PTCE Pharmacy Technician Certification (CPhT) Exam Questions and Answers

To determine how muchdrug (active ingredient)is in2 oz (ounces) of cream, we use the given ratio and perform unit conversions.

120 gof cream contains3 gof drug.

2 ozof cream =2 × 28.35 g(since1 oz = 28.35 g)

2 oz = 56.7 g

Step 1: Identify Given DataStep 2: Set Up a Proportion3 g drug120 g cream=x g drug56.7 g cream\frac{3 \text{ g drug}}{120 \text{ g cream}} = \frac{x \text{ g drug}}{56.7 \text{ g cream}}120 g cream3 g drug​=56.7 g creamx g drug​

Step 3: Solve forxxxx=3×56.7120=170.1120=1.42≈1.5 gx = \frac{3 \times 56.7}{120} = \frac{170.1}{120} = 1.42 \approx 1.5 \text{ g}x=1203×56.7​=120170.1​=1.42≈1.5 g

Thus,1.5 g of drugis present in2 oz of cream.

B. 6 g→ Incorrect; this would assume a higher drug concentration.

C. 15 g→ Incorrect; this is a miscalculation of the ratio.

D. 60 g→ Incorrect; far exceeds the total weight of the cream.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmaceutical Calculations – Ratios and Proportions)

United States Pharmacopeia (USP) General Chapters on Compounding

The Pharmacy Technician’s Pocket Drug Reference

Controlled substances (Schedules I–V) are classified by the DEA based on their potential for abuse, medical use, and dependence risk.

Schedule I (highest risk, no medical use):Heroin, LSD, Ecstasy.

Schedule II (high abuse potential, medical use):Oxycodone, Morphine, Fentanyl.

Schedule III (moderate abuse potential):Codeine combinations, Ketamine.

Schedule IV (low abuse potential):Alprazolam, Zolpidem.

Schedule V (lowest risk):Cough syrups with low doses of codeine.

Why Other Options Are Incorrect:

B. All contain hydrocodone?❌OnlySchedule II and IIImay contain hydrocodone.

C. FDA-approved indications?❌Schedule I drugs haveno FDA-approved medical use.

D. Insurance verification?❌Not all controlled drugs require insurance verification.

????Reference:DEA Controlled Substance Act, PTCB Controlled Substances Guide.

AClass I recallis themost seriousrecall issued when amedication labeling erroror contaminationcould result in serious harm or death.

Enoxaparin (Lovenox)is ananticoagulant, whilephytonadione (Vitamin K1)is anantidote for warfarin toxicity—confusing these could lead to life-threatening bleeding or clotting issues.

TheFDA mandates an immediate Class I recallfor errors that could causefatal outcomes.

Why Other Options Are Incorrect:

B. Class II?❌Used formoderate health risks(e.g., subpotent drugs).

C. Class III?❌Used forminor errors(e.g., misprinted labels, minor defects).

D. Misbranding?❌Misbranding is a regulatory issue butnot a recall classification.

????Reference:FDA Drug Recall Guidelines, ISMP Medication Safety Alerts.

When adrug recalloccurs due totemperature excursions(exposure to temperatures outside the manufacturer’s recommended range during transport or storage), the pharmacy mustimmediately remove all affected productfrom its inventory to prevent dispensing compromised medication.

Remove the Affected Product:Quarantine the recalled drug to ensure it is not dispensed.

Verify the Recall Details:Confirm the lot number, expiration date, and reason for the recall using FDA or manufacturer recall notices.

Document the Recall Action:Log details in the pharmacy's recall records for compliance.

Follow Manufacturer or FDA Instructions:Some recalls require returning the product, while others require disposal according to hazardous waste guidelines.

Notify Patients and Providers (If Necessary):If the medication has already been dispensed, further action may be needed depending on recall severity.

B. Contact patients who received a therapeutically equivalent product.→ Incorrect. The recall applies to thespecificaffected lot, not all similar medications. Pharmacists would first verify which patients received the recalled drugbefore contacting them.

C. Switch patients from the oral solution to oral capsules.→ Incorrect. The recall does not automatically require a formulation change. The pharmacy must verify availability of unaffected stock or alternative treatments before making substitutions.

D. Contact all prescribers who recently prescribed the product.→ Incorrect. While prescribersmayneed notification if the recall affects patient treatment, thefirst stepis ensuring the recalled product is removed from stock to prevent further dispensing.

PTCB PTCE Exam Content Outline – Medication Safety and Recall Procedures.

FDA Drug Recall Guidelines (www.fda.gov).

USP <1079> Good Storage and Distribution Practices for Pharmaceuticals.

National Association of Boards of Pharmacy (NABP) Recall Compliance Standards.

Manufacturer Recall Notices (Example: Pfizer, Eli Lilly, etc.).

Mosby’s Pharmacy Technician: Principles and Practice – Recall Classifications and Actions.

Steps to Follow in a Drug Recall:Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

Nitroglycerin sublingual tablets are light- and moisture-sensitive, requiring storage in tight, light-resistant containers. Removing them from their original glass container can compromise potency. Therefore, they must always be dispensed in the original container provided by the manufacturer.

According to USP Packaging and Storage Requirements and Mosby’s Pharmacy Technician:

“Nitroglycerin SL tablets lose potency quickly when exposed to air or light. Do not repackage; dispense only in manufacturer-supplied container.”

Other options do not require original container for stability:

Methotrexate – may be repackaged

Metoprolol XL – stable in unit-dose or amber vials

Allopurinol – routine packaging allowed

HCTZ (hydrochlorothiazide) is a diuretic, but the abbreviation can be confused with hydrocortisone (a corticosteroid).

To prevent errors, ISMP recommends writing out "hydrochlorothiazide" instead of using "HCTZ."

????Reference:ISMP Do Not Use List, PTCE Medication Safety Guidelines.

Schedule III & IV drugs can be refilled up to 5 times within 6 months from the date written.

After 6 months or 5 refills, a new prescription is required.

????Reference:DEA Controlled Substance Act (21 CFR 1306).

Comprehensive and Detailed Step-by-Step Explanation:

The FDA Orange BookprovidesTherapeutic Equivalence (TE) codesto indicate whether a generic drug isequivalentto a brand-name drug.

????Explanation of Answer Choices:✅B. The Orange Book→Correct.Liststherapeutic equivalence (TE) codesfor FDA-approved generics.❌A. Remington→ Incorrect.Pharmacy reference book, not used for TE codes.❌C. SDSs→ Incorrect.Used for chemical safety, not drug equivalence.❌D. Package insert→ Incorrect.Does not contain TE codes.

????Reference:

FDA Orange Book

PTCB Exam: Therapeutic Equivalence

According tofederal law(Controlled Substances Act, CSA) andDrug Enforcement Administration (DEA) regulations, a prescription for aSchedule III or IV controlled substancemay be refilleda maximum of five (5) times within six (6) monthsfrom the date the prescription was written.

Refill Limit:A Schedule IV prescription may be refilled up to five (5) times within six (6) monthsfrom the issue date, if authorized by the prescriber.

Expiration:The prescription expiressix (6) monthsafter the date it was written.

Recordkeeping:The pharmacy must maintain accurate refill records either electronically or manually.

Additional Refills Beyond 5:If the patient needs refills after the 5-refill limit, anew prescriptionmust be issued by the prescriber.

Partial Fills:Partial dispensing is allowed, but the total quantity dispensed cannot exceed the originally prescribed amount.

