PTCE Pharmacy Technician Certification (CPhT) Exam Questions and Answers

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

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.

Phenytoin (Dilantin)is ananticonvulsantthatstabilizes neuronal membranesbyblocking sodium channels, reducing seizure activity.

Used forepilepsy, tonic-clonic seizures, and status epilepticus.

Why Other Options Are Incorrect:

A. Clonidine?❌Used forhypertension and ADHD, NOT seizures.

B. Atomoxetine?❌Used forADHD, NOT seizures.

C. Guanfacine?❌Used forhypertension and ADHD, NOT seizures.

????Reference:FDA Drug Label for Phenytoin, Epilepsy Foundation Guidelines.

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.

Comprehensive and Detailed Step-by-Step Explanation:

A table with text and numbers Description automatically generated with medium confidence

To determine the total number of10 mg prednisone tabletsrequired to fill the prescription, let's break it down by daily dosing:

First 2 days→ 20 mgtwice daily(b.i.d) =40 mg per day

Total for 2 days:40 mg × 2 =80 mg

Next 2 days→ 20 mgonce daily=20 mg per day

Total for 2 days:20 mg × 2 =40 mg

Next 2 days→ 10 mgonce daily=10 mg per day

Total for 2 days:10 mg × 2 =20 mg

Final 2 days→ 5 mgonce daily=5 mg per day

Total for 2 days:5 mg × 2 =10 mg

Days 1–4:(20 mg doses) → Each 20 mg dose requirestwo 10 mg tablets

Total for these 4 days:(20 mg × 4 days) = 80 mg

Tablets required:80 mg ÷ 10 mg =8 tablets

Days 5–6:(10 mg doses) → Each day requiresone 10 mg tablet

Total for these 2 days:10 mg × 2 =20 mg

Tablets required:20 mg ÷ 10 mg =2 tablets

Days 7–8:(5 mg doses) → Each day requireshalf of a 10 mg tablet

Total for these 2 days:5 mg × 2 =10 mg

Tablets required:1 full tablet (split into halves for two doses)

Step 1: Understanding the Prescription DirectionsStep 2: Determining the Number of 10 mg Tablets NeededFinal Calculation:8 tablets (Days 1-4) + 2 tablets (Days 5-6) + 1 tablet (Days 7-8) = 15 tablets

PTCB PTCE Exam Content Outline– Covers dosage calculations, unit conversions, and prescription interpretation.

Basic Pharmacy Math Principles– Ensuring proper medication dispensing based on prescription instructions.

Pharmacy Practice Guidelines– Proper dispensing techniques for titration therapy, such as steroid tapering.

Key References:

1 pint =473 mL(since 1 pint = 16 fluid ounces, and 1 fluid ounce = 29.5735 mL).A1% suspensionmeans1 g (1000 mg) of rifampin per 100 mLof suspension.

Total dose required:2 tbsp daily =30 mL per day(1 tbsp = 15 mL).

Total volume of the suspension:473 mL

Total rifampin required:(473 mL × 1000 mg) ÷ 100 mL =4730 mg

Each rifampin capsule contains300 mg.So,4730 mg ÷ 300 mg/capsule = 15.77 capsules, which rounds up to16 capsules.

Thus, the correct answer isC. 32 capsules(since the full pint must be compounded).

????Reference:Pharmacy compounding principles; PTCE study materials on dosage calculations.

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:

ACE inhibitors (Angiotensin-Converting Enzyme inhibitors)are medications thatrelax blood vesselsandlower blood pressure. Drugs in this class typically end in "-pril" (e.g.,Lisinopril, Enalapril, Ramipril).

????Explanation of Answer Choices:✅C. ACE inhibitors→Correct.These lowerblood pressure and reduce strain on the heart.❌A. Beta blockers→ Incorrect.End in "-olol" (e.g., Metoprolol, Propranolol), reduce heart rate.❌B. Calcium channel blockers→ Incorrect.End in "-dipine" (e.g., Amlodipine, Nifedipine), lower blood pressure differently.❌D. Statins→ Incorrect.End in "-statin" (e.g., Atorvastatin, Simvastatin), used for cholesterol, not blood pressure.

