Medicinal electrophoresis

Medicinal electrophoresis is a combined physicochemical method of local exposure to a constant electric current and drugs injected by a current through electrodes and hydrophilic gaskets moistened with a solution of these agents and which are applied to the dermal surface or mucous membranes of certain areas of the patient's body.

The current density is 0.05-0.1 mA / cm2, the voltage is 30-80 V. The list of drugs for electrophoresis, their percentage in solution, and the polarity of their administration are determined by physical and chemical studies.

The characteristics of the combined effect and the main clinical effects are due to the influence of direct current and the corresponding drug.

Electrophoresis is that drugs are introduced into tissues in the form of positively and negatively charged particles (ions) through intercellular slits, the channels of sweat and sebaceous glands. The amount of drug administered is small (2-10% contained on the pad) and depends on the properties of the drugs, their concentration, current strength, duration of exposure, electrode area, blood supply to the skin. The bulk of drugs settles in the epidermis, a small amount - in the dermis and subcutaneous fat. Deposition of medicinal substances in the skin ensures their long reflex or focal effect on the body (during the day or more). Against the background of the action of direct current, the pharmacological activity of medicinal products increases, since they are introduced into tissues in an ionic and chemically pure form. A constant current causes changes in the functional properties of tissues, increasing their sensitivity to medicinal substances. Side effects of drugs are reduced, because they enter the body in small amounts, bypassing the gastrointestinal tract. At the same time, the concentration of the drug in the pathological focus increases and can several times exceed that achieved with parenteral administration of drugs.

Medicinal substances are introduced into the body according to their polarity: positively charged particles (cations) - from the anode, negatively charged (anions) - from the cathode. Optimal solvent for drugs - distilled water, providing the best electrolytic dissociation and high electrophoretic mobility of drugs. In addition to water, ethyl alcohol and a universal solvent - dimethylsulfoxide (dimexide, DMSO), which is also a good carrier of medicinal substances, are used for water insoluble and slightly soluble substances. To dissolve, 5, 10, 25 and 50% solutions of DMSO are used.

Complex substances - proteins and amino acids are amphoteric compounds having an isoelectric point. Their electrophoresis is carried out from solutions whose pH differs from the isoelectric point of proteins and amino acids. As a solvent for complex substances, distilled water (5-8 drops of a 5% solution of hydrochloric acid) or alkaline (5-8 drops of 5% sodium hydroxide solution), as well as buffer solutions (acetate, phosphate buffer, etc.) are used as a solvent for complex substances. Due to the presence of a large number of mobile ions in the buffer solution, its use is limited, so in practice, acidification or alkalinization of aqueous solutions is often used. When the solution is acidified, the proteins and amino acids acquire a positive charge and are introduced from the positive pole, with alkalization - a negative charge and introduced from the negative pole.

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Indications for drug electrophoresis

Cerebral atherosclerosis, transient cerebral circulatory disorders, residual effects and consequences of ischemic and hemorrhagic strokes, condition after removal of vascular aneurysms, cerebral arachnoiditis, consequences of craniocerebral trauma, hypothalamic syndromes of various genesis, consequences of tick-borne meningoencephalitis, infectious allergic and traumatic neuritis, trigeminal neuralgia , glossopharyngeal, occipital nerves, trauma and spinal cord disease, cervical and lumbar osteochondrosis, diseases Spondylitis, vibration disease, Raynaud's disease, and others.

Contraindications to drug electrophoresis

Contraindications are the same as in galvanization, and, in addition, intolerance of medicinal substances.

[5], [6], [7], [8]

Medicinal electrophoresis: mechanism of action

The mechanism of action of drug electrophoresis is determined by the influence of the galvanic current and the specificity of the substance administered. In the case of the use of non-violent agents, the main effect is determined by the direct current, the potent ones are the pharmacological properties and specificity of the preparation.

Medicinal electrophoresis has an anti-inflammatory, resorptive, local anesthetic effect on the body, improves blood circulation of tissues and conductivity of peripheral nerve fibers, reduces pathological impulse from the periphery, normalizes the functional state of the central and autonomic nervous system.

The method of drug electrophoresis

The technique of drug electrophoresis does not differ significantly from the galvanization technique. In addition to conventional electrodes, a medicine pad made of filter paper or several layers of gauze moistened with a drug solution is used. Medicines can also be injected from solutions via a bath (electrophoresis), using interstitial electrophoresis. The duration of exposure is 20-30 minutes. The course of treatment - 10-15 procedures, daily or every other day.

The essence of interstitial electrophoresis is that the patient is administered the drug substance by one of the known methods (intravenously, subcutaneously, intramuscularly, by inhalation), and then, after reaching its maximum concentration in the blood, galvanization is carried out transversely on the lesion site.

