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Vakul Aren
Vakul Aren, Doctor
Category: Medical
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Experience:  MBBS,DTM&H,34 years of experience
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Inquiring regarding precaution or definite contraindication

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Inquiring regarding precaution or definite contraindication of physical therapist application of physician prescribed iontophoresis with dexamethazone to medial knee region of 83 yo patient with referral diagnosis of knee medial compartment osteoarthritis (pt. reports that she has an implanted cardiac pacemaker in left chest wall)???

Absolute contraindication would be any open wound or sore, avoid over any implantation device/electrical pins/needles/staples,epiphyseal plates,malignancy,thrombophlebitis,laminectomies,breast implants.Relative contraindication would be in case of peripheral neuropathy and other numbing of the part,diabetes is also a relative contraindication.Allergy to the drug being applied is also a contraindication.precautions are that care is required to avoid burns,local ereythema and urticaria to the skin area.

Electrical stimulus is contraindicated in any patient with a pacemaker,thus iontophoresis should not be done..

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