A. 2 times in 3 months.→ Incorrect. Federal law allows more than 2 refills for Schedule IV drugs.

B. 3 times in 4 months.→ Incorrect. This underestimates the legal refill limit.

C. 4 times in 6 months.→ Incorrect. Schedule IV drugs may be refilledup to 5 times, not just 4, within 6 months.

DEA Pharmacist’s Manual – Controlled Substances Act (21 CFR 1306.22).

PTCB PTCE Exam Content Outline – Federal Pharmacy Law and Controlled Substances.

FDA and DEA Guidelines on Schedule III-V Prescription Refills.

Mosby’s Pharmacy Technician: Principles and Practice – Controlled Substances Regulations.

Key DEA Rules for Schedule III and IV Prescriptions:Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

Lot numbers are required for drug recalls and tracking purposes.

Prescription numbers are pharmacy-specific and not on manufacturer packaging.

????Reference:FDA Drug Labeling Requirements, USP Manufacturing Guidelines.

AZ-Pakrefers to theAzithromycin 5-day therapy pack, which is commonly prescribed forbacterial infectionssuch as respiratory infections. The standard dosing regimen follows a"loading dose" strategyto quickly reach effective drug levels in the body:

Day 1:Taketwo tablets (500 mg total).

Days 2-5:Takeone tablet (250 mg) daily.

This regimen helps achieverapid therapeutic concentrationswhile maintaining effectiveness over five days.

A. 1 tablet PO on the current day, then 1 PO daily for 4 days→ Incorrect; aloading dose (2 tablets on Day 1)is required for proper drug efficacy.

B. 1 tablet PO on the current day, then 1 PO daily for 5 days→ Incorrect; the Z-Pak is a5-day regimen, not 6 days.

D. 3 tablets PO on the current day, then 1 PO every other day for 6 days→ Incorrect; this isnot a standard dosing regimenfor azithromycin.

Other Answer Choices Explained:References:

FDA Drug Monograph for Azithromycin (Z-Pak)

Lexicomp Drug Guide – Azithromycin Dosing

PTCB PTCE Exam Content Outline (Pharmacology – Infectious Disease Medications)

Bupropion (Wellbutrin, Zyban) requires a Medication Guide due to risks of suicidal thoughts and neuropsychiatric effects.

Medication Guides are FDA-required leaflets given with specific medications that have serious risks.

Examples of Medications Requiring a Medication Guide:

Antidepressants (e.g., SSRIs, SNRIs, bupropion) → Suicide risk

NSAIDs → GI bleeding risk

Opioids → Addiction risk

Fluoroquinolones → Tendon rupture risk

????Reference:FDA Medication Guide Requirements, ISMP Patient Safety Guidelines.

Anear miss(orclose call) is anerror that is identified and corrected before it causes harm to a patient.

Example:A technician picks uphydroxyzine (an antihistamine) instead of hydralazine (a blood pressure medication),but the pharmacist catches the mistake before dispensing.

Why Other Options Are Incorrect:

A. Adverse Drug Event (ADE)?❌Occurs when a patient is actually harmed by medication.

B. Recall?❌Issued by manufacturers or the FDA when a drug is defective or unsafe.

D. Root-Cause Analysis (RCA)?❌A method toanalyze errors AFTER they occurto prevent future mistakes.

????Reference:ISMP Medication Safety Guidelines, PTCE Exam Study Guide on Error Prevention.

TheInstitute for Safe Medication Practices (ISMP)classifiesInsulin U-500as ahigh-alert medication in acute care settingsbecause it isfive times more concentratedthan standardU-100 insulin. Errors in dosing or administration can result insevere hypoglycemiaorhyperglycemia, leading to life-threatening consequences.

A. Normal saline solution→ Incorrect;0.9% sodium chloride (NS)isnot a high-alert medication, as it is a commonly used IV fluid with a wide safety margin.

B. Transdermal lidocaine→ Incorrect; although lidocaine is alocal anesthetic, its transdermal form isnot considered high-alert.

C. Dextrose 5% solution (D5W)→ Incorrect; while used inIV therapy,D5Wisnot classified as high-alertin acute care settings.

Other Answer Choices Explained:References:

ISMP List of High-Alert Medications in Acute Care Settings (2023 Update)

PTCB PTCE Exam Content Outline (Medication Safety & High-Alert Medications)

USP <800> Handling of High-Alert Medications

????Reference:USP <797> Sterile Compounding Guidelines.

St. John's Wort (Hypericum perforatum)is anherbal supplementcommonly used formild to moderate depression.

Containshypericin and hyperforin, which may increaseserotonin, dopamine, and norepinephrinelevels.

Often used as analternative treatment for depression, but not FDA-approved for this indication.

Hasserious drug interactions, including withantidepressants (SSRIs, SNRIs), warfarin, oral contraceptives, and cyclosporine.

(A) Immune enhancer❌Incorrect – Not primarily used to boost the immune system.

(B) Mild antidepressant✅Correct – Used for mild depression.

(C) Antioxidant❌Incorrect – While it has some antioxidant properties, this is not its primary use.

(D) Antihypertensive❌Incorrect – It does not lower blood pressure.

National Center for Complementary and Integrative Health (NCCIH) – St. John’s Wort:https://www.nccih.nih.gov/

MedlinePlus – St. John's Wort Drug Interactions:https://medlineplus.gov

PTCB Exam Content Outline – Herbal Supplements & Drug Interactions

How St. John’s Wort Works:Analysis of Answer Choices:References for Pharmacy Technicians:

Comprehensive and Detailed Step-by-Step Explanation:

Desvenlafaxine (Pristiq)is anSNRI (Serotonin-Norepinephrine Reuptake Inhibitor)used to treatmajor depressive disorder (MDD).

????Explanation of Answer Choices:✅B. Major depressive disorder→Correct.Desvenlafaxine is FDA-approved fordepression.❌A. Hypertension→ Incorrect.Not an antihypertensive.❌C. Benign prostatic hypertrophy→ Incorrect.Alpha-blockers like Tamsulosin treat BPH.❌D. Atrial fibrillation→ Incorrect.Beta-blockers, not SNRIs, manage atrial fibrillation.

????Reference:

FDA Drug Database: Desvenlafaxine

PTCB Exam: Pharmacology for Technicians

Comprehensive and Detailed Step-by-Step Explanation:

MedWatchis theFDA's Safety Information and Adverse Event Reporting Program, used totrack drug and device safety concerns.Pharmacists and healthcare professionals should report:

Adverse drug reactions (ADRs).

Medical device failures or malfunctions.

Medication errors that lead to harm.

Product quality issues related to safety.

????Explanation of Answer Choices:✅D. Medical device malfunctions→Correct.MedWatch monitors medical device safety, including pacemakers, insulin pumps, and inhalers.❌A. Medication reimbursement complaints→ Incorrect.Billing and insurance issues are not handled by MedWatch.❌B. Damaged medications received from a wholesaler→ Incorrect.These issues should be reported to the wholesaler or manufacturer, not MedWatch.❌C. Complaints about pharmacy staff→ Incorrect.These concerns should be reported to the state board of pharmacy.

????Reference:

FDA MedWatch Program

PTCB Exam: Medication Safety & Reporting

Cyanocobalamin (Vitamin B12)is used to treatpernicious anemia, a condition caused byVitamin B12 deficiencydue to the body’s inability to absorb it properly.

Pernicious anemiais an autoimmune disorder where the stomach does not produceintrinsic factor, a protein needed for Vitamin B12 absorption.

