Iontophoresis

Question 1

Iontophoresis Treatment Time

Answer 1

• Typical dose ranges from 20-80 mA-min
• Treatment time (dosage) = amplitude (mA) x duration (minutes)

Question 2

Ion Polarity’s

Answer 2

• Remember “AIDS” for the negative ones
• Negative —> Acetic acid, iodine, dexamethasone, salicylates
• Positive —> lidocaine, zinc oxide, hyaluronidase
• Alternating polarity —> tap water

Question 3

Iontophoresis Drug with their condition

Answer 3

• Dexamethasone — soft tissue inflammation
• Acetic acid — calcific tendonitis
• Iodine — scar tissue
• Salicylates — gout
• Lidocaine — soft tissue pain
• Zinc oxide — ischemic skin ulcers
• Tap water — hyperhydrosis
• Hyaluronidase — edema

Question 4

Iontophoresis Definition

Answer 4

• Technique where current is used to induced movement of ions across skin into target tissues
• Transfer of ions (meds)
• Like charges repel — this is good, we want this to happen so the electrode can repel the drug so it goes further into the tissue

Question 5

Iontophoresis Electrodes

Answer 5

• Cathode (-) = black in color — “dexter the black cat” — dexamethasone is negatively charged and so is the cathode
• Anode (+)
• Active electrode = one that is on top of medication (if med is negative then you wanna use the cathode because its also negative so these repel)
• Inactive electrode = distal electrode (reference or dispersive electrode)

Question 6

Iontophoresis Indications

Answer 6

• Soft tissue inflammation — #1 condition we use this for — dexamethasone
• Calcification tendonitis (calcium deposits)
• Edema
• Ischemic ulcers
• Hyperhydrosis (excessive sweating)
• Gout

Question 7

Iontophoresis Current Density

Answer 7

• Current Density (cD) = Current Amplitude (cA) / Conductive Surface Area (cSA)
• cSA — same thing as electrode size
• Cathode must be twice the size of the anode (but the current density of the cathode should always be half the anode)
• Cathode current density = 0.5 mA/cm^2
• Anode current density = 1.0 mA/cm^2

Question 8

Iontophoresis Electrode Placement

Answer 8

• Active electrode placed directly over area of pain
• Inactive electrode placed a distance away from active electrode
• Inter-electrode distance —> further the distance, deeper the current will go

Question 9

Iontophoresis Dosage

Answer 9

• Dosage = amplitude x duration
• Dosage range = 20-80 mA-minutes
• Amplitude range = 0.1-4 mA (determined based on the patients tolerance)
• Duration = based on amplitude

Question 10

Iontophoresis Contraindications

Answer 10

• Trunk or heart of patients with pacemakers or defibrillators
• Pregnancy — can be used during this but not over abdomen, hip/pelvis, or low back
• Pregnancy with prior miscarriage
• Carotid bodies
• Phrenic nerve
• Active myelitis
• Cancer
• Hemorrhage
• Eyes or reproductive organs

Question 11

Iontophoresis & Wounds

Answer 11

• HVPC remains most commonly used and supported for wound healing (twin peak mono phasic)
• Used with ischemic wounds and pressure ulcers
• Acute phase = inflammation / infection (cathode used)
• Proliferation phase (epithelialization) = anode used, electrode placed into wound inside of saline moistened sterilized guaze (can be used around wound, does not have to be inside)
• Dispersive or inactive electrode is placed nearby skin 15-30 cm distance from wound