IONTOPHORESIS

1
IONTOPHORESIS

• Veronica Southard PT MS GCS

2
General Statements

• Indicated to introduce ions into the body using
  direct current
• Advantages are its painless, sterile, noninvasive

3
Difference between Ionto and Phono

• Phonophoresis delivers whole molecules across the
  skin into the body.
• Iontophoresis delivers ions into the tissues.
• Both are noninvasive means to delivers chemicals
  to the body

4
Mechanisms of Ion Transfer

• Ionization requires soluble cmpds. I.e. acids,
  alkaloid or salts that dissociate or dissolve
  into ions, suspended in solution, creating
  electrolytes.
• Ions move/migrate in solution according to he
  electrically charged currents
• Electrophoresis- Def. - Movement of ions in
  solution

5
Electron Concentration

• Cathode is the negative electrode that has a gt
  concentration of electrons. The cathode is
  negatively charged
• The anode is positively charged and has a lt
  concentration of electrons

6
Polarity

• Negatively charged electrons are repelled from
  the cathode. Thus negatively charged electrons
  move toward the positive pole where they create
  an acid reaction.
• Positively charged ions are attracted to he
  negative electrode creating an alkaline reaction
  at the cathode

7
Using Iontophoresis

• Positively charged ions are driven into tissues
  from the positive pole
• Negatively charged ions are driven into tissues
  from the negative pole
• Therefore you must know the polarity and match it
  with the appropriate electrode

8
Current Density

• Ion flow is dependent upon
• Tissue impedance
• Strength of current field
• Ion migration is caused by the potential
  difference in current density between the active
  and dispersive electrodes

9
Current Density

• Adjusted by
• 1. Intensity adjustments
• 2. Changing the size of the electrode

10
Quantity of Ions Transferred

• Directly related to
• 1. Intensity of the current (density at the
  active electrode)
• 2. Duration of current flow
• 3. Concentration of ions in solution

11
Iontophoresis Generators

• Produce DC specifically for ionto
• Battery operated or AC
• Produce current at a constant rate, therefore
  gradually reduces skin resistance
• Generator should adjust output amperage to normal
  tissue impedance to reduce burning
• Automatically shut down if skin impedance
  decreases below a preset limit
• Current intensity control 1-5 ma

12
Generators cont

• Adjustable timer set up to 25 minutes
• Terminal polarity should be marked.
• Polarity reversal switch should be present
• Lead wires should be examined to assure good
  condition

13
Parameters Ionto Intensity

• Low amp more effective that higher current
  intensities
• Higher intensities reduce effective penetration
  to tissues
• Usually between 3-5 ma
• Increase the intensity slowly- WANT pt to Report
  Prickling or Tingling
• Pt reports of Burning or Pain mean STOP!!

14
Intensity cont

• Slowly decrease intensity to 0 when terminating
  treatment
• Remove electrodes
• Max current intensity may be determined by the
  size of the active electrode.
• Current amplitude is set so that the current
  density falls between .1-.5ma/cm2

15
Parameters Ionto Duration

• 10-20 minutes
• Average 15
• Check skin every 3-5 minutes

16
Electrodes

• Traditional
• Commercially produced electrodes. Have a chamber
  in which you inject ions that is covered by some
  type of semipermeable membrane

17
Procedure

• Skin should be shaved if necessary and clean
• Use great caution with decreased sensation.
• Make sure the polarity of the lead wire matches
  the polarity of the ion.
• Prepare the dispersive with water, gel or
  something conductive.
• Secure both electrodes to skin

18
Procedure cont

• Attach to lead wires and off generator
• Use larger electrodes for larger areas if
  possible
• Dispersive should be at least the diameter of the
  active electrode away from the active electrode.
• For PHTH 615 the farther the better. Some
  authors advocate 18 inches

19
Procedure cont

• As you increase the space between the electrodes,
  the current density in the superficial tissues
  decreases, therefore minimizes burns

20
Selecting Ions

• Only use compounds soluble in both fat and water
• Penetration lt1mm
• Heavy metals tend to become insoluble
  precipitates inhibiting their penetration
• Neg ions at anode produce acidic reax via
  formation of HCL.
• Pos ions at the cathode produce alkaline
  reactions, forming sodium hydroxide

21
Clinical Applications

• Analgesia
• Scar modification
• Wound healing
• Edema
• Burns
• RSD
• Inflammatory MS conditions

• CA deposits
• Hyperhidrosis
• M spasm
• Fungi open skin lesions
• Herpes
• Gout

22
Contraindications

• Skin sensitivity reax
• Sensitivity to agent
• Gastritis/ulcer-cortisone
• Asthma-mecholyl
• Sensitivity to metal
• Sensitivity to seafood-iodine

• Recent scars in treatment area
• Metal implants close to skin
• Acute injury where there is still bleeding
• PPM

23
Ionto Dosage

• Ma x time in minutes
• Ex 20 ma minutes
• Intensity 4ma applied for 5 minutes OR
• 2 ma applied for 10 minutes