Course Description
RET3354 is the pharmacology course for respiratory care. The Statewide Course Numbering System titles it Medical Therapeutic Agents and describes it precisely: "principles of medical physiology, biological and synthetic substances, mechanisms of action, and therapeutic evaluation applied to respiratory medicine. Mathematics of drugs and solutions and federal and state regulations are also emphasized." There is no statewide prerequisite.
Three Florida public institutions carry it, all at 3 credits:
| Institution | Its title | Sector |
|---|
| Palm Beach State College | Medical Pharmacology | Florida College System |
| Valencia College | Medical Pharmacology | Florida College System |
| University of West Florida | Cardiopulmonary Pharmacotherapy | State University System |
⚠⚠ This is an unusually clean example of a divergence that runs along the SECTOR boundary rather than between individual institutions — and it makes sense once you know how respiratory care is credentialled in Florida. The two state colleges run the entry-level A.S. programmes that lead to licensure; UWF runs a degree-completion pathway for practitioners who are already credentialled. ⚠ An entry-level programme needs broad medical pharmacology; a completion programme can go deeper on the cardiopulmonary agents its students already use daily. See *Offering Notes*.
⚠ And note an inversion worth spotting: the two broader-sounding titles sit at the entry level, while the narrower-sounding title is closest to the statewide description, which says "applied to respiratory medicine." The title is not a reliable guide to scope here; the programme's level is.
⚠⚠⚠ Before the content, the thing that matters most about this course: it contains dosage calculation, and dosage calculation is the part of respiratory care where an error injures a patient. The statewide description names it explicitly — "mathematics of drugs and solutions" — and ⚠ students consistently underestimate it because the arithmetic looks simple. It is simple. Doing it correctly, at speed, at three in the morning, on a patient who is deteriorating, is not.
Learning Outcomes
Required Outcomes
- Apply pharmacokinetics — absorption, distribution, metabolism and excretion — and explain how each is altered in critical illness, in renal or hepatic impairment, and at the extremes of age.
- Apply pharmacodynamics — receptor theory, agonists and antagonists, dose-response, therapeutic index, tolerance.
- ⚠ Explain the autonomic nervous system in enough detail to predict a drug's effects — the single most useful framework in respiratory pharmacology, because the airway is autonomically controlled.
- ⚠⚠ Apply the routes of administration used in respiratory care, and explain why the inhaled route is preferred where it can be used: lower dose, faster onset, fewer systemic effects.
- Select and explain aerosol delivery devices — metered-dose inhaler with and without a spacer, dry-powder inhaler, soft-mist inhaler, small-volume nebuliser — and match the device to the patient.
- ⚠ Explain the determinants of aerosol deposition — particle size, breathing pattern, airway calibre — and why technique changes the delivered dose more than the prescription does.
- Apply the bronchodilators: short- and long-acting beta-2 agonists, short- and long-acting antimuscarinics, and their combinations — indications, dosing, adverse effects, monitoring.
- Apply inhaled corticosteroids and other anti-inflammatory agents; ⚠ explain why rinsing the mouth matters and why the reliever/controller distinction is the patient-education point that matters most.
- Apply mucoactive agents, and dornase alfa and hypertonic saline in cystic fibrosis.
- Apply inhaled antimicrobials and surfactant; describe pulmonary vasodilators including inhaled nitric oxide.
- ⚠⚠ Apply oxygen as a drug — indications, targets, delivery devices, and the hazards of both hypoxaemia and excessive oxygen, including in chronic carbon dioxide retention.
- Apply the critical-care agents a respiratory therapist meets: sedatives, analgesics, neuromuscular blocking agents (⚠ and the absolute requirement that paralysis is never given without adequate sedation), and vasoactive drugs in outline.
- Describe cardiovascular agents relevant to cardiopulmonary practice — antiarrhythmics, diuretics, anticoagulants — and the ACLS drugs.
- ⚠⚠⚠ Perform dosage and solution calculations accurately: dimensional analysis, concentrations and percentage solutions, dilutions, drip rates and weight-based infusions, and unit conversions.
