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Treatment of chronic pain syndromes with transcutaneous iontophoresis of vinca alkaloids, with special regard to post-herpetic neuralgia.

Successful treatment of 35 post-herpetic neuralgia (PHN) patients by means of transcutaneous iontophoresis of Vincristine is reported. This technique, based on transganglionic regulation--a novel neurobiological principle discovered by Csillik and Knyihár-Csillik-, alleviated pain in both fresh and inveterated PHN cases. Statistical analysis of the results excludes a placebo-like action.

Administration, Cutaneous↗

[Possibilities of treatment of erectile disorders by the administration of vasoactive substances into the penis using iontophoresis].

The authors applied to 18 men with erection disorders vasoactive substances by iontophoresis of the penis. In 12 patients partial improvement was achieved, in four marked improvement. Only in two the condition was not influenced. The applied method is non-invasive, practically without negative side-effects. It can extend the range of therapeutic methods in psychogenic and mild organic erection disorders.

Adult↗

[Use of principles of iontophoresis and electrophoresis for controlled release of medical substances].

The present review describes work done over the past twenty years on the controlled release of drugs using iontophoresis or electrophoresis techniques. Following a description of therapeutic applications, in vivo and in vitro studies have been discussed with emphasis on the potentials of such techniques to control drug release. Different mathematical models have been reviewed and an attempt has been made to combine them to explain the various configurations of systems currently used.

Chemistry, Pharmaceutical↗

[Nature of the activity of cerebral cortical neurons in the case of their partial reversible functional isolation using EGTA iontophoresis].

The EGTA iontophoresis influence on activity of 63 neurons of the rat's sensomotor cortex has been investigated. Neurons with high and low sensitivity to calcium ions decreasing level in extracellular medium have been found. A possibility of partial reversible functional isolation of neuron from neuronal net by blocking the transmitter release by EGTA has been shown.

Animals↗

[Home treatment of hyperhidrosis of the hands and feet tap water iontophoresis].

Ten patients with severe palmo-plantar hyperhidrosis have been treated successfully at home with tap water iontophoresis for a period not less than 6 months. The patients were asked to evaluate the treatment subjectively; 8 considered the results to have been good to very good. The same results were obtained in an objective evaluation by gravimetry, hygrometry and colorimetry. The full effects were seen after an average of 15 treatments of 20-30 min each. Through the new possibility of treating patients at home, therapy for palmo-plantar hyperhidrosis, which to date was only possible under medical supervision, has been simplified.

Adolescent↗

Endogenous dopamine can modulate inhibition of substantia nigra pars reticulata neurons elicited by GABA iontophoresis or striatal stimulation.

Previous reports from this laboratory have described an ability of iontophoretically applied dopamine to attenuate the inhibitory effects of iontophoresed GABA on neurons of the substantia nigra pars reticulata. This finding raised the question of whether endogenous dopamine, released from dendrites of neighboring pars compacta dopamine neurons, might act as a neuromodulator which diminishes the inhibition of pars reticulata neurons evoked by either GABA iontophoresis or electrical stimulation of the striatonigral GABAergic pathway. Extracellular, single-unit activity of pars reticulata neurons was recorded in male rats anesthetized with chloral hydrate. In one set of studies, d-amphetamine, a drug reported to release dopamine from nigral dendrites, was administered intravenously (1.6 mg/kg) during regular, intermittent iontophoretic pulses of GABA. As had been previously observed with iontophoresed dopamine, i.v. amphetamine significantly lessened the inhibition of reticulata neurons produced by GABA application. This change was reflected by a decrease in GABA's inhibitory potency by 22% relative to the control level of inhibition achieved prior to amphetamine administration. Amphetamine caused no decreases in GABA's effectiveness, however, in animals that had previously received treatments that depleted or destroyed nigral dopamine stores, i.e., in rats pretreated with reserpine and alpha-methyl-p-tyrosine, or in rats with 6-hydroxydopamine lesions of the nigrostriatal dopamine pathway. In a second set of experiments, amphetamine or dopamine was delivered iontophoretically while monitoring the GABA-mediated (bicuculline-reversible) inhibition of reticulata neurons that can be elicited by striatal stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Visualization of the barrier layer through iontophoresis of ferric ions.

