PTCB PTCE Pharmacy Technician Certification (CPhT) Exam Exam Practice Test

A potential error is a mistake that is identified and corrected before it reaches the patient.

Example:A technician fillshydralazineinstead ofhydroxyzine, but the pharmacist catches the mistake before dispensing.

????Reference:ISMP Medication Error Categories, PTCE Pharmacy Error Prevention Guide.

Total daily dose = 23 units (AM) + 17 units (PM) = 40 units/day

60 days × 40 units = 2,400 units needed

Each NPH insulin vial contains 1,000 units (10 mL × 100 units/mL)

2,400 units ÷ 1,000 units/vial = 2.4 vials → round up to 3 vials

From Pharmacy Technician Certification Exam Review:

“When calculating insulin quantities, always round up to ensure the patient has sufficient supply. Insulin is typically dispensed in 10 mL vials containing 100 units/mL.”

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:

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:

Corticosteroidsare a class of medications used toreduce inflammation.Fluocinoloneis atopical corticosteroidused foreczema, psoriasis, and allergic reactions.

????Explanation of Answer Choices:✅B. Fluocinolone→Correct.Fluocinolone is a corticosteroidused in skin conditions.❌A. Progesterone→ Incorrect.Progesterone is a hormone, not a corticosteroid.❌C. Methyltestosterone→ Incorrect.Methyltestosterone is an androgen (male hormone).❌D. Spironolactone→ Incorrect.Spironolactone is a potassium-sparing diuretic, not a steroid.

????Reference:

FDA Drug Classification Database

USP Drug Information Handbook

TheInstitute for Safe Medication Practices (ISMP)maintains a list oferror-prone abbreviationsthat shouldnot be usedin medication orders to prevent misinterpretation and medication errors.

Analysis of the Answer Choices:Abbreviation

Meaning

ISMP Recommendation

U

Units

❌Do NOT use→ Can be mistaken for "0" or "4" (e.g., 10U could be misread as 100).Use"unit"instead.

AD

Right ear

❌Do NOT use→ Can be confused with "OD" (right eye).Use"right ear"instead.

AU

Both ears

❌Do NOT use→ Can be confused with "OU" (both eyes).Use"both ears"instead.

gtt

Drop

✅Accepted→ Common and not considered error-prone.

Since"gtt" for drop is not on ISMP's "Do Not Use" list, it is the correct answer.

ISMP List of Error-Prone Abbreviations– Confirms that "U," "AD," and "AU" should not be used in prescriptions.

Joint Commission "Do Not Use" List– Prohibits "U" and similar abbreviations to prevent dosing errors.

PTCB PTCE Exam Content Outline– Covers error prevention strategies, including abbreviation safety.

Key References:

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:

Insurance requires accurate “days supply” calculations.If a30-daysupply is incorrectly entered as a90-daysupply, the system will reject early refills.

????Reference:PTCE Pharmacy Billing and Reimbursement Guidelines.

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:

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:

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

Pseudoephedrineis regulated under theCombat Methamphetamine Epidemic Act (CMEA)of 2005 due to its potential use in methamphetamine production.

It is availableover-the-counter (OTC) but behind the pharmacy counter, and its sale requires:

Proof of ID

Purchase limits (3.6 g per day, 9 g per month)

A log of purchases maintained by the pharmacy

Loratadine, acetaminophen, and naproxendo not have federal restrictions like pseudoephedrine.

????Reference:U.S.Combat Methamphetamine Epidemic Act (CMEA)of 2005.

Breaking Down the SIG Code:"Sig: 1 tab PO q.i.d. p.c. & h.s."

Abbreviation

Meaning

1 tab

Take one tablet

PO

By mouth (oral route)

q.i.d.

Four times daily

p.c.

After meals (post cibum)

h.s.

At bedtime (hora somni)

"Take one tablet by mouth four times daily after meals and at bedtime."✅

(A) Take one tablet by mouth five times daily with meals and at bedtime.❌Incorrect – "q.i.d." means four times daily, not five.

(B) Take one tablet by mouth four times daily without meals and at bedtime with a snack.❌Incorrect – "p.c." meansafter meals, not without meals.

(C) Take one tablet by mouth four times daily before meals and at bedtime.❌Incorrect – "p.c." meansafter meals, not before.