Methods of drug electrophoresis

In order to increase the efficiency of the method, new methods of drug electrophoresis are being developed and are being improved. In particular, the following methods are proposed for use:

• prolonged galvanization (electrophoresis). It is used in the application of a current of small force (100-200 μA) for a long duration of action. The technique was developed and implemented in the practice of NA. Gavrikovym (1977, 1983). A "Krona" type battery can be used as a constant current source. The course of treatment - 20-30 procedures. The procedures have a sedative, analgesic, vasoconstrictive effect on the body. They are used for prolonged, persistent pain syndromes, in complex therapy of genoinic and traumatic epilepsy, with degenerative-dystrophic lesions of the joints and spine;
• labile galvanization or electrophoresis. One of the electrodes (indifferent) is fixed stably, the second moves at a speed of 3-5 cm per second along the surface of the body. To eliminate current oscillations during the action, a stabilizing device is additionally introduced into the apparatus. The procedures promote the enhancement of metabolic processes, increase blood supply to tissues, improve excitability and conductivity of neuromuscular formations. It is advisable to use the method in a complex of treatment of patients with traumatic neuritis, toxic and primary polyneuropathies and polyradiculoneuritis, neuroses (hysteria), etc .;
• interstitial (intraorganic) electrophoresis or electro-elimination. Intravenously spray or drip, through the cannula, subcutaneously, intramuscularly injected drug substance or mixture of substances. Transverse with respect to the lesion, galvanic electrodes are applied, so that in the zone of the pathological process, due to the improvement of blood supply, microcirculation, increase in the adsorption capacity of tissues, increase the concentration of drugs. With the jet administration of drugs, the galvanic current is included simultaneously with the administration of the drug, in the drip - after the introduction of 2/3 of the contents of the dropper, with parenteral - in the case of reaching the maximum concentration of the drug in the blood. With interstitial electrophoresis, it is possible to use a mixture of medicinal substances, drugs are introduced without regard to polarity, there is no loss of drugs.

In the neurological clinic, interstitial electrophoresis can be used for injuries and diseases of the central nervous system;

• vacuum electrophoresis - electrophoresis in conditions of low atmospheric pressure. The EVAK-1 apparatus is used, consisting of a vacuum pump, vacuum cuvettes, a device for galvanizing Potok-1. Vacuum-electrophoresis by rectified currents is performed on the appropriate apparatus for low-frequency therapy. The cells are rubber or plastic caps with spring-loaded lead electrodes inside. During the procedure, the cuvette is applied to the skin or mucous membrane, the pad is wetted with a medicinal solution. After creating a discharged pressure, the skin rises upwards and tightly contacts the medicinal pad. The duration of the procedure is 5-10 minutes. You can alternately act on 2-3 sites. Vacuum-electrophoresis is performed once in 4-5 days. The course of treatment - 5-10 procedures. With vacuum electrophoresis, the amount of drug administered, the depth of penetration increases. Vacuum therapy helps increase metabolism and increase blood circulation. The method can be used for chronic pain syndrome in patients with cervical and lumbar osteochondrosis, with traumas of peripheral nerves;
• microelectrophoresis. At carrying out use a cotton insert, in which nest insert a cotton wick, moistened with medicinal solution. On top of it, the electrode is positioned so as to create a contact between the metal tip and the cotton wool. A liner with a wick convex side will interfere with the acupuncture point (TA). Affect TA by acupuncture needles made of stainless steel with the help of special clamps. The wires from the clamps are fixed to the skin with an adhesive plaster to avoid tension and bending of the needles. Microelectrophoresis is carried out by penetration of the drug substance into the TA. The current on the face is 5-50 μA, on the trunk - 100-120, on the extremities 100-200 μA. The duration of exposure is 2-30 minutes. To carry out electropuncture and microelectrophoresis in TA, the following devices are used: "PEP-1", "Elita-1", "ELAP", "Ref-Lex-30-01", "Indicator-2 MT", "Biotonus" etc. Microelectrophoresis is advisable to appoint in hypertensive disease 1-11A stage, migraine, insomnia, postencephalitic hyperkinesia, peripheral nervous system diseases (radiculitis, neuralgia, traumatic neuritis and plexitis, neuritis of the facial nerve), consequences of craniocerebral trauma;
• combined effect of ultrasound and electrophoresis - electrophoresis of medicinal substances. A special device consisting of a therapeutic source of a high-frequency alternating current, a converting ultrasonic sensor, a source of rectified and stabilized current, an electric attachment, an indifferent electrode is manufactured. Electropacking consists of two cylinders placed one in the other. The space between their walls is filled with a medicinal solution. The base of the inner cylinder is the radiating surface of the ultrasonic sensor inserted into the cylinder. Below the space between the walls of the cylinder is made of Teflon and has 6 round holes filled with a porous glass. Above them in the cavity between the walls of the cylinders is installed an annular metal electrode, which is in contact with the solution of the drug substance.

The procedure is as follows: the indifferent electrode is fixed to the skin and connected to one of the poles of the current source. The electrofusion solution filled with the drug solution is attached to the ultrasonic sensor and connected to the other pole of the current source. Smoothly increase the current to the required value (current density 0.03-0.05 mA / cm2), then include ultrasound (intensity 0.2-0.6 W / cm2). Influence on zones on stable and labile methods within 10-15 minutes. The course of treatment - 10-15 procedures, daily or every other day.

The method can be used in the treatment of patients with cervical and lumbar osteochondrosis with pain syndrome, neuralgic pains of various genesis.

For the introduction of drugs other than galvanic, a pulsating current can be used that is constant in direction, but varies periodically in voltage, as well as rectified pulsed currents of low frequency (diadynamic, sinusoidal modulated, rectangular, exponential, fluctuating), which have an electrophoretic effect. At the same time, an analgesic, vasodilating, dissolving action of impulse currents and injectable drugs is potentiated. Compared with classical electrophoresis, electrophoresis with impulse currents introduces fewer drugs, but the depth of their penetration increases somewhat. Electrophoresis by impulse currents is used to treat patients with pain and vegetative-vascular syndromes, spinal cord injuries, neuritis of the facial nerve, etc.