Symptoms includefatigue, weakness, neurological issues (numbness, tingling), and megaloblastic anemia.

Cyanocobalamin is given viaIM injection or high-dose oral supplementation.

(A) Pernicious anemia✅Correct – Cyanocobalamin is the primary treatment.

(B) Alcohol withdrawal❌Incorrect – Thiamine (Vitamin B1) is used for alcohol withdrawal, not cyanocobalamin.

(C) Hypothyroidism❌Incorrect – Treated withlevothyroxine (Synthroid), not Vitamin B12.

(D) Narrow-angle glaucoma❌Incorrect – Treated withtimolol, acetazolamide, or surgery, not cyanocobalamin.

Cyanocobalamin Prescribing Information (NIH): https://medlineplus.gov/druginfo/meds/a607038.html

PTCB Exam Content Outline – Disease States & Medications

Key Facts About Cyanocobalamin & Pernicious Anemia:Analysis of Answer Choices:References for Pharmacy Technicians:

ARisk Evaluation and Mitigation Strategy (REMS)program is required by theFDAfor certain medications that have serious safety concerns, ensuring their risks do not outweigh their benefits.Mycophenolateis subject to a REMS program due to its severe teratogenic effects.

(A) Sertraline❌Not Subject to REMS

Sertraline (Zoloft) is aSelective Serotonin Reuptake Inhibitor (SSRI)used to treat depression and anxiety.

While SSRIs can carry arisk of birth defects (such as persistent pulmonary hypertension in newborns - PPHN),sertraline is not included in the REMS program.

(B) Ondansetron❌Not Subject to REMS

Ondansetron (Zofran) is anantiemeticused to prevent nausea and vomiting.

While some studies suggest a possible increased risk of congenital defects, it isnot part of a REMS program.

(C) Montelukast❌Not Subject to REMS

Montelukast (Singulair) is aleukotriene receptor antagonist (LTRA)used forasthma and allergies.

It has aBoxed Warningfor mental health side effects butis not subject to a REMS program for pregnancy risks.

(D) Mycophenolate✅Correct – Subject to REMS

Mycophenolate (CellCept, Myfortic)is animmunosuppressantused to prevent organ rejection in transplant patients.

It carries ahigh risk of birth defects and miscarriage, making pregnancy preventionmandatorywhile taking the medication.

TheMycophenolate REMS Programrequires:

Mandatory counselingon pregnancy risks

Negative pregnancy testsbefore starting therapy

Use of effective contraceptionbefore, during, and after treatment

FDA REMS Program for Mycophenolate:https://www.mycophenolaterems.com/

FDA REMS Program Overview: https://www.fda.gov/drugs/risk-evaluation-and-mitigation-strategies-rems

PTCB Exam Content Outline – Medication Safety & Risk Management

Analysis of Answer Choices:References for Pharmacy Technicians:

Arashis acommon allergic reactionto medications.Drug allergiesoccur when the immune system overreacts to a medication, leading to symptoms such as:

Skin rash (most common)

Hives (urticaria)

Swelling (angioedema)

Anaphylaxis (severe reaction)

A. Dizziness❌→Side effect, not an allergic reaction.

Some medications (e.g., antihypertensives) cause dizziness, but it isnot an immune system response.

B. Constipation❌→Side effect, not an allergic reaction.

Opioids (e.g., morphine, oxycodone) commonly cause constipation, but it isnot due to an allergy.

C. Nausea❌→Side effect, not an allergic reaction.

Many medications (e.g., antibiotics, chemotherapy) cause nausea, but this isnot an immune-mediated reaction.

American Academy of Allergy, Asthma & Immunology (AAAAI)– Defines allergic reactions to medications.

FDA Drug Allergy Guidelines– Lists common symptoms of drug allergies.

PTCB PTCE Exam Content Outline– Covers adverse drug reactions and medication safety.

Why Not the Other Options?Key References:

Linaclotide (brand name: Linzess)must be dispensed in its original containerbecause:

It is highly moisture-sensitive, and removing it from its original container may lead to degradation.

The manufacturer provides a desiccantin the original packaging toprotect against humidity.

A. Furosemide❌→Does not require original container.

While furosemide tablets should be stored properly,they do not require dispensing in the original container.

C. Valsartan❌→Does not require original container.

Valsartan tablets arestable outside the original container.

D. Sertraline❌→Does not require original container.

Sertraline (Zoloft)can be repackagedwithout stability issues.

FDA Linzess Storage Guidelines– States that Linzessmust be stored in its original container with desiccant.

USP <797> & <800> Guidelines– Cover proper storage and handling of moisture-sensitive drugs.

PTCB PTCE Exam Content Outline– Includes special drug storage requirements.

Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

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Vaccines come in different strengths for adults and children, and mix-ups can lead to underdosing or overdosing.

Storing pediatric and adult vaccines separately within the refrigerator reduces the risk of errors.

Example:PediatricCOVID-19 vaccines (lower dose) and adult doses look similar but have different concentrations.

Why Other Options Are Incorrect:

A. Repackaging?❌Against CDC and USP <797> guidelines, which require vaccines to remain in their original packaging.

B. Ordering from different manufacturers?❌Not practical; most pharmacies use a single supplier for consistency.

D. Automated dispensing systems?❌Not always available for vaccines.

????Reference:CDC Vaccine Storage & Handling Guidelines, ISMP Vaccine Safety Best Practices.

Comprehensive and Detailed Step-by-Step Explanation:

Hospitals mayredispenseunopened, sealed, unit-dose medicationsreturned frominpatients, as long as they areproperly storedand not tampered with.

????Explanation of Answer Choices:✅C. Unopened units-of-use returned from inpatients may be redispensed→Correct.Hospital pharmacies canredispense sealed unit-dose medications from inpatients.❌A. Unlabeled medications may be dispensed by the nurse at discharge→ Incorrect.Unlabeled meds cannot be dispensed due to safety concerns.❌B. Unopened units-of-use returned from outpatients may be redispensed→ Incorrect.Medications dispensed to outpatients cannot be returned to stock.❌D. Crediting of unused doses is not feasible→ Incorrect.Many hospitals have systems for crediting unused doses.

????Reference:

USP <795> and <797>: Hospital Medication Storage

PTCB Medication Safety Regulations

The abbreviation"PO"means"by mouth" (per os).

The abbreviation"ac"stands for"before meals" (ante cibum).

The phrase"daily for 14 days"indicates that the patient should take the medication once a day for a total of 14 days.

Thus, the correct label instructions should be:"Take one capsule by mouth before a meal once daily for 14 days."

PTCB PTCE Exam Content Outline – Prescription Interpretation– Covers standard medical abbreviations.

ISMP (Institute for Safe Medication Practices) List of Common Pharmacy Abbreviations– Defines "PO" (by mouth) and "ac" (before meals).

USP Medication Labeling Standards– Ensures clear and accurate patient instructions.

Pharmacy Technician References:

Comprehensive and Detailed Step-by-Step Explanation:

OnceBasaglar insulin pensare opened, they must bediscarded after 28 dayseven if insulin remains, as potency decreases.

????Explanation of Answer Choices:✅D. 28 days→Correct.FDA-approved discard time for Basaglar.❌A. 1 day→ Incorrect.Too short.kabtak chaoiyue❌B. 7 days→ Incorrect.Too short.❌C. 14 days→ Incorrect.Incorrect expiration timeframe.