????Reference:

American Heart Association (AHA) Guidelines

FDA Drug Classification Database

]

A medication'sstabilityrefers tohow well it maintains potency, effectiveness, and safety over time. Several factors candegrade medications, includingoxygen, moisture, temperature, and light.

Oxygen exposurecan causeoxidation, leading to drug degradation and loss of potency.

Many medications, especiallyvitamins (e.g., vitamin C), biologics, and certain antibiotics, are susceptible to oxidative damage.

Medications requiring protection from oxygen are often packaged inair-tight containersorblister packs.

A. Allergies→ Incorrect; allergies affect thepatient, not the drug’sstability.

B. Equivalence→ Incorrect; equivalence refers tobioavailabilitybetween generic and brand-name drugs, not drug stability.

D. Indications→ Incorrect; indications refer toapproved uses of a drug, not factors affecting its stability.

Other Answer Choices Explained:References:

USP <797> and <795> Guidelines on Medication Stability

FDA Drug Stability and Shelf Life Guidelines

PTCB PTCE Exam Content Outline (Medication Storage & Stability)

Briviact (brivaracetam) and Vimpat (lacosamide) are both anticonvulsantsused to treat epilepsy.

Therapeutic duplication alertswarn ofmultiple drugs treating the same condition, increasing the risk of side effects.

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

Comprehensive and Detailed Step-by-Step Explanation:

Mycophenolateis animmunosuppressantused inorgan transplantsand isteratogenic (causes birth defects).It requiresRisk Evaluation and Mitigation Strategies (REMS).

????Explanation of Answer Choices:✅B. Mycophenolate→Correct.High risk ofbirth defects, requiring REMS.❌A. Miconazole→ Incorrect.An antifungal with no REMS requirement.❌C. Phentermine→ Incorrect.Used for weight loss, not teratogenic.❌D. Phenytoin→ Incorrect.Has risks but no REMS requirement.

????Reference:

FDA REMS Program for Mycophenolate

PTCB Exam: Medication Safety & REMS

Drug interactions (like IV compatibility with heparin)must be evaluated bya pharmacisttoavoid adverse effects.

Pharmacy technicians can answer questions about generic names, drug schedules, and insurance issues but cannot provide clinical recommendations.

????Reference:ASHP Pharmacy Technician Scope of Practice, PTCE Guidelines.

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

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:

Oxybutynin (Ditropan, Oxytrol)is ananticholinergic/antispasmodicmedication thatrelaxes the bladder musclesto treatoveractive bladder (OAB).

It reduces symptoms such asfrequent urination, urgency, and urinary incontinenceby blockingmuscarinic receptorsthat control bladder contractions.

Why Other Options Are Incorrect:

A. Bronchitis?❌No, bronchitis is treated withbronchodilators, steroids, or antibiotics.

B. Hyperlipidemia?❌No, hyperlipidemia (high cholesterol) is treated withstatins (e.g., atorvastatin).

D. Pancreatitis?❌No, pancreatitis is managed withIV fluids, pain control, and pancreatic enzyme therapy.

????Reference:FDA Oxybutynin Drug Label, Pharmacology of Urinary Anticholinergics.

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)

Enbrel (etanercept) is a biologic that must be stored in the refrigerator (2°C–8°C or 36°F–46°F).

????Reference:Manufacturer Storage Guidelines, USP Refrigeration Standards.

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.

Comprehensive and Detailed Step-by-Step Explanation:

Adsorption occurs when a drug binds to a surface (e.g., IV tubing), reducing its potency.Some drugs, likeinsulin and nitroglycerin,canadhere to plastic tubing, reducing the active dose the patient receives.

????Explanation of Answer Choices:✅A. Lose potency→Correct.Adsorptionreduces drug strength.❌B. Become contaminated→ Incorrect.Adsorption does not introduce contaminants.❌C. Require refrigeration→ Incorrect.Refrigeration is unrelated to adsorption.❌D. Trigger anaphylaxis→ Incorrect.Adsorption does not cause allergic reactions.