(D) Take one tablet by mouth four times daily after meals and at bedtime.✅Correct – Matches the SIG interpretation.

ISMP List of Common SIG Codes and

PTCB Exam Content Outline – Prescription Interpretation & SIG Code Reading

Putting It Together:Analysis of Answer Choices:References for Pharmacy Technicians:

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

Arexvyis anRSV (respiratory syncytial virus) vaccinefor adults60+ years.

Oncereconstituted, itmust be used within 4 hoursto ensurestability and potency.

After4 hours, bacterial growth andloss of vaccine efficacymake it unsafe for administration.

Why Other Options Are Incorrect:

A. 30 minutes?❌Too short—vaccines are stable for a longer duration.

C. 24 hours?❌Too long—Arexvy degrades faster.

D. 1 week?❌No vaccine remains effective for 7 days after reconstitution.

????Reference:CDC Vaccine Storage & Handling Guidelines,Arexvy Manufacturer Labeling (GSK).

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

Other ADHD drugs:

Dexmethylphenidate = Focalin

Dextroamphetamine = Adderall

Lisdexamfetamine = Vyvanse

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

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:

Comprehensive and Detailed Step-by-Step Explanation:

Glimepiride (Amaryl)is asulfonylureaused tolower blood sugar in type 2diabetesby increasinginsulin secretion from the pancreas.

????Explanation of Answer Choices:✅C. Glimepiride→Correct.Atype 2 diabetes medication(sulfonylurea).❌A. Galantamine→ Incorrect.Used for Alzheimer’s disease.❌B. Gemfibrozil→ Incorrect.Used to lower cholesterol (fibrate).❌D. Granisetron→ Incorrect.Used for nausea and vomiting (antiemetic).

????Reference:

FDA Drug Database: Glimepiride

PTCB Pharmacology Section: Diabetes Medications

Step 1: Convert pounds to kilograms

1 kg = 2.2 lbs

132 lbs ÷ 2.2 = 60 kg

Step 2: Calculate total dose

5 mg/kg × 60 kg = 300 mg

Thus, the correct answer isC. 660 mg.

????Reference:PTCE Calculation Guide, Pediatric Dosage Calculations.

Apidra (insulin glulisine)is arapid-acting insulinthat must bestored between 36°F and 46°F (2°C to 8°C)in the refrigerator. If frozen,it is no longer usableand shouldnever be thawed or dispensed. The best course of action is toreturn it to the distributorto ensure medication integrity and patient safety.

A. Thawed and stored in a refrigerator→ Incorrect;frozen insulin loses its potencyand shouldnot be used.

B. Sent to the prescriber→ Incorrect; the prescriber does not handle medication storage or replacements.

C. Dispensed to a patient→ Incorrect;frozen insulin is ineffectiveand could harm the patient.

Other Answer Choices Explained:References:

FDA Insulin Storage and Handling Guidelines

USP <797> Sterile Preparations – Storage Conditions

Manufacturer Storage Requirements for Apidra (Sanofi-Aventis)

Famotidine suspension is stable for 21 days when stored in the refrigerator (2°C–8°C or 36°F–46°F).

????Reference:FDA Famotidine Stability Guidelines, USP Storage Guidelines.

Comprehensive and Detailed Step-by-Step Explanation:

To preventheparin dosing errors, theFDA requires labeling to display:

Strength per total volume (e.g., 10,000 units/10 mL)

Strength per mL in parentheses (e.g., 1,000 units/mL)

????Explanation of Answer Choices:✅C. Strength per mL enclosed in parentheses→Correct.❌A. Percentage weight per volume→ Incorrect.Heparin is not measured this way.❌B. Volume per total strength→ Incorrect.Reverse order of required labeling.❌D. mL per dose enclosed in parentheses→ Incorrect.Dosing varies by prescription.

????Reference:

FDA Heparin Labeling Guidelines

Comprehensive and Detailed Step-by-Step Explanation:

TheDEA (Drug Enforcement Administration) mandates that controlled substance records must be kept for at least 2 years.