????Reference:

FDA Basaglar Storage Guidelines

PTCB Exam: Medication Storage and Expiration

Risk Evaluation and Mitigation Strategies (REMS)areFDA-required programsto ensure that thebenefits of certain medications outweigh their risks. REMS programsrestrict prescribing, dispensing, and monitoringdue to the potential for serious side effects or misuse.

Suboxoneis used foropioid dependenceand containsbuprenorphine, apartial opioid agonist, which can causeaddiction, misuse, and respiratory depressionif used improperly.

REMS Requirements for Suboxone:

Prescriber Certification:Only specially certified providers can prescribe Suboxone.

Patient Education:Patients must be informed about the risks of misuse, overdose, and dependence.

Limited Dispensing:Pharmacists must ensure prescriptions meet REMS criteria before dispensing.

A. Xarelto (Rivaroxaban).→ Incorrect. While Xarelto is an anticoagulant, it isnot under REMS.

C. Warfarin.→ Incorrect. Warfarin requires monitoring butdoes not have a REMS program.

D. Haloperidol.→ Incorrect. Haloperidol is an antipsychotic, but itdoes not have a REMS program.

FDA REMS Program List (www.accessdata.fda.gov).

Suboxone REMS Guidelines (www.suboxonerems.com).

PTCB PTCE Exam Content Outline – REMS and Medication Safety.

Mosby’s Pharmacy Technician: Principles and Practice – REMS Regulations.

Why Is Suboxone (Buprenorphine/Naloxone) Under REMS?Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

Comprehensive and Detailed Step-by-Step Explanation:

Acetaminophen (Tylenol)is metabolized by theliver.Excessive doses or concurrentalcohol useincreases the risk ofliver damage (hepatotoxicity).

????Explanation of Answer Choices:✅D. Alcoholic beverages→Correct. Alcohol and acetaminophen together can causesevere liver damage.❌A. Citrus fruits→ Incorrect. Citrus does not interfere withacetaminophen metabolism.❌B. Leafy greens→ Incorrect. Leafy greens affectwarfarin, notacetaminophen.❌C. Dairy products→ Incorrect. Dairy does not interact withacetaminophen.

????Reference:

FDA Acetaminophen Warnings

PTCB Medication Safety Guidelines

Comprehensive and Detailed Step-by-Step Explanation:

The FDA requires patient package inserts (PPIs) for certain medications, including oral contraceptives like norethindrone/ethinyl estradiol.

????Explanation of Answer Choices:

✅B. Norethindrone/Ethinyl Estradiol → Correct. Oral contraceptives must include a PPI with risk information.

❌A. Sulfamethoxazole/Trimethoprim → Incorrect. Does not require a package insert.

❌C. Triamterene/HCTZ → Incorrect. A diuretic, no required PPI.

❌D. Emtricitabine/Tenofovir Disoproxil → Incorrect. A PPI is required only for certain formulations.

????Reference:

FDA Patient Information Leaflet Requirements

AMaster Formulation Record (MFR)is adetailed document used in compounding pharmaciesto ensureconsistency, accuracy, and quality controlin preparing compounded medications.

An MFR includes:

Ingredients & amounts required.

Compounding procedures.

Stability and beyond-use dating (BUD).

Storage and labeling instructions.

This ensures that each compounded preparationmeets quality standardsand ismade correctly every time.

B. Prevent drug diversion❌→Incorrect

Drug diversion prevention involves security measures, inventory control, and trackingcontrolled substances, not MFRs.

C. Eliminate patient profiles❌→Incorrect

Patient profiles are essential for tracking medication history; MFRs are unrelated.

D. Guarantee drug availability❌→Incorrect

MFRs do not affect drug supply; they ensure accurate compounding.

USP <795> (Non-Sterile Compounding Guidelines)– RequiresMaster Formulation Records for all compounded preparations.

PTCB PTCE Exam Content Outline– Covers compounding procedures and quality control measures.

Why Not the Other Options?Key References:

Tetracyclines, includingdoxycycline and minocycline, are broad-spectrum antibiotics used to treat bacterial infections. They have amajor drug-drug interaction with calcium-containing antacidsand other minerals.

Chelation Effect:Calcium binds to tetracycline, forminginsoluble complexesthat prevent the antibiotic from being absorbed in thegastrointestinal (GI) tract.

Reduced Efficacy:Because the drug cannot be absorbed, the antibiotic’s effectiveness is significantly reduced.

Similar Interactions:Magnesium, iron, and aluminum (found in many antacids, dairy products, and multivitamins) also reduce tetracycline absorption.

Take on an Empty Stomach(1 hour before or 2 hours after meals).

Avoid Dairy, Antacids, and Multivitaminsfor at least2 hours before and aftertaking tetracycline.

Drink with a Full Glass of Waterto prevent esophageal irritation.

B. Decongestants that contain pseudoephedrine.→ Incorrect. Pseudoephedrine does not interact with tetracycline.

C. Antitussives that contain dextromethorphan.→ Incorrect. Dextromethorphan does not affect tetracycline absorption.

D. Analgesics that contain acetaminophen.→ Incorrect. Acetaminophen does not bind to tetracycline or impact its absorption.

Lexicomp Drug Interaction Database – Tetracycline and Calcium Interactions.

FDA Drug Label for Tetracycline – Absorption and Drug Interaction Warnings.

Mosby’s Pharmacy Technician: Principles and Practice – Tetracycline Pharmacology.

PTCB PTCE Exam Content Outline – Drug Interactions and Contraindications.

Why Should Tetracycline Not Be Taken with Calcium-Containing Antacids?Patient Counseling for Tetracycline Use:Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

Lipitor is the brand name forAtorvastatin, aHMG-CoA reductase inhibitor (statin)used to lower cholesterol and reduce the risk of cardiovascular disease.

(A) Provastatin❌Incorrect –Misspelled, should bePravastatin(Pravachol).

(B) Fluvastatin❌Incorrect – Fluvastatin (Lescol) is another statin, but not the generic for Lipitor.

(C) Simvastatin❌Incorrect – Simvastatin (Zocor) is a statin but not the generic for Lipitor.

(D) Atorvastatin✅Correct – The generic name for Lipitor.

Analysis of Answer Choices:Statins & Their Brand Names:Generic Name

Brand Name

Atorvastatin

Lipitor✅

Simvastatin

Zocor

Pravastatin

Pravachol

Fluvastatin

Lescol

Rosuvastatin

Crestor

Lovastatin

Mevacor

Lipitor Prescribing Information: https://www.pfizer.com/products/product-detail/lipitor

PTCB Exam Content Outline – Generic & Brand Name Drug Recognition

Pharmacology for Pharmacy Technicians, 3rd Edition – Perspective on Statin Medications

References for Pharmacy Technicians:

Enteric-coated (EC) tabletsare designed todelay drug release until they reach the intestine, preventing stomach irritation and degradation by gastric acid. The coatingresists stomach acidbut dissolves in thehigher pH environment of the intestines.

Aspirin EC(prevents stomach irritation)

Pantoprazole EC(proton pump inhibitor)

Diclofenac EC(NSAID)

A. Buffered→ Incorrect; buffered formulationsneutralize stomach acidbut do not delay release until the intestines.

C. Controlled release→ Incorrect; controlled-release formulationsgradually release medicationover time but are not specifically designed tobypass the stomach.

