Iontophorosis

Iontophoresis is a process of transdermal drug delivery by use of a voltage gradient on the skin. Molecules are transported across the stratum corneum by electrophoresis and electroosmosis and the electric field can also increase the permeability of the skin.

1. IONTOPHOROSIS Dr. Arjun Patel

2. What is Iontophorosis ?? Iontophorosis is the transfer of the ions of drugs into the body through the skin by the use of a constant direct current.

3. Principle Same charge ions repeal to each other opposite charge ions attract to each other. External energy source (Continue direct current) for the better peneration , that increase the rate of peneration . When negatively charge drug is deliever across the epithelium, it is placed under the negative charge electrode. And as in positive charge..... Negatively charged electrode placed at the 50 cm distance from the other electrode.

4. Factors Affecting the Iontophorosis Chemical Property of compound : Molecular Size : Larger size takes more time Concentration of particular solution : Highly concentration requires less amount Charge : Either + ve or - ve

5. Drug Formation : Type of vehicle pH of the body part Viscocity Equipment : Properly working or not

6. 4. Biological Variation : Type of Skin : Oily Skin = Penetrate Easily Dry Skin = More irritable Site of skin : Such as flexor aspect of forearm Age : Older = More sensitive Adult = Less sensitive Gender : Female = More sensitive Male = Less sensitive

7. Apparatus Modern low frequency generators provides both direct and alternating current circuits for the connecting the patient. The DC is obtained from the mains power supply after it has been rectified by suitable rectifiers, inductors and capacitors in the circuit. The direct current controls in low frequency apparatus.

8. The application of DC in an apparatus are clearly indicated positive and negative terminals. Red denotes the positive terminal or anode. Black indicates the negative terminal or cathod . The power output and milliammeter must be clearly indicated.

9. There will be also a polarity reversal switch, which enables to change the polarity of the terminal. The ON/OFF switch connecting the machine to the mains.

10. Accessories with the Apparatus Electrode Aluminium foil Metal Circular electrodes are more useful Pads may be made from any smooth absorbent material such as, Lint Gauze pads Sponge Household absorbent cleaning cloth

11. The thickness of pad should be 10 mm. The covering pad should be uniform in thickness. Conducting leads attached with apparatus.

12. Formula For Iontophorosis The basic formula for using iontophorosis is : I × T × ECE = Grams of substance introduce Where, I = Intensity; measured in ampers T = Time; measured in hours ECE = Electrochemical equivalency

13. Properties Ions Charge Property Therapuetic Uses Hydrocortisone + ve Anti-inflammatory Arthritis Tendinitis Myositis Bursitis Lidocaine + ve Anaesthetic, Analgesics Neuritis Bursitis Painful range of motion Mecholyl + ve Vasodilator, Analgesic Neuritis Neurovascular deficits Spains Oedema Lithium + ve - Specially for Gout Hyaluronidase + ve Absorbant Oedema Sprains

14. Ions Charge Property Therapuetic Uses Chloride + ve Sclerolytic Scar tissue Adhesions Calcium + ve Analgesics, Stabilizer Mild tremors Frozen Joints Trigger fingers myospasm Zinc + ve Antiseptic Used for healing Otitis media Ulceration Open wound Dermatitis Copper + ve Antiseptic, Antifungal Rhinitis Dermatophytosis Magnesium + ve Antispasmodic, Analgesic, Vasodilator Myositis Neuritis Ostroarthritis

15. Ions Charge Property Therapuetic Uses Salicylate - ve Analgesic, Decongestant Myalgia Rheumatoid Arthritis Iodine - ve Antiseptic, Sclerolytic , Analgesic Scar tissue Adhesions fibrositis Acetic Acid - ve - Calcific deposits Myositis ossificans Frozen joints Chlorine - ve Sclerolytic Scar tissue Adhesions

16. Advantages Simple Non – invasive Eliminates the adverse drug reaction Eliminates the toxicity Can change the dosage Equal distribution inside the body

17. Disadvantages Intensity is limited May be painful Hyperhydrosis

18. Indications Relief of pain Cathodal galvanism : The counter irritant effect of cathodal galvanism produces a marked vasodilatation which, by helping to remove the pain factor is resposible for pain relief. Anodal gavlenism : It is thought to relieve the pain by removing the increased concentration of H+ and K+ ions, which accumulate in ischemia or inflammation.

19. 2. Adhesion : Renotin , which is a derivativee of histamine, can be used in iontophorosis . Renotine sets up a marked counter-irritation by producing response histamine, A feeling of increased heat Marked Vasodilatation This effects the fibrous tissues of adhesions and helps to resolve them. In case of ligamentous and tendinous adhesions, renotin ionization may be used.

20. 3. Chronic Congestion of mucous membrane Transfer of zinc sulphate into congested nasal membranes has proved beneficial for patients suffering with vasomotor rhinitis. 4. Calcium Deposits Acetic acid transfer into calcium deposits has proved effective. It relieves pain by reducing the size of calcium deposit.

21. 5. Idiopathic Hyperhidrosis : Glycopyrronium bromide administred by iontophorosis has been recommended for the treatment of excessive sweating. 6. Local Anaesthesia : Local cutaneous anaesthesia is achieved by the iontophorosis of suitable agent like lignocaine or procaine.

22. 7. Application of Antibiotics : Antibiotics can be applied to a vascular area by iontophorosis . 8. Oedema Reduction : Oedema in acute or chronic conditions can be reduced by using hyaluronidase intophorosis . 9. Neurogenic Pain : Iontophorosis of vinca alkaloids is used in treatment of malignancy and chronic pain syndrome.

23. Contraindications Open skin : Current tends to concentrate over these points. Large broken areas should be avoided. Small areas can be insulated by the use of vaseline . Infection Dangers of spreading infection by use of direct current.

24. Bony Areas : As it produces burns. Loss of sensation : It can lead to burns because of overdose. Dry Scaly skin : Increases the skin resistance.

25. Skin Lesions : Eczema and psoriasis are made worse by direct current. Pregnancy : It should be avoided in pelvic areas around uterus.

26. Dangers Shock : Inadequate earthing of apparatus Faulty ammeters Faulty power points Wet floors Reversing the polarity Increasing and decreasing current too quickly

27. Burns : Contact of metal with skin Over dosage Skin lesions Concentration of current Skin Sensitivity : It may be reduced due to anaesthetizing drugs.

28. Skin irritation : Caused due to hypersensitivity to chemicals. Can be prevented by washing the treatment part after treatment. Systemic Effects : Due to iontophorosis of anti-cholinergic drugs and histamine-like drugs.

29. Reference Helpline Electrotherapy for Physiotherapists : Virendra Kr. Khokhar .

30. Thank you…