Electrophoresis of the medical

Electrophoresis of medicinal (synonym: galvanometry, inegalitarian, enoterapija, iontophoresis, iontophoresis treatment) - effect on the body by direct current and entered it through the skin or mucous membranes particles of medicinal substances. During electrophoresis of medicinal change occurs total reactivity of organism, stimulation of the so-called protective functions of the organism, the increase of the intensity of metabolic and trophic processes, and so on, thus inherent medicinal substance pharmacological effects manifested in small doses, but as a result of delayed receipt of his skin depot in the blood flow during a long period.
Sources galvanic current, electrodes and electrode strip during electrophoresis of medicinal and rules of procedure of electrophoresis of the medical and safety are the same that is used in electroplating (see).
The medicinal substance during electrophoresis of medicinal put on a layer filter paper, which have a side electrode pads, addressed to the body of the patient. After the procedure the filter paper is thrown away. All electrode strip for electrophoresis of medicinal must be marked with the corresponding name of medicinal substance (the first letter).
In some cases, electrophoresis of medicinal you can apply baths (porcelain, glass, Fig. 2)filled with medicinal solution low concentration, down in them coal electrodes.


Fig. 2. Single-chamber baths: 1 - for hands; 2 - for the feet.
cervico-facial electrophoresis
Fig. 3. Cervico-facial electrophoresis

Method of the General electrophoresis (by S. B. to Vermel) - electrodes placed on the interscapular region (area strip 300 cm2), and in both calf muscles (150 cm2) at the current density of 0.03 to 0.05 mA/cm2. Treatments are performed daily, after a day or two, at the rate of 10-15 procedures. The repetition rate can be achieved through 3-6 months. Electrophoresis of the medical in cervico-facial methodology - electrodes with gaskets 150 - 180 cm2 have on both sides of the upper third of the neck and face. The auricle is between the plates of the electrode (Fig. 3); total current up to 7-8 mA, the duration of one session 7-10 minutes; procedures daily or every other day, at a rate of 12-15 procedures.
The readings. Electrophoresis of the medical assign diseases of cardiovascular system (used ions of calcium); with atherosclerosis (ions of iodine, novocaine); hypertension [ions of bromine, caffeine, magnesium (magnesium sulfate), potassium, iodine, novocaine]; in postoperative or pelvocalyceal scars, connective cords, Dupuytren's contracture, keloid scars, burns (iodine, lidaza, reidosa). With the defeat of rheumatic character electrophoresis of medicinal salicylic ions. In chronic inflammatory low current processes in the female genital area, biliary tract, the tonsils apply solutions of antibiotics (penicillin, tetracycline , and others); in diseases of the peripheral nervous system - novocaine.
Depending on peculiarities of clinical presentation, duration of the process and state of the body appointed reflectory-segmental, General or local procedure.
Contraindications: neoplasms, cardiac decompensation, acute inflammatory processes, some forms of eczema and dermatitis, intolerance appointed medicinal substance or galvanic current.


Fig. 4. The location of the electrodes in the induction of General ionic reflex

General ionic reflexes (by A. E. the Shcherbakov) - lead electrodes with cloth strips area of 120 - 140 cm2 have a cross or diagonal shoulder (Fig. 4) or the thigh. One of the strips swelling solution medicinal the substances, another simple warm water. Electrodes flexible insulated wires connect with the source of galvanic current in accordance with the polarity of the input of ions. Above electrodes impose rubber bandage to cause mild congestive hyperemia. The current density gradually increased from 0.05 to 0.1 mA/cm2. The duration of the procedure is 20 minutes; after 10 and 17 minutes to make a one-minute breaks to reduce polarization resistance. The total number of procedures 15-20 appointed day or every other day. For long-current or recurrent disease after one and a half - or two-month break valid refresher courses.
At the ionic reflexes apply solutions of calcium chloride, potassium Iodate, sulphate zinc, sodium bromide, magnesium sulfate, sodium salicylate.
Ion plated collars (calcium, magnesium, procaine, eufillinom and others). Electrode laying in the form of a turn-down collar area of 800 cm2soaked 50 ml solution medicinal the substances, put on the collar zone. The second electrode area of 400 cm2 have in the lumbar-sacral region. Collar electrode connected to positive terminal of the source galvanic current. The current strength gradually increase from 6 to 12 mA, duration of procedure is from 6 to 16 minutes (every two procedures adds 2 mA and 2 minutes). The number of procedures 15 - 20 appointed day or every other day.