????Explanation of Answer Choices:✅B. 2 years→Correct.TheControlled Substances Act (CSA) requires pharmacies to maintain records for at least 2 years.❌A. 1 year→ Incorrect.Too short.❌C. 5 years→ Incorrect.Some states require longer retention, but federal law states 2 years.❌D. 7 years→ Incorrect.Not required by federal law.

????Reference:

DEA Controlled Substances Act (21 CFR § 1304.04)

PTCB Exam: Pharmacy Law & Regulations

TheNational Drug Code (NDC)is a unique 10- or 11-digit number assigned to each drug product in the U.S.Understanding how NDC numbers are structuredis key to answering this question correctly.

The NDC format is as follows:XXXXX-YYYY-ZZ

First segment (XXXXX)→Labeler (Manufacturer or Distributor)

Second segment (YYYY)→Product Code (Specific Drug, Strength, and Formulation)

Third segment (ZZ)→Package Size (Quantity in the Package)

How to Find the Correct Answer?The given NDC:76439-103-10

76439= Manufacturer/Labeler Code

103= Product Code (Specific Drug & Strength)

10= Package Size

To matchthe same medication, theManufacturer (76439) and Product Code (103) must remain the same. Only thepackage size (last segment) can change.

A. 76439-208-10❌→Incorrect

Product Code (208) does not match (103).

B. 76439-103-50✅→Correct

Same manufacturer (76439) and same drug (103), but different package size (50 instead of 10).

C. 74693-103-10❌→Incorrect

Different manufacturer (74693 instead of 76439).

D. 74693-206-50❌→Incorrect

Different manufacturer (74693) and different product code (206).

FDA NDC Directory– Provides details on NDC structure and product identification.

PTCB PTCE Exam Content Outline– Covers NDC interpretation and drug identification.

Drug Supply Chain Security Act (DSCSA)– Reinforces correct medication identification using NDC.

Analyzing the Answer Choices:Key References:

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

When entering prescription information into a pharmacy computer system,using leading zeros helps prevent medication dosing errorsby clearly specifying the correct dose.

What Are Leading Zeros?Aleading zerois azero placed before a decimal pointto prevent misinterpretation.

✅Correct:0.5 mg(clearly means half a milligram)

❌Incorrect:.5 mg(could be mistaken for 5 mg, leading to a10× overdose).

A. Allergies❌→Important, butnot directly related to dosing errors.

C. Insurance Information❌→Unrelated to medication dosing safety.

D. Contraindications❌→Relevant to medication selection, but not specific to preventing dosing errors.

ISMP Best Practices for Medication Safety– Recommends usingleading zerosto prevent dosing mistakes.

Joint Commission "Do Not Use" List– Warns against missing leading zeros in prescriptions.

PTCB PTCE Exam Content Outline– Covers prescription entry and error prevention strategies.

Why Not the Other Options?Key References:

????Reference:PTCE Medication Usage Calculations.

Sig Code Breakdown:

2 gtt = 2 drops

OU (oculus uterque) = both eyes

q4-6h = every 4 to 6 hours

p.r.n. = as needed

Why Other Options Are Incorrect:

A. Both ears?❌"AU" (auris uterque) means both ears, NOT both eyes.

B. Right ear?❌"AD" (auris dextra) means right ear.

C. Right eye?❌"OD" (oculus dexter) means right eye.

????Reference:PTCB Approved Sig Code List, ISMP Safe Prescription Writing Guidelines.

Zyrtec (cetirizine)is asecond-generation antihistamineused to treatallergies.

Schizophreniais a psychiatric disorder treated withantipsychotics, NOT antihistamines.

This is likely aLook-Alike Sound-Alike (LASA) error, where the intended drug wasZyprexa (olanzapine), anantipsychoticcommonly used for schizophrenia.

The technician must alert the pharmacist before dispensing.

Why Other Options Are Incorrect:

A. Special Handling?❌No, Zyrtec is OTC and does not require special handling.

B. Exceeding Daily Dose?❌No, Zyrtec’s max daily dose is 10 mg for adults.

D. REMS Program?❌No, Zyrtec is not part of aRisk Evaluation and Mitigation Strategy (REMS) program.

????Reference:ISMP’s LASA Drug List,FDA Drug Labeling Guidelines.

TheZ-Pak(azithromycin 250 mg) is a5-day antibiotic coursewith aloading doseto reach effective levels quickly.