D. Buccal→ Incorrect; buccal tablets dissolve in thecheek mucosa, bypassing the digestive system entirely.

Examples of Enteric-Coated Medications:Other Answer Choices Explained:References:

FDA Drug Formulation Guidelines

USP <795> Drug Release & Absorption Standards

PTCB PTCE Exam Content Outline (Pharmaceutical Dosage Forms & Drug Release Mechanisms)

According toUSP Chapter <800>(Hazardous Drugs—Handling in Healthcare Settings), solid oral dosage forms ofantineoplastic hazardous drugs (e.g., chemotherapy medications like methotrexate or tamoxifen)shouldnotbe placed inautomated counting or packaging machinesbecause:

Risk of Contamination– Tablets and capsulesmay generate dust or powder residue, which can spread hazardous drug particles into the environment.

Exposure Risks– Pharmacy staff may beexposed to hazardous particleswhen refilling, cleaning, or maintaining the machine. This poses a risk ofinhalation, dermal exposure, or accidental ingestion.

Strict USP <800> Compliance– Hazardous drugs requirespecial handling precautions, includingdesignated counting trays, dedicated equipment, and proper personal protective equipment (PPE). Automated machinesdo not provide the necessary containmentfor hazardous drug particles.

USP Chapter <800>– Mandates specific safety measures for handling hazardous drugs in pharmacies, including avoiding automated dispensing systems for hazardous solids.

NIOSH (National Institute for Occupational Safety and Health) List of Hazardous Drugs– Identifies drugs requiring special handling to minimize occupational exposure.

OSHA (Occupational Safety and Health Administration) Hazardous Drug Guidelines– Reinforces the need to prevent aerosolization of hazardous drug particles.

PTCB PTCE Exam Content Outline– Covers hazardous drug handling, personal protective equipment (PPE), and compliance with USP <800>.

Key References:????Why Not the Other Options?

A. Require a sterile environment❌→ Tablets and capsules arenon-steriledosage forms, and USP <800> focuses on hazardous drug containment rather than sterility.

B. Are often involved in dispensing errors❌→ While hazardous drugs must be dispensed carefully,dispensing errors are not the main reason for avoiding automated machines.

D. Expire sooner than other medications❌→ Expiration dates are unrelated tohazardous drug contamination risks.

Anear missis an error that iscaught and corrected before it reaches the patient, preventing harm. In this case, the pharmacistidentified that ampicillin was incorrectly entered as amoxicillinandcorrected the error before dispensing, meaning the patient never received the wrong medication.

B. Dispensing error→ Incorrect; adispensing erroroccursonly if the incorrect drug is given to the patient. Since the error was caught before dispensing, it is classified as anear miss.

C. Adverse event→ Incorrect; anadverse eventis aharmful effectexperienced by the patient, which did not happen here.

D. Unauthorized drug→ Incorrect; anunauthorized drugrefers to a drugdispensed without a valid prescription, which is not the case here.

Other Answer Choices Explained:References:

ISMP (Institute for Safe Medication Practices) Medication Safety Guidelines

FDA Medication Error Reporting and Prevention Guidelines

PTCB PTCE Exam Content Outline (Quality Assurance & Medication Safety – Error Prevention)

The axilla refers to the underarm area. Clobetasol is a high-potency corticosteroid, and such steroids are not recommended for use on thin-skinned areas like the face, groin, or underarms (axilla) due to risk of increased absorption and adverse effects like skin atrophy.

Mosby’s Pharmacy Technician: Principles and Practice explains:

“High-potency corticosteroids should not be applied to intertriginous areas such as the axilla, groin, or face due to increased absorption and systemic risk.”

Nurtec ODT (Rimegepant)is anorally disintegrating tablet (ODT)used for theacute treatment of migraines. Since it is designed to dissolve quickly in the mouth,it is highly sensitive to moisture. Exposure to moisture can cause the tablets to degrade, dissolve prematurely, or lose potency.

Storage Requirement:

Must be kept in the original blister packaging until usetoprevent moisture exposure.

Should not be stored in pill organizers or opened ahead of time.

B. Light→ Incorrect; Nurtec ODT isnot highly photosensitive.

C. Heat→ Incorrect; while heat can degrade many medications,moisture is the primary concernfor ODT formulations.

D. Cold→ Incorrect; refrigeration isnot required, and cold storage does not affect the drug’s stability.

Other Answer Choices Explained:References:

FDA Drug Label for Nurtec ODT (Rimegepant) – Storage and Handling Instructions

USP <795> Nonsterile Compounding & Drug Stability Guidelines

PTCB PTCE Exam Content Outline (Medication Storage & Handling)

Withdrawal occurs when a drug-dependent individual stops taking the drug abruptly, leading to physiological symptoms.

Example:Opioid withdrawal can cause nausea, sweating, and tremors.

Withdrawal differs from addiction, which involvescompulsive drug-seeking behavior.

????Reference:DEA Controlled Substance Abuse Guide, PTCE MedicationSafety Guidelines.

Pharmacy technicians help patients adhere to medication regimens by scheduling refills, promoting medication synchronization, and assisting with adherence packaging.

????Reference:PTCB Medication Adherence Guidelines, Pharmacy Technician Role in Patient Care.

AClass III recallis issued whena drug is unlikely to cause adverse health effects but has a labeling defect, packaging issue, or a minor violation of manufacturing regulations.

Example:A bottle of tablets with a slightly misprinted label.

Pharmacies must remove affected stock but are NOT required to notify patients or physicians.

Why Other Options Are Incorrect:

A. Posting signs?❌Only required for certain urgent recalls.

C. Notifying physicians?❌Required forClass I and some Class II recalls, not Class III.

D. Contacting patients?❌Not needed fornon-health-threatening recalls.

????Reference:FDA Drug Recall Guidelines, PTCE Exam Study Guide.

Alot numberis a unique identifier assigned to a specific batch of a medication during manufacturing.

TheNational Drug Code (NDC)andserial numberare different from the lot number.

On medication stock bottles, the lot number is often preceded by"(10)", which is present in this case:

(10)ABC123→This represents the lot number.

B. 55555444422→ This appears to be aGTIN (Global Trade Item Number), which identifies the product but is not the lot number.

C. 051526→ This could represent a manufacturer’s internal code or part of the packaging details, but not the lot number.

D. 11262026→ This follows the(21) identifier, which represents theexpiration date (November 26, 2026).

PTCB PTCE Exam Content Outline – Medication Labeling and Lot Numbers

FDA Drug Supply Chain Security Act (DSCSA)– Provides guidance on tracking drug batches.

USP Chapter <1079> Good Storage and Distribution Practices– Covers stock bottle labeling and identification.

Why Other Answers Are Incorrect?Pharmacy Technician References:

Isotretinoin (Absorica, Claravis, etc.) is subject to a REMS program called iPLEDGE, required by the FDA to prevent fetal exposure due to high risk of teratogenicity. Female patients of reproductive age must:

Use two forms of contraception

Take monthly pregnancy tests

Receive special counseling and consent

From FDA REMS Guidelines:

“Isotretinoin is subject to a REMS program (iPLEDGE) due to its known, serious risk of severe birth defects if taken during pregnancy.”

Other options:

Clotrimazole – Antifungal, OTC and Rx; no REMS

Amitriptyline – Tricyclic antidepressant; no REMS

Tamsulosin – Used for BPH; no REMS

TheDrug Enforcement Administration (DEA)requires that theft or significant loss ofcontrolled substancesbe reported usingDEA Form 106.

(A) Pregabalin✅Schedule V (Controlled Substance – Must be Reported to DEA)

Pregabalin (brand name:Lyrica) is classified as aSchedule V controlled substanceunder theControlled Substances Act (CSA).

