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PubMed1992

Electrode and bacterial survival with iontophoresis in synthetic urine.

Urinary catheters, especially in patients with long-term catheter requirements, frequently are a source of infection. Iontophoresis has been proposed as a method to decrease or eliminate such infections. Several types of material were examined for their potential use as electrodes in an iontophoretic catheter system. Silver, copper and nickel electrodes did kill microorganisms but did not show longevity. Carbon and gold electrodes showed longevity and killing of microorganisms. Gold proved to be somewhat better than carbon in killing Klebsiella pneumoniae in a broth. Few organisms survived iontophoresis. Those few that survived (mainly Klebsiella in broth), when rechallenged by iontophoresis, did not show any striking resistance to iontophoresis. Our data support the proposition that inclusion of electrodes, depending on the electrode type, in a catheter probably will decrease or eliminate a bacterial population in urine and, thus, may help prevent catheter-related infections and their sequelae.

Bacteria↗

PubMed1998

Transdermal iontophoresis: modulation of electroosmosis by polypeptide.

The objective of this research was to further evaluate the relative importance of electrorepulsion and electroosmosis to the mechanism of enhanced transport across the skin during iontophoresis. Specifically, the impact of iontophoresing into the skin positively and negatively charged polypeptides (poly-L-lysines and poly-L-glutamic acids, respectively) on the membrane's permselectivity and hence on the quantity and direction of electroosmotic flow, was examined. Experiments were performed in vitro at pH 7.4 using conventional methodology; electroosmosis during the iontophoresis of the polypeptides into and across the skin was tracked in the usual way via the movement of the polar, uncharged, non-metabolizable marker, D-mannitol. Electrotransport of the cationic polypeptides attenuated electroosmotic flow in the normal anode-to-cathode direction; the degree of inhibition was correlated both with the initial concentration of poly-L-lysine in the anodal chamber and with the molecular weight of the polypeptide employed (from 1 to 25 kilodaltons). Iontophoresis of the anionic poly-L-glutamic acids from the cathode provoked a slight increase in electroosmotic flow in the 'reverse' direction (i.e. from the receptor phase beneath the skin towards the cathode chamber located on the epidermal side of the membrane); this effect, however, was much less dramatic than that produced in the opposite sense by the cationic polypeptides. The results suggest that driving large positively-charged polypeptide molecules into the skin leads to neutralization of the membrane's negativity, a subsequent loss of permselectivity and a concomitant attenuation of electroosmosis in the conventional anode-to-cathode direction. Presumably, the relatively poor iontophoretic permeability of these species (which becomes more and more evident with increasing molecular weight) results in a sufficiently important association of the polypeptide with the skin during the period of current passage. Much less significant effects are realized by the cathodal iontophoresis of poly-anions due to the difficulty of 'pushing' negative ions into an already negatively-charged membrane.

Administration, Cutaneous↗

PubMed2000

Analysis of skin permeation-enhancing mechanism of iontophoresis using hydrodynamic pore theory.

The effects of constant DC iontophoresis (0-1.5 mA/0.966 cm(2)) on the permeation of three hydrophilic compounds, antipyrine (ANP, M.W. 188.23), sucrose (SR, M.W. 342.30) and 1-kestose (KT, M.W. 506.73), through excised hairless rat skin were evaluated using hydrodynamic pore theory. The electro-osmotic flow caused by iontophoresis was measured using deuterium oxide (D(2)O). The penetration-enhancing mechanism of iontophoresis was found to increase solvent flow through electro-osmosis and pore enlargement and/or new pore production in the skin barrier, together with enhancement of electrochemical potential difference across the skin. These effects were closely related to the strength of the current applied. The electro-osmotic flow of D(2)O (J(D(2)O)) greatly enhanced the skin permeation clearance of all hydrophilic penetrants (CL(drug)). Pore production was classified into reversible and irreversible processes, which resulted from lower (0-0.5 mA/0.966 cm(2)) and higher (0.5-1. 5 mA/0.966 cm(2)) currents, respectively. Thus, the enhancing effects of iontophoresis on skin permeation of nonionic hydrophilic compounds can be explained by increase in pore size and higher solvent flow.

Administration, Topical↗

PubMed2003

Effect of iontophoresis on transcorneal permeation 'in vitro' of two beta-blocking agents, and on corneal hydration.

