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Equine Haler – Inhalation device
The Equine Haler is an inhalation device, which has been developed specifically for accurate administration of pharmaceuticals to horses with inflammatory respiratory diseases includingchronic obstructive pulmonary disease (recurrent airway obstruction—RAO). The EquineHaler is a convenient method of administering all available types of metered dose inhalers(MDI) to horses. The MDI delivers the medicine at a suitable particle size (< 5 microns) fordirect distribution to the small airways. Equine Haler has been developed in Denmark andtested at the Centre for Equine Studies, Animal Health Trust, Newmarket, UK.
One treatment takes 1–2 minutes.
Recommended dosages for
aerosol use in horses
Flutide/Flixotide® (Fluticasone propionate) inhalation aerosol 250 µg/actuation. CFC Free: 120 actuations
Recurrent airway obstruction (RAO): 7–8 actuations once or twice daily for a period of 2–3 weeks
When corticosteroids are administered it may be worth considering ending treatment over a few days with
an incrementally decreasing dose.
Long-acting beta2-agonist
Serevent® (Salmeterol) inhalation aerosol 25 µg/actuation. 120 actuations
Recurrent airway obstruction (RAO): 8 actuations once or twice daily for a period of 2–3 weeks
Short-acting beta2-agonist
Ventolin® (Salbutamol) inhalation aerosol 100 µg/actuation. Free: 200 actuations
Recurrent airway obstruction (RAO): 5–10 actuations 2–3 times daily for a period of 2–3 weeks
Mast cell stabiliser
Lomudal/Intal® (Sodium Cromoglicate) inhalation aerosol 1 µg/actuation, 10 actuations once or twice daily
If necessary the treatment can be extended to one month or longer.
For further information see alternative product recommendations and dosage-recommendations in EQUINEVETERINARY EDUCATION (1999) 11 (3) 124–130, but please note that: the clenbuterol dose, which is said to bemilligrams, should be micrograms, and the beclomethasone dose 1320 mg/kg is in some cases better at lower doses. Doping rules
Please check doping restrictions and minimum withdrawal period.
Jorgensen Labs, Inc.
1450 North Van Buren Ave.
Loveland, Colorado 80538 1-800-525-5614 • Fax: 970-663-5042 email: [email protected] EVALUATION OF A NEW SPACER DEVICE FOR DELIVERY OF DRUGS INTO THE EQUINE RESPIRATORY TRACT Funch-Nielsen, H., Roberts, C.A.1, Weekes, J.S.1, Deaton, C.M.1 and Marlin, D.J.1 Equine Healthcare APS, Denmark and 1Centre for Equine Studies, Animal Health Trust, Newmarket, UK.
LABELLING continued Pulmonary inflammatory disorders occur commonly in the horse PSD was determined with the MDI, actuator and spacer combined In Vitro Studies Systemic administration of corticosteroids may be associated withadverse sequelae Particle size distribution (PSD) was determined on The mean PSD of FP and radiolabel for 99mTc Labelled Fp were • Unlabelled FP found to be similar (Figure 2) indicating that the deposition of the Delivery of drugs directly into the affected airways may improve local • 99mTc Labelled FP - low activity radiolabel within the lungs was likely to reflect that of FP.
drug concentrations as well as reducing systemic uptake • 99mTc Labelled FP - high activity Inhaled corticosteroids are widely used in the treatment of human The activity and PSD of each MDI was determined prior to use inflammatory lung conditions, including asthma and chronic obstructive pulmonary disease Prior to each use, the count rate per second (cps) per actuation of the MDI was determined at a recorded time for subsequent decay Equine recurrent airway obstruction (RAO) is characterised by a correction to allow quantitative analysis of images marked inflammatory response in the presence of aeroallergens, Nebulisation of liquid corticosteroid preparations has been used, but a number of spacer devices have been developed to allow Figure 4. Distribution of 99mTc-labelled fluticasone propionate administration to horses of metered dose inhalers (MDI) designed for after administration of 3.5ug/kg bodyweight using the Equine Haler.
Particle size cutoff (um)
Figure 2. Mean PSD for FP and 99mTechnetium as a % of totalmetered dose from 99mTc labelled FP.
To determine the efficiency of the Equine HalerTM for deliveringfluticasone propionate from a metered dose inhaler into the equine To determine the pulmonary distribution of inhaled fluticasone propionate administered with the Equine HalerTM Figure 5. a) Distribution of 99mTc-labelled fluticasone propionate after administration of 3.5ug/kg bodyweight using theEquine Haler within the lung of one horse and approximate lung Figure 1. Equine HalerTM spacer for delivery of pharmaceuticals from MATERIALS & METHODS
border as determined by subsequent 99mTc-MAA. b) Example of metered dose inhalers to horses lung image obtained during inhalation of 81mkrypton gas in a horse with no history of respiratory disease.
Particle size cutoff (um)
6 healthy adult horses and 2 healthy adult ponies were studied. Allhorses were considered healthy based on TW & BAL cytology & Figure 3. Particle size distribution (ug) of FP delivered from a Images were obtained using a large field of view gamma camera bacteriology, clinical examination, thoracic radiographs and V/Q Flixotide Evohaler with and without a Volumatic spacer (data from fitted with a low energy general purpose collimator Cripps et al 2000) and PSD of FP from the Flixotide Evohalerused in conjunction with the Equine HalerTM.
Acquisition parameters: dynamic acquisition; 128 x 128 matrix; 60 x 2 The Equine Haler appears to achieve an acceptable and even Horses were administered 3.5 ug/kg of fluticasone propionate deposition of labelled FP within the equine lung.
labelled with 99mTechnetium from a new design of spacer The mass of respirable particles (sum of deposition on stages 3 to 5 or 1.1 - 4.7 um) of FP delivered from the spacer was 96 ± 28 ug Low delivery may be related to the angle at which the MDI is (mean ± sd; range 72-127 ug). It was noted that the variation actuated into the spacer.
Horses were sedated with romifidine 50 µg/kg bodyweight for appeared to be related to the angle of the MDI when actuated. It was Images were analysed using HERMES software (Nuclear observed that when the MDI actuator port was not facing directly at The Equine Haler was tolerated by all animals after a short the second inspiratory valve that the delivery was low. When care familiarisation prior to the study.
Sequential overlapping scintigraphic images were obtained of the was taken to ensure the MDI actuator port was facing directly at the right caudal lung, right cranial lung, cranial thorax, trachea, and head All images were motion corrected. Inhalation and MAA perfusion second inspiratory valve the delivery was always higher.
images were registered Estimates of the lung border were obtained with 99mTechnetium-MAA In Vivo Studies Markers containing 99mTechnetium were placed within each image to Cripps, A., Riebe, M., Schulze, M. and Woodhouse, R. (2000) allow referencing between images As expected, there was relatively high deposition of labelled FP Respiratory Medicine, 94 (Supplement B), S3-S9.
around the nostril and upper airways as far as the larynx (Figure 4).
The labelled FP appeared to be distributed throughout the lungaccording to the distribution of Krypton gas used for ventilation A single batch of Flixotide Evohalers (250ug per actuation) were studies. The labelled FP also appeared to reach the periphery of the lung as judged from comparison with images of perfusion obtainedwith Tc-MAA (Figure 5).
Radiolabelling was performed as described by Newman et al (1999)using a seven stage Anderson Cascade Impactor Mk and a flow rate Mean lung deposition for all animals was 8.2 ± 5.2 % of the dose administered (range 2.3 -18.6%).
PSD determined with MDI, actuator and spacer combined

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