Fig. 5. The location of the electrodes at ion plated belt.

Ion plated belt (calcium, magnesium, procaine and others). At the level of the lower thoracic and upper lumbar vertebrae or at the lower lumbar and sacral vertebrae impose electrode size 15X75 see gasket moistened with 50 ml of medicinal substance. The other two electrode strips area of 320 cm2 each feature on the front or back surface of both hips (Fig. 5). Current strength from 8 to 15 mA, the duration of the procedure 8-10 minutes, the number of procedures per course 10-12 through the day.
Indications are the same as with the General electrophoresis.
Contraindications - see Galvanization.

Medical electrophoresis (synonym: iontophoresis, iontophoresis, inegalitarian, galvanometer, electrotonotherapy) is a combined effect on the body galvanic current and input via the skin or mucous membranes of medicinal substances. Since 1953 the USSR decided to use only the term " medicinal electrophoresis" to indicate a method of introduction into the organism by means of galvanic current, not only ions of electrolyte solutions, but also associated with ions of larger particles and complex molecules of organic compounds.
Ions of medicinal substances if medicinal electrophoresis, penetrating mainly through the exit of the sweat and sebaceous glands, linger in the thickness of the skin below the electrode. From this skin depot ions enter the flow of lymph and blood gradually. This creates conditions for a more lasting impact of medicinal substance in an organism is one of the important advantages of electrophoresis in comparison with other ways of introduction of medicinal preparations. When medicinal electrophoresis is observed not only stimulation of various protective physiological reactions galvanic currents (see Galvanization), but also by specific action of medicinal substance, due to its pharmacological characteristics.
In the basis of the complex mechanism of physiological and therapeutic effects of the medicinal electrophoresis is a comprehensive irritation of the receptor apparatus of the skin galvanic current and the input through its ions of medicinal substance, to be transferred by the nerve paths upper autonomic centers of the brain, as well as pharmacological action medicinal substances in electrically active. Thus, during electrophoresis, along with the local changes in the tissues experiencing generalized autonomic reflexes (by A. E. the Shcherbakov, shared ionic reflexes). Ionic reflexes universal: they can be called from any, even small, skin with normal sensitivity. For a therapeutic effect is not necessary to place the electrodes in the area of the affected organ or strive in all cases to the creation of a high concentration of medicinal substances in the blood. In a physiotherapeutic practice widely used waachovia methods of electrophoresis of medicinal substances in a total calcium, iodine, zinc, magnesium, salicil and other ionic reflexes. Therapeutic importance and focal impacts occur through the reflex mechanism of action of galvanic current and the entered substances, and changes elektronnogo state tissues under the influence of the force lines of the electric field DC in interpolation space. Thus there is a local increase in the blood and lymph circulation, improves local metabolism, altered permeability gistogematicalkie barriers, which results in a preferential resorption tissue flowing through this area of medicinal substance after its penetration of the skin depot in General bloodstream.
The readings. Electrophoresis is prescribed in many diseases, including severe and long-term recurrent subject to treatment galvanization (see) and various medicinal substances. When prescribing medicinal electrophoresis of those or other drugs should take into account peculiarities of their pharmacological action, and indications for use of these drugs for other methods of their introduction. Medical electrophoresis should not be opposed to other methods of treatment; it must be considered as a way of expanding the potential of the use of many drugs with therapeutic and prophylactic purpose when nervous, surgical, internal, gynaecological disorders, diseases of the eye, ear, etc. By electrophoresis you can enter a variety of medicinal substance, unless the possibility of placing them under the action of a direct current (see table).

