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unit 2 > EEI 10/24b Iontophoresis > Flashcards

EEI 10/24b Iontophoresis Flashcards

1
Q

neutral atom

A

protons = electrons

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2
Q

positive ion

A

protons > electrons

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3
Q

negative ion

A

protons < electrons

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4
Q

solvent

A

breaks down solute

-saliva is a solvent and breaks down our food

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5
Q

electrophoresis

A

ionic movement according to the electrically charged current acting on it

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6
Q

positive ions

A

cations

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7
Q

negative ions

A

anions

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8
Q

cathode

A

negative electrode

lots of cations want to stick to it

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9
Q

anode

A

positive electrode

attracts negative

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10
Q

three main pathways for ionto

A
  1. Paracellular (between cells)
  2. Transcellular (through cells)
  3. Appendageal (along pores: hair follicles, sweat glands, etc)
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11
Q

positives for ionto rather than injection

A
  1. non-invasive
  2. less risk of infection
  3. more local/less systemic
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12
Q

define iontophoresis

A

use of low amplitude direct current to administed ionized medications across the skin

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13
Q

typical substances that travel on ionto

A

anti-inflammatories

local anesthetics

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14
Q

what is the typical current range of ionto device?

A

1-4 mA

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15
Q

drug delivery mechanisms

A

electrophoresis (main technique clinically)
electro-osmosis
electroporation

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16
Q

define electroporation

A

process by which a large transmembrane voltage temporarily disturbs the phospholipid bilayer membranes, creating a “pore” through which molecules can pass

-within stratum corneum

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17
Q

electroosmosis

A

movement of a solvent, carrying with it other dissolved substances, through the skin under the influence of direct current

-same direction as the flow of counter ions
> at physiologic skin pH (~7); skin carries a negative charge, counter ions are positive

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18
Q

electro-osmosis electrodes

A

anode (+) medication = enhanced

cathode (-) medication = hindered

19
Q

advantages of iontophoresis

A 
non-invasive
get local reaction, decreased systemic
painless (itching or slight tingling)
avoids tissue damage
decreases side effects - maybe
20
Q

disadvantages of iontophoresis

A

the amount that gets to the target tissue (biggest factor) is less known
can get burns from DC current

21
Q

for pain, which drug do you take and what charge is it

A

lidocaine

(+) charged

22
Q

for calcium deposits, which drug do you take and what charge is it

A 
acetic acid 
(-) charged
23
Q

for inflammation, which drug do you take and what charge is it

A

dexamethasone

(-) charged

24
Q

for pain, overuse, and arthritis which drug do you take and what charge is it

A 
sodium salicylates
(-) charged
25
Q

what is dexamethasone best for?

A

itises

-plantar fasciitis, lateral epicondyle, rotator cuff tendons, infrapatellar tendon, tib. post. tendon, etc

26
Q

electrochemical effects of DC current

A

AABC - acid anode, basic cathode

27
Q

what effects do DC anodes have on the body

A

Acidic
caustic HCl
hardens tissue
accelerates tissue growth
decreases nerve excitability (HYPERPOLARIZATION)
increases capillary coagulation (restricts BF)

28
Q

what effects do DC cathodes have on the body

A

Basic
caustic NaOH
softens tissue
bacteriostatic effect (keeps area clear of bacteria)
increases nerve excitability (DEPOLARIZATION)
promotes vasodilation

29
Q

what are the current, duration, and pH targets with cathode DC current

A

current 2-4mA
duration 30 min
pH change from 7 to 10.1

30
Q

medication of ionto is driven due to

A
  • amplitude of current (1-4 mA)
  • duration of treatment (20-40 min)
  • total current dosage (mAxmin = 40-80mA*min)
  • polarity (medication dependent)
31
Q

if current density has to be less than 0.5mA/cm2, for a 2x2 electrode what is the maximum amplitude you should provide?

A

current density = current/area

current = current densityxarea
=2.0mA as the peak amplitude

32
Q

what happens if the maximum calculated amplitude is 6mA?

A

devices normally don’t go over 4mA, so we wont utilize that current

33
Q

how do you know which dosage is best?

A

research is not there to justify one vs the other, but it depends on the patient’s needs, schedule, and sensitivity

34
Q

what is the best factor to utilize with penetration of the drug into the skin?

A

TIME ELAPSED

  • current intensity does not matter
  • after 20minute treatment, leave on patch for another 5-6 hrs to continue flow
35
Q

penetration of the ions is the ___ in the region of the ___, it is in proportion to the ____ magnitude, and it is most likely deposited below the _____. Onward migration to the ___ tissues is achieved by ____ rather than being ___ ___ by the current

A 
greatest
pores
current
stratum corneum
deeper
diffusion over time
driven/ionto'd deeper
36
Q

how to set up electrodes

A
  1. active - delivery electrode, medicated
  2. return - dispersive electrode (to finish circuit)
  3. polarity - cathode (- lead) to deliver (-) medicine; anode (+ lead) to deliver (+) medicine
37
Q

what lead does dexamethasone go under when delivering ionto

A

cathode (-)

38
Q

what don’t you want to do when delivering ionto?

A
  1. ultrasound (Increases blood flow - so would be contra to the ionto)
  2. heat/ice (During heat, BF increases and with Ice vessels constrict but when you take it off it triggeres BF back to tissue so it’s not good!)
  3. short wave diathermy (waves and heat)
  4. massage
  5. exercise
39
Q

what do you want to consider for the patient when delivery ionto

A

Keep the medication in the location that we want!
Want to avoid increased blood flow to the area

Do ionto at the end of the treatment

40
Q

clinical considerations for ionto?

A
  1. drug allergies (to NSAIDs and others - contact physician)
  2. size of affected area (targetted, small, and superficial; thumb>hamstring)
  3. depth of penetration (increase duration)
  4. contraindications and precautions (same as stim)
    - broken, damaged skin
    - reduced sensation
    - pacemaker, bladder stimulators, phrenic nerve stilumators
41
Q

do you directly start with 4 mA of current on a new patient?

A

No, begin with 1 or 2 then progressively crank up to 4

42
Q

possible skin reactions from ionto

A
  1. mild skin reaction - not a burn; some erythema
  2. small blister-like vessicles may appear and resolve in minutes to hours (if doesn’t resolve, don’t do treatment again)
  3. abnormal response: bright white spots
43
Q

inflammation and ionto

A

use dexamethasone -> deliver with cathode for lateral epicondylitis, carpal tunnel syndrome, de Quervain synovitis, planta fascitis

Side effects:

  • break down of collagenous tissue (muscle, tendon, bone)
  • don’t do every day
  • if not effective in 3-4 treatments STOP
44
Q

what is the big risk with anesthetizing the skin with lidocaine?

A

delivered with anode, skin becomes numb, increased risk of electrical or chemical burns

unit 2 (31 decks)

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