????Reference:

USP <797>: Sterile Compounding

ISMP Guidelines on IV Drug Stability

Butorphanolis aSchedule IV controlled substanceunder theControlled Substances Act (CSA). It is anopioid analgesicused formoderate-to-severe painandmigraine relief. Due to itsabuse potential, it is classified as acontrolled substanceand requires special handling in pharmacies.

A. Metoprolol→ Incorrect; metoprolol is abeta-blockerforhypertension and heart diseaseand isnot a controlled substance.

C. Carvedilol→ Incorrect; carvedilol is also abeta-blockerforheart failure and hypertension, not a controlled drug.

D. Propranolol→ Incorrect; propranolol is abeta-blockerused forhypertension, migraines, and anxiety, but it isnot a controlled substance.

Other Answer Choices Explained:References:

DEA Controlled Substances List (Schedule IV – Butorphanol)

PTCB PTCE Exam Content Outline (Pharmacy Laws & Regulations – Controlled Substances)

Federal Controlled Substances Act (CSA)

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.

Mycophenolate is an immunosuppressant that can cause severe birth defects, requiring a REMS program to ensure patient safety.

????Reference:FDA REMS Drug List, PTCE Study Guide.

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:

MedWatch is the FDA’s reporting system for adverse drug events, medication errors, and safety concerns.

????Reference:FDA MedWatch Program.

According toCDC Hand Hygiene Guidelines, pharmacy technicians should wash their hands withsoap and waterinstead of alcohol-based hand sanitizer when:

Hands are visibly dirty→ Alcohol-based sanitizers are ineffective against certain contaminants like dirt, grease, and some bacteria.

Before eating→ Prevents ingestion of harmful pathogens.

After using the restroom→ Soap and water are required to remove potential fecal contamination.

A. They have time, before eating, and after eating❌→Incorrect

Handwashing ismandatorywhen hands are dirty or after using the restroom, not just when there's time.

B. Their hands are visibly clean, after eating, and before each patient❌→Incorrect

Washing isnot required if hands appear clean—sanitizer is acceptable in most situations except when visibly soiled.

C. They have finished filling prescriptions, before eating, and after each patient❌→Incorrect

Hand hygiene is important, but hand sanitizer is typically used between patients unless hands are visibly dirty.

CDC Hand Hygiene in Healthcare Settings– Recommendssoap and waterfor visibly soiled hands and after restroom use.

USP <797> Guidelines for Aseptic Technique– Emphasizes proper handwashing for sterile compounding.

PTCB PTCE Exam Content Outline– Covers infection control and hand hygiene protocols.

Why Not the Other Options?Key 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)

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:

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 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.

USP <800> mandates that personal protective equipment (PPE) be worn when handling hazardous drug spillsto protect againstinhalation, skin absorption, or accidental ingestion.

Full PPE includes gloves, gowns, eye protection, and respiratory protection when necessary.

????Reference:USP <800> Hazardous Drug Handling Guidelines.

The Master Formulation Record (MFR) is a standardized document that provides step-by-step instructions on how to compound a specificnonsterile preparation.

It includes:

Active and inactive ingredients

Mixing instructions

Equipment needed

Beyond-use dating (BUD)

Storage requirements

Why Other Options Are Incorrect:

A. Medication Guide?❌Intended for patient information, not compounding.

C. Patient Package Insert?❌Explains medication use but doesn’t contain compounding instructions.

D. Safety Data Sheet (SDS)?❌Contains safety and hazard information, not formulation instructions.

????Reference:USP <795> Nonsterile Compounding Standards, PTCB Compounding Study Guide.

Methadone is a Schedule II controlled substanceunder theControlled Substances Act (CSA).

Pharmacies must useDEA Form 222orCSOS (Controlled Substance Ordering System)to orderSchedule II drugs.

Why Other Options Are Incorrect:

A. Buspirone?❌NOT a controlled substance(used for anxiety).

B. Nortriptyline?❌NOT a controlled substance(an antidepressant).

D. Sildenafil (Viagra)?❌NOT a controlled substance(used for erectile dysfunction).

????Reference:DEA Controlled Substance Ordering Requirements (21 CFR 1305).

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:

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.

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:

Methotrexateis achemotherapy agentand animmunosuppressantused for cancer and autoimmune diseases.

