👤 By the CinnaEMS Content Team🕐 Updated 2026-09-28🏷️ Airway, Respiration & Ventilation🔖 Free to read, print, and share
Also known as: bronchodilator · beta-2 agonist · anticholinergic · corticosteroid · nebulizer · magnesium sulfate · racemic epinephrine · status asthmaticus
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Use this quick-reference guide to recognise, treat and hand over Respiratory Pharmacology on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Spasm
Beta-2 agonist
+ anticholinergic
Magnesium if refractory
📌 Inflammation
Corticosteroid
Early — works in hours
📌 Swelling
Nebulized epinephrine
Croup · angioedema
🚩 Danger
Silent chest
Rising ETCO2
Don't delay CPAP
📚 Respiratory Pharmacology — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
Respiratory drugs work on three targets: smooth muscle spasm, airway inflammation, and airway swelling. Knowing which class hits which target explains why a nebulized bronchodilator fixes wheezing, why steroids are given early but work late, and why stridor needs a different drug.
Anticholinergics add bronchodilation by blocking vagal tone; best paired with a beta-2 agonist.
Corticosteroids reduce inflammation but take hours — give early so the effect arrives in time.
Magnesium relaxes smooth muscle and is reserved for severe or refractory bronchospasm.
Nebulized epinephrine shrinks swollen upper-airway tissue in croup and angioedema.
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Treatment priorities
What to do, in order
In severe asthma with poor air movement, consider intramuscular epinephrine alongside nebulized therapy.
Reassess breath sounds, work of breathing and end-tidal CO2 after every treatment.
Do not delay CPAP or ventilatory support while waiting for drugs to work.
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Red flags — report now
Escalate immediately
Silent chest with fatigue
Rising end-tidal CO2 in an asthmatic
Stridor at rest in a child
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Patient teaching
What patients must know
Wheezing that fades as air movement falls is worsening, not improving — a quiet chest in severe asthma means almost no air is moving.
❓ Respiratory Pharmacology: NREMT FAQs
What are the priority actions for Respiratory Pharmacology in the field?
In severe asthma with poor air movement, consider intramuscular epinephrine alongside nebulized therapy. Reassess breath sounds, work of breathing and end-tidal CO2 after every treatment. Do not delay CPAP or ventilatory support while waiting for drugs to work.
What findings in Respiratory Pharmacology change your plan or your transport decision?
Silent chest with fatigue. Rising end-tidal CO2 in an asthmatic. Stridor at rest in a child.
What do I need to know about Respiratory Pharmacology for the NREMT?
Beta-2 agonists relax bronchial smooth muscle; expect tachycardia, tremor and lower potassium. Anticholinergics add bronchodilation by blocking vagal tone; best paired with a beta-2 agonist. Corticosteroids reduce inflammation but take hours — give early so the effect arrives in time. Magnesium relaxes smooth muscle and is reserved for severe or refractory bronchospasm.
What should the crew communicate or document for Respiratory Pharmacology?
Wheezing that fades as air movement falls is worsening, not improving — a quiet chest in severe asthma means almost no air is moving.