The barrier layer in the intact epidermis of pig skin effectively limits the penetration of ferric ions even under conditions of iontophoresis. This was microscopically demonstrated using a ferric ion salt in conjunction with a soluble ferrocyanide to produce a Prussian blue ferric ferrocyanide precipitate. The effectiveness of various skin preparation techniques in breaking through the epidermal barrier layer was examined, utilizing this chemical reaction to stain the skin.

Animals↗

Potential novel methods for insulin administration: I. Iontophoresis.

It is theoretically feasible to administer an ionized solute transcutaneously using an electric current. Attempts by our group to administer conventional, regular (soluble) insulin to human volunteers by iontophoretic methods failed, probably because such insulin is only weakly ionized and much of it is present in the polymeric form. Animal experiments with pigs defined patterns of portal and systemic insulin concentrations for native insulin secretion, intraperitoneal injection of insulin, and peripheral (intramuscular) injection of insulin. Using a more strongly ionized and predominantly monomeric form of insulin, transcutaneous administration of this hormone by iontophoresis was demonstrated in an experimental animal.

Animals↗

[Tap water iontophoresis in the treatment of hyperhidrosis of the hands and feet].

Seven patients with hyperhidrosis of the palms or soles resistant to topical application of aluminum chloride solution were treated successfully with tap water iontophoresis. After an average of 10 or 11 treatments 80% sweating suppression was found on palms and 74% suppression on soles. As side effects of treatment discomfort and transient skin irritation were observed depending on the amperage used. The effect lasts up to several weeks; however, maintenance treatment on an individual schedule is required.

Adult↗

Mechanism of action of iontophoresis in the treatment of palmar hyperhidrosis.

Sweat glands from the palm of a patient with hyperhidrosis were examined by light and electron microscopy before and after treatment with tap water iontophoresis. No changes in structure were noted after treatment, disclaiming the currently accepted theory that mechanical ductal obstruction is the mechanism of action of this method. Furthermore, we believe the safety and effectiveness of this treatment are supported by our experience.

Adult↗

Iontophoresis of indocyanine green and monastral blue B for gonioscopic diode laser sclerectomy.

Ab interno gonioscopic diode laser sclerectomy should allow the creation of a filtration fistula in glaucoma treatment using light energy in the near infrared range. Diode laser sclerectomy can be facilitated by dying the sclera to optimize laser energy absorption at the appropriate wavelength. Indo-cyanine green (ICG) and Monastral Blue B (MBB) are two dyes that have their peak absorptions in the near infrared region. This study determined the feasibility of ICG and MBB iontophoresis in human cadaver sclera and transconjunctivally in rabbits in vivo. MBB was unable to achieve full-thickness scleral staining in either model. ICG was able to penetrate 400 microns in human cadaver sclera and approximately 500 microns transconjunctivally in rabbit sclera in vivo.

Animals↗

[Cutaneous iontophoresis of hyaluronidase in the treatment of hemorrhages in hemophilic patients].

After a surgery of the theoretical background of iontophoretic technic and the physico-chemical properties of hyaluronidases, a clinical application is presented, based on over 500 hemophilic patients treated percutaneously, in cases both of hemarthrosis and hematomas. The results are presented and discussed. The conclusion is that hyaluronidase iontophoresis is useful and should be performed together with the other measures for the prevention and the treatment of the damages produced by hemorrhages in hemophilic patients.

Hemophilia A↗

[Iontophoresis in the conservative treatment of Peyronie's disease: preliminary experience].

In Peyronie's disease an early "peri-vasculitic" phase and a late "sclerogenic" one are described. In the former, conservative management is believed useful; unfortunately it is empirical concerning treatment modalities, drugs and administration routes, due to the poor pathogenetic knowledge of the disease itself. The Authors report on a preliminary experience based on iontophoresis, that is the drugs' ions direct transport from a solution into the tissues by means of a local electric field. 15 patients (47 to 64 years old, mean 55) all with penile recurvatum due to a well (physically and U.S.) documented Peyronie's plaque, and all but one with normal stiffness during erection, were submitted to the following therapeutic schedule: 3 sessions a week for three weeks; in each session (20 minutes) 10 mg verapamil and 4 mg dexamethasone are administered; the iontophoretic equipment delivers a 3 mA current; the active electrode, shaped as a small cup is placed on the penile skin above the plaque; the other electrode is set on one thigh. At a mean 5 months follow up (3-10 months) penile pain during erection disappeared in 66% patients, recurvatum diminished in 53%, and the plaque was reduced in size and/or was softened in 40% of the cases. No patient worsened nor became impotent during the treatment. The contextual improvement of all three above mentioned parameters (pain-recurvatum-physical examination) was observed in 26% of patients (versus 13% in a previous series treated by the Authors by drug peri-plaque injections). Although a longer follow up is necessary before drawing conclusions about the iontophoretic approach to the Peyronie's disease, the Authors wish to stress two main advantages of this therapeutic modality: absence of pain; absence of local trauma, in order to avoid local sclerogenic stimuli, which could perpetuate the hardening process.