It is classified ashazardous pharmaceutical wasteunderResource Conservation and Recovery Act (RCRA)due to itstoxicity.

It must be disposed of followingEPA guidelines for hazardous waste disposal.

????Reference:RCRA hazardous waste disposal regulations;USP <800> guidelines for hazardous drugs.

Lamivudine (Epivir)is anantiretroviral agent used to treat HIV/AIDS and hepatitis B. Some antiretroviral drugs are classified ashigh-alert medications in certain healthcare settingsbecause:

Dosing errors can lead to treatment failure or resistance.

Severe side effects and toxicities may occur if misused.

TheInstitute for Safe Medication Practices (ISMP)includes some antiretrovirals in theirhigh-alert medication list, especially in hospitals.

A. Meperidine❌→Not an antiretroviral; it's a narcotic analgesic (opioid pain reliever).

B. Olopatadine❌→Not an antiretroviral; it's an antihistamine (used for allergies).

D. Tizanidine❌→Not an antiretroviral; it's a muscle relaxant.

ISMP High-Alert Medication List– Includes certainantiretroviral drugs as high-alert medications in some settings.

FDA Drug Labeling for Lamivudine (Epivir)– ListsHIV/AIDS and Hepatitis B as indications.

PTCB PTCE Exam Content Outline– Covers high-alert medications and their risks.

Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Hazardous drugs (HDs)must be handled withpersonal protective equipment (PPE), including:

Gloves (chemotherapy-rated)

Gown (disposable, impermeable material)

Eye protection (if splashing risk exists)

Respirator (if airborne exposure is possible)

????Explanation of Answer Choices:✅B. Wearing personal protective equipment→Correct.USP <800> mandatesPPEfor handling hazardous drugs.❌A. In a chemical safety cabinet→ Incorrect.Only sterile hazardous drugs require a biological safety cabinet.❌C. Using disposable gloves washed between each use→ Incorrect.Disposable gloves should be discarded, not washed.❌D. In a positive-pressure clean room→ Incorrect.Hazardous drugs require negative pressure rooms, not positive pressure.

????Reference:

USP <800>: Hazardous Drug Handling

NIOSH Guidelines on PPE for Hazardous Drugs

To determine the required volume in milliliters (mL) to administer 120 mg of furosemide using a stock concentration of 40 mg/2 mL, follow these steps:

Ordered dose =120 mg

Stock concentration =40 mg per 2 mL

Step 1: Identify Given ValuesStep 2: Set Up a ProportionUse the formula:

Volume required (mL)=(Ordered dose (mg)Stock concentration (mg/mL))\text{Volume required (mL)} = \left( \frac{\text{Ordered dose (mg)}}{\text{Stock concentration (mg/mL)}} \right)Volume required (mL)=(Stock concentration (mg/mL)Ordered dose (mg)​)

First, determine the concentration inmg per mL:

40 mg2 mL=20 mg/mL\frac{40 \text{ mg}}{2 \text{ mL}} = 20 \text{ mg/mL}2 mL40 mg​=20 mg/mL

Now, calculate the required volume:

120 mg20 mg/mL=6 mL\frac{120 \text{ mg}}{20 \text{ mg/mL}} = 6 \text{ mL}20 mg/mL120 mg​=6 mL

Thus, the correct answer is6 mL.

Final Answer: C. 6 mLPharmacy Technician References:

PTCB PTCE Exam Content Outline (Medication Order Interpretation & Dosage Calculations)

USP <797> Guidelines for Sterile Compounding

Mosby’s Pharmacy Technician Exam Review

American Pharmacists Association (APhA) Pharmacy Technician Guide

Comprehensive and Detailed Step-by-Step Explanation:

Procardiais thebrand name for Nifedipine, acalcium channel blocker (CCB)used totreat hypertension and angina.

????Explanation of Answer Choices:✅A. Nifedipine→Correct.Procardia = Nifedipine.❌B. Felodipine→ Incorrect.Another CCB, but not the generic for Procardia.❌C. Diltiazem→ Incorrect.A different CCB (Cardizem).❌D. Amlodipine→ Incorrect.A CCB (Norvasc), but not the generic for Procardia.

