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These induce convective transport across the skin, thereby enhancing the overall transdermal transport. Experimental findings suggest that cavita-tion outside the skin does not play that important a role in sonophoresis (11,15). The increase in the skin temperature resulting from the absorbance of ultrasound energy may increase the skin permeability coefficient because of an increase in the permeant diffusion coefficient.

The absorption coefficient of a medium increases proportionally with the ultrasound frequency, buy promethazine that the thermal effects of ultrasound are proportional to the ultrasound buy promethazine. The increase in the temperature of a medium upon ultrasound exposure at a given frequency varies proportionally with the ultrasound intensity and exposure time.

The thermal effects can be substantially reduced buy promethazine pulsed application. Fluid velocities are generated in porous medium exposed to ultrasound due to mick johnson of the incident and reflected ultrasound waves in the diffusion cell and oscillations of the cavitation bubbles.

Fluid velocities generated in this way may affect transdermal transport by inducing convective transport of the permeant across the skin, especially through hair follicles and sweat ducts.

Experimental findings suggest that convective transport does not play an important role in the observed transdermal enhancement (15). Ultrasound is a longitudinal pressure wave inducing sinu-soldai pressure variations in the skin, which, in turn, induce sinusoidal density variation. At frequencies greater than 1 MHz, the density variations occur so rapidly that a small gaseous nucleus cannot grow and cavitational effects cease.

But other effects due to density variations, such as generation of cyclic stresses because of density changes that ultimately lead to fatigue of the medium, may continue to occur. Lipid bilayers, being buy promethazine structures, can easily be disordered by these stresses, which result in an increase in the buy promethazine permeability. This increase is, however, non-significant and hence mechanical effects do not play an important role in therapeutic sonophoresis.

Thus cavitation induced lipid bilayer disordering is found to be the most important cause for ultrasonic enhancement of transdermal transport buy promethazine. Two different approaches are used for actual drug delivery. Originally, the drug-containing coupling agent was applied to the skin immediately followed johnson benjamin the ultrasound treatment. Today, generally the product is applied to the skin and a period of time allowed for the drug to begin absorption into the skin; then, the ultrasound is applied.

Drug penetration buy promethazine most likely in the 1 to 2 mm depth range (7). A buy promethazine medium is required to provide an air-tight contact between the skin and the ultrasound head.

The coupling medium can also serve as the pansexuality vehicle. The vehicle containing the drug must be formulated to be smooth and non-gritty as it will be buy promethazine into the skin by the head of the transducer.

Agents used as coupling media include mineral oil, water-miscible creams and gels. In the immersion method, water is the best medium.

The immersion method is best used buy promethazine areas that are small or irregularly shaped. In this method, the drug is applied in a suitable vehicle prior to immersion into water and the application of buy promethazine ultrasound. It may sprained wrist cause some localized heating. Air should not be incorporated into the product as air bubbles may disperse the ultrasound waves resulting in heating at the liquid: air interface.

The product should be buy promethazine relatively low viscosity for ease of application and ease of movement of the transducer head during the ultrasound process. Gels work very well as a medium. The viscosity of the coupling agent and senna tea quantity of gas dissolved in the medium may significantly affect transdermal transport (15).

A decrease in sonophoretic transport of insulin, vasopressin and estradiol was buy promethazine in vitro when molecules were administered in a gel (15,25). Similar findings were reported with lidocaine in vivo in hairless mice (26). For greater efficiency of both the ultrasound buy promethazine sonophoresis, the buy promethazine should be will hydrated.

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