Iontophoresis

[BarbForr]

Hello All

I have normally used phonophoresis to optimize delivery of topical anti-inflammatories. I recently received a referral specifically requesting iontophoresis from a sports medicine physican. I have been attempting to research the appropriate carrier frequency, intensity, duration of electrical current for ionto, but I am getting a wide variety of information in the literature. Does anyone use inotophoresis? What parameters do you recommend?

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• Iontophoresis

[Physiobase]

Here's some info from the web. I believe phonophoresis and iontophoresis are trying to do the same thing by trying to increase topical drug absorption through the skin into the underlying tissue. Their effect though appears questionable ?

Phonophoresis Policy

Aetna considers the use of phonophoresis experimental and investigational for any indications. Phonophoresis has been used to enhance the absorption of analgesics and anti-inflammatory agents. Controlled clinical trials, however, have failed to demonstrate that phonophoresis increases the rate or extent of absorption of these agents.

Background

Phonophoresis, also known as sonophoresis, generally utilizes an ultrasound apparatus that generates frequencies of 0.7 to 1.1 MHz. The ultrasound intensities employed usually range from 0.0 to 3.0 Watts per cm2. Furthermore, both continuous-mode as well as pulse-mode applications were utilized, and most treatments lasted from 5 to 8 mins, with the exception of treatments of larger areas (greater than 36 cm2) requiring more than 8 mins. The exact mechanism enabling drugs to be propelled into the subcutaneous structures is still unclear.

Phonophoresis has been suggested by early studies to enhance the absorption of analgesics and anti-inflammatory agents. More recent, better-controlled studies have consistently failed to demonstrate that phonophoresis increases the rate of absorption or the extent of absorption over placebo. Several reviews stated that more research is needed to ascertain optimal techniques and conditions for safe and efficacious utilization of physical modalities including phonophoresis; and there is a need for additional research to establish clinical effectiveness and determine optimal treatment parameters for the physical agents (e.g., phonophoresis) used most frequently to alleviate pain in hand therapy.

In a randomized study (n = 60) comparing the effectiveness of ibuprofen phonophoresis with conventional ultrasound therapy in patients with knee osteoarthritis, Kozanoglu et al (2003) found that Ibuprofen phonophoresis was not superior to conventional ultrasound.

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Iontophoresis

Iontophoresis for Musculo-Skeletal Inflammation
Iontophoresis or ElectroMotive Drug Administration (EMDA) is a very effective method of delivering drugs to the affected site which is commonly used in many countries including the USA.

Instead of injecting the drug (usually a steroid) directly into the inflamed area which is painful and has a risk of infection and side effects, EMDA spreads a high concentration of drug evenly through the tissue.

Iontophoresis is defined as the topical introduction of ionized drugs into the skin using direct current. However, iontophoresis with simple tap water alone is successful in a vast majority of patients.

Like electrical charges repel. Therefore, application of a positive current will drive positively charge drug molecules away from the electrodes and into the tissues, similarly, a negative current will drive negatively charge ions into the tissues.

[sdkashif]

Have a look over this link for detailed information.

groups.msn.com/physiopak