Context: Transdermal delivery of hydrocortisone by phonophoresis is used for the treatment of musculoskeletal conditions. Research shows hydrocortisone and other white or opaque topical preparations transmit ultrasound energy poorly. Effective transmission of ultrasound is important in phonophoresis. Main Outcome measured: Samples of subcutaneous interstitial fluid were collected during and for 20 minutes following phonophoresis treatment. Cortisol concentrations were analyzed by an enzyme linked immune-assay (ELISA) test. Objective: Determine the subcutaneous cortisol concentration after two different phonophoresis treatments using a 2.5% hydrocortisone preparation. Design: Randomized design in which 22 healthy participants were assigned to receive a phonophoresis treatment where: 1) hydrocortisone cream was rubbed in completely prior to phonophoresis or 2) hydrocortisone powder was compounded with an ultrasound coupling gel. Test Subjects: 22 healthy individuals were recruited: 13 females with a mean age of 21 years and 9 males with a mean age of 21.8 years. Intervention: Phonophoresis consisted of pulsed ultrasound at 1 MHz, 1.0 w/cm2, and a 50% duty cycle. The treatment duration was 10 minutes and was localized over the distal gastrocnemius muscle. Results: We observed no significant difference in subcutaneous cortisol concentration between the two phonophoresis treatments (p=0.05). Also no significant difference was detected between pre and post-treatment cortisol levels within each individual treatment group. Conclusions: Our data indicates that completely rubbing a topical hydrocortisone application into the skin prior to placement of ultrasound gel does not result in increased transdermal delivery of cortisol when compared with the use of a compound of ultrasound gel and hydrocortisone powder applied topically to the skin.

Interest within the healthcare profession in transdermal delivery of pharmaceuticals through passive, mechanical (phonophoresis) or electromotive (iontophoresis) forces has increased significantly throughout the past decade. The current review will examine the histology and cellular biology of the integument system as related to regulation of transcutaneous delivery of pharmaceutics, and examine currently accepted mechanism(s) of iontophoretic delivery. Additionally, a survey of current iontophoretic devices and electrodes available within the U.S. market, and the limitations of current technology will be presented. Experimental research supporting the use of iontophoresis for local delivery of pharmaceuticals will also be presented in conjunction with the outcomes of clinical investigations where iontophoresis was utilized for the local delivery of these pharmaceuticals. Topic areas to be covered within this section include iontophoresis of antibiotics into integument wounds, local anesthetics, and steroidal and nonsteroidal anti- inflammatory drugs. Finally, an examination of the benefits of combining various forces to enhance transcutaneous drug delivery and future direction(s) of research within this field will be discussed. The purpose of the present review is to provide both researchers and clinical practitioners with an objective basis for the current use of iontophoresis in rehabilitation medicine.

Interest within the healthcare profession in transdermal delivery of pharmaceuticals through passive, mechanical (phonophoresis) or electromotive (iontophoresis) forces has increased significantly throughout the past decade. The current review will examine the histology and cellular biology of the integument system as related to regulation of transcutaneous delivery of pharmaceutics, and examine currently accepted mechanism(s) of iontophoretic delivery. Additionally, a survey of current iontophoretic devices and electrodes available within the U.S. market, and the limitations of current technology will be presented. Experimental research supporting the use of iontophoresis for local delivery of pharmaceuticals will also be presented in conjunction with the outcomes of clinical investigations where iontophoresis was utilized for the local delivery of these pharmaceuticals. Topic areas to be covered within this section include iontophoresis of antibiotics into integument wounds, local anesthetics, and steroidal and nonsteroidal anti-inflammatory drugs. Finally, an examination of the benefits of combining various forces to enhance transcutaneous drug delivery and future direction(s) of research within this field will be discussed. The purpose of the present review is to provide both researchers and clinical practitioners with an objective basis for the current use of iontophoresis in rehabilitation medicine.