Purpose of the present investigation was to examine the effect of iontophoresis on permeation of two beta-blocking agents, timolol maleate (TM) and betaxolol hydrochloride (BX) across rabbit corneas in vitro. Continuous or pulsed current of variable intensity and duration was applied, and possible corneal damage due to the electric treatment was assessed by measuring the corneal hydration level. The effect of iontophoresis on corneal permeation of the relatively more hydrophilic TM was much greater than the effect on the more lipophilic BX. It was found that for both drugs the iontophoretically driven transcorneal penetration is governed only by current density and overall time of treatment, irrespective of the type of treatment (single or repeated) and of current (constant or pulsed). For both drugs all significant permeation increases due to iontophoresis were invariably accompanied by a significant increased corneal hydration, indicative of damage to the corneal epithelium. Even if the present in vitro data cannot be extrapolated to an in vivo treatment, they confirm the potential risk associated with ocular iontophoresis.

Adrenergic beta-Antagonists↗

PubMed2003

Investigation into the potential of iontophoresis facilitated delivery of ketorolac.

The potential for iontophoresis facilitated transdermal transport of ketorolac was investigated using rat skin. Studies of electrical, physicochemical and device-related factors acting on the permeation kinetics of in vitro iontophoresis were performed. Iontophoresis increased the transdermal permeation flux of ketorolac as compared to the diffusion. Increase in applied current density or decrease in ionic strength of the donor solution enhanced the flux of the drug. Use of either platinum or silver/silver chloride electrodes resulted in similar enhancement of drug flux. Continuous current was more potent than pulsed current in promoting ketorolac transdermal permeation. Increasing the frequency or on:off ratio of pulse current induced an enhancement of the flux through the skin. An increase in donor drug loading dose or increasing the duration of current application resulted in enhancement of the drug flux. Pretreatment of the skin with D-limonene in ethanol or D-limonene in ethanol + ultrasound significantly enhanced the iontophoretic flux of the drug in comparison to passive flux with or without pretreatment. Trimodality treatment comprising of pretreatment with D-limonene in ethanol + ultrasound in combination followed by iontophoresis was found to be most potent for enhancing the rate of permeation of ketorolac.

Adjuvants, Pharmaceutic↗

PubMed1999

Effect of linolenic acid/ethanol or limonene/ethanol and iontophoresis on the in vitro percutaneous absorption of LHRH and ultrastructure of human epidermis.

The effect of enhancer(s) (e.g. ethanol (EtOH), 5% linolenic acid/EtOH, and 5% limonene/EtOH) and iontophoresis was investigated on the in vitro percutaneous absorption of luteinizing hormone releasing hormone (LHRH) and ultrastructure of human epidermis by transmission electron microscopy (TEM). 5% linolenic acid/EtOH or 5% limonene/EtOH significantly enhanced (P<0.05) the passive flux of LHRH through human epidermis in comparison to the control (no enhancer treated epidermis). Iontophoresis further increased the flux of LHRH through enhancer(s) treated epidermis. Iontophoretic flux of LHRH through 5% linolenic acid/EtOH and 5% limonene/EtOH treated epidermis was significantly (P<0.05) enhanced in comparison to iontophoretic flux through the control epidermis. TEM is the most efficient way to visualize the ultrastructure of the stratum corneum (SC). TEM results reveal that iontophoresis in combination with enhancers (e.g. linolenic acid/EtOH or and limonene/EtOH) transformed the highly compact cells of the SC into a looser network of filaments, disrupted the keratin pattern, and resulted in swelling of SC cell layers of human epidermis. Thus, linolenic acid/EtOH or limonene/EtOH in combination with iontophoresis increased the flux of LHRH through human epidermis by disrupting keratin pattern as well as loosening and swelling of SC cell layers.

Cyclohexenes↗

PubMed2003

Iontophoresis promotes percutaneous absorption of L-ascorbic acid in rat skin.

BACKGROUND: Percutaneous absorption of ascorbic acid is limited by its impermeability and instability. OBJECTIVE: We attempted to improve the percutaneous absorption of ascorbic acid by use of iontophoresis after topical application of ascorbic acid. METHODS: Radioactivities extracted from epidermal, dermal and blood compartments after topical application of [14C]ascorbic acid was measured in the presence or absence of iontophoresis. Autoradiography was also performed to study the histological distribution of the radioactivity of ascorbic acid. RESULTS: Iontophoresis greatly enhanced percutaneous absorption of [14C]ascorbic acid in the rat skin. Radioactive ascorbic acid in the dermis reached a maximum level at 1 h after application whereas, in the topical application method, the uptake of ascorbic acid in both epidermis and dermis was quite low. Autoradiography of skin specimens indicated that iontophoresis accelerated the absorption of ascorbic acid through both transepidermal and pilo-sebaceous routes. CONCLUSION: Iontophoretic delivery system of ascorbic acid may provide a more efficient tool for its percutaneous absorption than a simple topical application.