- Apply the rights of medication administration and the procedures that prevent error — independent double checks, high-alert drugs, look-alike/sound-alike names.
- ⚠ Recognise, manage and report adverse drug reactions, and check interactions.
- ⚠⚠ Apply the legal framework: the federal Controlled Substances Act and the DEA schedules; Florida respiratory care practice and its scope; protocol-driven therapy and physician orders; and documentation.
- Teach a patient to use an inhaler correctly and confirm by demonstration.
Optional Outcomes
- Address neonatal and paediatric dosing and agents.
- Address pulmonary hypertension therapeutics in depth.
- Address smoking cessation pharmacotherapy.
- Address asthma and COPD guideline algorithms (GINA, GOLD) in detail.
- Address biologics for severe asthma.
- Address antimicrobial stewardship and resistance.
- Address therapist-driven protocols and their evidence.
- Address pharmacogenomics in outline.
- Use a simulation laboratory for administration and emergency scenarios.
Major Topics
Required Topics
- Principles — pharmacokinetics, pharmacodynamics, drug nomenclature, and reading a drug monograph.
- ⚠ Autonomic pharmacology — sympathetic and parasympathetic control of the airway and the cardiovascular system.
- Routes and aerosol delivery — devices, deposition, technique, and the patient factors that defeat all of it.
- Bronchodilators — beta agonists and antimuscarinics, short and long acting, combinations.
- Anti-inflammatory agents — inhaled and systemic corticosteroids, leukotriene modifiers, biologics in outline.
- Mucoactive agents and airway clearance pharmacology.
- Anti-infectives relevant to the respiratory system, including inhaled agents.
- Surfactant and neonatal agents.
- ⚠ Oxygen and medical gases — as therapy, with targets and hazards; inhaled nitric oxide and heliox.
- Critical care — sedation, analgesia, neuromuscular blockade, vasoactive support.
- Cardiovascular and ACLS agents.
- ⚠⚠ Dosage and solution mathematics — and enough of it to be automatic.
- Safety — the rights of administration, error prevention, high-alert medications, adverse reactions and reporting.
- Law and regulation — controlled substances, Florida scope of practice, orders and protocols, documentation.
- Patient education — inhaler technique, adherence, the reliever/controller distinction.
Optional Topics
- Neonatal and paediatric pharmacology.
- Pulmonary hypertension therapeutics.
- Smoking cessation pharmacotherapy.
- GINA and GOLD guideline algorithms.
- Asthma biologics.
- Antimicrobial stewardship.
- Therapist-driven protocols.
- Pharmacogenomics.
- Simulation and emergency drug scenarios.
Resources & Tools
- ⚠ Rau's Respiratory Care Pharmacology (Gardenhire) is the standard text for this course by a wide margin, and it is written specifically for respiratory therapists rather than adapted from a nursing text. Respiratory Care Pharmacology and Egan's Fundamentals of Respiratory Care (which carries the pharmacology chapters alongside everything else) are the common companions.
- ⚠ For the mathematics: a dosage-calculation workbook, and ⚠⚠ the method that matters is DIMENSIONAL ANALYSIS — set the problem up so the units cancel to what you want. It is the same technique this catalog's chemistry guides name as the highest-value preparation, and it is the technique that makes drug calculations reliable rather than remembered.
- ⚠⚠ Free and authoritative:
- The American Association for Respiratory Care (AARC) — ⚠ its Clinical Practice Guidelines are free and are the profession's own standards, including for aerosol delivery and oxygen therapy. Student membership is inexpensive.
- GINA (Global Initiative for Asthma) and GOLD (Global Initiative for Chronic Obstructive Lung Disease) — ⚠⚠ free, updated annually, and the documents that actually govern how these drugs are used. Read the current year's, not a textbook's summary of a previous one.
- DailyMed (NIH) — free, and the authoritative source for a drug's approved labelling; the FDA for safety communications and MedWatch for adverse-event reporting.
- The Institute for Safe Medication Practices (ISMP) — free, and the source of the high-alert medication and look-alike/sound-alike lists that prevent real errors.
