iontophoresis Flashcards
iontophoresis
an active transdermal drug delivery system that delivers drug ions through the skin using an electric DC current
basic principle
like charges repel like charges so the drug ions are repelled or pushed into the underlying tissue
what is it used for
site specific, non invasive administration of soluble salts or other drugs instead of injection and or oral medication
advantages
avoids pain that accompanies injection
avoids damage caused by needle insertion
avoids risks of needles
minimizes infiltration of carrier fluids
avoids GI and other systemic side effects of NSAIDs and Cox 2 inhibitors
indications
used to administer water soluble ionic medications
contraindications
damages or denuded skin
recent scar tissue
drug allergies
transcranial
orbital
electrically sensitive support systems –> pacemakers
considerations
diabetes
pregnancy
over external metal fixation devices
elderly skin
TMJ
dizziness or metallic taste
sensation
some pts feel little or no sensation
some pts describe it as tingling or warm sensation
disappear after a few minutes
intensity
intensity decision varies b/w pts and depends on site being treated
tips for increasing comfort
place dispersive electrode over adipose/muscle
ensure good contact
avoid sensitive areas of skin
share thorough hydration of electrode
increase current slowly
avoid additional modalities prior to
do not shave area
do not tape or bind electrodes
typical skin reactions
DC current causes capillary dilation leading to erythema of skin under one or both electrodes
appearance of very small fluid filled bumps caused by release of histamine from dermal mast cells is a less frequent skin rxn
factors of rx
skin type
sensitivity to DC current
skin pigmentation
skin type
fair sensitive skin to pts will exhibit more skin irritation or sensation
sensitivity to DC current
can cause increased redness as well as release of histamine in the skin
in sensitive individuals
–> can lead to appearance of an allergic rxn even though pt is not allergic to the drugs used
skin pigmentation
darked skinned pts normal reddening is usually less visible
minimizing skin rxs
properly cleanse skin prior to treatment
soothing skin
done after treatment
alley unscented non irritating non greasy neutral pH skin lotion
preparations with aloe vera gel replenished skin moisture are reported to work well
components of system
power source
drug and dispersive electrodes
medication
power source
= dose controller
drug and dispersive electrodes
place drug delivery electrode over area to be treated
placed dispersive pad over adipose/muscle
medication
must be water soluble
must be ionized
molecular weight below 5000
local diffuse dose is delivered to a depth of approximately 1.7 cm
quantity delivered
drug dose calculation
unbroken skin at treatment site
quantity delivered
less than injection but more than oral
drug dose calculation
dosage = current x treatment time
preparation for treatment
ask pt about meds, skin sensitivity, pacemaker, pregnancy
use large electrodes and lower currents for pt with sensitivity
mention possible erythema and histamine rxn
trim excessive hair
cleanse area of skin for 2 electrodes using standard alc wipe
hydrate drug electrode and place over area to be treated
placing electrodes for treatment
place dispersive electrodes 4-6 inches away from the drug delivery electrode
connect dose controlled to electrode
performing treatment
set desired drug delivery dose and current
treatment time –> 10-15 min
dose controlled beeps when treatment is complete
remove electrodes and dispose
apply lotion
mechanism of action
when DC is applied to an ionized drug solution
ions that have same charge as electrode are repelled by electrode and are delivered through the skin