Medicinal substances most often used for electrophoresis
Enter ion or particle (used substance) Solution concentration (%) Pole DC
Adrenaline (hydrochloric)
Aconitine (nitrate)
Akrikhin
Aloe (extract)
Phenazone (salicylate)
Ascorbic acid
Atropine (sulfate)
Acetylcholine (chloride)
Biomitsin (hydrochloric acid)
Bromine (sodium or potassium)
Vitamin B1 (thiamin)
Hyaluronidase
Histamine
Dikain
Dimedrol
Dionin
Iodine (potassium or sodium)
Calcium (chloride)
Potassium (chloride)
Sulfation (acid residue; Ichthyol)
Codeine (phosphate)
Cocaine (hydrochloric)
Caffeine sodium benzoate)
Lithium (salicylate and others, except carbonate)
Magnesium (magnesium sulphate)
Copper (sulfate)
Morphine (hydrochloric acid)
Nicotinic acid
Novocaine (hydrochloric acid) Osarsol
Papaverine (hydrochloric)
PABK (procaine)
PASK
Penicillin (sodium salt)
Pilocarpine (hydrochloric acid)
Platifillin (sour vinnokamennoj)
Neostigmine
Salicylic acid (an acid residue; sodium)
Sultolin (hydrochloric)
Sulfur (Hypo)
Silver (nitrate)
The syntomycin
Streptomycin (potassium chloride)
Streptocide (white)
Strychnine (nitrate)
Sulfanol
Sulfate (magnesium sulfate)
The sulphite (sodium hyposulphite)
Terramycin (oxytetracycline, powder)
Tuberculin
Urotropine
Phosphoric acid (radical, sodium)
Ftalazol
Quinine (dwuhlopastny)
Chlorine (sodium)
Zinc (chloride)
Ezerin (salicylate)
Aminophylline
Ephedrine
0,1
0,001-0,002
1
*
1-10
5-10
0,1
0,1
0,5
1-10
2-5
0.5-1 g (in 1 % solution novokaina)
0,01
2-4
0,25-0,5
0,1
1-10
1-10
1-10
1-10
0,1-0,5
0,1
1 (5% solution of soda)
1-10
1-10
1-2
0,1
1
1-10
1 (0.5% solution of soda)
0,1
1-10
1-5
**
0,1-1
0,03
0,1
1-10
0,1
2-5
1-2
0,3
***
0,8 (in 1% solution of soda)
0,1
0,8 (in 1% solution of soda)
2-10
2-2,5
***
10-25
2-10
2-5
0,8
1
3-10
0,1-2
0,1
2
0,1
+
+
+
-
+
-
+
+
+
-
+
+
+
+
+
+
-
+
+
-
+
+
-
+
+
+
+
-
+
+
+
+
-
-
+
+
+
-
+
-
+
+
+
-
+
-
-
-
+
+
+
-
-
+
-
+
+
+
+
* Aloe extract prepared from the leaves, aged 15 days in a dark place at temperature of 4-8 degrees. Prepare a paste and fill with distilled water (100 g weight in 300 ml of water), infused for hours at room temperature, boil for 2 minutes, filtered and bottled in the dishes from 50-200 ml Bottles boil in water bath for 15 minutes Extract stored in a dark place.
** 600-1000 ED 1 cm2 strip (5000-10 000 UNITS in the first ml).
*** As penicillin.
**** 100 000-1 000 000 IU (0.1-1 g of powder) on the strip (solvent-physiological solution, 10-30 ml).

Depending on peculiarities of clinical presentation, duration of the process and state of the body appointed reflectory-segmental (see reflexosegmental therapy), General or local procedure electrophoresis.
Contraindications: neoplasms, cardiac decompensation, acute inflammatory processes, the propensity to bleeding, some forms of eczema and dermatitis, individual intolerance appointed medicinal substance or galvanic current.
Technique electrophoresis. For medicinal electrophoresis are used sources of galvanic current. Apply metal electrodes, thick cloth pads, observing all rules of procedures and the location of the electrodes, as with galvanization. Unlike galvanization, to wet the pad under the active electrode impose wetted prepared on distilled water solution of medicinal substance sheet of filter paper or a piece of folded twice Marley - size gaskets and gasket under the indifferent electrode moisten with warm water.
At the dosage procedures medicinal electrophoresis proceed from the position that the number of ions of the substance introduced into the body, is proportional to the current, square pads and duration of the session, and depends on the concentration of medicinal solutions, more or less content "parasitic" and competing ions and other conditions.
Procedures are carried out at the current density in the range from 0.01 to 0.1 mA/cm2 , depending on the method (the larger the area of the strip, the less current density should be used to avoid pererazbiyeniya and adverse reactions). Duration of procedure 10-20 minutes, at least 30 minutes, if needed it increases up to 40-60 minutes during the course of treatment should be conducted on average 15 - 20 of procedure, appointed day, a day or at different intervals with special techniques. For long-current or recurrent disease after one-two-month break can be re-treatment courses.
In practice, in addition to local applications, the most common are the following methods of electrophoresis of medicinal substances.


