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526 Electro > Ionto > Flashcards

Ionto Flashcards

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1
Q

ionto

A

method of delivering med ions through intact skin
alternative to IV or parenteral delivery

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2
Q

how does ionto work?

A

direct current pushes meds into dermis and tissue using coulombs law of like charges repelling

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3
Q

general types of meds used in ionto

A

anti inflammatory
anesthetic
prescription

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4
Q

advantages of ionto over injection

A

no trauma to skin from puncture - decreased infection risk
less meds into blood supply - less systemic effect
relatively painless

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5
Q

direct current

A

uninterrupted flow of electricity in one direction in circuit

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6
Q

disassociation

A

compounds placed in a solution disassociate into positive and negative ion components and more +/- state

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7
Q

ion pole attraction

A

positive cations will be attracted to the negtaive pole/cathode and repelled from positive pole anode

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8
Q

cathode

A

negative pole
attracts positive and repels negative

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9
Q

anode

A

positive pole
attracts negative and repels positive

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10
Q

hydrolysis

A

compound split into ions in water
electrical current causes water to split in OH- and H+ which affect pH

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11
Q

the anode creates what pH reaction and why?

A

acidic reaction
H+ are repelled from positive anode to skin making it more aciidic

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12
Q

the cathode creates what pH reaction and why?

A

OH- are repelled from negtaive cathode and into skin creating basic reaction

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13
Q

three mechanisms of movement of ions into the tissue

A
  1. electrical repulsion of charges
  2. electroporation increasing openings in skin surface
  3. electroosmosis: movement of water and sodium towards cathode creating a stream ions move on
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14
Q

how much current through anode vs cathode

A

in a complete circuit, the same amount of current flows through both

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15
Q

dispersive electrode

A

larger than the active electrode to decrease current density at that electrode
reduces risk of discomfort or skin irritation

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16
Q

chemistry under the electrode in ionto

A

electrodes repel hydrolyzed ions of the same charge, changing the pH at the skin as ions build up in number
can cause irritation or burns

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17
Q

is negative pole or positive pole delivery stronger? Which should you use a smaller amplitude current with?

A

negative pole is stronger and should use a smaller amplitude over a longer period of time

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18
Q

if drug dissociates into a relatively negative charge, which pole should the medication be placed on?

A

negative pole or cathode because this pole will repel the medication and push it into the tissueg

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19
Q

if a drug dissociates into a relatively positive charge, which pole should it be placed on?

A

positive pole or anode because this pole will repel the medication and push it into the tissue

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20
Q

active electrode

A

treatment electrode containing the drug
monopolar set up

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21
Q

why can ionto only be used with ionic solutions?

A

the cathode and/or anode only repel ions which is the mechanism for getting the medication into the tissue

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22
Q

negatively charged medications include:

A

dexamethasone
acetic acid
sodium chloride
potassium iodide

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23
Q

criteria for ionic medications which can be used with ionto

A

charged ions produced
relatively small ions w molecular weight <8000 daltons
medications in a solution
should only be used on surface tissues

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24
Q

why is direct current used in ionto?

A

it creates unidirectional, constant flow of medication
be careful of negative side effects like pH changes due to polar effects