Day 1: 2 tablets (500 mg total)

Days 2–5: 1 tablet (250 mg) daily

????Reference:FDA Azithromycin Dosing Guidelines, PTCE Exam Study Materials.

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

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

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.

Risperidone (Risperdal oral solution)is anatypical antipsychoticused to treatschizophrenia, bipolar disorder, and autism-related irritability.

Itsoral liquid formulationmust be storedin the refrigerator (between 2°C and 8°C or 36°F to 46°F)to maintain stability.

If left at room temperature for an extended period, theactive ingredients can degrade, reducing the medication's effectiveness.

Storage Considerations for Other Medications:

Gabapentin (Neurontin liquid formulation):Must be refrigerated.✅

Sertraline (Zoloft oral solution):Stored at room temperature.❌

Aripiprazole (Abilify liquid formulation):Stored at room temperature.❌

????Reference:Manufacturer’s storage guidelines,USP Chapter <797>for compounded sterile preparations.

Incompatibility in a nonsterile compound can be identified through various physical, chemical, and therapeutic changes.An unexpected change in odoris a key indicator of chemical instability, contamination, or degradation of a compounded preparation. Some ingredients may break down into volatile compounds, leading to noticeable odor changes.

A. A clear solution→ Incorrect; clarity alone does not indicate incompatibility.Some solutions may be clear but still chemically unstable.

B. The use of a pH buffer system→ Incorrect; buffer systems are used to maintain pH stability and prevent incompatibility rather than indicate it.

D. Suspension particles settling to the bottom of a container→ Incorrect; suspensions naturally settle and require shaking before use.This is not necessarily a sign of incompatibility.

Other Answer Choices Explained:References:

USP <795> Pharmaceutical Compounding—Nonsterile Preparations

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

Remington: The Science and Practice of Pharmacy

TheVaccine Adverse Event Reporting System (VAERS)is a national system managed by theCDC and FDAto monitoradverse events following vaccination.

Anaphylaxisis asevere, life-threatening allergic reactionthat must beimmediately reported to VAERS, as it is a known but rareserious vaccine side effect.

Other serious events likeGuillain-Barré syndrome, myocarditis, and seizuresalso require VAERS reporting.

A. Constipation→ Incorrect;not a serious vaccine-related event.

C. Drowsiness→ Incorrect; commonbut not severeenough to require VAERS reporting.

D. Hyperlipidemia→ Incorrect;unrelated to vaccines.

Other Answer Choices Explained:References:

CDC VAERS Reporting Criteria for Adverse Vaccine Reactions

FDA Vaccine Safety Monitoring Guidelines

PTCB PTCE Exam Content Outline (Immunizations & Adverse Drug Event Reporting)

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

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

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)

Cytotoxic agents are drugs that kill or damage cells, particularly rapidly dividing cells. They are primarily used in the treatment of cancer (chemotherapy) because cancer cells multiply quickly. These medications interfere with cell division (mitosis), leading to cell death.

According to Mosby’s Pharmacy Technician: Principles and Practice:

“Cytotoxic drugs are most commonly used in oncology. Their use requires special handling and storage protocols to protect healthcare workers and patients.”

Additional Notes:

Diabetes treatments involve insulin or oral antidiabetics, not cytotoxics.

Rosacea and allergies are treated with antimicrobials and antihistamines/steroids, respectively.

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

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:

Tall Man lettering is a patient safety strategy endorsed by the FDA and Institute for Safe Medication Practices (ISMP). It involves capitalizing portions of drug names to highlight differences between look-alike, sound-alike (LASA) medications (e.g., hydrOXYzine vs. hydrALAZINE).

As stated in the ISMP Guidelines:

“Tall Man letters are used to help distinguish look-alike drug names and reduce medication errors, particularly during selection from computer screens or bins.”

It is not mandatory by law, but highly recommended for pharmacies and hospitals to implement.

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:

Experiencingphotosensitivity(increased sensitivity to sunlight) as a result of takingciprofloxacinis an example of anadverse drug reaction (ADR). Thisunexpectedandundesirableeffect occurs in some individuals due tofluoroquinolones causing cellular damage from UV exposure.

A. Intended effect→ Incorrect; the intended effect of ciprofloxacin isbacterial infection treatment, not photosensitivity.

