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- Therapeutic Modalities
- Jeff Seegmiller EdD, ATC
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- Iontophoresis: Therapeutic technique that involves the introduction of
ions into the body tissues by means of low-voltage direct electrical
current
- Ion transfer first described by Leduc in 1903
- Has come in and out of popularity
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- Ionization: the process by which soluble compounds such as acids,
alkaloids or salts dissociate or dissolve into ions that are suspended
into some type of solution.
- Ions of a specific polarity can be driven into the tissues with a
polarity of the same charge
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- The force that moves the ions is determined by
- Strength of the electrical field (current density)
- Electrical impedance of tissues to current flow
- Can deliver medication to depths of 6 to 20mm below the skin
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- In regular e-stim the active electrode is positive, in Ionto the active
electrode is the one your drug is under.
- Under the (-) electrode there is an accumulation of (+) ions making it
more Alkaline (more likely to cause tissue damage)
- (-)=acidic (+)=alkaline
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- Electrolytes: Solutions in which ionic movement occurs
- Electrophoresis: the movement of ions in solution
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- Painless
- Sterile
- Non-invasive
- By-pass the liver
- localized concentration of medication vs. sytemic
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- Unreliable results with certain medications
- doubt to how much medication is actually introduced into the tissues
- In children anxiety caused by Ionto was not significantly less than that
of an injection
- medication must have small ions vs, large
- Only 6 to 20mm depth
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- Size, shape and type of electrodes
- Skin contact
- Adipose tissue or tissue thickness
- Spacing the electrodes (one study says 18 inches apart)
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- Must be able to produce continuous direct current
- Automatically adjusts for changes in current density throughout the
treatment
- Automatically shuts down if skin impedance decreases to some preset
limit
- Adjustable intensity from 1 to 5mA
- Automatic timer that figures out the duration based on the intensity
(mA/min)
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- Clip hairs
- Check for abrasions
- Clean with isopropyl alcohol
- Screen patient for any drug allergies or sensitivities
- Inform the patient of effects and possible side effects
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- Place electrodes on patient (polarity of the wire is the same as the
polarity of the ion in solution)
- Increase intensity to patient tolerance (no Pain) 3-5mA
- Duration is found by dividing the amplitude by 24mA
- Recheck the skin every 3 to 5 min
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- Dose Range - 0 to 80 mA-minutes
- Current Range - 0 to 4.0 mA (constant current; 0.1 mA increments)
- Maximum Voltage - 80V DC
- Display - Dose, Time Remaining, Current (displayed simultaneously with
interactive set-up)
- Current Ramp Up - Automatic (0 to 4.0 mA; built in option for manual
override)
- Current Ramp Down - Automatic at end of treatment (built in option for
manual override)
- Controls - 2 (dose and current)
- Pause Feature - Yes
- Low Battery Light - Yes
- Open Circuit Light - Yes
- Audible Alerts - Yes
- Battery - 1 - 9V (1604A/6LR61)
- Battery Life - 50 - 60 treatments (40 mA-minutes each)
- Accessories - Twin lead cable, batteries (2), carrying case, instruction
guide, warranty card
- Warranty - 1 year (limited)
- Includes TL7 snap style twin lead cable
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- Traditional
- Capsule
- Hydratable
- Integrated electrode and battery
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- Acetate
- Chlorine
- Dexamethasone
- Lidocaine
- Magnesium
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- Caused from the current not the drug
- pH of the skin is greater than 5
- Sodium Hydroxide which is positive causes an alkaline reaction resulting
in sclerosis
- Lesion is pink and raised at first
- Within hours it turns grey and oozing
- Poor electrodes
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