????Reference:

FDA Orange Book

PTCB Exam: Generic & Brand Name Medications

Citalopram (Celexa) is an SSRI (Selective Serotonin Reuptake Inhibitor) used for depression and anxiety.

Other drugs listed are for schizophrenia (clozapine, haloperidol) or anxiety (lorazepam).

????Reference:FDA Approved Antidepressants, PTCE Medication Classification Guide.

Comprehensive and Detailed Step-by-Step Explanation:

Levothyroxine (Synthroid)is athyroid hormone replacementused to treathypothyroidism. It must be takenon an empty stomachbecause food, calcium, and ironinterfere with its absorption.

Administration Guidelines for Levothyroxine:

Take30-60 minutes before breakfastwith afull glass of water.

Avoidcalcium, iron, and antacidsfor4 hoursafter taking it.

????Explanation of Answer Choices:✅A. Levothyroxine→Correct.Absorption is reduced by food, calcium, and iron.❌B. Amlodipine→ Incorrect.A calcium channel blocker that can be taken with or without food.❌C. Cyclobenzaprine→ Incorrect.A muscle relaxant with no food restrictions.❌D. Loratadine→ Incorrect.An antihistamine that does not require fasting.

????Reference:

American Thyroid Association (ATA) Levothyroxine Guidelines

FDA Drug Labeling for Synthroid

Needlegauge (G)refers to thediameter of the needle’s lumen(opening).The higher the gauge number, the smaller the needle diameter.

Lower gauge (e.g., 13G, 18G)→Larger needle(wider opening)

Higher gauge (e.g., 27G)→Smaller needle(narrower opening)

Common Needle Gauges and Their Uses:Gauge (G)

Needle Diameter (mm)

Common Use

13G

2.4 mm

IV drug administration (large-bore)

18G

1.2 mm

Drawing thick medications (e.g., oil-based injections)

20G

0.9 mm

General intramuscular (IM) injections

27G

0.4 mm

Subcutaneous (SC) or intradermal (ID) injections (e.g., insulin, vaccines)

Since27Gis the highest gauge listed, it corresponds to thesmallestneedle diameter, making it the correct answer.

A. 13G❌→ One of the largest gauges, used for IV fluids or blood transfusions.

B. 18G❌→ Large needle used for thick medications likedepot injections or contrast agents.

C. 20G❌→ Common forintramuscular injectionsbut larger than 27G.

PTCB PTCE Exam Content Outline– Covers needle gauges, injection routes, and proper medication administration.

USP <797> & USP <800>– Provide sterile compounding guidelines, including appropriate needle gauge selection.

CDC Vaccine Administration Guidelines– Recommend25-30Gfor subcutaneous and intradermal injections.

Why Not the Other Options?Key References:

Diflucan (fluconazole) is an antifungal, whileDiprivan (propofol) is a sedative/anesthetic used for surgery.

Look-Alike, Sound-Alike (LASA) errorsoccur when medications havesimilar names but different indications.

Why Other Options Are Incorrect:

B. Clonidine (BP medication) & Klonopin (anxiolytic)→ LASA error but not antifungal vs. anesthetic.

C. Metronidazole (antibiotic) & Metformin (diabetes drug)→ LASA error but different categories.

D. Amiloride (diuretic) & Amlodipine (BP medication)→ LASA error but different categories.

????Reference:ISMP List of High-Risk LASA Medications.

Comprehensive and Detailed Step-by-Step Explanation:

If a prescriber fails to include a quantity on a prescription, it is considered a prescribing error. Pharmacists and pharmacy technicians must contact the prescriber for clarification.

????Explanation of Answer Choices:

✅D. Prescribing → Correct. The prescriber made the error by omitting critical information.

❌A. Administration → Incorrect. This refers to errors in how the patient takes the medication.

❌B. Dispensing → Incorrect. This refers to pharmacy errors in filling the prescription.

❌C. Dosage → Incorrect. A dosage error occurs when the wrong dose is prescribed or administered.

????Reference:

ISMP Medication Error Guidelines

PTCB Exam: Types of Medication Errors

Comprehensive and Detailed Step-by-Step Explanation:

Retin-A (Tretinoin)is atopical retinoidused foracne treatmentandshould be stored with other topical medicationsatroom temperature (68-77°F or 20-25°C).