- The National Board for Respiratory Care (NBRC) — free examination content outlines. ⚠ Read the detailed content outline for the TMC examination early; it tells you exactly what you will be tested on.
- ⚠ Florida-specific: the Florida Board of Respiratory Care within the Department of Health publishes the licensure requirements and the scope of practice — ⚠⚠ and scope is a legal question, so read the state's own text rather than a textbook's generic account. The Florida Society for Respiratory Care is the state affiliate.
- ⚠ A drug reference on your phone (Lexicomp, Micromedex or Epocrates — many are institutionally licensed) ⚠⚠ and the professional habit that goes with it: look it up. Nobody in clinical practice is impressed by a therapist reciting a dose from memory; they are impressed by one who checks.
Career Pathways
- Respiratory Therapist (SOC 29-1126) — ⚠ the direct destination, and a licensed health profession with a clear, well-defined route.
- ⚠⚠ The credentialling ladder, stated plainly because students often do not know it:
- Graduate from a CoARC-accredited respiratory care programme — normally an A.S. at a Florida College System institution.
- Sit the NBRC Therapist Multiple-Choice (TMC) examination. ⚠ A lower cut score yields the Certified Respiratory Therapist (CRT); a higher cut score qualifies you to sit the Clinical Simulation Examination for the Registered Respiratory Therapist (RRT).
- ⚠⚠ The RRT is the credential to aim for. Many Florida employers — particularly hospitals with intensive care and neonatal units — prefer or require it, and it is the gateway to the specialty credentials.
- Licensure by the Florida Board of Respiratory Care is separate from the credential and is what permits practice in the state.
- Specialty credentials that build on this course: NPS (neonatal/paediatric), ACCS (adult critical care), RPFT/CPFT (pulmonary function), AE-C (certified asthma educator), SDS (sleep disorders). ⚠ Each carries a pay differential and several are directly pharmacology-dependent.
- ⚠ Where the bachelor's completion degree leads — and this is the UWF pathway's purpose: supervisory and management roles, clinical education, protocol and quality work, disease management, and the graduate routes to Physician Assistant (SOC 29-1071), perfusion, nurse anaesthesia and health administration (SOC 11-9111).
- Adjacent employers: home medical equipment and home respiratory care, sleep laboratories, pulmonary rehabilitation, clinical specialist and sales roles with device and pharmaceutical manufacturers (⚠ which pay well and specifically want a therapist who understands the pharmacology), transport and flight teams, and ECMO programmes.
- Florida context: ⚠⚠ a large and stable market. The state's older population, high rates of COPD and asthma, and very large hospital systems — AdventHealth, Orlando Health, BayCare, Baptist Health, Tampa General, Memorial, Lee Health, UF Health, Ascension Sacred Heart and Baptist Health Care in Pensacola — employ respiratory therapists across intensive care, emergency, neonatal and pulmonary services. Add the children's hospitals, the home-care sector and the sleep laboratories. ⚠ Demand is not seasonal and it does not fall in a recession.
Special Information
Offering Notes — offerings and hours, school by school
| Institution | Its title | Credits | Contact hours |
|---|
| Palm Beach State College | Medical Pharmacology | 3 | not published |
| Valencia College | Medical Pharmacology | 3 | not published |
| University of West Florida | Cardiopulmonary Pharmacotherapy | 3 | not published |
Two Florida College System institutions and one State University System institution. ✅ No credit divergence — all three at 3 credits — and ✅ no divergence of subject: all three are pharmacology for respiratory care.
⚠⚠ The divergence runs along the SECTOR boundary, and it is explained by the credentialling structure
| Florida College System (Palm Beach State, Valencia) | State University System (UWF) |
|---|
| Entry-level A.S. programmes leading to the NBRC examinations and licensure | ⚠ Degree-completion pathway for practitioners who are already credentialled |
| Medical Pharmacology — ⚠ broad: the whole drug landscape a new therapist meets on a ward, including agents outside the respiratory system | Cardiopulmonary Pharmacotherapy — ⚠ deeper on the cardiopulmonary agents these students already use daily |
| Emphasis on administration, calculation and safety for a student who has not yet practised | Emphasis on therapeutic reasoning, protocols and evaluation for a student who has |
⚠ Both are legitimately this number, and the difference is audience rather than quality. ⚠⚠ But note the inversion, because it defeats the obvious reading of the titles: the BROADER-sounding titles are the entry-level courses, and the NARROWER-sounding title is the one closest to the statewide description, which says "applied to respiratory medicine." Judge the scope by the programme's level, not the title.
