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Phys Agents > Electrotherapy for Iontophoresis > Flashcards

Electrotherapy for Iontophoresis Flashcards

1
Q

Who used electromotive force to move ions through skin and when

A

Pivati 1747

Fabre-Palaprat 1833

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2
Q

True or False:

Ionized medication must be placed under electrode of the same charge

A

True

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3
Q

What is the mechanism of topical drug delivery without iontophoresis

A

Passive diffusion

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4
Q

What is the stratum corneum

A

Outer most layer of skin

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5
Q

True or False:

The stratum corneum limits the drug diffusion rate through the skin

A

True

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6
Q

How does a topical drug get into the blood stream

A

The medicinal molecules permeate the dermis and are absorbed into the blood stream via the capillaries

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7
Q

What is iontophoresis

A

The introduction of medicinal ions into the body tissues by means of a low voltage direct electromotive force (DC current)

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8
Q

How does iontophoresis occur

A

By the direct electrostatic repulsion of an ion by a similarly charged electrode

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9
Q

What causes the medication to get into the body

A

The permeability of the stratum corneum is increased

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10
Q

What is electroporation

A

Temporary production of water soluble pores in the skin

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11
Q

What is electroosmosis

A

As water is carried through the skin it can carry other objects dissolved in it along with it

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12
Q

True or False:

DC current produces a buildup of ions under the electrodes producing chemical reaction and altering skin pH

A

True

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13
Q

What builds up under the negative electrode during iontophoresis and what type of reaction does it cause

A

Sodium hydroxide (+ions) alkaline reaction

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14
Q

What builds up under the positive electrode during iontophoresis and what type of reaction does it cause

A

Hydrochloric acid (-ions) acidic reaction

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15
Q

How do you minimize these reactions

A

Decrease current density

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16
Q

True or False:

In ionotphoresis the electrodes are generally buffered to keep pH in a specific region

A

True

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17
Q

What is the dosage of iontophoresis measured in

A

mA.minutes

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18
Q

How do you determine the dosage of iontophoresis

A

Amplitude*duration

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19
Q

True or False:

The dosage depends upon the specific electrode being used

A

True

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20
Q

What did Delacerda determine was the drug delivery range for iontophoresis

A

40-80 mA.minutes

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21
Q

What do most manufacturers recommend for the dosage of iontophoresis

A

40 mA.minutes

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22
Q

How does a higher current amplitude and a shorter duration provide a greater delivery of the drug for iontophoresis

A

The higher the push of the drug through the skin to achieve the desired effect in a shorter time

23
Q

What is a side effect of higher current amplitude

A

Higher build up of electrochemical response and effect under the electrode leading to potential pain and discomfort

24
Q

How long does it take to get a dose of 40 mA.minutes with 1, 2, 3, and 4 mA of current

A

1: 40 minutes
2. 20 minutes
3. 13.3 minutes
4. 10 minutes

25
Q

What is the depth of penetration of iontophoresis

26
Q

12-24 hours after treatment what may the penetration of the drug reach

27
Q

What are the advantages of iontophoresis (5)

A
  1. Painless, sterile, noninvasive
  2. May avoid systemic distribution
  3. Avoids the first pass effect at the liver
  4. Less chance of over dose
  5. Easy drug termination
28
Q

What are the general indications for iontophoresis (3)

A
  1. Localized problem
  2. Fairly superficial
  3. Patient able to tolerate drug and effective current dosage
29
Q

What are the indications for iontophoresis (6)

A
  1. Localized chronic and sub-acute inflammation
  2. Pain
  3. Hyperhidrosis
  4. Muscle spasms
  5. Calcium deposits
  6. Gout
30
Q

What is hyperhidrosis

A

Excessive sweating

31
Q

What are the localized chronic and sub-acute inflammatory processes treated by iontophoresis most commonly

32
Q

What are the contraindications for iontophoresis (7)

A
  1. Anesthetic skin in the area to be treated
  2. Recent scars in the treatment area
  3. Metal embedded close to the surface of the skin
  4. Damage or denuded skin
  5. Cardiac pacemaker or presence of arrythmias
  6. Placement of electrodes over carotid sinus or areas of venous or arterial thrombosis
  7. Sensitivity to the treatment drug
33
Q

What are the drug requirements for iontophoresis (4)

A
  1. Must be in ionized state
  2. Must be soluble in water and lipids
  3. Must be able to permeate through the skin
  4. Most medications require a prescription from a physician
34
Q

What must be known about the solubility of the drug

A

What is the active ion

35
Q

True or False:

Iontophoresis electrodes have a small chamber to house the drug

36
Q

True or False:

Iontophoresis electrodes are covered by a semipermeable membrane and are self adherent to the skin

37
Q

When makes the iontophoresis electrode an active electrode

A

The one with the drug in it

38
Q

What is the dispersive electrode prepared with

A

Water, gel, or other conducting material

39
Q

What is current density equal to

A

Current amplitude/electrode size (area)

40
Q

Is the current more focused with a smaller or larger electrode during iontophoresis

A

Smaller electrode

41
Q

What can a smaller electrode result in

A

Tissue burn

42
Q

What is one benefit to a smaller electrode for iontophoresis

A

It mat increase ion velocity

43
Q

What is the recommended maximum current density if delivered from the cathode

A

0.5 mA/cm2

44
Q

What is the recommended maximum current density if delivered from the anode

A

1.0 mA/cm2

45
Q

What is the anode

A

Positive electrode

46
Q

What is the cathode

A

Negative electrode

47
Q

What does an increased ion velocity result in

A

Increased drug transmission

48
Q

What are the ions used for iontophoresis under the negative electrode (5)

A
  1. Acetate
  2. Chloride
  3. Dexamethasone phosphase
  4. Salicylate
  5. Iodine
49
Q

What is the source of acetate, chloride, dexamethasone phosphase, salicylate, and iodine for iontophoresis

A
  1. Acetate: Acetic acid
  2. Chloride: NaCl
  3. Dexamethasone phosphase: DexNa2PO3
  4. Salicylate: NaSal
  5. Iodine: Iodine
50
Q

What is the indication for acetate, chloride, dexamethasone phosphase, salicylate, and iodine for iontophoresis

A
  1. Acetate: Calcium deposits
  2. Chloride: Sclerotic
  3. Dexamethasone phosphase: Inflammation
  4. Salicylate: Inflammation and plantar warts
  5. Iodine: Scar
51
Q

What are the ions used for iontophoresis under the positive electrode (4)

A
  1. Copper
  2. Hyaluronidase
  3. Lidocaine
  4. Magnesium
52
Q

What is the source of copper, hyaluronidase, lidocaine, and magnesium for iontophoresis

A
  1. Copper: CuSO4
  2. Hyaluronidase: Wydase
  3. Lidocaine: Lidocaine 1:50000 with epinephrine
  4. Magnesium: MgSO4
53
Q

What is the indication for copper, hyaluronidase, lidocaine, and magnesium

A
  1. Copper: Sclerotic
  2. Hyaluronidase: Edema reduction
  3. Lidocaine: Local anesthetic
  4. Magnesium: Muscle relaxant and vasodilator

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