Orientador: Jose Pedrazzoli Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T07:53:42Z (GMT). No. of bitstreams: 1 Fusaro_Claudio_M.pdf: 210087 bytes, checksum: 82412467f7edce8db8bce228762ae320 (MD5) Previous issue date: 2006 / Resumo: O transporte transdérmico de substâncias com o ultra-som terapêutico, método denominado fonoforese, oferece muitas vantagens quando comparado as outras vias de administração de drogas. O objetivo deste estudo foi verificar a influência do ultra-som na absorção de diclofenaco dietilamônio (Cataflam Emulgel®, Novartis) após fonoforese em voluntários sadios. Doze voluntários sadios foram submetidos à aplicação tópica de Cataflam Emulgel® em uma área de 150cm2 na região do dorso. No grupo controle os voluntários receberam a aplicação tópica sem emissão de ultra-som (sham) e o grupo teste recebeu a aplicação tópica através da fonoforese. A concentração plasmática de diclofenaco foi mensurada pelo HPLC (high perfomance liquid chromatography) durante um período de 8h após as aplicações. Neste trabalho demonstramos que a aplicação transdérmica de diclofenaco dietilamônio pela fonoforese, em uma única aplicação, não induz aumento da concentração plasmática quando comparada a aplicação sem ultra-som / Abstract: Transdermal drug delivery with therapeutic ultrasound, method called phonophoresis, offers many advantages when compared to other drug delivery methods. The aim of this study was to verify the influence of ultrasound on the transdermal delivery of diclofenac diethylammonium (Cataflam Emulgel®, Novartis) post phonophoresis in healthy volunteers. Twelve healthy human volunteers were submitted to topical application of Cataflam Emulgel® on 150cm2 area on the dorsum. In the Control Group, the volunteers received topical application with the ultrasound switched off and the Test Group received topical application by phonophoresis. The diclofenac plasma concentration was measured by high perfomance liquid chromatography (HPLC) during a period of 8h after dosing. We provided evidence that transdermal application of diclofenac diethylammonium by phonophoresis, in a single dose, has not induced plasmatic concentration increase when compared to topical application alone / Mestrado / Mestre em Farmacologia

M.Tech. / Purpose: A study to determine the efficacy of Traumeel® gel using phonophoresis in the treatment of a latent trapezius myofascial trigger point, with regards to pain perception, cervical spine range of motion and pressure pain tolerance.Methods: A single-blinded, controlled study design was utilised. Thirty participants who all presented with a latent trapezius myofascial trigger point were randomly divided into two groups of fifteen. Each individual was subjectively and objectively assessed from baseline values prior to receiving treatment. Group A received ultrasound utilising ultrasound gel over the trapezius myofascial trigger point, as the control group. Group B received phonophoresis with Traumeel® gel over the trapezius myofascial trigger point. All participants received two treatments per week, with a total of seven consultations, over the three week study period. The subjective data was obtained utilising a Numerical Pain Rating Scale (NPRS) whilst a hand held Algometer tested pressure pain tolerance and a Cervical Range of Motion Measuring Instrument (CROM) measured cervical spine range of motion. These were utilised to form the objective data. The Data was analysed using non-parametric tests. The two independent treatment groups were assessed for capability at treatments one, four and seven using the Mann-Whitney U-test (non-parametric version of the independent sample T-test). Changes over the three week period were observed and analyzed using the Repeated Measures test or the Friedman Test (Devey, 2010). Results: In this study ultrasound utilising ultrasound gel had a statistically significant impact on the trapezius myofascial trigger point. Statistical analysis of the Traumeel® gel suggests that there was no statistical significance with regards to any of the treatment parameters or variables measured. Subjectively ultrasound gel proved to be statistically and clinically significant in decreasing the participant’s pain perception. There was no statistical improvement but there was a clinical improvement in the Traumeel® gel group.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The aim of the first study was to evaluate the plasma concentration of diclofenac sodium (DS) in dogs submitted to diclofenac phonophoresis and to evaluate if phonophoresis induces greater absorption of this drug. .Five dogs were used in eight different groups at different times: Group 1, application of ultrasound for six minutes, removal of the ultrasound gel and topical application of two grams of DS gel for six minutes; Group 2, topical application of two grams of DS gel for six minutes; Group 3 topical application of two grams of DS gel and then covering it with common gel to apply ultrasound for six minutes; Group 4, similar to Group 1, but the ultrasound device was switched off; Group 5, similar to Group 3, but the ultrasound device was switched off, Group 6, the application of ultrasound was performed using only two grams of DS; Group 7, similar to Group 6, but the ultrasound device was switched off and Group 8, oral administration of 40mg of DS. The application area was 20cm². It was used a frequency of 1MHz, continuous ultrasound and intensity of 0,4W cm-2. Blood collections were performed before treatment (T0), 1h (T1) and 4h (T2) after ultrasound