NREMT Paramedic Cognitive ExamAirway, Respiration & VentilationEasy
A 30-year-old male with a history of asthma is experiencing a severe exacerbation. His peak expiratory flow (PEF) is 40% of his personal best. He is alert but anxious, with prolonged expiratory phase and diffuse wheezing. Which of the following medications is indicated to address the bronchoconstriction?
- AMethylprednisolone (Solu-Medrol)
- BIpratropium bromide (Atrovent)
- CEpinephrine (Adrenalin)
- DAlbuterol (Proventil)
Show answer & explanationAnswer & explanation
Correct answer: D. Albuterol (Proventil)
Albuterol is a short-acting beta-2 adrenergic agonist, which is the primary bronchodilator used to rapidly reverse bronchoconstriction in asthma exacerbations. It works by relaxing the smooth muscles of the airways.
Why the other options are wrong
- A. Methylprednisolone is a corticosteroid that reduces inflammation, but its onset of action is slow (hours) and it does not directly relieve acute bronchoconstriction.
- B. Ipratropium bromide is an anticholinergic bronchodilator, often used in conjunction with albuterol, but albuterol is the first-line for acute bronchoconstriction.
- C. Epinephrine is used for anaphylaxis or severe, life-threatening asthma (status asthmaticus) unresponsive to other treatments, but albuterol is the initial go-to for bronchoconstriction.
Albuterol for Asthma
Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that causes bronchodilation by relaxing the smooth muscles in the airways. It is the first-line medication for rapid relief of acute bronchoconstriction in asthma exacerbations.
- Rapid onset of action (5-15 minutes).
- Administered via nebulizer or metered-dose inhaler.
- Common side effects include tachycardia and tremors.
Memory trick: Albuterol Always Addresses Asthma