Write a note on Iontophoresis. Explain its method of treatment and contraindications?

 IONTOPHORESIS:

DEFINITION: 

                          It is defined as a technique in which medically useful ions are driven through the patient's skin into the tissues.

PRINCIPLE:

                      The basic principal is to place the ion under an electrode with the same charge; e.g. a negative ion is applied under the cathode. This electrode is known as active electrode. A constant current is then applied and the ion is electrically propelled into the patient. 

HYPERHIDROSIS:

Constant current is used in the treatment of Hyperhidrosis ( excessive sweating ).  The use of tap water for this treatment produces no side effects but the ions in it may not inhibit sweating and therefore the use of anticholinergic compound in water is recommended. 

Apparatus:

The apparatus required is:

• a source of constant current of low voltage and low amperage;
• a shallow plastic tray for the anode
• a foot or arm bath for the cathode
• two large electrodes and leads;
• two large lint pads to cover the electrodes;
• solution of anticholinergic compounds
• Distilled water.

The machine should be tested prior to use. Leads are attached to the terminals and held with free ends, not touching, in a bowl of tap water. 

Method Of Treatment:

In it hands and feet may be affected, and require treatment.

HANDS:

Preparation:  The shallow plastic tray is placed on the arm bath table and the patient sits alongside. The active electrode is placed in the plastic tray and covered with one of the lint pads. The pads should be at least eight layers thick so that they make good contact with the tissues and with the electrode. The tray also contains enough of a 0.05 percent solution of the anticholinergic compound, glycopyrronium bromide in distilled water to cover the palm wet.

Application:    The hand is placed in the tray and electrode connected to the positive terminal of treatment unit. One of the patient's feet is placed in a few cms of warm water in the foot bath, on a lint pad covering the electrode connected to negative terminal. The current is now switched ON. The glycopyrronium becomes the positive ion when the salt is dissolved in distilled water, so the positive ions will repelled by the anode and attached to cathode.

FEET:

For treatment of the feet the arrangements should be reversed by placing the shallow tray with the anode on the floor and the arm bath with the cathode, for the arm to complete the circuit.

Dosage:

For an average adult, 12 milliamperes for 12 minutes, and half this amount for a child. The need to repeat the treatment varies with each patient.

Precautions:

1. Skin Abrasions
2. Remove the patient's rings.
3. Ensure correct thickness of pads.

ContraIndications:

1. Pregnancy
2. Conditions where there is congestion of lungs and respiratory system.

References:

Clayton's Electrotherapy ( Angela Forster and Nigel Palastanga )

About Author:

Tayyba Saleem ( PT )

Doctor Of Physical therapy.