What Is Iontophoresis Bilateral?

The various methods of delivering medications and other substances to a particular body site are technically referred to as routes of administration. Common routes include oral administration, injection and topical application directly to the skin's surface. Transdermal iontophoresis is an alternative drug route that uses electric current to transfer medications through intact skin. When performed on both sides of the body, the procedure is called bilateral iontophoresis.

Principle

• The skin is selectively permeable. It allows small amounts of nonionized substances, those lacking a positive or negative electrical charge, to pass through, but resists the passage of charged, or ionized substances. Iontophoresis uses a small electric current to move charged drug particles across the outermost layer of the skin, called the stratum corneum. The process is based on the principle that opposite charges attract and like charges repel. Electrodes similar to those used for electrocardiograms, deliver the current. The ionized drug is placed beneath an electrode of the same charge. Another electrode, opposite in charge to the drug, is placed at another location on the body's surface. When the current is applied, the drug is repelled by the like electrode and attracted to the opposite electrode, thereby significantly increasing its penetration through the skin.

Uses

• Iontophoretic treatment typically has two requirements: the drug being administered must be charged, and the disorder being treated must be near the body's surface. It has numerous applications for treating disorders of the skin, muscles and joints. Iontophoresis is often used to administer anesthesia for minor surgery, and deliver drugs that reduce inflammation in joints and soft tissues. Specific conditions for which the procedure might be used bilaterally include excessive sweating of the armpits, hands or feet, a condition known as primary hyperhidrosis; temperomandibular disorders, commonly known as TMJ; and rheumatoid arthritis. Drugs commonly administered include cortisone and lidocaine. Water or drugs called anticholinergics, are used for treating hyperhidrosis. Iontophoresis of a substance called pilocarpine is used to diagnose cystic fibrosis. According to Aetna, it is the only practical and reliable laboratory test for confirming diagnosis of the disorder.

Advantages

• Iontophoresis is a painless and noninvasive route of drug administration. It eliminates the gastrointestinal side effects sometimes associated with oral drug administration and reduces the risk of infection and inflammation associated with injections or infusions. It provides controlled drug delivery rates and improves patient compliance because it is convenient, effective and reduces total drug dose and dosing frequency.

Disadvantages

• Although major side effects of iontophoresis are rare, it can burn the skin if performed improperly. Common minor reactions associated with the procedure include redness, itching and general irritation of the iontophorectic skin surface. Some drugs may increase skin pigmentation at the administration site. Adverse reaction risk rises with increased treatment duration and/or increased current. The procedure should not be performed on individuals who have electrically sensitive implanted medical devices, such as pacemakers, or those with damaged or broken skin surfaces.