Iontophoresis Definition Transfer of ions of the drugs into the body through the skin by the use of constant

direct current. Principles of ion transfer are A) Dissolving the medicinal substances in water breaks them into ions (ionization) B) Like charges repel: Positive ions are introduced into the skin or mucous membrane at the positive electrode or anode Negative ions are introduced into the skin or mucous membrane at the negative electrode, or cathode. C) Deeper penetration is produced than would result from mere topical application of the medicinal substance.

Condition Fungus infection Scleroderma Varicose veins Indolent ulcers Keloids Recent scars Calcium deposits Chronic arthritis Traumatic lesions of ligaments and tendons Hyperhydrosis Vasomotor rhinitis

Drug Copper sulphate Mecholyl Mecholyl Zinc sulfate Potassium iodide Sodium chloride Acetic acid Mecholyl Renotin Glycopyrrolate Zinc sulfate

Polarity Copper+ Choline+ Choline+ Zinc+ Iodide ChlorideAcetateCholine+ Renotin+ Bromide+ Zinc+

Strength of solution It is important to make a dilute solution of the drug, since a high concentration reduces its conductance into the tissues. Generally a 0.1 molar strength is sufficient. APPARATUS FOR DIRECT CURRENT AND IONTOPHORESIS TREATMENTS All modern low frequency generators provide both direct current and alternating current circuits for connection to the patient.

The current from main supply should be rectified by suitable rectifiers, inductors, and capacitors in the circuit. The machine should indicate clearly the positive and negative terminals by colorings. For example red denotes anode or positive, black denotes cathode or negative. Intensity may ranges from 0 to 12mA and from 0 to 30mA. Siemens Neurotron machine having choices: 0 to 5mA, 0 to 20mA, and 0 to 80mA. Some machines have polarity reversal switch that enables you to change the polarity of the terminal. Also look for a clear ON/OFF switch connecting the machine to the mains. Some machines have the option of superimposing a faradic type current over the DC. This will have a separate circuit. It is important to select the circuit that produces a direct current only. ACCESSORIES The electrodes are made from aluminium foil or metal. Electrodes should have rounded edges Rubberized electrodes are often used in modern machines. The pads may be made from any smooth absorbent material such as lint, gauze, sponge, or household absorbent cleaning cloth. The important factor is that when compressed the thickness of the pad should be 10mm. Lint generally requires 16 layers, and household absorbent material requires 6 to 8 layers. The pad should be uniform in thickness. Conducting leads with a variety of end fittings are provided with the apparatus. It is important to ensure that the fittings to the lead wires are firm and not broken. Indications for direct current and iontophoresis 1. Relief of pain. Relief of pain is by 2 ways a) Cathodal galvanism b) Anodal galvanism Cathodal galvanism produces counter irritation effect that will result in vasodilatation which removes the pain substances from that area. Cathodal galvanism also inhibits pain at the spinal level through pre-synaptic inhibitory mechanisms. Anodal galvanism relieves pain by removing the increased concentration of H+ and K+ ions which accumulate in ischaemia or inflammation.

2) Adhesions. Renotin which is the derivative of histamine, can be used in iontophoresis. Renotin sets up a marked counter irritation by producing the triple response to histamine. 3 responses A feeling of increased heat, A marked vasodilation, and A wheal. These 3 reactions affect the fibrous tissue of the adhesions and help to resolve them. 3) Chronic congestion of mucous membrane. Transfer of zinc sulfate into congested nasal membranes has proved beneficial for patients suffering with vasomotor rhinitis. 4) Calcium deposits Acetic acid transfer into calcium deposits has proved effective. It relieves pain by reducing the size of the calcium deposits. 5) Idiopathic hyperhydrosis Glycopyrronium bromide administered by iontophoresis has been recommended for the treatment of excessive sweating. Contraindications 1. Open skin. Large broken areas must be avoided. Small areas can be insulated by the use of Vaseline. 2. Infection. There is a danger of spreading infection if DC is given to an infected area. 3. Bony areas The uneven surfaces will prove to be an impediment when trying to gain even contact with the electrode pad. 4. Loss of sensation It can lead to a burn if an overdose is given inadvertently. 5. Dry scaly skin. It gives more impedance to current flow, so the scales should be removed and skin should be made capable of conducting electricity. This can be achieved by moistening the skin with wet pad.

6. Skin lesions Eczema, fungus, psoriasis, and other such conditions will be irritated by DC and made worse. Dangers: 1. Shock 2. Burns Dosages: a) Anodal galvanism(low dosage for a long duration) 0.15 to 0.25mA per cm2 Duration 15 minutes for the first treatment, progressed by 5 minutes to 30 minutes. b) Cathodal galvanism (higher dosage for shorter duration) 0.5 to 0.8mA per cm2 Duration: 10 minutes for the first treatment, progressed by 5 minutes to 20 minutes. Both intensity and duration primarily determined by the patients tolerance. Frequency: treat on alternate days. Anodal galvanism may be given daily for a few days.