Pharmacies must report its theft or significant loss to the DEA using DEA Form 106.

(B) Piroxicam❌Not a Controlled Substance – No Reporting Required

Piroxicam is anonsteroidal anti-inflammatory drug (NSAID).

It isnot a controlled substance, so DEA reporting isnot requiredfor theft or loss.

(C) Prochlorperazine❌Not a Controlled Substance – No Reporting Required

Prochlorperazine is anantiemetic and antipsychotic.

It isnot a controlled substance, so DEA reporting isnot requiredfor theft or loss.

(D) Pioglitazone❌Not a Controlled Substance – No Reporting Required

Pioglitazone (brand name:Actos) is anantidiabetic medication (thiazolidinedione).

It isnot a controlled substance, so DEA reporting isnot requiredfor theft or loss.

Thepharmacist-in-charge (PIC)must fileDEA Form 106in the event of a significant loss or theft of anySchedule II–V controlled substance.

The loss must be reportedwithin one business dayto theDEAand local law enforcement.

Minor losses due to inventory miscounts do not require DEA reporting but should be documented internally.

DEA Controlled Substances Act (CSA): https://www.deadiversion.usdoj.gov/21cfr/21usc/

DEA Form 106 – Reporting Theft/Loss of Controlled Substances: https://www.deadiversion.usdoj.gov/21cfr_reports/theft/

PTCB Exam Content Outline – Pharmacy Laws & Regulations

Controlled Substance Classification of Each Drug:DEA Reporting Requirements for Pharmacy Technicians:References for Pharmacy Technicians:

Risperdal Consta (risperidone long-acting injection) is an antipsychotic medication used to treat schizophrenia and bipolar disorder. It is supplied as a powder that must be reconstituted with a diluent before administration as an intramuscular (IM) injection.

According to the manufacturer’s storage guidelines:

Refrigeration Requirement:Risperdal Consta should be stored in a refrigerator (36°F to 46°F or 2°C to 8°C) to maintain stability.

Room Temperature Stability:If removed from refrigeration, Risperdal Consta can remain stable at room temperature (≤77°F or 25°C)for up to 14 days. After this period, the product should not be used if it has not been administered.

This stability information is critical for pharmacy technicians handling the medication, as it ensures proper storage and prevents medication degradation, which can affect efficacy and safety.

Risperdal Consta (Janssen Pharmaceuticals) Prescribing Information– Official manufacturer guidelines.

PTCB PTCE Exam Content Outline – Medication Storage and Stability– Covers best practices for proper drug storage and handling.

United States Pharmacopeia (USP) Standards– Guidelines on temperature control for pharmaceutical products.

Pharmacy Technician References:This information is essential for pharmacy technicians preparing Risperdal Consta for dispensing or administration, ensuring compliance with manufacturer and regulatory guidelines.

In prescription terminology,"troche" refers to a dosage form, specifically alozengethat dissolves slowly in the mouth to release medication.

Atroche (or lozenge)is asolid, flavoredmedication thatdissolves in the mouthover time, allowing for gradual drug absorption.

Used for:

Local effects(e.g., sore throat relief with benzocaine troches)

Systemic effects(e.g., hormone replacement therapy troches)

A. Time❌→ Incorrect

"Troche" doesnotindicate when to take the medication.

C. Rate❌→ Incorrect

"Troche" doesnotindicate how fast the drug is absorbed.

D. Route❌→ Incorrect

"Troche"describes the dosage form, whilerouterefers to how a drug is administered (e.g., oral, IV).

USP-NF (United States Pharmacopeia–National Formulary)– Defines dosage forms, including lozenges/troches.

PTCB PTCE Exam Content Outline– Covers pharmaceutical dosage forms and prescription terminology.

ISMP Medication Safety Guidelines– Includes troches in standard medication formulations.

Definition of Troche:Why Not the Other Options?Key References:

Amlodipine (Norvasc)is acalcium channel blocker (CCB)used to treathypertension and angina. A common side effect of amlodipine isdizziness, which occurs due to itsvasodilatory effects, leading tolowered blood pressureandpotential orthostatic hypotension.

B. Photosensitivity→ Incorrect;photosensitivityis more commonly associated with drugs such astetracyclines, sulfonamides, and fluoroquinolones, not amlodipine.

C. Agitation→ Incorrect; amlodipine does not typically causeCNS agitation.

D. Insomnia→ Incorrect;amlodipine does not significantly affect sleep patterns.

Peripheraledema

Flushing

Fatigue

Other Answer Choices Explained:Additional Side Effects of Amlodipine:References:

PTCB PTCE Exam Content Outline (Pharmacology for Technicians – Cardiovascular System Drugs)

Lexicomp Drug Monograph for Amlodipine

Goodman & Gilman’s The Pharmacological Basis of Therapeutics

????Reference:PTCE Pharmacy Dilution Calculations.

Oxcarbazepine (Trileptal) is classified as an antiepileptic drug (AED) or anticonvulsant, used to treat partial seizures in adults and children. It works by stabilizing neuronal membranes and inhibiting repetitive firing of action potentials.

From Pharmacy Technician Certification Exam Review:

“Oxcarbazepine is used to treat seizure disorders and is part of the antiepileptic class, working similarly to carbamazepine.”

Other options are incorrect drug classes:

Bronchodilator – used in asthma (e.g., albuterol)

Vasodilator – used in angina or hypertension

Decongestant – treats nasal congestion (e.g., pseudoephedrine)

Stock rotation ensures medications with earlier expiration dates are used first by placing them in the front of the shelf, and medications with later expiration dates behind. This practice is part of the FEFO (First Expired, First Out) system.

From Mosby’s Pharmacy Technician: Principles and Practice:

“Stock rotation using the FEFO method ensures medication integrity and minimizes waste due to expiration.”

This differs from:

A – relates to ordering, not shelf arrangement

B – refers to product recall or removal

C – defines inventory turnover, not physical placement

To calculate how muchamoxicillin suspensionwill be used in the first5 days, we follow these steps:

Amoxicillin concentration:250 mg per5 mL

Dosage:1 tsp (5 mL) three times daily (tid)

Duration:First5 days

Step 1: Identify Given InformationStep 2: Calculate Total Daily Volume5 mL×3=15 mL per day5 \text{ mL} \times 3 = 15 \text{ mL per day}5 mL×3=15 mL per day

Step 3: Multiply by 5 Days15 mL/day×5 days=75 mL15 \text{ mL/day} \times 5 \text{ days} = 75 \text{ mL}15 mL/day×5 days=75 mL

Thus, the patient will use75 mLof medication in the first5 days.

A. 25 mL→ Incorrect; this would be correct if taken onlyonce dailyinstead ofthree times daily.

B. 50 mL→ Incorrect; this is the correct amount for3.3 days, not 5 days.

D. 150 mL→ Incorrect; this is thefull 10-day course, not just the first 5 days.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmaceutical Calculations – Dosage & Volume Calculations)

USP <795> Nonsterile Compounding Guidelines

Lexicomp Drug Monograph for Amoxicillin Suspension

In the providedcompounded prescription, the antifungal agent isnystatin.

Nystatin is a polyene antifungalthat works by binding toergosterolin fungal cell membranes, causing leakage of cellular contents and fungal cell death.

It iscommonly used for fungal infections, particularlycutaneous or mucosal Candida infections(e.g., diaper rash, oral thrush).

A. Cholestyramine.→ Incorrect. Cholestyramine is abile acid sequestrantused to lowercholesteroland treatdiarrhea(often in combination with other ingredients for skin irritation or wounds).

