ELECTRO THERAPY FILE WORK

Write in detail about dose calculation and factors affecting dosimetry in

Iontophoresis along with various drugs used.
BY: APOORV GARG
B. P. T. 2ND YEAR
ROLL NO. 04
20TH BATCH

IONTOPHORESIS:
This is the term used to describe the technique in which medically useful
ions are driven through the patient’s skin into the tissues. Basically this
technique uses the flow of current between the 2 electrodes to push ions
through the skin barrier, clinically using the direct current to move drug
through the skin.
The purpose is to drive active ions locally rather than having to inject
them or have them taken systematically. Each electrode is either
negative or positive depending upon the polarity of drug ion.
 Iontophoresis works by the mechanism of conduction. Ions pass through
the skin barrier primarily by the hair follicles and sweat glands. This
mechanism only works for the charged ions not for the neutral ones.

DOSE CALCULATION

Dose in iontophoresis is measured in milliampere-min (mA/min) as it is

proportional to the current and the duration of the treatment. Total
dosage delivered is usually calculated by the formula:

I ×T×ECE= amount of drug introduced/Dose of Drug given

Where,
I= current intensity
T= Treatment Time
ECE= Electro-chemical Equivalent- It represents standardized figures
for ionic transfer with known current and time factor.

As determination of ECE for many substances is very complex, so its

value is generally taken very small i.e. fewer milligrams of these
complex substances will penetrate the skin and the formula becomes:

I×T= amount of drug introduced/Dose of Drug given.

Now,
I = J × A. i.e.
Current intensity = Current density ×Surface area of Electrode used.
(mA) (mA/cm2) (cm2)

For clinical Purpose,

Current density of cathode= 0.5mA/cm2
Current Density of anode= 1mA/cm2.

DOSIMETRY:
Dosimetry is the measurement of the amount of material (administered
dose) in the body.
It depends upon:
· Drug selection as per condition- different drugs are prescribed for
different scenarios
· Polarity of the drug
· Concentration of the volume of ions- higher the concentration
under that particular electrode, more will be the availability of the
drug
· Dose of drug is directly proportional to current intensity (A) and
total application duration (T). Maximum dose is 80mA-min and
minimum 40 mA-min. Current intensity (A) is product of current
density and area of electrode.

Practical consideration:
· Increase the intensity till tingling/prickling sensation arrives
· If patient feels burn or pain under the electrode area then lower the
intensity
 · Treatment duration is from 10 to 20 minutes
· Patient should be comfortable with no reported or visible signs of
pain or burning
· Check skin every 3-5 minutes for signs of skin irritation

Lower the intensity to accommodate for decrease in skin impedance to

avoid pain or burning.

DRUGS USED IN IONTOPHORESIS:

Ions Polarity Effects Conditions

Acetic acid -ve Decalcifying Myositis ossificans,

agent calcaneal spur, calcific
tendinitis
Lidocaine +ve Anaesthetic/ Neuralgia, severe pain
analgesic
Salicylate -ve Analgesic/anti- Post-operative pain, sprain,
inflammatory strain
Glucocorticoid -ve Anti- Sprain, strain, bursitis
s inflammatory
Hyaluronidase +ve Anti-oedema Lymphedema
MgSO4
Inflammation:+ve Muscle relaxants
Oedema:Muscle spasm
ZnODexamethasone+ve Hyaluronidase
Anti-sweating (+ve)
Hyperhidrosis
(-ve) Salicylate (-ve)
TapHydrocortisone
water +/-ve
(-ve) Metholyl (+ve)
Salicylate (-ve)
Spasm: Open skin lesions:
1. DEXAMETHASONE
Calcium (+ve) Zn (+ve) :
Magnesium (+ve)
Analgesia: Scar tissue:
Lidocaine (+ve) Cl (-ve)
Mg (+ve) I (-ve)
Salicylate (-ve)
Polarity of the ions = Negative
Therapeutic use = inflammation (Tennis elbow, golfer’s elbow,
epicondylitis, arthritis), allergic reactions.
Type of electrode use for iontophoresis = cathode, which has
negative polarity, will be used as an active electrode here, and
should be double the size of anodal electrode.
Since active electrode is cathode, thus cathodal iontophoresis.
Area of metal anodal electrode= 2×2.5 = 5 cm²
Area of metal electrode of cathode = 2×4= 8 cm²
Current amplitude or intensity= current density of cathodal
electrode × area of active electrode
I= 0.5× 8 = 4 mA
So total time of application duration (T) = dose given/ current
intensity
T= 40 / 4 = 10 minutes.
So direct galvanic current will be given with current
intensity of 4 mA for duration of 10 minutes.
THANK
YOU