Phonophoresis Flashcards
Phonophoresis =
US is used to deliver a medication via a safe, painless, noninvasive technique
(Usually anti-inflammatory/analgesics)
Opens pathways to drive molecules into the tissues (acoustical streaming)
Less likely to damage/burn skin vs ___
iontophoresis (which uses electrical current to drive medications)
___ the area may enhance delivery of medication
Preheating
= Encourages vascular absorption & distribution of meds.
Some medications are poor ___
conductors
common drugs used with phonophoresis:
hydrocortisone
dexamethasone
benzydamine
salicylates
various anesthetics
effectiveness of phonophoresis is largely based on the theory of:
diffusion through the skin, as described by Fick’s Law
substances (like medications) move from an area of higher concentration (on the skin’s surface) to an area of lower concentration (into the underlying tissues)
How Ultrasound Enhances Diffusion (Physiological Enhancement):
Increase in Metabolic Rate
Enzymatic Activity
Increased Cellular Permeability
Ion Flux
Enhanced Diffusion
Increase in Metabolic Rate:
raises the temperature of tissues, which can increase local metabolic rates
enhances the absorption and activity of enzymes involved in the transport of medications through skin layers
Enzymatic Activity:
increasing tissue temperature and micro-massage effects
facilitating the breakdown and transport of the drug across the skin barrier
Increased Cellular Permeability:
drug molecules to pass through more easily
mechanical effects of ultrasound, such as acoustic streaming, create micro-channels or openings that allow medication to diffuse deeper into the tissues
Ion Flux:
increases the movement of ions across cell membranes
enhances the penetration of the medication but also may facilitate cellular uptake of the drug once it crosses the skin barrier
Enhanced Diffusion:
improves the diffusion coefficient of the medication
increasing its movement across the skin by lowering the barrier resistance
direct effect of the acoustic energy
Increased Efficacy of Topical Medications:
increasing the skin’s permeability and the overall tissue’s ability to absorb the medication
(e.g., anti-inflammatory or analgesic creams)
drugs can reach the targeted tissues more effectively
Enhanced Drug Transport:
effects on cellular permeability, enzyme activity, and ion flux help create an environment where the drug can more easily penetrate and reach deeper tissues
Medication Preparation:
typically prepared in a 1-5% solution
then blended with an ultrasonic gel (which acts as the coupling medium), ensuring that the ultrasound waves can pass efficiently into the skin and tissues
Ultrasound Parameters:
Continuous Ultrasound: when thermal effects are needed to facilitate drug delivery and promote tissue healing
Applied at 1 MHz for deeper tissues (greater than 2.5 cm depth) or at 3 MHz for more superficial tissues (less than 2.5 cm depth)
Pulsed Ultrasound: goal is to achieve non-thermal effects (e.g., reducing inflammation or enhancing drug absorption without raising tissue temperature)
- preferred in conditions like chronic inflammation
Treatment time is ____
1 min/sq. cm area
if the treatment area is 10 cm², the total treatment duration would be around 10 minutes
Intensity is =
.8-1.5 w/sq.cm (pulsed or cont.)
Treatment duration =
is usually 7-10 days at once per day
Patient Safety & Monitoring:
Minimal Side Effects:
little to no skin irritation
Less risk of burns or skin damage compared to iontophoresis
Monitoring for Adverse Reactions:
Clinician must observe the patient for any signs of:
Allergic reaction to the medication.
Skin burns (especially with continuous ultrasound at higher intensities).
Redness, irritation, or discomfort at the treatment site.
Can be used alongside other therapeutic modalities to maximize treatment outcomes:
Heat therapy (hot packs, warm compresses)
Range of Motion (ROM) exercises
Therapeutic Exercise (TherEx) optimize function.
Massage
Joint Mobilization
w/ Heat therapy (hot packs, warm compresses) →
Increases circulation, enhances drug penetration
w/ Range of Motion (ROM) exercises →
Helps maintain/improve joint mobility
