maintaining minimal side effects. Due to a number of unique advantages of the recent microfluidic lab-on-a-chip technology, microfluidic lab-on-a-chip has provided unprecedented opportunities for controlled drug delivery. Drugs can be efficiently delivered to the target sites at desired rates in a well-controlled manner by microfluidic platforms via integration, implantation, localization, automation, and precise control of various microdevice parameters. These features accordingly make reproducible, on-demand, and tunable drug delivery become feasible. On-demand self-tuning dynamic drug delivery systems have shown great potential for personalized drug delivery. This review presents an overview of recent advances in controlled drug delivery using microfluidic platforms. The review first briefly introduces microfabrication techniques of microfluidic platforms, followed by detailed descriptions of numerous microfluidic drug delivery systems that have significantly advanced the field of controlled drug delivery. Those microfluidic systems can be separated into four major categories, namely drug carrier-free micro-reservoir-based drug delivery systems, highly integrated carrier-free microfluidic lab-on-a-chip systems, drug carrier-integrated microfluidic systems, and microneedles. Microneedles can be further categorized into five different types, i.e. solid, porous, hollow, coated, and biodegradable microneedles, for controlled transdermal drug delivery. At the end, we discuss current limitations and future prospects of microfluidic platforms for controlled drug delivery.

All-in-one low-intensity pulsed ultrasound stimulation system using piezoelectric micromachined ultrasonic transducer (pMUT) arrays for targeted cell stimulation

A novel cell-stimulation system was fabricated using 10 × 29 piezoelectric micromachined ultrasonic transducer (pMUT) arrays for targeted ultrasonic cell stimulation. Both the diameter of a single pMUT element and the edge-to-edge gap were 120 μm, and the size of a pMUT array was 2.27 × 6.84 mm, to be placed at the bottom of a Transwell. The measured resonance frequency of a single pMUT element was 1.48 ± 0.13 MHz and the measured acoustic intensity of the pMUT array was 0.15 ± 0.03 MPa at 1 mm away from the transducer. A pMUT array was mounted on a print circuit board (PCB), which was designed in accordance with the size of a 12-well Transwell. The Transwell was placed on the PCB and wire bonding was performed to electrically connect the PCB and pMUT arrays. After wiring, the PCB and pMUT arrays were coated with 2.6-μm thick parylene-C to ensure biocompatibility and waterproofing. PC12 cells were used for ultrasonic cell stimulation tests to examine the proposed all-in-one low-intensity pulsed ultrasound stimulation system. Various stimulation times and duty cycles were used simultaneously for cell proliferation in a confined cell culture environment. All stimulation groups showed increased cell proliferation rates, in the range 138-166%, versus the proliferation rate of the control group.

Minimally invasive probes for programmed microfluidic delivery of molecules in vivo

Site-specific drug delivery carries many advantages of systemic administration, but is rarely used in the clinic. One limiting factor is the relative invasiveness of the technology to locally deliver compounds. Recent advances in materials science and electrical engineering allow for the development of ultraminiaturized microfluidic channels based on soft materials to create flexible probes capable of deep tissue targeting. A diverse set of mechanics, including micro-pumps and functional materials, used to deliver the drugs can be paired with wireless electronics for self-contained and programmable operation. These first iterations of minimally invasive fluid delivery devices foreshadow important advances needed for clinical translation.

Microfluidic neural probes: in vivo tools for advancing neuroscience

Microfluidic neural probes hold immense potential as in vivo tools for dissecting neural circuit function in complex nervous systems. Miniaturization, integration, and automation of drug delivery tools open up new opportunities for minimally invasive implants. These developments provide unprecedented spatiotemporal resolution in fluid delivery as well as multifunctional interrogation of neural activity using combined electrical and optical modalities. Capitalizing on these unique features, microfluidic technology will greatly advance in vivo pharmacology, electrophysiology, optogenetics, and optopharmacology. In this review, we discuss recent advances in microfluidic neural probe systems. In particular, we will highlight the materials and manufacturing processes of microfluidic probes, device configurations, peripheral devices for fluid handling and packaging, and wireless technologies that can be integrated for the control of these microfluidic probe systems. This article summarizes various microfluidic implants and discusses grand challenges and future directions for further developments.

A simple check valve for microfluidic point of care diagnostics

Check valves are often essential components in microfluidic devices, enabling automated sample processing for diagnostics at the point of care. However, there is an unmet need for a check valve design that is compatible with rigid thermoplastic devices during all stages of development-from initial prototyping with a laser cutter to final production with injection molding. Here, we present simple designs for a passive, normally closed check valve that is manufactured from commonly available materials with a CO₂ laser and readily integrated into prototype and production thermoplastic devices. The check valve consists of a thermoplastic planar spring and a soft elastomeric pad that act together to seal against fluid backflow. The valve's cracking pressure can be tuned by modifying the spring's planar geometry and thickness. Seal integrity is improved with the addition of a raised annular boss beneath the elastomeric pad. To demonstrate the valve's usefulness, we employ these valves to create a finger-operated on-chip reagent reservoir and a finger-actuated pneumatic pump. We also apply this check valve to passively seal a device to enable portable detection of RNA from West Nile virus in a laser-cut device.

Osmotically driven drug delivery through remote-controlled magnetic nanocomposite membranes

Implantable drug delivery systems can provide long-term reliability, controllability, and biocompatibility, and have been used in many applications, including cancer pain and non-malignant pain treatment. However, many of the available systems are limited to zero-order, inconsistent, or single burst event drug release. To address these limitations, we demonstrate prototypes of a remotely operated drug delivery device that offers controllability of drug release profiles, using osmotic pumping as a pressure source and magnetically triggered membranes as switchable on-demand valves. The membranes are made of either ethyl cellulose, or the proposed stronger cellulose acetate polymer, mixed with thermosensitive poly(N-isopropylacrylamide) hydrogel and superparamagnetic iron oxide particles. The prototype devices' drug diffusion rates are on the order of 0.5-2 μg/h for higher release rate designs, and 12-40 ng/h for lower release rates, with maximum release ratios of 4.2 and 3.2, respectively. The devices exhibit increased drug delivery rates with higher osmotic pumping rates or with magnetically increased membrane porosity. Furthermore, by vapor deposition of a cyanoacrylate layer, a drastic reduction of the drug delivery rate from micrograms down to tens of nanograms per hour is achieved. By utilizing magnetic membranes as the valve-control mechanism, triggered remotely by means of induction heating, the demonstrated drug delivery devices benefit from having the power source external to the system, eliminating the need for a battery. These designs multiply the potential approaches towards increasing the on-demand controllability and customizability of drug delivery profiles in the expanding field of implantable drug delivery systems, with the future possibility of remotely controlling the pressure source.