????Explanation of Answer Choices:✅D. Topical preparations→Correct.Retin-A is atopical medicationand should be stored accordingly.❌A. Liquid preparations→ Incorrect.Retin-A is not an oral liquid.❌B. Chemotherapy drugs→ Incorrect.Tretinoin is not classified as chemotherapy.❌C. Refrigerated drugs→ Incorrect.Retin-A should not be refrigerated.

????Reference:

USP <1079>: Storage of Pharmaceuticals

Manufacturer’s Storage Guidelines for Retin-A

Comprehensive and Detailed Step-by-Step Explanation:

Phenazopyridine (Pyridium) is a urinary analgesic that turns urine orange/red, so the correct auxiliary label should warn patients about this effect.

????Explanation of Answer Choices:

✅A. May discolor urine → Correct. Phenazopyridine causes urine discoloration.

❌B. May cause drowsiness → Incorrect. Does not cause sedation.

❌C. Chew or crush the tablets → Incorrect. Should not be crushed.

❌D. Take with food or milk → Incorrect. Not required.

????Reference:

FDA Drug Label for Phenazopyridine

Multiple-dose vials (MDVs)containpreservativesto inhibit microbial growth. These vials are designed formultiple withdrawalsover time, increasing the risk of contamination. Preservatives, such asbenzyl alcohol or phenol, help prevent bacterial or fungal contamination after repeated needle insertions.

A. stability and compatibility→ Incorrect. Preservatives do not inhibit drug stability; they prevent microbial contamination.

B. sorption and leaching→ Incorrect. Sorption (adsorption/absorption of drugs onto container surfaces) and leaching (release of chemicals from containers) are unrelated to preservatives.

D. synergistic reactions→ Incorrect. Synergistic reactions refer to drug interactions, not contamination prevention.

Incorrect Answer Choices:Pharmacy Technician References:

PTCB PTCE Exam Content Outline (Sterile and Non-Sterile Compounding)

USP <797> Guidelines for Sterile Compounding

American Society of Health-System Pharmacists (ASHP) Guidelines on Multiple-Dose Vials

Mosby’s Pharmacy Technician Exam Review

Upon receiving a recall notice, thefirststep a pharmacy technician should take is toverify whether the recalled product is present in the pharmacy’s inventory. This is critical because:

Product Identification– The pharmacy must determine if it has the affected lot numbers, expiration dates, or specific product variations mentioned in the recall notice.

Patient Safety– If the product is in stock, it must be removed from inventory immediately to prevent accidental dispensing.

Regulatory Compliance– TheFDA, manufacturer, or wholesaleroften provides specific instructions for handling recalled medications, and the pharmacy must comply with those guidelines.

FDA Drug Recall Guidelines– Recalls are classified intoClass I, II, and III, and the process requires inventory verification before further actions.

PTCB PTCE Exam Content Outline– The PTCB exam emphasizes medication safety and regulatory compliance, which includes proper handling of recalls.

The Drug Supply Chain Security Act (DSCSA)– This federal law mandates tracking and traceability of pharmaceutical products, reinforcing the importance of inventory checks during recalls.

Pharmacy Policy & Procedures– Most pharmacies followStandard Operating Procedures (SOPs)where verification of stock is the first step before contacting patients or returning products.

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

A. Call any affected patients❌→ This step is necessaryafterthe recall is confirmed and documented. If the pharmacy does not have the recalled product, patient notification is unnecessary.

B. Put the recall notice in the inventory technician’s box for processing❌→ Delaying action by simply passing the notice alongwithout verifying stockcan lead to patient harm.

D. Send the product back❌→ While returning recalled products is part of the process, itshould only occur after verification and proper documentation.

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:

Comprehensive and Detailed Step-by-Step Explanation:

TheNational Drug Code (NDC)is a10- or 11-digit numberidentifying a drug'smanufacturer, product, and package size.

