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At least 793 records · Page 44Linked to original sources
PubMed2003

Percutaneous lidocaine administration via a new iontophoresis system in children: tolerability and absence of systemic bioavailability.

OBJECTIVE: Rapid achievement of dermal anesthesia in pediatric practice without discomfort is both desirable and difficult. The Northstar Iontophoretic Drug Delivery System (IDDS) is designed to achieve this objective in 10 minutes using a current of 1.78 mA, compared with the 40 to 60 minutes required for traditional percutaneous methods (eg, eutectic mixture of local anesthetics or EMLA cream). For evaluating the tolerance of this IDDS in pediatrics, 12 healthy children (5-15 years, 4 girls and 8 boys, 10 white, weight 19-79 kg) were evaluated. METHODS: An open-label trial with random applications of IDDS containing lidocaine (100 mg of 10%) and epinephrine (1.05 mg of 1:10,000) to 3 of the 4 possible sites (back, chest, dorsum of hand, and antecubital fossa) was conducted. Three successive applications (time = 0, 3 hours and 3.5 hours) were performed in each subject, with repeated blood sampling (n = 12 over 10 hours) for assessment of plasma lidocaine concentrations. Skin evaluation (by Draize scoring) at both anode and cathode sites was performed at 10 and 24 hours. RESULTS: Few of the subjects (0%-28%) experienced any dermal abnormalities at 10 hours. These findings were maintained at the 24-hour follow-up evaluation with the vast majority of subjects (92%-100%) having no evidence of erythema or edema irrespective of application site. Erythema associated with the anode seemed to be more prominent when the study device was applied to either the chest or the back as compared with the antecubital fossa or dorsum of the hand. No subjects complained of pain/discomfort associated with IDDS delivery. Plasma lidocaine levels in all subjects were below 10 ng/mL at all time points. CONCLUSIONS: The IDDS seems not to deliver a significant, systemic dose of lidocaine and to be well tolerated and potentially suitable for clinical use in pediatric subjects.

Administration, Cutaneous↗
PubMed1991

Iontophoresis of vasoactive drugs. Effect on peripheral blood flow during pregnancy.

The aim of this study was to evaluate whether iontophoretic administration of the vasoactive agents noradrenaline (NA) and angiotensin (AII) combined with measurement of skin blood flow with a laser Doppler technique could serve as a predictive method for pre-eclampsia. Nine healthy non-pregnant women, 9 healthy pregnant women and 9 pre-eclamptic patients were investigated. A significant reduction of skin blood flow was induced by NA in all three groups and by AII in the non-pregnant group. There was no significant difference between healthy pregnant and pre-eclamptic patients in the degree of reduction of blood flow with respect to NA and AII administration.

Angiotensin II↗
PubMed1998

Effects of pH, electric current, and enzyme inhibitors on iontophoresis of delta sleep-inducing peptide.

Delta sleep-inducing peptide (DSIP), a peptide of nine amino acid residues, was used as a model drug to investigate the effects of pH, electric current, and enzyme inhibitors on the transdermal iontophoretic delivery of peptide drugs. DSIP was fairly stable in pH 4-9 buffer solutions but was cleaved by the skin enzymes during iontophoretic delivery. Enzyme inhibitors, such as o-phenanthroline, ethylene-diaminetetraacetic acid (EDTA), dilucine, and sodium deoxycholate, could inhibit the degradation of DSIP to a certain extent in the skin homogenate. Our results showed that metalloproteases were probably more important enzymes for DSIP hydrolysis. By using 0.2 mM o-phenanthroline in the iontophoretic delivery of DSIP at pH 4, we were able to significantly enhance the penetration of DSIP. The flux was about eight times as much as control (without o-phenanthroline) at pH 7.4.

Administration, Cutaneous↗
PubMed1996

An investigation of the gate control theory of pain using the experimental pain stimulus of potassium iontophoresis.

This study investigated a prediction derived from gate control theory-that there would be a pulse of pain as a pain stimulus was being ramped off due to the rapidly transmitting, inhibitory large fiber activity falling away sooner at the spinal level than the excitatory activity of the slow-transmitting, small nociceptive afferents. A further prediction was that the more distant the peripheral stimulus was from the spine, the greater the pain pulse would be. Fourteen subjects had the pain stimulus of iontophoretically applied potassium ions (K+) applied to an upper and a lower site on the dominant arm. In a threshold detection task using the double random staircase method, subjects were asked to indicate whether they could detect a pulse of additional pain during this ramp-off phase. The average rate of stimulus ramp-off in order to detect a pain pulse was statistically greater for the upper-arm site (14.3 micrograms K+/sec) than for the lower-arm site (9.4 micrograms K+/sec). These results were consistent with gate control theory. Alternative explanations, including intrinsic differences in nociceptive responding for different dermatomes and anode break, were considered. It was concluded that the detection of a pain pulse during the ramping off of a peripheral pain stimulus potentially provides a quantitative measure of the spinal modulation of pain.

Adult↗
PubMed1982

Iontophoresis.

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