1. DRUGS USED IN CURRENT PHYSICAL THERAPY PRACTICE By Pashmina khan

2. LEARNING OBJECTIVES DRUGS USED IN CURRENT PHYSICAL THERAPY PRACTICE  Drugs administered by Iontophorosis and Phonophrosis  Potential Interactions between Physical Agents and Therapeutic drugs.

3. PHARMACOLOGY FOR PHYSIOTHERAPISTS Drug therapy is pervasive among patients coming for therapy. Some beneficial affects of drugs enhanced by physical therapy.  Massage & strengthening exercises - insulin Physical therapy may exacerbate some of the adverse effects of drugs. Understanding what drugs do to help patients know WHY focus on physiotherapy.

4. Four specific reasons 1.PT’s must understand the patient’s response to different drugs affecting PT – Drugs causing fatigue or sedation 2.Optimal scheduling purposes – Pain medication 3.Drug-therapy interactions – Heat-related modalities – antihypertensives 4.Adverse Drug Reactions

5. Iontophoresis vs Phonophoresis.  Iontophoresis uses electrical current to transport ions into tissues  VS  Phonophoresis involves the use of acoustic energy in the form of ultrasound to drive whole molecules across the skin into the tissues

6. iontophoresis The term iontophoresis is simply defined as ion transfer (ionto = ion; phoresis = transfer). Introduction of ions into the body using direct electrical current It is a specialized technique of electrical stimulation that uses electrical polarity of continuous direct current to ionize medicines placed beneath surface electrodes and transfers them into the body through the skin

7. iontophoresis

9. Iontophoresis Duration of Tx: – Based on intensity desired usually every other day for 3 weeks Indications – Acute or Chronic Inflammation – Arthritis – Myositis – Myofacial Pain Syndromes – Invasive method for delivering drugs Contraindications – Hypersensitivity to electrical currents – Contraindications to meds. – Pain of unknown origin Precautions – Prescription – Dosage – Do not reuse electrode – Burns if intensity to great

11. phonophoresis What type of ultrasound energy is suitable for phonophoresis? A. Low intensity, low frequency ultrasound, applied over longer durations (>8 min) is most suited for phonophoresis

12. phonophoresis Phonophoresis mediated trans dermal delivery of proteins Phonophoresis is the use of ultrasound to enhance the delivery of topically applied drugs. It has been used in an effort to enhance the absorption of topically applied biotech products through the therapeutic application of ultrasound. It involves the application of low- frequency (20 kHz) ultrasound waves It induces the air pockets present in the stratum corneum layer to oscillate, thereby creating cavities Then increase permeability of skin. This process is known as cavitation.

13. phonophoresis

14. Drugs Administered by Iontophoresis and Phonophoresis Drugs that may be administered by iontophoresis and phonophoresis Administration of these agents by these techniques is largely empirical. The use of these substances in the conditions listed is based primarily on clinical observation and anecdotal reports in the literature. Likewise, the preparation strengths given here are merely suggestions based on currently available information.

17. Potential Interactions between Physical Agents and Therapeutic drugs

22. REFERENCE Pharmacology in Rehabilitation (5 rd Edition-2015 ) By Charles D. Ciccone.