⚠⚠ The transfer consequence is the practical one. A student moving from an A.S. programme into a bachelor's completion programme is the intended path, and this number appears on both sides of it. ⚠ Ask the receiving programme whether your A.S. pharmacology course satisfies its requirement or whether you will take its version as well — it is a reasonable outcome either way, because the two courses genuinely do different work, but it is better known in advance than discovered at an audit.
⚠ The 45 contact hours at the top of this guide are derived — the Florida convention for a 3-credit lecture course. No institution publishes an hour figure. ⚠ No laboratory suffix appears on this number, so where device technique and administration are practised — and they must be — it happens inside the lecture hours, in a simulation laboratory, or in the clinical courses that run alongside.
⚠⚠⚠ Dosage calculation: the part of this course that can hurt someone
⚠⚠ The statewide description names it — "mathematics of drugs and solutions" — and it deserves the emphasis. Respiratory therapists administer continuous nebulised bronchodilators, weight-based infusions, high-alert critical-care drugs and neonatal doses where a decimal place is a tenfold error.
What the course expects you to do without hesitation: convert between units (mg, mcg, mL, %, ratio strengths); ⚠ compute a dose from a percentage solution — a 0.5% solution is 5 mg/mL, and that conversion appears constantly; perform dilutions; compute weight-based doses and infusion rates; and check that an answer is plausible.
⚠⚠⚠ Two habits, and they are the difference between safe and unsafe practice:
- Use dimensional analysis every time. Set the problem up so the units cancel to what you want. ⚠ If the units do not cancel correctly, the answer is wrong no matter how plausible the number looks — and that single check catches most errors.
- ⚠⚠ Sanity-check the magnitude before you act. If the calculation says give 30 mL of a drug that normally comes as 3 mL, stop. An order-of-magnitude error is the one that kills, and it is the one a plausibility check catches instantly.
⚠ And the professional habit that goes with both: independent double checks for high-alert drugs, and looking things up rather than recalling them. The ISMP high-alert list is free and short.
⚠⚠ Scope of practice: what a respiratory therapist may do with a drug in Florida
⚠ Respiratory care is a licensed profession with a statutorily defined scope, and this course is where the boundary gets taught.
Broadly, a licensed therapist administers respiratory-care medications under a physician's order or an approved protocol, monitors the response, and documents it. ⚠⚠ Three points are worth internalising:
- An order is not a licence to stop thinking. ⚠ A therapist who recognises that an ordered dose is wrong, or that a drug is contraindicated for this patient, is expected to question it — and the professional obligation to do so is real.
- ⚠⚠ Therapist-driven protocols are a defining feature of modern respiratory care, and they are a delegation of clinical judgement. Working under a protocol means assessing, selecting and titrating within defined limits — which raises the pharmacological knowledge required rather than lowering it.
- ⚠ Scope is set by Florida law and by your employer's policy, and the two are not identical. Read the Board of Respiratory Care's own text, and then your hospital's.
⚠ Prerequisites: none stated, and several that are functionally required
No statewide prerequisite is listed, but the number is 3000-level and ⚠⚠ in practice the gate is admission to a respiratory care programme, which is competitive and has its own prerequisites.
What is functionally required, whether or not it is stated:
- Anatomy and physiology with laboratory — ⚠ and cardiopulmonary physiology specifically. You cannot understand a bronchodilator without understanding airway smooth muscle and autonomic innervation.
- General chemistry — for solutions, concentrations and the behaviour of gases.
- ⚠⚠ Arithmetic fluency — fractions, ratios, percentages, decimals, scientific notation and unit conversion. Not algebra; arithmetic, done reliably. ⚠ If that is shaky, fix it before the term starts; it is a weekend of work and it is the binding constraint on this course.