C. Synergistic effect→ Incorrect; asynergistic effectoccurs whentwo drugs work togetherto produce a greater effect, which is not the case here.

D. Anaphylactic reaction→ Incorrect;anaphylaxisis asevere allergic reactionwithrespiratory distress, hypotension, and swelling, not photosensitivity.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Medication Safety & Side Effects)

Lexicomp Drug Monograph for Ciprofloxacin

FDA Fluoroquinolone Safety Warnings

Comprehensive and Detailed Step-by-Step Explanation:

High-alert medicationsaredrugs that carry a higher risk of significant patient harmif used incorrectly.IV propranololis abeta-blocker (adrenergic antagonist)that can causesevere bradycardia, hypotension, and cardiac arrestif administered improperly.

????Explanation of Answer Choices:✅A. Adrenergic antagonist→Correct.Propranololblocks beta receptors, reducing heart rate and blood pressure.❌B. Chemotherapeutic agent→ Incorrect.Propranolol is not a chemotherapy drug.❌C. Opioid→ Incorrect.Propranolol is not an opioid.❌D. Anticoagulant→ Incorrect.Propranolol does not affect blood clotting.

????Reference:

ISMP List of High-Alert Medications

PTCB Exam: Medication Safety & Risk Management

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.

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.

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

????Reference:FDA NSAID Safety Guidelines.

Comprehensive and Detailed Step-by-Step Explanation:

Pseudoephedrine(Sudafed) is asympathomimetic decongestantthat causesvasoconstrictionand canincrease blood pressure.

????Explanation of Answer Choices:✅B. Hypertension→Correct.Pseudoephedrinecan cause arise in blood pressure, so it should be used cautiously in patients withhypertension.❌A. Asthma→ Incorrect.Pseudoephedrine does not directly worsen asthma, but it may cause mild bronchodilation.❌C. Hypokalemia→ Incorrect.Pseudoephedrine does not affect potassium levels.❌D. Eczema→ Incorrect. Eczema is unrelated topseudoephedrine use.

????Reference:

Combat Methamphetamine Epidemic Act (CMEA) Regulations

American Heart Association (AHA) Guidelines on Hypertension

Comprehensive and Detailed Step-by-Step Explanation:

Methotrexate is a hazardous antineoplastic drug listed by NIOSH (National Institute for Occupational Safety and Health). It requires PPE when handled or cleaned up.

????Explanation of Answer Choices:

✅C. Methotrexate → Correct. Listed as a hazardous drug requiring PPE.

❌A. Amiodarone → Incorrect. Not classified as hazardous.

❌B. Atorvastatin → Incorrect. A statin, not hazardous.

❌D. Midazolam → Incorrect. A benzodiazepine, not hazardous.

????Reference:

NIOSH List of Hazardous Drugs (2020)

USP <800>: PPE Requirements for Hazardous Drugs

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:

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

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

????Reference:PTCE Pharmacy Dilution Calculations.

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.

Tall Man letteringis amedication safety strategyrecommended by theFDA, ISMP (Institute for Safe Medication Practices), and The Joint Commissiontoprevent medication errorscaused bylook-alike, sound-alike (LASA) drug names.

Thedistinctive portionsof similar drug names are written inuppercase lettersto highlight differences.

Helps pharmacists, technicians, and healthcare professionals distinguish medications that areeasily confuseddue to similar names.

Reduces the risk ofprescription misinterpretationandmedication errorsin pharmacy settings.

How Tall Man Lettering Works:Examples of Tall Man Lettering (ISMP and FDA-Approved List):Regular Name

Tall Man Lettering Version

prednisone

predniSONE

prednisolone

prednisoLONE

hydroxyzine

hydrOXYzine

hydralazine

hydrALAzine

dobutamine

dobutAMINE

dopamine

dopaMINE

A. Highlights the similarities in drug names.→ Incorrect. Tall Man lettering highlightsdifferences, not similarities, toprevent confusion.

B. Ensures all trade names will be capitalized.→ Incorrect. Tall Man lettering applies toboth brand and generic names, but it is used specifically for drugs with look-alike names.

D. Keeps the pharmacy inventory in alphabetic order.→ Incorrect. Inventory order is based onstandard drug names, not Tall Man lettering.

