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Brady M. Smith, David O. Draper, Robert D. Hyldahl and Justin H. Rigby

cause drug clearance. Previous studies 3 , 5 have produced conflicting theories concerning vasoconstriction and its effect on transdermal drug delivery transport in tissues. Gurney et al 3 stated that vasoconstriction hinders diffusion of Dex-P, requiring more time for the drug to be found at deeper

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Christopher D. Brown, Christine A. lauber and Thomas Cappaert

Clinical Scenario:

Iontophoresis is a method of local transfer of ionized medicated and nonmedicated substances through the skin and into the target tissues using magnetic polarization. The anti-inflammatory properties exhibited by dexamethasone sodium phosphate (DEX) combined with iontophoresis make it a potentially desirable treatment for clinicians wishing to administer a noninvasive localized drug concentration without having a large systemic concentration of that drug. Since concurrent treatments are commonly used in clinical practice, many of the published studies that included the use of DEX also used concurrent treatments. However, this may make it difficult for clinicians to determine the individual effectiveness of DEX iontophoresis in treating musculoskeletal conditions.

Focused Clinical Question:

Does DEX iontophoresis, alone, decrease pain and improve function in patients with musculoskeletal conditions when compared with placebo or control?