application for all groups. DS concentrations in plasma were measured by high performance liquid choramatohraphy (HPLC). There was significant increase of DS plasma concentration only at T1 in the Group 8. It was no possible to detect any concentration of DS in the plasma of dogs after topical application of DS, even after DS phonophoresis. The facilitation of transdermal penetration by ultrasound has not been verified under the protocol specified in this research. The aim of the second study was to use medium frequency Neuromuscular Electrical Stimulation (NMES) in femoral quadriceps of dogs with induced muscular atrophy, evaluate the occurrence of gain in mass in these muscles and to compare NMES in different periods of treatment. Eight dogs, weighing between 15 and 25kg, were randomly placed in two groups: GI (NMES for 30min), GII, (NMES for 60min). For the induction of the muscular atrophy, the right femoral-tibial-patellar joint was immobilized for 30 days by the percutaneous transfixation type II method. NMES was carried out in the dogs of groups, three times a week, with an interval of 48h between each session, during 60 days. The parameters measured were: thigh perimetry, knee goniometry, creatine kinase (CK) enzyme activity and morphometry of the muscular fibers in transversal cuts of the vastus lateralis muscle, collected through a muscular biopsy. There was no significant difference regarding the values of thigh perimetry and CK enzyme activity. The goniometry presented a significant increase (P<0.05) in the groups GI and GII at 30 days from the surgical procedure for immobilization when compared with time zero. As for the morphometry of the fibers of the vastus lateralis, a significant increase (P<0.05) was observed in the transversal area of the treated groups GI e GII at 90 days from the surgical procedure for immobilization when compared with time zero. Thus, it can be concluded that NMES of medium frequency brings about hypertrophy of the vastus lateralis muscle in dogs after induced muscular atrophy. NMES for 60min (GII) presents a greater muscular gain related to the GI / Esta tese foi dividida em duas pesquisas distintas utilizando fonoforese e eletroterapia, na primeira pesquisa o objetivo foi constatar a concentração plasmática de diclofenaco sódico emulgel em cães com ou sem o uso de fonoforese e se a fonoforese induz maior absorção deste fármaco. Para a realização da fonoforese foram utilizados cinco cães em oito grupos distintos, denominados: Grupo1: aplicação de ultrassom (US) por 6 minutos, remoção do gel com papel toalha e após aplicação de dois gramas de diclofenaco sódico (DS) emulgel permanecendo por 6 minutos; Grupo2: aplicação de dois gramas de DS emulgel tópico permanecendo por 6 minutos; Grupo3 aplicação de dois gramas de DS emulgel, posteriormente recobrindo-o com gel comum para acoplamento e realizado US pelo tempo de 6 minutos; Grupo4: repetiu-se o protocolo do Grupo1 com o ultrassom desligado; Grupo5: repetiu-se o protocolo do Grupo3 com o ultrassom desligado; Grupo6: aplicação de dois gramas de DS emulgel tópico e realizado diretamente sobre este o US pelo tempo de 6 minutos; Grupo7: repetiu-se o protocolo do Grupo6 com o ultrassom desligado; Grupo8: administração oral de um comprimido de DS (40mg) por animal. A área de aplicação foi de 20cm². A frequência do ultrassom foi de 1MHz, modo contínuo, com intensidade de 0,4W cm-2. Realizou-se a coleta de amostra sanguínea antes de executar os protocolos (Tempo zero), após uma hora (Tempo 1) e após 4 horas da aplicação (Tempo 2) em todos os grupos e posterior análise das mesmas por Cromatografia Líquida de Alta Eficiência (CLAE). Houve diferença (P<0,05) apenas no Tempo 1 do Grupo8. Não foi possível verificar concentração plasmática de diclofenaco sódico com aplicação tópica, em cães submetidos ou não à fonoforese, apenas quantificou-se o diclofenaco sódico pela administração via oral. A facilitação da penetração transdérmica pelo ultrassom não foi verificada sob o protocolo especificado nesta pesquisa. Na segunda pesquisa o objetivo foi avaliar a ocorrência de ganho de massa muscular utilizando a estimulação elétrica neuromuscular de média freqüência (corrente de Kotz 2500Hz) no músculo quadríceps femoral de cães com atrofia muscular induzida e comparar a EENM sob diferentes tempos de tratamento. Para a realização da eletroterapia foram utilizados oito cães, pesando entre 15 e 25kg e distribuídos aleatoriamente em dois grupos denominados de GI (30minutos) e GII (60minutos). Para a indução da atrofia muscular, a articulação fêmoro-tíbio-patelar direita foi imobilizada por 30 dias por transfixação percutânea tipo II. Foi realizada a EENM nos cães dos grupos GI e GII três vezes por semana, com intervalo mínimo de 48 horas entre cada sessão, pelo período de 60 dias. Foram mensuradas a perimetria das coxas, goniometria dos joelhos, atividade da enzima creatina-quinase (CK) e morfometria das fibras musculares do vasto lateral em cortes transversais colhido mediante a biópsia muscular. Não houve diferença quanto aos valores da perimetria da coxa e atividade da enzima CK. A goniometria revelou significância (P<0,05) nos grupos GI e GII entre os tempos zero e 30. Os grupos GI e GII tiveram aumento significativo (P<0,05) da área de secção quando comparados com o dia zero e noventa. Pode-se concluir que a EENM de média freqüência ocasiona hipertrofia do músculo vasto lateral em cães após atrofia muscular induzida. A EENM com duração de 60minutos (GII) promove um maior ganho de massa muscular em relação ao GI.