- Microbiology where the course covers anti-infectives.
Budget eight to ten hours a week. ⚠ The load is memorisation plus calculation, and both reward daily short sessions over weekly long ones. The drug lists are long and the examinations are cumulative.
⚠⚠ The characteristic failure: memorising drug names instead of mechanisms
⚠⚠⚠ Students approach pharmacology as a vocabulary list and are defeated by its length. There are dozens of agents, each with a generic name, one or more trade names, a dose, a route and a list of adverse effects — and treated as flashcards it is unmanageable and does not survive the examination.
⚠ The alternative works and is faster: learn the CLASS, then the mechanism, then predict the rest. A beta-2 agonist stimulates beta-2 receptors; beta-2 receptors relax airway smooth muscle; beta-1 receptors are cardiac, so a less selective agent causes tachycardia and tremor. ⚠⚠ From that one chain you can predict the indications, the adverse effects and the monitoring for the whole class — and the NBRC examination is written to reward exactly that reasoning rather than recall.
⚠ The second failure is neglecting device technique. The most perfectly chosen inhaled drug does nothing if the patient cannot use the inhaler, and ⚠⚠ a large proportion of patients use theirs incorrectly. Teaching technique and confirming it by demonstration is the intervention with the largest real-world effect in this entire course — and it is the one students treat as an afterthought.
AI Integration
Genuinely useful: explaining a mechanism a second and third way — autonomic pharmacology and receptor selectivity are the classic sticking points; building class-by-class comparison tables; generating practice calculation problems (⚠ with the answers worked so you can check the method, not only the number); explaining what a guideline algorithm is doing; producing patient-education wording at a readable level; and drilling for the NBRC content outline.
⚠ One genuinely strong use: ask it to predict a drug's adverse effects FROM its mechanism, then check against the labelling. That is exactly the reasoning the course wants, and verifying it against DailyMed teaches both halves at once.
⚠⚠ Where it fails, and the first two are patient-safety matters rather than academic ones:
- ⚠⚠⚠ NEVER take a dose, a concentration, a dilution or an infusion rate from a generated answer. ⚠ It makes arithmetic errors in multi-step calculations while presenting them in a confident, correctly formatted way — and in this domain a wrong number is a harmed patient. Doses come from the order, the labelling (DailyMed), a licensed drug reference and your institution's protocol. Check the units; if they do not cancel, the answer is wrong.
- ⚠⚠⚠ NEVER put patient information into an AI tool. HIPAA protects it, and a patient's details typed into a chat interface is a disclosure whether or not anyone notices. ⚠ This applies to clinical-rotation reflections as much as to a question about what to do.
- ⚠⚠ It states superseded guideline recommendations as current. GINA and GOLD are revised annually and have changed substantially — ⚠ GINA's move away from short-acting-beta-agonist-only treatment of asthma is exactly the kind of change a corpus-trained model will miss, because decades of text describe the older approach. Read the current year's document.
- ⚠ It invents drug data — half-lives, onset times, dose ranges, interaction claims — and DailyMed and a licensed reference are free or institutionally provided.
- ⚠⚠ It will give clinical advice. Asked what to give a deteriorating patient it answers. That is a physician's order or a protocol decision made by a licensed therapist at the bedside, and a tool that helps a student feel competent to make it is dangerous.
- ⚠ It is unreliable on Florida scope of practice and on controlled-substance handling — both legal, both state- and employer-specific.
- It cannot assess a patient, and it cannot watch someone use an inhaler — which is where the largest real effect in this course lies.
⚠ The professional framing: a licensed therapist who administers a drug is personally accountable for it, and "I looked it up online" is not a defence to a board, an employer or a family. Use these tools to understand mechanisms and to drill; take every number from the order, the label and the protocol; and make clinical judgements at the bedside, within scope.
Academic integrity: read your syllabus, and expect a health-professions programme's policy to be strict — ⚠ the coursework prepares for a licensed role, and programmes reasonably treat integrity as a professionalism matter. The NBRC examination is proctored and the clinical competencies are observed, so the question largely settles itself.