????NDC Format:

XXXXX−YYYY−ZZ\text{XXXXX} - \text{YYYY} - \text{ZZ}XXXXX−YYYY−ZZ

First 5 digits= Manufacturer

Middle 4 digits= Drug, strength, and formulation

Last 2 digits=Package size

✅A. Package size→Correct.Since the first two segments(00781-1506)are identical, the difference is in thelast segment, which representspackage size.❌B. Dosage→ Incorrect. Thedosage (mg strength) remains the same.❌C. Manufacturer→ Incorrect. Themanufacturer is the same (first 5 digits are identical).❌D. Strength→ Incorrect. Thestrength is unchanged.

????Reference:

FDA NDC Directory

PTCB Inventory Management Guidelines

To determine the correct volume of amoxicillin suspension per dose, use the given concentration and dose.

Prescription dose:150 mg per dose

Suspension concentration:250 mg per 5 mL

Formula to calculate volume needed:Volume (mL)=Prescribed dose (mg)Concentration (mg/mL)\text{Volume (mL)} = \frac{\text{Prescribed dose (mg)}}{\text{Concentration (mg/mL)}}Volume (mL)=Concentration (mg/mL)Prescribed dose (mg)​

Step 1: Identify Given InformationStep 2: Calculate150 mg250 mg/5 mL=150×5250=750250=3 mL\frac{150 \text{ mg}}{250 \text{ mg/5 mL}} = \frac{150 \times 5}{250} = \frac{750}{250} = 3 \text{ mL}250 mg/5 mL150 mg​=250150×5​=250750​=3 mL

Thus, the patient should take3 mL per dose.

B. 4 mL→ Incorrect; this would correspond to a different strength.

C. 5 mL→ Incorrect; this would deliver250 mg, which is incorrect.

D. 6 mL→ Incorrect; this would deliver300 mg, exceeding the prescribed dose.

Other Answer Choices Explained:References:

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

USP <795> Guidelines for Nonsterile Compounding & Drug Dilution

Lexicomp Drug Monograph for Amoxicillin Suspension

The prescription forhydroxyzine (25 mg q6h) for hypertensionis likely alook-alike, sound-alike (LASA) medication error, ashydroxyzineis anantihistamineused foranxiety, nausea, and allergiesbutnot for hypertension.

A common LASA confusion is between:

Hydroxyzine (antihistamine, sedative effects, brand names: Vistaril, Atarax)

Hydralazine (antihypertensive, vasodilator, used for hypertension, brand: Apresoline)

Sincehydralazineis used forhypertension, the prescription likely contains anordering errorthat must be clarified with the prescriber.

A. Hydroxyzine requires special handling→ Incorrect; hydroxyzine does not require special handling.

B. The prescription exceeds the maximum recommended daily dose→ Incorrect; hydroxyzine's max daily dose is400 mg/day, and this prescription does not exceed it.

D. Hydroxyzine is subject to a REMS program→ Incorrect; hydroxyzineis not part of a Risk Evaluation and Mitigation Strategy (REMS) program.

Other Answer Choices Explained:References:

FDA & ISMP Look-Alike Sound-Alike (LASA) Drug List

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

Lexicomp Drug Monographs for Hydroxyzine & Hydralazine

Look-alike/sound-alike (LASA) medications pose asignificant risk of medication errors. To reduce this risk, pharmacies should:

Use both brand and generic nameson labels to clarify drug identity.

Example:"Celexa (Citalopram)" vs. "Celebrex (Celecoxib)."

B. Place the drug next to another look-alike/sound-alike drug on the shelf if they are alphabetical.❌→Incorrect

LASA drugs shouldnotbe stored next to each other.

Example:Hydroxyzine and Hydralazine should be stored separatelyto avoid mix-ups.

C. Review the first five digits of the NDC to confirm the correct product.❌→Incorrect

The first five digits (manufacturer code) only identify the manufacturer, not the specific drug.

Instead, checking theentire NDC (all 10-11 digits) is necessary.

D. Take hazardous drug precautions.❌→Incorrect

LASA errors are a labeling issue, not a hazardous drug issue.

Institute for Safe Medication Practices (ISMP) LASA Guidelines– Recommends usingboth brand and generic names on labels.

FDA & Joint Commission LASA Drug Safety Recommendations– Emphasizes labeling improvements for LASA drugs.