O objetivo do presente trabalho foi de analisar, experimentalmente, a variação do índice de transmissão e o coeficiente de atenuação ultra-sônica no meio diclofenaco gel, bem como, a penetração do fármaco em amostras de gelatina semelhante a pele humana através da fonoforese. A variação destes parâmetros foi investigada em 120 amostras de agar-agar, (modo contínuo, 1 MHz de freqüência, nas intensidades de 1,0 e 1,5 W/\'CM POT.2\'), por 5 minutos. Os corpos de prova forma divididos em grupos referentes as intensidades de ultra-som utilizadas, e cada um destes grupos, foi subdividido em sub-grupos correspondendo aos diferentes meios utilizados para irradiação. A investigação da transmissão ultra-sônica foi medida a partir de um dosímetro de precisão ULTRASONIC POWER METER, modelo UPM-DT 10. O cálculo do coeficiente de atenuação foi realizado a partir dos dados de leitura da transmissão ultra-sônica. A penetração ou não da droga foi estudada por análise macroscópica e microscópica. Segundo os resultados obtidos não houve variação significativa nos índices de transmissão e nos coeficientes de atenuação do diclofenaco gel em comparação ao gel neutro. A penetração do medicamento foi de 3 mm para as amostras irradiadas com a intensidade de 1,0 W/\'CM POT.2\' e de 5 mm para as amostras irradiadas com 1,5 W/\'CM POT.2\', não houve evidência de penetração do fármaco no grupo controle. Os resultados obtidos neste estudo sugerem que a fonoforese do diclofenaco gel é efetiva nas intensidades 1,0 e 1,5 W/\'CM POT.2\'. / The objective of the present work was of analyzing, experimentally, the variation of the transmission index and the coefficient of ultrasonic reduction in the half diclofenaco gel, as well as, the penetration of the drug in samples of similar jelly the human skin through the phonophoresis. The variation of these parameters was investigated in 120 agar-agar samples, (continuous way, 1 MHz of frequency, in the intensities of 1,0 and 1,5 W/\'CM POT.2\'), for 5 minutes. The proof bodies form divided in referring groups the ultrasound intensities used, and each one of these groups, it was subdivided in sub-groups corresponding to the different means used for irradiation. The investigation of the ultrasonic transmission was measured starting from a ULTRASONIC POWER METER, model UPM-DT 10. The calculate it of the reduction coefficient was accomplished starting from the data of reading of the ultrasonic transmission. The penetration or not of the drug it was studied for it analyzes macroscopic and microscopic. According to the obtained results there was not significant variation in the transmission indexes and in the coefficients of reduction of the diclofenaco gel in comparison with the neutral gel. The penetration of the medicine went of 3 mm to the samples irradiated with the intensity of 1,0 W/\'CM POT.2\' and of 5 mm for the samples irradiated with 1,5 W/\'CM POT.2\', there was not evidences of penetration of the drug in the group control. The results obtained in this study suggest that the phonophoresis of the diclofenaco gel is effective in the intensities 1,0 and 1,5 W/\'CM POT.2\'.

