L. P. Gangarosa, J. Hill
Sep 12, 1995
Citations
0
Influential Citations
28
Citations
Quality indicators
Journal
International Journal of Pharmaceutics
Abstract
Iontophoresis, a process that promotes ionic drug penetration using electricity as an energy source, was suggested long ago. Nevertheless, it only achieved some stature after scientific studies conducted during the 1950s and 1960s indicated at least two rational applications : (1) detecting cystic fibrosis by iontophoresis of pilocarpine and (2) myringotomy by iontophoresis of lidocaine/epinephrine. Recently, there has been more interest and further research in the field. Studies from our laboratories on local use of iontophoresis indicated multiple applications in dentistry, dermatology, ophthalmology and physical medicine. In a double-blind evaluation, iontophoresis of fluoride into dentin caused immediate and long-lasting desensitization of thermally sensitive teeth. Studies on fluoride iontophoresis indicated its mechanism of desensitization, safety for use on vital teeth, tooth hardening effect and anticaries effect. Also, we provided extensive evidence that antiviral iontophoresis was effective vs herpes simplex virus type 1 (HSV-1) and HSV-2 lesions in animals. In a double-blind study of human herpes orolabialis, vidarabine monophosphate (Ara-AMP) iontophoresis lowered the HSV titer by more than 4 log units to almost zero at 24 and 48 h. This reduction was statistically different (P < 0.05) compared with iontophoresis of a placebo or of acyclovir. In a separate study, idoxuridine iontophoresis resulted in no HSV detected in nine of 11 lesions after 24 h. In active herpes zoster, iontophoresis of Ara-AMP, or of acyclovir, significantly accelerated clinical signs of viral inactivation, compared with placebo. Post-herpetic neuralgia (PHN) was treated by corticosteroid iontophoresis resulting in a marked reduction of pain in 60-70% of more than 1000 patients. In a double-blind trial, absence of pain in areas of skin treated by corticosteroid was noted in six out of six PHN patients, compared with no improvement in a matched placebo-treated area. The research on herpes virus diseases provides scientific evidence that iontophoresis of antivirals should be part of the therapeutic armamentarium for treating surface viral infection. Also, corticosteroid iontophoresis may be useful for therapy of PHN, a painful condition that has no consistently effective therapy at this time.