PTCB PTCE Exam Content Outline– Covers medication safety and error prevention strategies.

Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Shingrix (Zoster Vaccine Recombinant)must be stored in therefrigerator (2°C to 8°C / 36°F to 46°F)and shouldnever be frozen.

????Explanation of Answer Choices:✅C. Shingrix that was stored in a freezer→Correct.Shingrixloses potencywhen frozen.❌A. Boostrix (Tdap) stored in a refrigerator→ Incorrect.Proper storage condition.❌B. Havrix (Hepatitis A vaccine) stored in a refrigerator→ Incorrect.Proper storage condition.❌D. Varivax (Varicella vaccine) stored in a freezer→ Incorrect.Varivax must be stored frozen (-50°C to -15°C).

????Reference:

CDC Vaccine Storage & Handling Guidelines

USP <1079>: Vaccine Storage

Carbon dioxide exposure can cause oxidation and degradation of certain medications, reducing theirstability and effectiveness.

????Reference:USP Drug Storage and Stability Guidelines.

????Reference:PTCE Pharmacy Dilution Calculations.

Carvedilol (Coreg) and labetalol are both non-selective beta-blockersused to treathypertension and heart failure.

Therapeutic substitutionis allowed whentwo drugs have similar effects but different chemical structures.

Carvedilol is often used in place of labetalol, especially in heart failure patients.

Why Other Options Are Incorrect:

A. Albuterol?❌Abronchodilator for asthma/COPD, not a beta-blocker.

C. Tramadol?❌Apain reliever (opioid-like), not a beta-blocker.

D. Estradiol?❌Ahormone replacement therapy, not a beta-blocker.

????Reference:PTCE Medication Classification Guide, FDA Beta-Blocker Comparisons.

Levigating agentsreduce theparticle sizeof powders to make themeasier to mix into an ointment base.

Common levigating agents includemineral oil, glycerin, and propylene glycol.

Why Other Options Are Incorrect:

A. Emulsifying agents?❌Help mix oil and water but do NOT help incorporate solids into ointments.

B. Diluents?❌Used toincrease bulk volume(e.g., lactose in tablets).

D. Preservatives?❌Prevent microbial growth, but do NOT help mix solids into ointments.

????Reference:USP <795> Nonsterile Compounding Guidelines.

Comprehensive and Detailed Step-by-Step Explanation:

Amedication erroroccurs when a patientreceives the wrong drug, dose, or administration method, which can result inadverse effects.High-risk medicationsinclude:

Injectable insulins(risk of hypoglycemia, coma).

Antineoplastic (chemotherapy) agents(toxic at incorrect doses).

Oral anticoagulants (e.g., warfarin, apixaban)(can causefatal bleeding).

????Explanation of Answer Choices:✅A. Topical creams→Correct.While topical medicationscan cause localized irritation or allergies, theyrarely cause systemic toxicitywhen used improperly.❌B. Injectable insulins→ Incorrect.Can cause life-threatening hypoglycemia.❌C. Antineoplastic agents→ Incorrect.High risk of toxicity and organ damage.❌D. Oral anticoagulants→ Incorrect.Incorrect dosing can lead to fatal bleeding.

????Reference:

ISMP List of High-Alert Medications

FDA Guidelines on Medication Errors

PTCB Exam: Medication Safety & Risk Management

Lyrica (pregabalin) is an anticonvulsant that causes drowsiness, dizziness, and sedation.

It is commonly prescribed for nerve pain, epilepsy, and fibromyalgia.

????Reference:FDA Pregabalin Drug Label, PTCE Medication Safety Guide.

Asmanex HFA (Mometasone) is an inhaled corticosteroid used for asthma.

A spacer improves medication delivery by holding the medication in a chamber, allowing better lung absorption.

This is especially important for children and elderly patients.

Why Other Options Are Incorrect:

A. Nebulizer?❌Not needed for an HFA inhaler; used for liquid medications.

C. Ventilator?❌Used for mechanical breathing, not asthma maintenance.

D. Glucometer?❌Used for blood sugar monitoring, unrelated to inhalers.

????Reference:Global Initiative for Asthma (GINA) Guidelines, PTCB Respiratory Medication Guidelines.