General ionic reflexes by Scherbak. Two electrode strips area of 120-140 cm2 each have a cross or diagonally, often on the shoulder (Fig. 3) or on the thigh. Electrodes through flexible insulated wires connect with sources of galvanic current in accordance with the polarity of the input of ions. Usually use solutions of calcium chloride, potassium iodide, zinc sulfate, sodium bromide, magnesium sulfate, salitsilovaya sodium. Above electrodes impose rubber bandage to cause mild congestive hyperemia. The current density gradually increased from 0.05 mA/cm2 and 0.15-0.2 mA/cm2. The duration of the procedure is 20 minutes After the 10-th and 17-th minutes to make one-minute break to reduce polarization resistance.

Fig. 3. The location of the electrodes in the induction of General ionic reflex:
1 and 2 - lead plates with cloth strips;
3 - insulated wire;
4 - rubber bandage.
ion collars
Fig. 4. The location of the electrodes at ion collar.

Ion collars (calcium, iodine, bromine, salicylic acid, magnesium, procaine, eufillinom and others). For collar zone (cervical and two upper breast skin segment) impose three layers of filter paper or gauze area of 1000 cm2, moistened in a 50 ml solution medicinal the substances, prepared on distilled water (temperature 38-39 degrees). Over come with a strip of the same area of flannel or coarse calico with a thickness of 1 cm to a metal electrode. The other electrode with gasket area of 400 cm2 have in the lumbar-sacral region (Fig. 4). Cloth strips moisten with warm water (temperature 38-39 degrees). With the help of ion collar you can enter the calcium from the anode and bromine from the cathode (calcium-bromide collar), novocaine anode and iodine with cathode (novocaine-iodine collar) and some other combination. During the first procedures the current gradually increase from 4-6 to 10 mA, and each session lasts from 6 to 10 minutes If necessary, the current can be increased to 16 mA and the duration of the procedure is 20 minutes

ion zone
Fig. 5. The location of the electrodes at the top and bottom ion zones.

Ion zone (calcium, bromine, iodine, magnesium, and others). At the level of the lower thoracic and upper lumbar vertebrae (the upper belt) or at the level of the lower lumbar and sacral vertebrae (the lower belt) impose three layers of filter paper or gauze square 1125 cm2 (15X75 cm), moistened in a 50 ml solution medicinal the substances, prepared on distilled water (temperature 38-39 degrees). Top offer a cloth strip same size and thickness of 1 m and a metal electrode. Two indifferent electrode pads area of 320 cm2 each feature on the front surface of the upper third of the thighs in the upper zone or on the back surface of the hips in the lower zone (Fig. 5). The current from 8 to 15 mA, the duration of the procedure 8-10 minutes, if necessary, be increased to 15-20 min.


Fig. 6. The location of the electrodes with the General electrophoresis.

General electrophoresis Vermel. The active electrode with a filter paper laying on the area of 300 cm2moistened with a solution medicinal the substances, have scapula region, and two indifferent electrode pads with area of 150 cm2 is placed on the rear surface of the legs (Fig. 6). Current 10-30 mA, the procedure duration is 20-30 minutes

Orbital-occipital electrophoresis Bourguignon. Two active electrodes of round shape with a diameter of 5 cm with pads soaked in the solution medicinal the substances, put in orbit over the closed eyes; indifferent electrode with gasket area of 40-60 cm2 have on the back of the neck. Current up to 4 mA, the procedure duration is up to 30 min
Nasal electrophoresisproposed N. I. Grashenkov and G. N. The Kassil, is the introduction into both nostrils soaked medicinal substance with a cotton swab on tin the wire ends or gauze torontoca, the ends of which are stacked on top of the strip oilcloth above the upper lip, covering an active electrode size 2x3 see Indifferent electrode with gasket area of 80 cm2 have on the back of the neck.

Sometimes used electrophoresis of medicinal substances with the help of four - or two-chamber baths. A number of special methods of electrophoresis is used in otiatria, ophthalmology, gynecology, dermatology. Electrophoresis of medicinal substances can be combined with inductothermy (see) and mud applications (see Mud therapy).