Iontophoresis Flashcards
Iontophoresis Definition
Therapeutic delivery of medication through a non-invasive method of topical delivery of a prescribed medication (ionized drugs) into a localized area of tissue by using the force of direct electrical current create a therapeutic effect.
Methods for Iontophoresis
Uses DC current (a small battery charged unit) to move medication across epidermis into the subcutaneous tissue.
Epidermis is a barrier to water and ionic substances
DC current of iontophoresor moves the ions of the drug in a particular direction (like charger repel; opposites attract.
Ions (or medication composed of ions) with a negative charge are moved across the epidermis when connected to a negative electrode charge.
Mediation Molecules move past the stratum corneum and the drug dispensers to all local tissues with the highest concentration in the tissues closest to the electrode site.
Ion penetration =
1mm
Chemical effect from medication extend deeper by capillary action and conduction of current.
Tx. guidelines
Requires doctors order for specific type of medication and tx.
Tx. generally three times a week for 5-9 session.
Technique that generally takes 10-20 minutes dependent on dosage rate.
Iontophoresor
Technique that is an accelerated method of medication delivery that generally takes 3 minutes although sensation during delivery may be more intense
Hybresis
3 effects of iontophoresis and there related Dx.
1) Reduce inflammation of soft tissue
Dx: Epicondylitis, bursitis, tendonitis, DeQuervains, CTS Med: 0.4 dexamethasone- anti-infalmmatory (most common)
2) Reduce calcium deposit
Dx: Heel Spur
Med: 2% Acetic Acid
3) Reduce scare adhesion Followed by PROM for scar remolding)
Dx: scar adhesions, following flexor/extensor tendon repair, dupytren’s
Med: 2% NaCL
Effectiveness depends on 6 factors:
1) Use of DC Current: increases skin permeability and blood flow.
2) # of ions transferred
3) Depth of penetration
4) Combing of other ions in the skin
5) Ability of the individual ion to enter the body
6) Vasodilation from tissue being warmed by exercise or heat modality or casoconstriction by cold modality will affect the dispersement of meds.
4 Contraindication & 1 precaution in addition to general electrical modality precautions.
1) Allergy to medication
2) Allergy to sulfites (preservative to meds)
3) Allergies to shellfish (if using lodex for scars)
4) Diabetes- Alters sugar levels when using corticosterpids)
1) Consider effect of heat on dispersal of meds.
Application of tradition iontophoresis
Pt. is in a position of relaxation, ask questions, remove creams, lotions that limit penetration.
Determine polarity of medication and attach lead pads so the medication pas is attached to the same polarity of the medication to allow for repel into the epidermis.
Fill medication pad w/ amount indicated on pad and other dispersive pad w/ saline provided w/ pads.
Set tx. parameters
Prep pt. before turning on, encourage them to remain still, adjust current density as tolerated once tx. begins.
Apply soothing lotion post tx., observe skin for galvanic rash to determine if can tolerate higher current density next tx.
Pad application
Apply pads working (medication) electrode over the treatment site.
Dispersive (indifferent electrode) over a major muscle approximately 4-5” away.
Dosage Treatment Parameters
Current amplitude and time. Measured in milliamps-minutes (Mamp x min) This reflects total dosage. Unit defults to 40 mAmp-min but can increase for a total dose of 80 mAmp-min on future visits as tolorated.
Current Density Treatment Parameter
Current Density: to tolerance (no greater than 3.0 mAmp at first session w/ max current density of 4.0 mAmp). 2.0 is considered the lowest therapeutic current density and this is where you will being your first tx. to assess tolerance.
Documentation
Include site of application, type of medication, current density (mAmp) and current ampulitude or final dosage (mAmp-min)
3 Advantages for iontophoresis
1) Non-invasive alternative to a needle injection such as cortisone q/ less harmful side effects.
2) Medication can be delivered to a specific area vs. the entire body.
3) Short tx. time