Administration, Topical↗

PubMed2002

Post-iontophoresis recovery of human skin impedance in vivo.

The objective of this study was to better understand the recovery of human skin impedance following iontophoresis in vivo. Volunteers were subjected to a 15-min period of iontophoresis in the presence of aqueous solutions of either NaCl, KCl, CaCl(2) or MgCl(2) at 133 mM. Subsequently, the low-frequency impedance (at 1 Hz) recovery was followed for a further 30 min. Assuming direct proportionality between the reciprocal impedance and the ion concentration in the membrane, the experimental data were fitted to the appropriate solutions of Fick's second law of diffusion to derive characteristic diffusion parameters (D/L(2)), apparent diffusivities (D), diffusion pathlengths (L) and mobilities, and ion concentrations in the skin immediately post-iontophoresis. Ion fluxes out of the membrane after termination of current flow were also deduced. In general, recovery was relatively independent of the background electrolyte as previously reported, and the data were consistent with ion transport in predominantly aqueous pathways. Compared to its mobility in aqueous solution, however, the apparent Cl- mobility in the skin was smaller, presumably due to the fact that, under normal physiological conditions, the human skin barrier supports a net negative charge. In parallel, the initial "release" of Na+ and K+ from the skin post-iontophoresis was faster than that of Ca(2+) and Mg(2+), the latter cations of higher charge density being able to associate more strongly, it seems, with the negatively-charged skin. The simple physicochemical analysis of the data presented serves to emphasize that a decrease in skin impedance is not a manifestation of damage to the barrier--rather, it is a natural response to the relevant electrical potential and ion concentration gradients involved.

Body Composition↗

PubMed1998

Epidermal iontophoresis: I. Development of the ionic mobility-pore model.

PURPOSE: An integrated ionic mobility-pore model for epidermal iontophoresis is developed from theoretical considerations using both the free volume and pore restriction forms of the model for a range of solute radii (rj) approaching the pore radii (rp) as well as approximation of the pore restriction form for rj/rp < 0.4. In this model, we defined the determinants for iontophoresis as solute size (defined by MV, MW or radius), solute mobility, solute shape, solute charge, the Debye layer thickness, total current applied solute concentration, fraction ionized, presence of extraneous ions (defined by solvent conductivity), epidermal permselectivity, partitioning rates to account for interaction of unionized and ionized lipophilic solutes with the wall of the pore and electroosmosis. METHODS: The ionic mobility-pore model was developed from theoretical considerations to include each of the determinants of iontophoretic transport. The model was then used to reexamine iontophoretic flux conductivity and iontophoretic flux-fraction ionized literature data on the determinants of iontophoretic flux. RESULTS: The ionic mobility-pore model was found to be consistent with existing experimental data and determinants defining iontophoretic transport. However, the predicted effects of solute size on iontophoresis are more consistent with the pore-restriction than free volume form of the model. A reanalysis of iontophoretic flux-conductivity data confirmed the model's prediction that, in the absence of significant electroosmosis, the reciprocal of flux is linearly related to either donor or receptor solution conductivity. Significant interaction with the pore walls, as described by the model, accounted for the reported pH dependence of the iontophoretic transport for a range of ionizable solutes. CONCLUSIONS: The ionic mobility-pore iontophoretic model developed enables a range of determinants of iontophoresis to be described in a single unifying equation which recognises a range of determinants of iontophoretic flux.

Biological Transport↗

PubMed1990

Transport mechanisms in iontophoresis. III. An experimental study of the contributions of electroosmotic flow and permeability change in transport of low and high molecular weight solutes.

