The
therapeutic techniques involving the introduction of ion into the body
tissue through patient’s skin is called Iontophoresis.
Principle:
Place
the ions under the electrode with the same charge i.e. negative ions
placed under cathode and positive ions under anode. The electrode under
which ions are placed is called active electrode. Iontophoresis is used
for hyperhydrosis (excessive sweating).
Use of tape water:
The
use of tape water produces no side effect but the ions in it may not
inhibit sweating sufficiently. So an anticollinerfic compound in
distilled water is recommended. The hands and feet may be affected and
require treatment but no attempt should be made to treat the hands and
feet on the same day. There should be elapse of several days in their
treatment.
Apparatus:
- Source of direct current
- Shallow plastic tray
- Foot or arm bath for cathode
- Two lint pads to cover electrodes
- Anti-cholinergic compound solution
- Distilled water
Methods of application:
Hands:
The
shallow plastic tray is placed on arm bath table and patient sit along
its side. The active electrode is placed in the plastic tray (anode) and
is covered with one of the lint pads, the pads should be minimum 8
layers thick so that they make good contact with the tissues and the
electrodes. The tray may also contain 0.05 % solution of anti –
cholinergic compound glycopyronium in distilled water. The hand is
placed in the tray and the electrode is connected to the positive
terminal.
Feet:
One
of the feet is placed in a few cm water in a foot bath and the lint
pads covered electrode (cathode) which is connected to the negative
terminal and slowly increased to the desired effect for desired time.
Dosage:
The
dosage is based on the size of the patient and skin tolerance. For an
average Adult the dosage is 12mA for 12 min and half of this treatment
for child. The need to repeat the treatment varies with each patient.
Some patients have relief for month after treatment and some patients
require a repeat less than 4 – 6 weeks.
Precautions of Iontophoresis:
- Care about skin abrasion
- Open wounds
- Remove the rings
- Thickness of pads (minimum 8 layers)
- Warm the patient
Side effects:
Anti – cholinergic compound act as sympathomimatic (increases heart rate, respiratory rate)
Ions which are used for different conditions:
Ions
|
Source
|
Condition
|
Concentration
|
Acetateˉ
|
Acetic acid
|
Deposition of Ca over tendon e.g. tendonitis
|
2 -5 %
|
Chlorideˉ
|
Sodium chloride
|
Adherent scars
|
2 %
|
Copper +
|
CuSO4
|
Fungal infestation e.g. allergic rhinitis
|
2 %
|
Dexamethasone phosphate ˉ
|
Dexa Na2PO3
|
Inflammation
|
0.5 %
|
Iodine ˉ
|
Iodex (potassium Iodide)
|
Scar mobilization
|
5 %
|
Lidocane +
|
Lidocane
|
Local anesthetic
|
5 %
|
Magnesium+
|
MgSO4
|
Muscle relaxant, vasodilatation, oedema reduction
|
2 %
|
Salicylate ˉ
|
Na Sal (Na2S2O3)
|
Inflammation, pain management
|
2 %
|
Zinc +
|
ZnO
|
Dermal ulcer
|
20 %
|
Glycopyronium Bromide ˉ
|
Cholinergic compound + distilled water
|
Hyperhydrosis
|
20 %
|
Calcium+
|
CaCl2
|
Mycospasm (tremors)
|
2 %
|
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