ionto color

7/17/2019 Ionto Color

http://slidepdf.com/reader/full/ionto-color 1/17

IONTOPHORESISReading: Cameron pgs 272-276

• Use of Direct Current to facilitate delivery of

ions into the skin for therapeutic purposes.

• Mechanism of delivery:

“ LIKE CHARGES REPEL”



Contemporary Use• In PT: primarily for treating localized

inflammatory conditions in superficial

tissues

– Use corticosteroids,

(usually dexamethasone)

• Multiple uses of other non-steroidal ions

both within & outside PT

• Ex: Dentistry, Dermatology, Emergency

Dept, Ophthalmology



Dexamethasone: mostcommonly used for Ionto• Dexamethasone Sodium Phosphate

• 0.4% aqueous solution

• 0.4% = 0.004 g/ml = 4 mg/ml

– Dissolves & ionizes into Dex-P & Na

• corticosteroid for anti-inflammatory

effects; polarity is (-)



Additional Ions Used in PT(FYI)

• Acetic Acid (-) dissolve Ca deposits

• Calcium Chloride (+) ms. relaxant

• Hyaluronidase (+) disperse edema; not acute

• Iodine (-) softens adhesions & scar tissue• Magnesium Sulfate (+) ms. relaxant

• Sodium Salicylate (-) ms. & joint pain

• Lidocaine (+) local anesthetic



Depth of ion penetration• Believed to occur primarily thru pores

(sweat & oil) & hair fol licles

• Passive diffusion and local circulation

are required to transport the drug

deeper, to the cells of the target tissue

• Research – effect is often inferred based

on clinical effectiveness (pain, ROM, MMT,

function)

• max depth of ion penetration is largelyunknown in humans (8-10mm in mammals)



Ionto: Advantages over injection

• non-invasive; less risk of infection

• less pain & anxiety

• less drug into systemic circulation;

decreased side effects• Less risk of local collagen

catabolism*

* assuming use of corticosteroid



Ionto: Advantages over drug PO

• avoids “ first-pass” elimination by

liver.• less drug into systemic circulation;

decreased side effects.

• potentially greater concentration of

drug in the target area

• supervised; maximizes compliance.



Ionto: Disadvantages• risk skin irritation or burn

• depth of penetration known to vary b/c of

variation of current density, skin

impedence, skin/fat thickness, and

ionization/pH

• greater risk of local collagen catabolism

than oral administration*

• Action of drug – localizedimmunosuppression*

* assuming use of corticosteroid



Contraindications & Precautions• Typical E-stim contraindications & precautions

apply

• Pt. allergic to drug/substance being used?• No thermal modalities immediately before or

after. Why??

• No conductive gel before Ionto. Why??• Diabetes is a precaution due to decreased

peripheral sensation, and combination of

localized immunosuppression caused by

corticosteroid and risk of skin damage byDirect Current.



Treatment Parameters• Current: DC (can cause elctrochemical changes)

• Amplitude: 0.08 to 4.0 mA is the range

• Dosage Formula: amplitude X time = mA·min

• Dosage: 40 to 80 mA-min is the range

• POLARITY– use the same polarity as the drug ion

• Rx frequency: every other day at the most• steroid effects can be delayed & last several days

• allows time for skin to recover

• minimize risk of side effects• Rx number: 4 - 7 max



Equipment & Supplies Needed• Drug ion in aqueous solution

• Absorbent & buffered electrode

• Iontophoresis delivery systems (equipment)

– DC stimulator (>1.0 mA; Rx time <1 hr)

– Patch products: (<0.25 mA, Rx time 4-6 hrs)Iontopatch, ActionPatch, etc..

– Hybresis by EMPI (high, then low mA, Rxtime > 1hr)



DC Stimulator: Dupel by EMPI



Skin Safety with use of DC stimulator• Amplitude: pt feels a tolerable itching or stinging.

• Erethema under the electrodes is a normal reaction

due heat build-up & chemical build-up• Skin pigmentation: skin response harder to judge.

OK NOT OK NOT OK



Patch: Iontopatch



Patch: Action-Patch by EMPI



Hybrid System: HYBRESIS by

EMPI



Effectiveness Factors• Dosage: mA-min

– Do different combinations of amplitude & time

provide equivalent amounts & depth of iontransfer?

• Preparation of skin

• must be clean; no competing ions.

• Depth of target tissue

• skin thickness, fat layer, overlying tissues

• Electrode Contact

ionto color

Documents