IONTOPHORESIS


WHAT IS IONTOPHORESIS

Iontophoresis is defined as the process of transfer of ions of drugs into the body through the skin by the use of a constant direct current.

PRINCIPLE OF IONTOPHORESIS

Iontophoresis is based on the fact that ions of drugs will migrate to the electrode of opposite charge under the influence of an electromotive force.

EQUIPMENT USED FOR IONTOPHORESIS

All modern low frequency generators provide both direct and alternating current circuits for connecting to the patient. direct current is obtained from the main supply after it has been rectified by suitable rectifiers, inductors and capacitors in the circuits.

the basic requirements for the application of direct current in an equipment indicated as positive and negative terminals, red indicates the positive terminal or anode and black indicates the negative terminal or cathode.

the power output and the miliammeter must be clearly indicated. Generally there will be two current ranges which should be clearly marked. and there should also be a clear ON/OFF switch connecting the machine to the main supply.

It is important to select the circuit that would produces only direct current.

FORMULA USED FOR IONTOPHORESIS

The basic formula used for iontophoresis is:

I * T * ECE = grams of ions of drugs introduced into the body 

where,

I - Intensity: measured in amperes

T - Time: measured in hours

ECE - Electrochemical equivalency refers to standard figures for ionic transfer with known currents and time factors.

IONS AND THEIR RELATION WITH PATHOLOGIC CONDITIONS

       Pathology                               Ions selection

(1) Pain                      ---   Hydrocortisone, lidocaine, magnesium and

                                          salicylate

(2) Inflammation       ---    Hydrocortisone, salicylate


(3) Spasm                 ---    Calcium, magnesium


(4) Oedema              ---    Mecholyl, iodine, magnesium, salicylate 

                                         Hyaluronidase

(5) Ischemia            ---     Mecholyl, magnesium, iodine


(6) Calcific deposits ---    Acetic acid


(7) Gouty tophi        ---     Lithium


(8) Fungi                 ---     Copper


(9) Allergic rhinitis ---     Copper


(10) Open lesions   ---     Zinc


(11) Scars, adhesions --- Chlorine, iodine, salicylate.


(12) Hyperhidrosis     --- Tap water with alternating polarity.

POSITIONING OF PATIENT FOR IONTOPHORESIS

Patient should never lie with full body weight on an electrode. because this creates pressure and ischemic condition which can lead to a burn since the cooling effect of the circulatory sweep is missing.

Therefore, shoulder, face, hand, elbow, neck and brachial parts are better treated with the patient in sitting position.

side-lying, supine and prone positions are appropriate for trunk, lower back, anterior chest, thigh and abdominal procedures.

the knee is best treated with the patient in the sitting position.

INDICATIONS OF IONTOPHORESIS

(1) For relief of pain 

(2) For breaking adhesion

(3) Chronic congestion of mucous membrane

(4) Calcium deposits

(5) To reduce oedema

(6) For application of antibiotics into the body through a vascular area

(7) For local anaesthesia

(8) For application of anti-inflammatory drugs into the body

(9) For treating neurogenic pain.

CONTRAINDICATIONS OF IONTOPHORESIS

(1) Open skin

(2) Bony areas

(3) Loss of sensation

(4) Infection

(5) Skin lesions

(6) Pregnancy

(7) Dry scaly skin.

DANGERS OF IONTOPHORESIS

(1) Shock 

(2) Burns

(3) Skin irritation

(4) Skin sensitivity

(5) Systemic effects: which may occur due to iontophoresis of anti-cholinergic drugs and histamine like drugs.






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