The objective of this research was to provide in vitro transport data designed to clarify the relative importance of permeability increase and electroosmotic flow in flux enhancement via iontophoresis. Iontophoretic fluxes were measured with both anode and cathode donor cells, and passive fluxes were measured both before iontophoresis (Passive 1) and after iontophoresis (Passive 2). Data were generated for three uncharged low molecular weight solutes (glycine, glucose, and tyrosine) and two high molecular weight anionic species (carboxy inulin and bovine serum albumin). Flux enhancement is greater for anodic delivery than for cathodic delivery, even for the negatively charged molecules, and anodic flux of glucose decreases as the concentration of NaCl increases. Both observations are consistent with a mass transfer mechanism strongly dependent on electroosmotic flow. Steady-state anodic flux at 0.32 mA/cm2, expressed as equivalent donor solution flux (in microliters/hr cm2), ranged from 6.1 for glycine to about 2 for the large anions. As expected, iontophoretic flux is higher at 3.2 mA/cm2 than at 0.32 mA/cm2, and passive flux measured after iontophoresis is about a factor of 10 greater than the corresponding flux measured before the skin was exposed to electric current. There are two mechanisms for flux enhancement relative to passive flux on "fresh" hairless mouse skin: (1) the effect of the voltage in increasing mass transfer over the passive diffusion level, the effect of electroosmotic flow dominating this contribution in the systems studied in this report; and (2) the effect of prior current flow in increasing the "intrinsic permeability" of the skin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1996

Iontophoresis of bases, nucleosides, and nucleotides.

PURPOSE: To investigate whether transdermal iontophoresis may be potentially useful for delivery of oligonucleotide drugs, the electrotransport of representative bases (uracil and adenine), nucleosides (uridine and adenosine) and nucleotides (AMP, ATP, GTP and imido-GTP) across mammalian skin in vitro has been considered. METHODS: While the passive permeability of all compounds investigated (from 1 mM solutions at pH 7.4) was very low, the application of constant current iontophoresis (0.55 mA/cm2) significantly enhanced the transport of both charged and uncharged species. RESULTS: The efficiency of delivery depended only weakly upon lipophilicity, varied quite linearly with concentration (for AMP and ATP), was inversely sensitive to molecular weight, and was strongly influenced by charge. Neutral solutes were delivered better from the anode than the cathode, as expected; post-iontophoresis, passive permeabilities were greater than those of the untreated controls, suggesting that iontophoretically-induced changes in barrier function cannot be completely repaired in in vitro model systems. The triphosphate nucleotides, ATP and GTP, were essentially completely metabolized (presumably to their corresponding mono-phosphates) during their iontophoretic delivery, while imido-GTP was apparently resistant to enzymatic attack; however, comparison of the transport data from AMP and ATP suggested that ATP metabolism occurred primarily after the rate-limiting step of iontophoresis. CONCLUSIONS: The results obtained are consistent with the general patterns of behavior previously observed in investigations of amino acid and peptide electrotransport. It remains to be seen whether extension of the research described here to larger oligonucleotide species is a feasible long-term objective.

Adenine↗

PubMed1996

Transdermal permeation of alniditan by iontophoresis: in vitro optimization and human pharmacokinetic data.

PURPOSE: The aim of this paper was to assess the feasibility of electrically enhanced transdermal delivery of alniditan, a novel 5 HT1D agonist for the treatment of migraine. METHODS: An in vitro study was first performed to optimize the different parameters affecting iontophoresis efficiency. The mechanism of alniditan permeation by iontophoresis was investigated. Finally, a phase I clinical trial was performed to assess systemic delivery of alniditan by iontophoresis. RESULTS: i) In vitro: The optimal conditions were found with a buffer like ethanolamine at a pH of 9.5, with Ag/AgCl electrodes and a direct current application. Alniditan permeation was enhanced when increasing the current density, the duration of current application and the drug concentration. Iontophoresis slightly increased drug quantities in stratum corneum compared to passive diffusion but it strongly increased alniditan quantities in viable skin. ii) The objective to deliver in vivo 0.5 mg of alniditan within less than 1 h was reached but an erythema was detected at the anode. CONCLUSIONS: This study demonstrates the feasibility of iontophoretic delivery system for antimigraine compounds.

Administration, Cutaneous↗

PubMed1995

Reverse iontophoresis: noninvasive glucose monitoring in vivo in humans.