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25
side effects of negative pole/cathode/black electrode
alkaline reaction or burn depolarization proteolysis and tissue softening bacteriostatic
26
side effects of positive pole/anode/red electrode
acid reaction or burn hyperpolarization proteoscleriosis and tissue hardening increased healing
27
which factors affect current amplitude that should be used?
patient tolerance polarity of active electrode size of the active electrode duration of treatment
28
dosage of treatment means:
amount of charge that is delivered which has a direct relation to the quantity of ions delivered because the charge is delivering the dose
29
calculate dosage
dosage mA*min = current mA x time min eg 4mA x 10 min = 40 mA*min
30
typical PT treatment dosage of ionto is:
40-80 mA*min
31
relationship of duration and magnitude of current in ionto
duration is inversely proportional to magnitude of current longer delivery time means a smaller current magnitude
32
cathode maximum current density
.5 mA/cm2 calculated based on electrode size/area and current amplitude negative pole is stronger
33
anode maximum current density
1 mA/cm2 calculated based on electrode size/area and current amplitude
34
will adding more drug to the electrode increase delivery?
NO ionto is current limited and drug delivery is determined by current amplitude and duration
35
can you mix drugs on ionto electrode?
no, creates competition for which is delivered and reduces effects of both
36
competing ions
ion present in the electrode of a solution with the same change as the therapeutic ion being delivered they compete with therapeutic ions to be delivered through the skin decrease efficiency of delivery, especially with smaller more mobile ions like CL-
37
you should increase or decrease blood flow while using ionto?
decrease blood flow to systemic areas we want to keep medication in the general area and not increase circulation systemically
38
clinical applications of ionto
size limited area surface level depth localized conditions so electrode can cover area
39
drug penetration factors
type of drug size and location of structure current dosage current density skin thickness adipose tissue
40
considerations of electrodes in ionto
don't place electrodes too close to avoid skin irritation and burns from current bridging redness and blistering under electrode with drug should disappear within minutes to hours, if not pt is not tolerating tx use lotion or aloe to assist skin recovery
41
In which part of the skin is it easiest for a drug to penetrate?
pores, hair follicles, oil glands
42
buffer
substance that controls pH changes binds and neutralizes both acidic and basic ions controls pH and allows greater treatment dosage by decreased risk of burn or irritation
43
indications for ionto
superficial location inflammation scarring Ca deposits myositis ossificans antifungal/wound healing/infected wounds trigger points
44
contraindications to ionto
cancer pacemaker pregnancy implanted electrical device decreased skin sensation residual skin irritation from previous treatment
45
dexamethasone
most commonly used ion in ionto negative ion decreases acute inflammation by inhibiting inflam response of WBC half life of 36-72 hours use every other day
46
acetic acid
second most popular ion negative used for calcium deposits or chronic tendonitis causing scarring breaks down insoluble ca deposits into soluble compounds to allow healing delivered 3x week for 3-6 weeks
47
sodium chloride
negative ion used at cathode scar tissue softening and mobilization interacts with cross binding of collagen in scars to make them softer
48
potassium iodide
negative ion used at cathode scar tissue softening and mobilization interacts with cross binding of collagen in scars to make them softer Kl contraindicated to
49
normal response to iontophoresis
skin will be pink under electrode and fades over hours sweat retention vesicles form as very small blister like appearance that resorb with time
50
buffered delivery of ionto
competing ions are eliminated by buffer allowing optimal delivery of medication with derceased skin irritation and competition
51
side effects of glucocorticoids like dexamethasone
contribute to tissue breaksown of muscle, tendon, bone, collagen reduce body's production of these hormones with continued use leave one recovery day between uses effects should be seen in 3-4 treatments
52
salicylate
anti inflamatory inhibits biosynth of prostaglandins indicated for bursitis, tendonitis
53
positive ions used in ionto
lidocaine
54
lidocaine
positive ion blocks transmission of impulses of peripheral nerves for anesthetic effect to tissue loss of sensation increasing risk of burn, used low current use to decrease pain for interventions
55
opioids and ionto
experimental not administered over site, instead as slow continuous stream in blood for post op pain work w Dr works on peripheral opioid receptors
56
treat soft tissue mineralization
acetic acide from cathode use for myositis ossificans over 3 weeks
57
lithium in ionto
delivered from anode demineralizing urate deposits occurring with gout
58
wounds and ionto
ionto can help with infection or facilitate healing with zinc oxide at positive pole accelerate tissue growth
59
edema and ionto
use hyaluronidase enzyme to increase permeability of connective tissue draw out excess fluid which is dispersed into vascular and lymphatic systems
60
scar tissue adhesions and ionto
iodine for antimicrobial effects sclerolytic effects delivered at negative pole over scar tissue contraindicated due to decreased sensation
61
ionto for hyperhidrosis
apply cathode over affected areas followed by anode with tap water causes keratin plugs in sweat glands use 8-20 days as needed and must be repeated

526 Electro (13 decks)

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