A proposta deste estudo foi comparar a eficácia de tratamento da aplicação tópica de hidrocortisona, do ultra-som terapêutico e da fonoforese no processo de reparo do tendão de Aquiles (tendo calcaneus) de ratos, após tenotomia. O grupo controle foi definido como tenotomizados com simulação da aplicação sônica e tendões não tenotomizados. Os dois grupos tratados com ultra-som terapêutico foram no modo pulsado. A irradiação do ultra-som terapêutico foi realizada na freqüência de 1 MHz e uma intensidade de 0.5 Watts por centímetro ao quadrado (SATA), por cinco minutos cada sessão. No 13° dia de pós-operatório, os tendões foram removidos e analisados por meio da microscopia de luz polarizada, com o propósito de investigar e medir a organização das fibras de colágeno, por meio da birrefringência. Os resultados demonstraram que o grupo tratado com a aplicação tópica de hidrocortisona apresentou valores estatísticos similares ao grupo que recebeu simulação sônica, indicando que não houve penetração da hidrocortisona e que as moléculas de colágeno responderam a estimulação ultra-sônica. Tal fato acontece provavelmente originado pelo efeito piezoelétrico que o ultra-som causa no tecido. O tratamento com fonoforese demonstrou ser o método mais eficiente, devido a maior birrefringência, revelando melhor organização e agregação das fibras de colágeno. Esses achados permitem concluir que o ultra-som terapêutico estimula a aceleração do processo de reparo tecidual e induz a penetração transcutânea da hidrocortisona a 10% numa concentração terapêutica / The purpose of this study was to compare the treatment efficacy of topic hydrocortisone appliance, therapeutic ultrasound and phonophoresis on the rats’ Achilles tendon (tendo calcaneus) repair process after tenotomy. The control group was designed in tenotomized with sham sonic application and non-tenotomized tendons. The two treated groups with therapeutic ultrasound was made in a pulsed mode. The irradiation of therapeutic ultrasound was performed at a frequency of 1 MHz and an intensity of 0.5 Watts for square centimeter (SATA), for five minutes each session. On the 13 th postoperative day, the tendons were removed and analyzed using the polarized light microscopy, with the purpose to detect and measure the organization of collagen fibers through birefringence. The results showed that the treated group with the hydrocortisone topic appliance showed similar statistician values of group that received sham sonic treatment, indicating that not have delivery transdermal and that the molecule of collagen respond to the ultrasonic stimulation. This fact occurs probably by piezoelectric effect originated by ultrasound on the tissue. The treatment with phonophoresis demonstrated being the method more efficient, due the high birefringence, revealing the best organization and aggregation of collagen fibers. These findings allow conclude that the therapeutic ultrasound stimulate the acceleration of tissue repair process and induce the transdermal delivery of hydrocortisone 10% in a therapeutic concentration

A proposta deste estudo foi verificar o efeito da sonoforese com Arnica montana sobre a fase inflamatória aguda de uma lesão muscular. Para isso, 40 ratos Wistar machos (300±50 g), lesados cirurgicamente, foram divididos em 4 grupos: grupo controle (C), 10 ratos lesados, não submetidos a tratamento algum; grupo ultra-som (US), 10 ratos lesados, tratados com US; grupo ultrasom+ arnica (US+A), 10 ratos lesados, tratados com sonoforese com gel de arnica; e grupo arnica (A), 10 ratos lesados, tratados com massagem de gel de arnica. O ultra-som com freqüência de 1 MHz e 0,5 W/cm2 de intensidade foi aplicado 24 h após a lesão uma vez ao dia durante 3 minutos, por 3 dias; o grupo US+A recebeu aplicação de ultra-som idêntica, mas com gel de arnica; o grupo A recebeu massagem de gel de arnica nos mesmos tempo e período. O terço médio do músculo tibial anterior lesado foi removido, montando-se séries de lâminas para análise quantitativa (contagem de células mononucleares e polimorfonucleares) e qualitativa (morfologia das fibras musculares). Os resultados foram tratados estatisticamente, com nível de significância p<0,05. Foi encontrada maior densidade de células mononucleares nos grupos US, US+A e A, sem diferença entre estes, mas com diferença significativa (p<0,0001) destes para o grupo controle, onde a densidade de células polimorfonucleares também foi significativamente diferente (p=0,0134) dos demais. Ainda quanto a essa densidade, não houve diferença entre os grupos US e US+A, mas houve entre o grupo A (p=0,0134) e os demais. A análise qualitativa revelou estágio mais avançado de regeneração nos tecidos dos grupos US e US+A igualmente. A similaridade de resultados entre os grupos US e US+A leva a concluir que a sonoforese com arnica não foi mais eficaz que o ultra-som na recuperação da lesão muscular. Sugere-se que o US pode ter anulado ou minimizado o efeito regenerativo da Arnica montana por sonoforese na