PURPOSE: To demonstrate that "reverse iontophoresis" can be used to noninvasively obtain information about systemic glucose levels in vivo in humans. METHODS: The passage of current across the skin in vivo drives ions into the tissue, from the electrode chambers positioned on the skin surface, and simultaneously pulls ions from the body in the opposite direction. Because of the net negative charge on the skin, under normal conditions, the membrane is permselective to cations, and a potential gradient also results, therefore, in electroosmotic convection of solvent in the direction of counterion flow (i.e., from anode to cathode). Thus, it is also possible to enhance the transport of polar, yet uncharged, species using iontophoresis. In an earlier study, the in vitro extraction of glucose, by "reverse iontophoresis" was established, and extension of the approach to an in vivo model was indicated. The idea has therefore been further explored in vivo in humans. RESULTS: Using small, simple, prototypical electrode chambers, attached to the ventral forearm surface, direct current iontophoresis at 0.25 mA/cm2 for periods of up to 1 hour, and a sensitive analytical procedure to measure the quantities of glucose extracted, it has been shown that iontophoretic sampling of glucose is feasible. However, the shorter periods (15 minutes or less) of extraction considered yield results which are "contaminated" (it is believed) by glucose that is a product of lipid metabolism within the skin. While this material is expected to complicate the initial calibration of the approach, the problem is effectively resolved within one hour, by which time the glucose arriving in the electrode chambers on the skin surface is expected to directly reflect the subcutaneous tissue concentration. CONCLUSIONS: Based upon these initial observations, further investigation can now be directed towards optimization of electroosmotic flow and sampling time, improved reproducibility and the development of a practical assay methodology.

Blood Glucose↗

PubMed2002

Iontophoresis with cortisone in the treatment of lateral epicondylalgia (tennis elbow)--a double-blind study.

Lateral epicondylalgia (tennis elbow) is a common dysfunction of the arm. Because there is no agreement concerning the pathophysiology, several modes of treatments have been tried and one of the most common is local steroid injection. Iontophoresis using corticosteroids is a fairly new method recommended in the treatment of lateral epicondylalgia and has become popular owing to impression of superiority compared to local injections-noninvasive, painless and nontraumatic. The aim of this double-blind prospective, randomized study was to evaluate the short- and the long-term pain-relieving effect of corticosteroid iontophoresis in lateral epicondylalgia. Sixty-four patients suffering from lateral epicondylalgia were consecutively randomized into two groups for corticosteroid or placebo iontophoresis. The patients were treated four times during 2 weeks. Follow-ups were done the day after the final treatment and after 3 and 6 months. Twenty-three patients dropped out before the 3-month follow-up because they wanted to complement the treatment or replace it with other treatments. No significant difference between the corticosteroid group and the placebo group in relation to subjective and objective outcome could be observed after the treatment period or at the follow-ups. In fact, both groups improved throughout the study. The results of the present study do not support the use of corticosteroid iontophoresis in lateral epicondylalgia.

Adult↗

PubMed2002

Prior iontophoresis of saline enhances vasoconstriction to phenylephrine and clonidine in the skin of the human forearm.

AIMS: To determine whether postjunctional alpha1- and alpha2-adrenoceptors mediate vasoconstrictor responses in the cutaneous vasculature of the human forearm. METHODS: Drugs were administered transdermally by iontophoresis in the forearm of 20 healthy participants. Phenylephrine and clonidine were administered at sites pretreated with the relevant antagonist (terazosin and rauwolscine), and at additional untreated sites and sites pretreated with saline. To enhance the contrast between sites, the forearm was heated to 42 degrees C before flow was measured with the laser Doppler technique. RESULTS: After the iontophoresis of phenylephrine, blood flow at the site pretreated with terazosin was 24+/-37% (+/-95% confidence interval) greater than flow at the reference site, whereas flow was 53+/-24% lower than reference flow at the previously untreated site and 77+/-10% lower than reference flow at the site pretreated with saline (P<0.001). After the iontophoresis of clonidine, blood flow at the site pretreated with rauwolscine was 25+/-21% greater than flow at the reference site, whereas flow was 56+/-15% lower than reference flow at the previously untreated site and 72+/-8% lower than reference flow at the site pretreated with saline (P<0.001). The saline pretreatment enhanced vasoconstriction to phenylephrine (P<0.05) and clonidine (P=0.05). CONCLUSIONS: Pre-treatment with the appropriate antagonist blocked vasoconstrictor responses to phenylephrine and clonidine, consistent with the presence of both alpha-adrenoceptor subtypes in cutaneous vessels of the human forearm. In addition, iontophoretic pretreatment with saline facilitated vasoconstrictor responses, suggesting that a nonspecific effect of iontophoresis may enhance drug penetration through the stratum corneum.

Administration, Cutaneous↗

PubMed2005

Effect of chronic aerobic exercise on cutaneous microcirculatory flow response to insulin iontophoresis and to ischemia in elderly males.