Institute for Safe Medication Practices (ISMP) – Official Tall Man Lettering List.

FDA and The Joint Commission Medication Safety Guidelines.

PTCB PTCE Exam Content Outline – Medication Safety Strategies.

USP <797> and ISMP Guidelines on Look-Alike, Sound-Alike Medications.

Mosby’s Pharmacy Technician: Principles and Practice – Error Prevention Strategies.

Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:Conclusion:Tall Man lettering is anessential tool for pharmacy techniciansto helpreduce medication errorsby drawing attention todifferencesbetweensimilar drug names, ensuringsafer dispensing and administrationof medications.

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.

The original sig reads:

“i tab PO t.i.d.” which means “take one tablet by mouth three times a day”.

If the label instructs twice daily (b.i.d.) instead of t.i.d., it is a dosage frequency error, leading to under-dosing.

According to Mosby’s Pharmacy Technician: Principles and Practice:

“A transcription error in the frequency of administration can result in subtherapeutic dosing or treatment failure. Accuracy in translating sig codes is essential.”

Other options:

Route (PO) is correct.

Days supply is still 7 days.

Dosage form (tablet) is unchanged.

The NDC number (National Drug Code) is the most effective way to ensure the correct drug is selected.

Hydralazine (blood pressure medication) and hydroxyzine (antihistamine) are Look-Alike, Sound-Alike (LASA) drugsthat can cause serious medication errors if mixed up.

????Reference:ISMP LASA Guidelines, FDA NDC Number Verification.

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.”

Comprehensive and Detailed Step-by-Step Explanation:

The abbreviation "PR" stands for "per rectum", which is a route of administration where the medication is inserted into the rectum for absorption.

????Explanation of Answer Choices:

✅A. Route of administration → Correct. "PR" means rectal administration (e.g., suppositories).

❌B. Frequency of dosing → Incorrect. Frequency abbreviations include BID (twice daily), QD (once daily), etc.

❌C. Medication strength → Incorrect. Strength is indicated by mg, mcg, etc.

❌D. Dosage form → Incorrect. Dosage forms include tablets, capsules, solutions, etc.

????Reference:

ISMP List of Common Prescription Abbreviations

PTCB Exam: Medication Order Interpretation

Fentanyl is a Schedule II controlled substance under the Controlled Substances Act (CSA). The DEA requires that invoices and DEA Form 222 records for Schedule II drugs be filed separately from other controlled (Schedule III–V) and non-controlled drug records.

According to DEA Pharmacist’s Manual:

“Records of Schedule II controlled substances must be maintained separately from all other records of the registrant.”

Other drugs listed:

Lidocaine – non-controlled

Oseltamivir – non-controlled antiviral

Diltiazem – non-controlled calcium channel blocker

Outdated (expired) medicationsmust not be dispensedand should bequarantinedin a separate area to prevent accidental use.

Remove outdated products from active stock immediately.

Label and store them separatelyuntil proper disposal.

Follow DEA, FDA, and state board guidelines for disposal.

Some medications (e.g., controlled substances) require special disposal procedures.

(A) Shipped to the DEA for disposal❌Incorrect – Only controlled substances require DEA disposal (viaReverse Distributor).

(B) Kept on the shelf to be dispensed first❌Incorrect – Expired medications should NEVER be dispensed.

(C) Isolated from active dispensing stock✅Correct – Medications must be separated from usable stock to prevent dispensing errors.

(D) Reported to the ISMP for tracking❌Incorrect – ISMP (Institute for Safe Medication Practices) monitors medication errors, not expiration management.

FDA Drug Disposal Guidelines:

DEA Controlled Substance Disposal Regulations:

PTCB Exam Content Outline – Inventory Management & Drug Disposal

Pharmacy Technician Guidelines for Handling Expired Medications:Analysis of Answer Choices:References for Pharmacy Technicians:

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.

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

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

Cefdinir is a third-generation cephalosporin antibiotic commonly used to treat bacterial infections, including otitis media (middle ear infection) in children. It is available in both capsule and suspension forms. However, cefdinir suspension is supplied in different concentrations, typically125 mg/5 mLand250 mg/5 mL.

