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Re: Do any PT's recommend anti-inflams for pts?
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Re: Do any PT's recommend anti-inflams for pts? - September 28, 2006 1:34:00 PM
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Jon Newman
Posts: 1708
Joined: April 24, 2004
From: Amherst, WI
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Hi Steve and Jason,
Please note that I did state "homeopathic doses" but what do you think happens to those molecules? I don't know about you but I tell my patients that it goes right to the pain, binds with it, and becomes muscle cells. Not to brag or anything but I get much better results than most who use iontophoresis.
This whole issue brings up an interesting point. It seems that what makes iontophoresis OK is the dose, not the molecule itself.
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Do any PT's recommend anti-inflams for pts? - September 29, 2006 7:34:00 AM
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PHSPT
Posts: 119
Joined: December 1, 2005
From: Oklahoma
Status: offline
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Jason,
Hey big guy, nothing personal, these forums can sometimes can give that impression.
Our profession has evolved tremendously over the past 25 yrs. Direct access (some of you that have been around that long, can agree) was only a dream, we have over 43 states that have passed legislation to grant us some type of direct access. 25 yrs ago thoughts/plans for a PT to ever see a pnt without an MD referral drew MUCH criticism from the outside medical prof, as well as from within our ranks.
But thankfully the pendulum has swung in our direction and thanks to the APTA, our role as PT's has expanded from "modality flippers" to a an elite musculoskeletal diagnostician. This change has TAKEN A L-O-N-G time, and still on the works. Over time the Medical population and th general public will recognize the potential that we have as practicioners backed by the latest evidence. It may be apples and oranges now, but with the APTA efforts is beginning to look more like red and green apples.
Im not advcocating breaking the law, by all means follow your practice acts, but make efforts into expanding your level of care. Especially in the light of evidence.Who knows what the next 25 yrs will bring, who are we to say, that one day PT's wont be able to prescribe,treat and diagnose 100%, and function as physician extenders as the military has done.
Jon,
The literature points to positive outcomes w the use of iontophoresis for the treatment for some inflammatory conditions.
As far as the systemic delivery, youre corect! well partially..the molecular binding once inside the membrane, causes a breakdown of ionic charged molecules, allowing for the current to continue to travel and leaving the drug (dex) molecules behind, creating an excess of the drug molecules under the electrode(at least for Dex sodium phosphate) it is at this point through diffusion that the molecules can travel deeper via bloodstream, but in such low concentrations that it will not have any systemic effects, this has been reported in another study from blood drawing near the treatment site.
The study below will explain, given my poor rambling of words. hope it helps.
http://www.ptjournal.org/cgi/content/full/83/2/161
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Re: Do any PT's recommend anti-inflams for pts? - September 29, 2006 8:37:00 AM
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jlharris
Posts: 477
Joined: April 12, 2006
From: Nebraska
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PHSPT,
Well stated and I agree 100%. Thank you for the response.
_____________________________
Jason L. Harris, PT, DPT
My PT Blog
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Re: Do any PT's recommend anti-inflams for pts? - September 29, 2006 3:51:00 PM
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Karie
Posts: 107
Joined: August 14, 2006
From: Wisconsin
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I'm not sure what it is like in other states, but here in Wisconsin you cannot get Dexamethasone for use in iontophoresis without a prescription from a physician. I am in private practice and the patients have to bring it in from their pharmacy when ordered. I can't just go and order it from a supplier. In larger clinics and hospitals where there is a physician medical director for the PT department, they blanket the order for the PT department to have it readily on hand. So even though we are administering it, we have to have it ordered on the PT scrip and it isn't in our possession without an MD ordering at some level of the process.
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Re: Do any PT's recommend anti-inflams for pts? - October 2, 2006 3:36:00 AM
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Dr.Wagner
Posts: 1242
Joined: January 24, 2003
From: Indianapolis
Status: offline
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Here is a very recent article on Overuse of OTC analgesics by the public...remember, they will NOT tell you this stuff.
[URL=http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WB0-4J43YWD-3&_user=10&_handle=V-WA-A-W-VA-MsSAYVA-UUW-U-AAZWWUZAEV-AACEDYZEEV-AZCVZAYYV-VA-U&_fmt=summary&_coverDate=09%2F30%2F2006&_rdoc=22&_orig=browse&_srch=%23toc%236696%232006%23999519996%23630715!&_cdi=6696&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0732d58811a4f7e893401c181a39ab41]http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WB0-4J43YWD-3&_user=10&_handle=V-WA-A-W-VA-MsSAYVA-UUW-U-AAZWWUZAEV-AACEDYZEEV-AZCVZAYYV-VA-U&_fmt=summary&_coverDate=09% 2F30%2F2006&_rdoc=22&_orig=browse&_srch=%23toc%236696%232006%23999519996%23630715!&_cdi=6696&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0732d58811a4f7e893401c1 81a39ab41[/URL]
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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