The aim of this study was to assess whether chronic aerobic exercise can favourably influence the vascular activity of insulin in elderly subjects. We measured in arbitrary units (A. U.) the cutaneous blood flow basally and in response to iontophoresis of insulin, by the means of a Laser Doppler flowmeter, on the right arm of 10 elderly athletes (10 males, aged 65 +/- 6 years) and of 10 sex- and age-matched sedentary subjects. The cutaneous blood flow response to ischemia was also explored in the right leg of the same subjects by means of the same instrument. No significant differences in cutaneous arm and leg blood flow were observed basally between athletes and sedentary subjects (7.25 +/- 2.65 A. U. versus 6.35 +/- 4.04 A. U. and 9.74 +/- 5.11 A. U. versus 9.41 +/- 6.40 A. U., respectively). Cathodal iontophoresis (six poulses of 0.1 mA each for 20 s, with 40-s interval between stimulations) of regular insulin (0.1 ml Humulin R 100 IU/ml diluted 1/10 with 0.9 % saline) induced a significant increase of cutaneous blood flow in both groups (p < 0.01 in athletes, p < 0.01 in sedentary subjects). However the maximal cutaneous blood flow response to insulin was higher in athletes than in sedentary subjects (24.69 +/- 13.34 A. U. versus 14.33 +/- 7.73 A. U., respectively, p < 0.05) as well as the curve of the net blood flux response to insulin iontophoresis (% change from baseline in response to insulin minus % change from baseline in response to saline iontophoresis) (p < 0.001 ANOVA for repeated measures). After ischemia there was a significant increase of leg cutaneous blood flow in both groups (p < 0.001 in athletes and in sedentary subjects) with higher blood flow response in athletes than in sedentary subjects (38.18 +/- 17.08 A. U. versus 26.01 +/- 6.39 A. U., respectively, p < 0.05). The time reached from the release of ischemia to peak-flow was significantly longer in sedentary subjects than in athletes (43.5 +/- 28.5 s versus 20.0 +/- 9.3 s, p < 0.05, respectively). These results suggest that chronic aerobic exercise increases insulin vasodilatory activity and improves endothelial function in elderly subjects.

Aged↗

PubMed2002

Safety, tolerability, and efficacy of iontophoresis with lidocaine for dermal anesthesia in ED pediatric patients.

INTRODUCTION: This study examined the safety, tolerability, and efficacy of iontophoresis with 30 mA of lidocaine for dermal anesthesia in children younger than 84 months in the emergency department and the usefulness of a modified version of the Pre-verbal, Early Verbal Pediatric Pain Scale (M-PEPPS). METHODS: Three expert nurses completed the protocol for iontophoresis and inserted an intravenous catheter. Parents scored pain by using the 10-cm visual analogue scale, nurses used the M-PEPPS, and children, if able, self-reported pain during the procedure and at needle stick. RESULTS: Serum lidocaine levels were within the normal laboratory reference range. Adverse effects were minor and disappeared prior to discharge from the emergency department. Eighty-five percent of the children had M-PEPPS scores < or=6 during the iontophoresis procedure; 42% had scores of < or =6 at needle stick. Eighty-two percent of the parents marked the vas as < or =30 during the procedure; 65% indicated scores of < or =30 at needle stick. Four children self-reported "a lot of pain" at needle stick. Although low to moderate, M-PEPPS scores and parental pain ratings were significantly correlated at both points in time. DISCUSSION: Iontophoresis with lidocaine is safe for use in young children. It does not create any long-term untoward effects and is quite well tolerated. It is not clear if the higher pain scores at needle stick reflect anxiety and fear of a needle or a painful experience.

Administration, Cutaneous↗

PubMed1990

Iontophoresis: an effective modality for the treatment of inflammatory disorders of the temporomandibular joint and myofascial pain.

The use of the iontophoresis modality for driving medications through the skin for treatment of certain TM dysfunction and myofascial pain dysfunction syndrome was first suggested by Gangarosa and Mahan in 1982. This paper introduces the iontophoresis technique for treatment of inflammatory and myofascial disorders of the craniomandibular system. The historical aspects of iontophoresis in medicine and dentistry is reviewed. As an aid to understanding the clinical applications of this method, a review of diagnostic classification of temporomandibular disorders and an in-depth review of the role of the inflammatory process are provided. The effect of inflammation on the synovial/lymphatic system is detailed. Reference is made to the advantages of iontophoresis over hypodermic injection. The basis materials and methods of use of the modality are shown along with a protocol for patient treatment. Several case studies are discussed with clinical observations given.

Adult↗