The prescription provided specifies"Cefdinir suspension 5 mL PO q12h x 10 days", but it does not mention the concentration (strength) of the suspension. Without this crucial information, the pharmacy cannot accurately determine the total dosage the patient will receive. Different strengths would result in significantly different amounts of cefdinir per dose.

For example:

If the prescriber intended125 mg/5 mL, then the patient would receive125 mg per dose (250 mg daily).

If the prescriber intended250 mg/5 mL, then the patient would receive250 mg per dose (500 mg daily).

This discrepancy could lead tounderdosing or overdosing, making it essential for the pharmacy to contact the prescriber to confirm the correct concentration before dispensing.

A. Cefdinir is not available as a suspension.→ Incorrect. Cefdinir is available inoral suspensionform, typically in 125 mg/5 mL and 250 mg/5 mL concentrations.

C. Cefdinir suspension is not indicated for otitis media.→ Incorrect. Cefdinir is FDA-approved for the treatment of otitis media in pediatric patients.

D. Cefdinir suspension was prescribed for a child old enough to swallow capsules.→ Incorrect. While some 8-year-old children may be able to swallow capsules, many pediatric patients prefer liquid formulations, and prescribers often choose suspensions for better compliance.

PTCB PTCE Exam Content Outline – Medication Order Entry and Fill Process(Ensuring accuracy of prescriptions, including strength and formulation).

FDA Drug Label for Cefdinir– Indicates available strengths and dosing requirements.

Lexicomp Drug Information for Cefdinir– Lists the recommended pediatric dosages and available suspension concentrations.

Pharmacology Textbooks (e.g., "Mosby’s Pharmacy Technician: Principles and Practice")– Reinforce the importance of verifying missing prescription details before dispensing.

Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

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.

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

FDA REMS Program Overview:

PTCB Exam Content Outline – Medication Safety & Risk Management

Analysis of Answer Choices:References for Pharmacy Technicians:

Addyi (flibanserin)is used to treat hypoactive sexual desire disorder (HSDD) in premenopausal women. It is subject to aRisk Evaluation and Mitigation Strategy (REMS) programbecause of its potential to causesevere hypotension (low blood pressure) and syncope (fainting), especially when taken with alcoholor moderate-to-strong CYP3A4 inhibitors.

The REMS program requires healthcare providers and pharmacists to be certified before prescribing or dispensing Addyi. Patients must be counseled on the risks, and alcohol use is strictly contraindicated while taking this medication.

B. is an emergency oral contraceptive→ Incorrect. Addyi is not a contraceptive; it treats HSDD.

C. contains an opioid analgesic→ Incorrect. Addyi is not an opioid; it affects serotonin and dopamine receptors.

D. is a monoclonal antibody→ Incorrect. Addyi is a non-hormonal serotonin receptor agonist/antagonist, not a monoclonal antibody.

Incorrect Answer Choices:Pharmacy Technician References:

PTCB PTCE Exam Content Outline (Medication Safety and REMS Programs)

FDA REMS Database for Addyi (Flibanserin)

Lexicomp Drug Monograph on Addyi

Mosby’s Pharmacy Technician Exam Review

Cytoxan (cyclophosphamide)belongs to thechemotherapy agentdrug classification. It is analkylating agentused to treat various types ofcancer, including:

Leukemia

Lymphoma

Breast cancer

Ovarian cancer

It works byinterfering with DNA replication in rapidly dividing cells, preventing cancer growth.

A. ACE inhibitor❌→Incorrect

ACE inhibitors (angiotensin-converting enzyme inhibitors)are used forhypertension and heart failure(e.g., lisinopril, enalapril).

C. Antibiotic❌→Incorrect

Antibioticstreatbacterial infections(e.g., amoxicillin, azithromycin).

D. Narcotic❌→Incorrect

Narcotics (opioids) are pain relievers(e.g., morphine, oxycodone).Cytoxan is not an opioid.

National Cancer Institute (NCI) Drug Dictionary– ClassifiesCytoxan as an alkylating chemotherapy agent.

PTCB PTCE Exam Content Outline– Covers chemotherapy drugs and their classifications.

FDA Drug Classification Guidelines– Lists Cytoxan as acytotoxic antineoplastic (chemotherapy) drug.

Why Not the Other Options?Key References: