Electromotive Administration of Topical Medications in Clinical Physiotherapy Practice: A Review
Oral and injection routes of drug administration has adverse effect in the body system, hence, there is paradigm shift in route of drug administration to the use of electromotive force via the skin where applicable; and this by passes the first pass effect metabolism. Both iontophoresis and ultra-sonophoresis are examples of procedures for the electromotive administration of drugs. Potential serious side-effects are eliminated because transdermal routes of drug administration are known to possess little or no side effects. Iontophoresis is the introduction of medicinal ions into the body using Direct Current. It is a painless, sterile and non invasive technique with minimal adverse reactions in the gastro-intestinal system. The dose depends on current and time of treatment and a typical dosage is 40 mA-min. This review revealed that Iontophoresis is being used to subdue inflammation using topical Non-steroidal anti-inflammatory drugs, administer antibiotics to combat infection, manage bicep brachii spasticity of stroke survivours, promote wound healing, reduce bacteria colonization, combat fungal infection; and has produced analgesic effects in several studies. Also, the reviewed showed that ultrasonophoresis is relevant in clinical physiotherapy practice.
Electromotive Administration of Topical Medications in Clinical Physiotherapy Practice: A Review, American Journal of Health Research. Special Issue:Supplementary Prescribing in Nigeria: A Needy Concept to Promote Clinical Physiotherapy Practice.
Vol. 2, No. 5-1,
2014, pp. 34-39.
WCPT (2013). http://www.wcpt.org/node /101751 Accessed July 14, 2014
CSP UK (2013).http://www.csp.org.uk/ professional-union/professionalism/ prescribing Accessed July 14, 2014
Onigbinde Ayodele Teslim, Olaogun M.O.B, Obembe Adebimpe Olayinka, Samotu Adedayo Ayobami, Bamitale Kayode D.S, Ogundele Abiola, Adetoogun Gbadegesin Elubode (2013). Electromotive drug administration of magnesium sulphate on spastic biceps brachii of stroke survivors: A Technical report. Online Journal of Medicine and Medical Science Research, Vol 2, 4, 38 – 43.
Dale, M.M., Rang, H.P., & Dale M. M. (2007): Rang & Dale’s Pharmacology. Edinburgh: Churchill Livingstone.
Saggini, R.; Zoppi, M.; Vecchiet, F.; Gatteschi, L.; Obletter, G.; Giamberardino, M. A (1996). Comparison of electromotive drug administration with ketorolac or with placebo in patients with pain from rheumatic disease: a double-masked study. Clin Ther, 18(6), 1169-1174.
Vranken, J. H.; Dijkgraaf, M. G. W.; Kruis, M. R.; van Dasselaar, N. T.; van der Vegt, M. H. (2005)Iontophoretic administration of S (+)- Katamine in patients with intractable central pain: A placebo-controlled trial. Pain, , 118, 224-231
Drugs.com Physiotherapeutic: (2014): http//:www.drugs.com/dict/ physiotherapeutic. html. Accessed July 14, 2014
Costello CT, Jeske AH, (1995). Iontophoresis: Applications in transdermal medication delivery. Physical Therapy Journal; (75): 554-563.
Capital Blue (2014) Medical Policy; Policy Title: Iontophoresis/ Phonophoresis: Policy Number Mp-4.013 Original Issue Date (Created): July 12, 2002; Most Recent Review Date (Revised): November 26, 2013; Effective,
Kalia, Y.N., et al. ( 2004) Iontophoretic drug delivery. Adv Drug Deliv Rev. 56(5): p. 619-58.
Costello CT, Jeske AH. Iontophoresis: Applications in transdermal medication delivery. Physical Therapy Journal, 1995; (75): 554-563.
Hamann H, Hodges M, Evans B, (2006): Effectiveness of iontophoresis of anti-inflammatory medications in the treatment of common musculoskeletal inflammatory condition: a systematic review. Physical Therapy Reviews, 01 Sepetmber, 11/3(190-194).
Onigbinde AT, Adetogun GE, Ojoawo AO, Omotuyi OC. ( 2009) Comparative efficacy of low metal glucosamine sulphate iontophoresis in the management of lumbar spondylosis. Ind J Phys Occup Ther; 3(3): 12-15.
Clijsen R, Taeymans J, J.P. Baeyens, A.O. Barel and P. Clarys (2012) The Effects of Iontophoresis in the Treatment of Musculoskeletal Disorders - A Systematic Review and Meta-Analysis; Drug Delivery Letters, , 000-000 1.
Panus PC, Cambell J, Kulkarni B. (1996) Effect of iontophoretic current and application time on the transdermal delivery of Ketoprofen in man. Pharm Scs,; 2: 467-469.
Williams A.C, BarryB.W,(1992) Skin absorption enhancers, Crit. Rev. Ther. Drug. Carrier Syst.,1992;9:305–353.
Aetna. (2013) Clinical Policy Bulletin: Iontophoresis. Number: 0229. http://www.aetna.com/cpb/medical/data/200_299 /0229.html, 2013. Accessed on 3rd January 2012.
Ines, L.P. and J.A. da Silva, (2005) Soft tissue injections. Best Pract Res Clin Rheumatol, 19(3): p. 503-27.
Banga A.K., Panus P.C. (1998): Clinical Application of Iontophoretic Devices in Rehabilitation Medicine. Critical Reviews in Physical and Rehabilitation Medicine, 10(2): p. 147-179.
Onigbinde Ayodele Teslim, Orolade Ibidayo Akanji. An assessment of knowledge and opinion of Nigerian physiotherapists on application of Iontophoresis in the management of selected skin disorders and Arthritis. Technology and Health Care, 2012
Marowino Tiziano (2014) Iontophoresis in Pain Management. Practical Pain Management. www. Practical Pain Management.com. Accessed on the 26th August 2014.
Khan A., Yasir M., Asif M., Chauhan I., Alok P. Singh, Rajat Sharma,Pradeep Singh and Shubham Rai (2011) Iontophoretic drug delivery: History and applications. Journal of Applied Pharmaceutical Science 01 (03); 2011: 11-24
Helmstädter, A. (2001) The history of electrically-assisted transdermal drug delivery ("iontophoresis"). Pharmazie;56: 583–587.
Green P.G, Flanagan M, Shroot B, Guy RH. (1993) In Physical Skin Penetration Enhancement, Walters, K.A.; Hadgraft. J. Eds.; Marcel Dekker Inc.: New York,
Thomas CL, ed. Tubers Cyclopedic (1997) Medical Dictionary. 13th ed. Philadelphia, Pa: FA Davis Co; 19773-47.
Glikfeld P., Cullander C., Hinz R.S., Guy R.H., (1988) A new system for in vitro studies of iontophoresis, Pharm. Res., 5: 443–446
Williams A.C., B.W. Barry, Terpenes (1991) and the lipid-protein partitioning theory of skin penetration enhancement. Pharm. Res.,;8:17–24.
Rijwan M, Aquil M, Talegoankar S, Azeem A, sultana Y, Ali A (2009) Enhanced transdermal drug delivery techniques: an extensive review on patents. Recent Patents on Drug Delivery and Formulation 3(2): 105-124
Bijaya G, Preethi GB, Roopak M, Versha P. Transdermal delivery of ibuprofen and its products.
Banga A.K., Panus P.C. (1998): Clinical Application of Iontophoretic Devices in Rehabilitation Medicine. Critical Reviews in Physical and Rehabilitation Medicine, 10 (2): p. 147-179by
Practical Pain Management (2008): Iontophoresis in Pain Management, Published on Practical Pain Management. Assessed Online http://www.practical painmanagement.com/treatments/interventional/iontophoresis-pain-management
Panchagnula R., O. Pillai, V.B.Nair, P.Ramarao. (2000): Transdermal Iontophoresis revisited. Current Opinion in Chemical Biology, 4:468-473.
Bilir A, Gulec S, Erkan A, Ozcelik A. (2007) Epidural magnesium reduces postoperative analgesic requirement. Br J Anaesth, (98): 519-23.
TEC Assessment (2000). Iontophoresis for medical indications. www.tecassessment. com.
Brukner, P., Khan, K., (2007) Clinical sports medicine. 3dr ed., Sydney: McGraw-Hill. 1032.
Sylvestre Jean-Philippe (2007): Applications Of Iontophoresis In Sports Medicine; A thesis submitted for the degree of Doctor of Philosophy.University of Bath; Department of Pharmacy and Pharmacology ; November 2007.
Hariharan S, Ramsewak R, Chen D, Merritt-Charles L, Bridglal C. (2007).A study of the efficacy of diclofenac iontophoresis for providing effective topical analgesia. Internet Journal of Pain, Symptom Control and Palliative Care, 13 Auguust, Vol./Is. 5/2(0-10), 15288277.
Bailey, D.C., et al.,( 2003) A Comparison of the Use of Iontophoresis and Oral Non-steroidal Anti-inflammatory Medication in the Pain Management of Acute Soft Tissue Injuries in the Emergency Department Setting. Acad Emerg Med,10 (5): p. 470
Yarrobino, T.E., et al., (2006) Lidocaine iontophoresis mediates analgesia in lateral epicondylalgia treatment. Physiother Res Int,. 11(3): p. 152-60.
Onigbinde A.T, Talabi A.E, Ogunsakin E.A, Adesoye A.A, Awotipe A Mbada C.E, Obiyemi O.O, Oyerinde O. (2010): Acute effect of lidocaine iontophoresis on pain and joint motions during application of mobilization techniques– A Technical Report. Ghana Journal of Physiotherapy Vol 2 No 1, 23 – 29,
Onigbinde Ayodele Teslim, Olafimihan Kehinde Foyeke, Ojoawo Adesola, Mothabeng Joyce, Ogundiran Opeyemi Olufemi (2011) Management of decubitus ulcer using Gentamycin sulphate iontophoresis- A case study. Internet journal of Allied Health Sciences and Practice, vol 9, 3, 1 – 4
Haggard HW, Strauss MJ, Greenberg LA. (1939) Fungous infections of the hands and feet treated by iontophoresis of copper. JAMA.;112:1229-1232.
Garzione Garzione J.E, (2008) Pain Management Special Interest Group. Lithium Iontophoresis for Gout Pain: a case study. Orthopaedic Physical Therapy Practise, 01 September, Vol./Is. 20/3(149-149).
Osborne H.R., Allison GT, 2006: Treatment of plantar fasciitis by Low Dye taping and iontophoresis: Short term resuts of a double blinded, randomized, placebo controlled clinical trial of dexamethasone and acetic acid. British Journal of Sports Medicine, 01 June, Vol./Is. 40/6(545-549).
Perron M, Malouin F (1997). Acetic acid iontophoresis and ultrasound for the treatment of calcifying tendinitis of the shoulder: a randomized control trial. Arch Phys Med Rehabil. 1997 Apr;78(4):379-84.
Nikhil Sharma, GetaAgarwal, A. C. Rana, Zulfiqar Ali Bhat, Dinesh Kumar“A Review: Transdermal Drug Delivery System: A Tool For Novel Drug Delivery System”,Int. J. Drug Dev. & Res., Jul-Sep 2011, 3(3): 70-84
Vijay Krishna Rachakonda (2008). Effective screening of chemical penetration enhancers for transdermaldrug delivery. Thesis Submitted to the Faculty of the Graduate College of the Oklahoma State University in partial fulfillment of the requirements for the Degree of Master of science.
Dasgupta, Rajdeep; Banthia, Ajit Kumar; Tibarewala, D.N. Trends in Biomaterials and Artificial Organs Study of diffusion characteristics of salicylic acid through cellulose acetate membrane and extracted mouse skin by iontophoresis.
Akinbo, Sunday; Owoeye, Oluwatoyosi; Adesegun, Sunday, Comparison of the therapeutic efficacy of diclofenac sodium and methyl salicylate phonophoresis in the management of knee osteoarthritis Turkish Journal of Rheumatology Jun 1, 2011
Archana K. Gaikwad Aurangabad Reviewed Article Transdermal drug delivery system: Formulation aspects and evaluation 431001, Maharashtra India. Email:g29archana@ yahoo.com Accepted 7 February, 2013
Mark R. Prausnitz and Robert Langer , Transdermal drug delivery, NIH Public Access available in PMC 2009 June 23.
Hsieh Yueh-Ling. Hung-Kuang University, Taichung, 34, Chung-Chie Road, Sha Lu, Taichung 433, Taiwan, Republic of China Effects of Ultrasound and Diclofenac Phonophoresis on Inflammatory Pain Relief: Suppression of Inducible Nitric Oxide Synthase in Arthritic Rats The American Physical Therapy Association
Kumar Sampath, Debjit Bhowmik, M.Komala. Indian Journal of Research in Pharmacy and Biotechnology Volume 1(3) May-June 2013 Page 379 Transdermal sonophoresis technique- an approach for controlled drug delivery. Department of Pharmaceutical Sciences, Coimbatore medical college, 2. Karpagam University, Coimbatore.
Gurney A. Burke, Daniel Wascher, Robert Schenck, Alexandria Tennison, Bettina Jaramillo, DPT Sports Physical Therapy Absorption of Hydrocortisone Acetate in Human Connective Tissue Using Phonophoresis
Saliba Susan, Dilaawar J. Mistry, David H. Perrin, Joe Gieck, Arthur Weltman (2007). Phonophoresis and the Absorption of Dexamethasone in the Presence of an Occlusive by the National Athletic Trainers Journal of Athletic Training 2007;42(3):349–354 .
Giovana C. ROSIM, Cláudio Henrique Barbieri, Fernando Mauro Lanças, NiltonMazzer (2004). Diclofenac phonophoresis in human volunteers. Seminar at the department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, RibeirãoPreto School of Medicine, São Paulo University, RibeirãoPreto (SP), Brazil and tDepartment of Analytic Chemistry, São Carlos Institute of Chemistry, São Paulo University, São Carlos (SP), Brazil;