Microsoft word - updated current uses of flexineb feb 2013

Current Uses of Flexineb® in Ireland
Nortev have gained a considerable amount of feedback from existing customers and their veterinarians on different drugs and the regimes used with these drugs Corticosteroids
The 3 most common Corticosteroids that have been used with the Flexineb® are
FlixotideTM (Fluticasone Propionate), Dexameth (Dexamethasone) and Pulmicort®
(Budesonide). Both FlixotideTM and Pulmicort® come in nebules specifically for
nebuliser use and Dexameth comes in an Injectable solution for IV treatment. All 3
should be diluted 50/50 with Saline (0.9% Solution) to help increase the life of the
replaceable medication cup. Typical uses of these Corticosteroids are to help treat a
horse suffering from “Bleeding” EIPH, after “Wind” operations and also along with
Antibiotics to help treat Infections. Studies have shown that by nebulising
Corticosteroids you can reach a far greater concentration of the drug directly into the
lungs compared to MDIs, IV and IM. In addition you use far less of the Injectable
Corticosteroids solution (typically 25%) when nebulising, in which only a small amount
crosses the blood barrier, so there is a far less chance of systemic side effects
associated with injected Corticosteroids
Antibiotics
The 3 most common Antibiotics that have been used with the Flexineb® are Cobactan®
(Cefquinome), Excenel® (Ceftiofur) and Gentaject (Gentamicin). All of these come in
Injectable solutions. Cobactan® and Excenel® are nebulised neat; Gentaject is diluted
50/50 with Saline (0.9% Solution) to increase the rate of nebulisation and to help
increase the life of the replaceable medication cup. All Antibiotics that have been used
with the Flexineb® are for treating respiratory Infections. Studies have shown, by
nebulising Antibiotics that you can get a far greater concentration (up to 12 times) of
Antibiotic into an equines respiratory system compared to IV treatment, with the added
benefit of using much less of the drug, typically 25% of what you would give by injection.
Consequently this also lowers the risk of systemic secondary effects such as diarrhoea
associated with large doses of Antibiotic by injection.
Bronchodilators
The 3 most common Bronchodilators that have been used with the Flexineb® are
Atrovent ® (Ipratropium), VentolinTM (Salbutamol/Albuterol) and Ventipulmin®
(Clenbuterol). Both Atrovent® and VentolinTM come in nebules specifically for nebuliser
use and Ventipulmin® comes in an Injectable solution. All 3 should be diluted 50/50 with
Saline (0.9% Solution) to help increase the life of the replaceable medication cup. These
substances act by relaxing the smooth cell muscle surface of the lungs during
bronchoconstriction. They also have a role in the control of mucus transport in the
airways of equines suffering from obstructive lung disease. Bronchodilators can also be
used along with Corticosteroids and Antibiotics to help treat respiratory infections.
Studies show that by nebulising these drugs you get a far greater concentration of the
drug directly into the lungs compared to MDIs, IV and IM. By nebulising Ventipulmin®
you lower the risk of sweating and muscle tremors associated with IV and IM treatment
significantly.
Mucolytics
The 2 most common Mucolytics that have been used with the Flexineb® are Parvolex®
(Acetylcysteine) and Saline (0.9% Solution). The Parvolex® comes in a solution for
infusion and should be diluted 50/50 with Saline (0.9% Solution) to help speed up the
process of nebulisation and to help increase the life of the replaceable medication cup.
These two Mucolytics help brake up the mucus in the lungs by reducing the viscosity
(Thickness) of the mucus in the lungs making the mucus easier to remove.
Natural Therapy
Flexineb® can also be used to help maintain and keep horses lungs in top
condition by the use of natural therapy solutions. Drugs used to treat respiratory
conditions in horses can be quite expensive, especially as a lot of these
conditions will remain for the remainder of the horse’s life. Some natural therapy
solutions, regularly used, which are a lot cheaper than the current drugs used,
have been tested and have shown to prevent problems and help maintain the
respiratory system. “Prevention can sometimes be better than the cure”.
Nebulised natural therapy solutions can improve the natural physiological state of
a horse’s respiratory system and its general defence system of the lungs. Below
are some of the natural therapy solutions that are currently being used with
Flexineb®.
Balsamic Air contains essential oils and natural plant active principles selected
for their antibacterial, antiviral, soothing, fluidizing and antispasmodic properties.
It participates in the maintenance of healthy airways in horses throughout the
year.
Nebulin® is a natural therapy solution used to treat COPD and RAO in horses; it
also helps to regulate immune functions and the mechanism for the elimination of
bronchial secretion.
EquiSilver™ is a patented chelated Silver Solution which destroys the majority of
microorganisms including many of the antibiotic resistant super pathogens.
EquiSilver’s Silver Solution is a safe, non-toxic; it is also known to help horses
suffering from EIPH (Bleeding).
Saline (0.9% Solution) with a few drops of eucalyptus oil is a very popular
choice of natural therapy to help open up the lungs and brake down mucus.
Equine Conditions and the different solutions that can be used with
Flexineb to treat them
Condition
Non-Doping Natural
Therapy Solution
COPD/RAO
Brochodilatators: (Atrovent ® ,VentolinTM Ventipulmin® ) Corticosteroids: (FlixotideTM , Dexameth Pulmicort® ) EIPH (Bleeding)
Corticosteroids: (FlixotideTM , Dexameth Respiratory
Antibiotics: Cobactan®, Excenel® ,Gentaject Balsamic Air and Infections
,EquiSilver™,
Mucus Removal Parvolex®
Everyday
Respiratory
Air,EquiSilver™,
Maintenance

Source: http://www.ultimatequip.fi/documents/Flexineb.pdf