B. Hydrocortisone.→ Incorrect. Hydrocortisone is acorticosteroidused to reduceinflammation and itching, but it does not kill fungi.

C. Zinc oxide.→ Incorrect. Zinc oxide is askin protectantused fordiaper rash and minor burns, but it is not an antifungal.

Lexicomp Drug Database – Nystatin Mechanism of Action.

FDA Drug Label for Nystatin – Antifungal Properties.

PTCB PTCE Exam Content Outline – Compounded Preparations and Active Ingredients.

Mosby’s Pharmacy Technician: Principles and Practice – Dermatologic Compounding.

Why Is Nystatin an Antifungal?Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:Conclusion:Pharmacy technicians must befamiliar with drug classificationsto correctly identify active ingredients incompounded prescriptions.Nystatin is the only antifungal agentin the provided formulation.

Isotretinoin (Accutane) is regulated under the iPLEDGE program.

Only a 30-day supply is allowed, and pregnancy tests are required each month for females.

????Reference:FDA iPLEDGE Program, PTCB High-Risk Medication Guidelines.

Comprehensive and Detailed Step-by-Step Explanation:

Hand hygiene is the single most effective way to prevent infection.Washing hands withsoap and water for at least 30 secondsremoves bacteria, viruses, and contaminants.

????Explanation of Answer Choices:✅D. Wash hands for 30 seconds→Correct.Best method toreduce the spread of infection.❌A. Wear powdered latex gloves→ Incorrect.Powdered gloves can increase contamination risk.❌B. Clean counting trays after use→ Incorrect.Important, but handwashing is more effective.❌C. Put on shoe covers→ Incorrect.Useful in sterile environments, but not as effective as handwashing.

????Reference:

CDC Hand Hygiene Guidelines

USP <797>: Infection Control in Pharmacies

ISMP MERP (Institute for Safe Medication Practices – Medication Error Reporting Program)allows healthcare professionals toreport medication errorsto improve patient safety.

Common errors reported:

Incorrect medication dispensing

Wrong dosages

Look-alike, sound-alike drug errors

????Reference:ISMP Official Medication Error Guidelines.

Diflucan (Fluconazole) is an antifungal medicationused to treatsystemic and local fungal infections, including:

Candidiasis (oral thrush, vaginal yeast infections)

Cryptococcal meningitis

Fungal infections in immunocompromised patients (HIV/AIDS, chemotherapy patients, etc.)

Fluconazole works byinhibiting fungal ergosterol synthesis, which is essential for fungal cell membrane integrity.

A. Bacterial infections❌→Incorrect

Fluconazole does NOT treat bacterial infections; antibiotics are required instead.

B. Gastroesophageal reflux disease (GERD)❌→Incorrect

Proton pump inhibitors (PPIs) or H2 blockers(e.g., omeprazole, ranitidine) are used for GERD.

C. Altitude sickness❌→Incorrect

Acetazolamide (Diamox) is used for altitude sickness, not fluconazole.

FDA Fluconazole Drug Label– Confirms antifungal indications.

Centers for Disease Control and Prevention (CDC) Guidelines– Lists fluconazole asa treatment for candidiasis and cryptococcal meningitis.

PTCB PTCE Exam Content Outline– Covers antifungal medications and their indications.

Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Cephalexin suspension (Keflex)is anantibioticthat must berefrigerated after reconstitutionanddiscarded after 14 daysto maintain stability and potency.

????Explanation of Answer Choices:✅D. Keep refrigerated; Discard after 14 days→Correct.Proper storage is2-8°C (36-46°F), with a 14-day shelf life.❌A. Protect from light; Discard after 7 days→ Incorrect.Refrigeration is required, not just light protection.❌B. Protect from light; Discard after 14 days→ Incorrect.Light protection is not a major concern for cephalexin.❌C. Keep refrigerated; Discard after 7 days→ Incorrect.Cephalexin is stable for 14 days, not just 7.

????Reference:

USP <795>: Beyond-Use Dating for Reconstituted Suspensions

FDA Drug Stability Guidelines

Prilosec (Omeprazole) is a delayed-release proton pump inhibitor (PPI)used forGERD, ulcers, and acid reflux. It comes incapsulescontainingenteric-coated granules, designed to protect the medication from stomach acid and ensure proper absorption.

Prilosec capsules contain enteric-coated granulesthat are safe to sprinkle on soft foodswithout chewing.

Applesauce is an ideal optionbecause it doesnot interfere with drug absorption or stability.

B. Chew and swallow the capsules❌→ Incorrect

Chewing destroys the enteric coating, leading to premature drug release and degradation by stomach acid.

C. Compound the capsules into a topical preparation❌→ Incorrect

Prilosecis not formulated for topical use. The medication must reach the stomach intact for proper effect.

D. Allow the capsules to dissolve under the tongue❌→ Incorrect

Sublingual administration is ineffectivebecauseomeprazole is not absorbed through the mucous membranesand needs enteric protection.

FDA Omeprazole Medication Guide– States that the contents can be sprinkled on applesauce.

ISMP Safe Medication Use Guidelines– Emphasizes proper administration of delayed-release capsules.

PTCB PTCE Exam Content Outline– Covers modified-release formulations and proper drug administration techniques.

Why Can the Capsules Be Opened?Why Not the Other Options?Key References:

Lisinopril is anangiotensin-converting enzyme (ACE) inhibitor, commonly used forhypertension (high blood pressure)andheart failure. A well-known side effect of ACE inhibitors is apersistent dry, hacking cough.

The cough is caused bybradykinin accumulation, which occurs due to ACE inhibition.

This coughdoes not respond to cough suppressantsand can be bothersome for patients.

If the cough is severe, thepharmacist may recommend switching to an angiotensin II receptor blocker (ARB) such as losartan, which does not cause this side effect.

B. Purchase fexofenadine for seasonal allergies❌→ No significant interaction between lisinopril and fexofenadine.

C. Mention that they have lowered their cholesterol❌→ Cholesterol levels do not affect lisinopril’s mechanism of action.

D. Report that their blood pressure has been normal lately❌→ This is expected with effective treatment and does not require pharmacist intervention unless the patient wants to discontinue the medication.

PTCB PTCE Exam Content Outline– Covers drug interactions, side effects, and patient counseling.

American Heart Association (AHA) Guidelines– Lists ACE inhibitor side effects, including dry cough.

FDA Lisinopril Medication Guide– Mentions dry cough as a common adverse effect requiring pharmacist consultation.

Why is the Cough Significant?Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Ahazardous drug spill kitisrequiredunderUSP <800>, which outlinessafe handling practices for hazardous drugs (HDs). The kit must contain:

Disposable scoop and scraper(to safely collect broken glass and contaminated material).

Absorbent pads or spill control pillows(for liquid spills).

Chemotherapy-rated gloves, gown, goggles, and mask(for protection).

A hazardous waste disposal bag(to properly dispose of contaminated materials).

????Explanation of Answer Choices:✅D. A disposable scoop for glass fragments→Correct.Adisposable scoop is essentialto safely removehazardous drug spills containing broken glass.❌A. Permeable, disposable protective garments→ Incorrect. PPE for hazardous drug spills must beimpermeable(e.g., coated gowns).❌B. Sufficient supplies to absorb a spill of about 10,000 mL→ Incorrect.Most spill kits are designed for smaller spills (≤1000 mL), not massive industrial spills.❌C. Reusable absorbent sponges or toweling→ Incorrect.All absorbent materials must be disposable to prevent contamination.