fase inflamatória aguda da lesão muscular. / This study aimed at verifying the effects of ultrasound associated to Arnica montana (phonophoresis) onto the acute phase of an inflammatory muscle lesion. Forty Wistar male rats (300±50 g), of which the Tibialis Anterior muscle was surgically lesioned, were divided into 4 groups (n=10 each): control group received no treatment; the ultrasound group (US) was treated with 1-MHz, 0.5W/cm2-intensity US during 3 minutes, once a day, for 3 days; the US+A group was treated with arnica phonophoresis (the same US parameters plus arnica gel); and the arnica group (A) was submitted to massage with arnica gel, also during 3 minutes, once a day, for 3 days. Treatment started 24 h after the surgical lesion. On the 4th day after lesion animals were sacrificed and sections of the lesioned, inflamed muscle were removed for quantitative (mononuclear and polymorphonuclear cell count) and qualitative analysis (muscle fiber morphology). Collected data from the 4 groups were statistically analysed and the significance level set at p<0.05. Results show higher mononuclear cell density in all three treated groups with no significant difference between them, but values were significantly different (p<.0001) when compared to control group\'s. As to polymorphonuclear cell density, significant differences were found between control group (p=0.0134) and the other three groups; the arnica group presented lesser density of polymorphonuclear cells when compared (p=0.0134) to the other groups, and no significant differences were found between US and US+A groups. Qualitative analysis showed a more advanced regeneration stage in tissues from both US and US+A groups. The similarity of results between US and US+A groups points to ineffectiveness of Arnica montana phonophoresis, US having seemingly checked or minimized its anti-inflammatory effect.

O objetivo do presente trabalho foi de analisar, experimentalmente, a variação do índice de transmissão e o coeficiente de atenuação ultra-sônica no meio diclofenaco gel, bem como, a penetração do fármaco em amostras de gelatina semelhante a pele humana através da fonoforese. A variação destes parâmetros foi investigada em 120 amostras de agar-agar, (modo contínuo, 1 MHz de freqüência, nas intensidades de 1,0 e 1,5 W/\'CM POT.2\'), por 5 minutos. Os corpos de prova forma divididos em grupos referentes as intensidades de ultra-som utilizadas, e cada um destes grupos, foi subdividido em sub-grupos correspondendo aos diferentes meios utilizados para irradiação. A investigação da transmissão ultra-sônica foi medida a partir de um dosímetro de precisão ULTRASONIC POWER METER, modelo UPM-DT 10. O cálculo do coeficiente de atenuação foi realizado a partir dos dados de leitura da transmissão ultra-sônica. A penetração ou não da droga foi estudada por análise macroscópica e microscópica. Segundo os resultados obtidos não houve variação significativa nos índices de transmissão e nos coeficientes de atenuação do diclofenaco gel em comparação ao gel neutro. A penetração do medicamento foi de 3 mm para as amostras irradiadas com a intensidade de 1,0 W/\'CM POT.2\' e de 5 mm para as amostras irradiadas com 1,5 W/\'CM POT.2\', não houve evidência de penetração do fármaco no grupo controle. Os resultados obtidos neste estudo sugerem que a fonoforese do diclofenaco gel é efetiva nas intensidades 1,0 e 1,5 W/\'CM POT.2\'. / The objective of the present work was of analyzing, experimentally, the variation of the transmission index and the coefficient of ultrasonic reduction in the half diclofenaco gel, as well as, the penetration of the drug in samples of similar jelly the human skin through the phonophoresis. The variation of these parameters was investigated in 120 agar-agar samples, (continuous way, 1 MHz of frequency, in the intensities of 1,0 and 1,5 W/\'CM POT.2\'), for 5 minutes. The proof bodies form divided in referring groups the ultrasound intensities used, and each one of these groups, it was subdivided in sub-groups corresponding to the different means used for irradiation. The investigation of the ultrasonic transmission was measured starting from a ULTRASONIC POWER METER, model UPM-DT 10. The calculate it of the reduction coefficient was accomplished starting from the data of reading of the ultrasonic transmission. The penetration or not of the drug it was studied for it analyzes macroscopic and microscopic. According to the obtained results there was not significant variation in the transmission indexes and in the coefficients of reduction of the diclofenaco gel in comparison with the neutral gel. The penetration of the medicine went of 3 mm to the samples irradiated with the intensity of 1,0 W/\'CM POT.2\' and of 5 mm for the samples irradiated with 1,5 W/\'CM POT.2\', there was not evidences of penetration of the drug in the group control. The results obtained in this study suggest that the phonophoresis of the diclofenaco gel is effective in the intensities 1,0 and 1,5 W/\'CM POT.2\'.