Anti-Inflammatory Agents↗

[Enhancement of drug absorption by iontophoresis and phonophoresis and clinical application].

Concepts of iontophoresis and phonophoresis are described. Main factors regarding iontophoretic transdermal drug delivery of ionized drugs or non-ionized drugs and clinical applications are outlined. Iontophoretic and sonophoretic transdermal drug delivery has some advantages and disadvantages. However, its clinical use for controlled drug delivery corresponding to chronopharmacology will bring more benefit to patients in near future.

Animals↗

[Occupational exposure to vibration: Raynaud's phenomenon and the vascular response to methacholine iontophoresis].

A homogeneous group of 34 subjects exposed to occupational vibratory stress were studied to determine their vasodilatory response to methacoline. The methacoline was administered by iontophoresis. Methacoline is an acetylcholine derivate with the same pharmacological properties of acetylcholine. The 34 study subjects were divided into 3 groups according to their plethysmographic response to a preliminary cold test: group 1, had a typical Raynaud's response; group 2 had normal response to cold, and group 3 had an "intermediate" response. The subjects in group 1 did not respond to methacoline with vasodilation, suggesting endothelial damage at the arterial and arteriolar level, those in group 2 responded with clear vasodilation, and those in group 3 had an intermediate plethysmographic response to methacoline--modest, slowed vasodilation. Based on the results obtained, the authors believe that the true pathogenetic mechanism is an alteration in the vasomotor stability. This change in circulatory homeostasis occur after a vasoconstrictive stimulus, due to vascular endothelium disfunction, in its turn damaged by vibratory microtrauma. This would be the basis for diminished autonomic vascular regulation, mediated by EDRF at the arterial and arteriolar level. It is also probable that the pathogenesis of Raynaud's syndrome in workers exposed to physical or chemical stress has a similar mechanism.

Aged↗

Electrophysiology of Purkinje neurons in the weaver mouse: iontophoresis of neurotransmitters and cyclic nucleotides, and stimulation of the nucleus locus coeruleus.

We compared the Purkinje cells of adult normal and weaver mutant (wv/wv) mice by iontophoretic and electrophysiological tests. Although weaver Purkinje cells fire spontaneously at a rate (38 Hz) similar to normal mouse neurons (40 Hz), several abnormalities of firing were seen: high frequency bursts of single (simple) spikes occurred in 5-10-sec episodes in 38% of weaver cells, compared to 8% in normal mice; spontaneous complex spikes (climbing fiber-like burst responses) occurred in several different forms in a given Purkinje cell. As in normal mice and rats, the spontaneous single spike activity is readily depressed by electrical stimulation of the locus coeruleus, the presumed source of a dense noradrenergic plexus in the weaver cerebellar cortex. In a preliminary experiment the adrenergic blocking agent, fluphenazine, antagonized the responses to locus coeruleus stimulation. Iontophoresis of norepinephrine (NE), GABA and serotonin (5-HT) also uniformly depressed Purkinje cell single spike activity in all normal and weaver mice; cyclic AMP depressed 55% of normal and 70% of weaver Purkinje cells. Glutamate was always excitatory. The only qualitative difference was seen with acetylcholine, which was mostly inhibitory in normal mouse, but increased the firing rate in 42% of weaver Purkinje neurons. Cyclic GMP was predominantly excitatory in both types. Thus, despite the absence of parallel fibers, weaver Purkinje neurons grossly resemble normal Purkinje cells electrophysiologically as well as morphologically. Since several sites of indirect presynaptic actions are eliminated in weaver, our results further substantiate the direct post-synaptic inhibitory nature of GABA, 5-HT and NE, and the noradrenergic pathway from locus coeruleus to Purkinje cells. Similarly, consistent inhibitory responses to cyclic AMP in the weaver support the previously hypothesized role of cyclic AMP in the post-synaptic inhibitory response to NE.

Acetylcholine↗