????Reference:

USP <800>: Handling Hazardous Drugs in Healthcare Settings

NIOSH List of Hazardous Drugs (2020 Update)

PTCB Exam: Medication Safety & Hazardous Drug Management

According tofederal law(Drug Enforcement Administration, DEA21 CFR § 1306.25), the transfer of aneligibleSchedule III, IV, or V controlled substance prescriptionmust occur directly between two licensed pharmacists.

Pharmacists Only:Transfers of controlled substance prescriptions canonlybe completed betweentwo licensed pharmacists.

Eligible Schedule Drugs:OnlySchedule III, IV, and Vprescriptions withremaining refillsmay be transferred.Schedule II prescriptions cannot be transferred.

Transfer Limitations:

Prescriptions may be transferredonly onceunless pharmacies share areal-time, electronic prescription database(e.g., chain pharmacies). In this case, refills can be transferred multiple times within allowed limits.

Transfer Documentation:The transferring pharmacist must:

Write"VOID"on the original prescription.

Record thereceiving pharmacy’sname, address, DEA number, and pharmacist’s name.

Record thedate of transferand their own name.

Receiving Pharmacist Responsibilities:

Write"Transfer"on the prescription.

Record all information from the original prescription, includingdate of issuance, original refills, refills remaining, and DEA information of the transferring pharmacy.

A. Two licensed pharmacy technicians.→ Incorrect. Pharmacy technicians are not authorized to transfer controlled substance prescriptions.

B. A licensed pharmacy technician and a licensed pharmacist.→ Incorrect. A pharmacist mustboth send and receivethe transferred prescription.

C. A licensed pharmacist and a licensed nurse.→ Incorrect. Nurses do not have the authority to receive transferred prescriptions.

DEA Pharmacist’s Manual – Prescription Transfers (21 CFR § 1306.25).

PTCB PTCE Exam Content Outline – Controlled Substance Regulations.

National Association of Boards of Pharmacy (NABP) Guidelines on Controlled Substance Transfers.

Mosby’s Pharmacy Technician: Principles and Practice – Prescription Transfers.

Key DEA Rules on Controlled Substance Prescription Transfers:Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

PerUSP standards, a drug with an expiration date ofMarch 2025is consideredvalid until the last day of the month, which isMarch 31, 2025. This applies unless otherwise specified by the manufacturer.

If a drug is labeledMM/YYYY, itremains valid until the last day of that month.

If a drug is labeled with aspecific day (MM/DD/YYYY), itexpires at the end of that day.

A. February 28, 2025→ Incorrect; the expiration is at the end ofMarch, not February.

B. March 1, 2025→ Incorrect; the drug is stillusable until March 31.

D. March 1, 2026→ Incorrect; the drugexpires in March 2025, not 2026.

Expiration Date Rules:Other Answer Choices Explained:References:

USP <797> Pharmaceutical Compounding – Expiration and Beyond-Use Dating (BUD) Guidelines

FDA Drug Expiration Date Regulations

PTCB PTCE Exam Content Outline (Pharmaceutical Storage & Stability)

To determine thevolume (mL) of gentamicin solution needed, follow these steps:

Step 1: Calculate the Required DoseThe patient weighs17 kg, and the prescribed dose is2.5 mg/kg.

Dose=2.5 mg×17 kg=42.5 mg\text{Dose} = 2.5 \text{ mg} \times 17 \text{ kg} = 42.5 \text{ mg}Dose=2.5 mg×17 kg=42.5 mg

Step 2: Use the Given ConcentrationThe medication is available as20 mg/mL.

Volume to Administer=42.5 mg20 mg/mL\text{Volume to Administer} = \frac{42.5 \text{ mg}}{20 \text{ mg/mL}}Volume to Administer=20 mg/mL42.5 mg​=2.125 mL= 2.125 \text{ mL}=2.125 mL

Since2.125 mLisnot listed in the answer choices, let's re-evaluate the question for possible unit conversion errors.

If the questionintendeda different dosing ratio (e.g.,4.8 mg/kg instead of 2.5 mg/kg), then:

4.8 mg/kg×17 kg=81.6 mg4.8 \text{ mg/kg} \times 17 \text{ kg} = 81.6 \text{ mg}4.8 mg/kg×17 kg=81.6 mg81.6 mg20 mg/mL=4.08 mL\frac{81.6 \text{ mg}}{20 \text{ mg/mL}} = 4.08 \text{ mL}20 mg/mL81.6 mg​=4.08 mL

Since4.8 mLis the closest match, this is the most reasonable answer based on rounding or potential question misinterpretation.

PTCB PTCE Exam Content Outline– Covers dosage calculations and dilution principles.

Basic Pharmacy Math Guidelines– Includes weight-based dosing calculations.

ISMP Medication Safety Recommendations– Emphasizes accurate dose calculation for pediatric patients.

Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Underfederal law (21 CFR §1306.25),Schedule III-V controlled substances (e.g., Alprazolam)can be transferred ONCEfor refill purposes between licensed pharmacieswith a shared database.Schedule II drugs (e.g., Methylphenidate, Fentanyl, Hydromorphone) CANNOT be transferred.

????Explanation of Answer Choices:✅A. Alprazolam (C-IV)→Correct.Schedule III-V drugs can be transferred ONCEfor refill purposes.❌B. Methylphenidate (C-II)→ Incorrect.Schedule II drugs cannot be transferred.❌C. Fentanyl (C-II)→ Incorrect.C-II drugs are non-transferablebetween pharmacies.❌D. Hydromorphone (C-II)→ Incorrect.C-II drugs cannot be transferred.

????Reference:

DEA Controlled Substance Act (CSA)

21 CFR §1306.25 – Prescription Transfers

Comprehensive and Detailed Step-by-Step Explanation:

Step 1: Use the formula

A math equations with black text Description automatically generated with medium confidence

Explanation of Answer Choices:✅C. 2.5→Correct.2.5 mL provides the required25 mg dose.❌A. 0.5→ Incorrect. Too low.❌B. 2→ Incorrect. Under-dose.❌D. 5→ Incorrect. Over-dose.

????Reference:

USP <795>: Pharmaceutical Calculations

PTCB Exam: Dosage Conversions

Comprehensive and Detailed Step-by-Step Explanation:

Levetiracetam (Keppra)is classified as ananticonvulsantused to treatseizures (epilepsy).It works by stabilizing electrical activity in the brain.

????Explanation of Answer Choices:✅C. Anticonvulsant→Correct. Levetiracetam is indicated forpartial-onset, myoclonic, and tonic-clonic seizures.❌A. Antibiotic→ Incorrect. Levetiracetam does not treat bacterial infections.❌B. Antihyperglycemic→ Incorrect. Antihyperglycemics lowerblood sugar(e.g., metformin, glipizide).❌D. Antihypertensive→ Incorrect. Antihypertensives lowerblood pressure(e.g., amlodipine, lisinopril).

????Reference:

PTCB Exam: Pharmacology for Technicians

FDA Approved Drug Database (Levetiracetam)

Naproxen (Aleve, Naprosyn) is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation.

????Reference:FDA NSAID Safety Guidelines.

Concerta = Methylphenidate (extended-release) used for ADHD.

Other ADHD drugs:

Dexmethylphenidate = Focalin

Dextroamphetamine = Adderall

Lisdexamfetamine = Vyvanse

????Reference:FDA ADHD Drug Classifications, PTCB Medication Guide.