PTCE Pharmacy Technician Certification (CPhT) Exam Questions and Answers

Comprehensive and Detailed Step-by-Step Explanation:

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Explanation of Answer Choices:✅C. 20→Correct.2 tablets per day × 10 days = 20 tablets.❌A. 5→ Incorrect. Under-dose.❌B. 10→ Incorrect. Under-dose.❌D. 40→ Incorrect. Over-dose.

????Reference:

USP <795> Pharmaceutical Calculations

PTCB Exam: Dosing Conversions

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.

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).

During pregnancy, medication safety is classified by theFDA Pregnancy Categories(prior to 2015) or thePregnancy and Lactation Labeling Rule (PLLR)(current system).

Acetaminophen (Tylenol) is considered the safest analgesic for pregnant women, especially for treating mild to moderate pain or fever.

It hasno known teratogenic effectswhen used at recommended doses.

A. Isotretinoin❌→Severe risk in pregnancy (Category X / Contraindicated)

Causes severe birth defects(craniofacial, cardiac, and central nervous system malformations).

Requires enrollment in theiPLEDGE programto prevent pregnancy exposure.

C. Lovastatin❌→Not safe in pregnancy (Category X / Contraindicated)

Cholesterol-lowering statins are teratogenic, as fetal development requires cholesterol.

D. Triazolam❌→Not safe in pregnancy (Category X / Contraindicated)

A benzodiazepine that can cause birth defects, neonatal withdrawal syndrome, and CNS depression in the fetus.

FDA Pregnancy and Lactation Labeling Rule (PLLR)– Discusses medication risks in pregnancy.

American College of Obstetricians and Gynecologists (ACOG) Guidelines– Listsacetaminophen as the preferred pain reliever during pregnancy.

PTCB PTCE Exam Content Outline– Covers drug safety in special populations, including pregnancy.

Why Not the Other Options?Key References:

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.

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:

Comprehensive and Detailed Step-by-Step Explanation:

Alendronate (Fosamax)is abisphosphonateused forosteoporosis. Itprevents bone lossbut can cause severeesophageal irritation and ulcersif not taken correctly.

Correct Administration Instructions for Alendronate:

Take on an empty stomach with a full glass of water (at least 8 oz).

Remain upright (sitting or standing) for at least 30 minutesto prevent esophageal irritation.

Do NOT take with food, milk, or calcium supplementsas they reduce absorption.

????Explanation of Answer Choices:✅A. Do not lie down for at least 30 minutes→Correct.This preventsesophageal irritation and ulcers.❌B. Take with food or milk→ Incorrect.Calcium inhibits alendronate absorption.❌C. May cause drowsiness→ Incorrect.Alendronate does not cause drowsiness.❌D. If a dose is missed, take 2 doses the next day→ Incorrect.Double-dosing increases the risk of side effects.

????Reference:

FDA Drug Labeling for Alendronate

American Association of Clinical Endocrinologists (AACE) Osteoporosis Guidelines

PTCB Exam: Patient Administration Instructions

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

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

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

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

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

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

Drink with a Full Glass of Waterto prevent esophageal irritation.

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

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

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

Lexicomp Drug Interaction Database – Tetracycline and Calcium Interactions.

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

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

PTCB PTCE Exam Content Outline – Drug Interactions and Contraindications.

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

A spacer is a non-prescription medical devicethat enhances the delivery of medication from anMDI (metered dose inhaler).

Since the patient never picked it up and it isnot a controlled or perishable item, the pharmacy canreturn it to dispensing stock for resale.

Why Other Options Are Incorrect:

A. Damaged stock?❌Only if the spacer was opened, broken, or contaminated.

B. The manufacturer?❌Not necessary unless it is defective.

C. The study sponsor?❌Applies only to clinical trial supplies.

????Reference:ISMP Safe Handling of Medical Devices, PTCE Study Guide.

Comprehensive and Detailed Step-by-Step Explanation:

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

Adverse drug reactions (ADRs).

Medical device failures or malfunctions.

Medication errors that lead to harm.

Product quality issues related to safety.

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

????Reference:

FDA MedWatch Program

PTCB Exam: Medication Safety & Reporting

Intradermal (ID) injectionsare deliveredinto the dermis (just below the epidermis).

Used forallergy testing, tuberculosis (TB) testing, and some vaccines.

Theneedle angle is 10–15 degrees, and only asmall volume (0.1 mL – 0.5 mL)is injected.

Why Other Options Are Incorrect:

A. Intraperitoneal?❌Injected into theperitoneal cavity, used in animal research.

B. Intravenous (IV)?❌Injected into aveinfor rapid drug action.

C. Intramuscular (IM)?❌Injecteddeep into the muscle(e.g., vaccines, pain medications).

????Reference:CDC Injection Guidelines, PTCE Exam Study Guide.

Comprehensive and Detailed Step-by-Step Explanation:

Alot number (or batch number)is aunique identifierassigned to a specific batch of medication by themanufacturer. It helps trackrecalls, expiration dates, and quality control.

????Explanation of Answer Choices:✅D. Manufacturer→Correct.Manufacturers assignlot numbersfor tracking and recall purposes.❌A. FDA→ Incorrect. TheFDA does not assign lot numbersbut regulatesdrug safety and labeling.❌B. DEA→ Incorrect. TheDEA controls controlled substancesbut does not issuelot numbers.❌C. Wholesaler→ Incorrect.Wholesalers distribute drugs but do not assign lot numbers.

????Reference:

FDA Drug Product Recall Guidelines

PTCB Inventory Management Section

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

????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.

DEA requires allcontrolled substance prescriptionsto include thedate of issueas per21 CFR 1306.05(a).

Other required elements:

Patient’s full name and address

Drug name, strength, dosage form, quantity

Directions for use

Prescriber’s name, address,DEA number, and signature

????Reference:DEA Controlled Substance Act;21 CFR 1306.05.

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:

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:

Cyclophosphamideis ahazardous drugclassified byNIOSH (National Institute for Occupational Safety and Health).USP Chapter 800mandates thatall surfaces exposed to hazardous drugs (HDs), including counting trays, must be decontaminated after each useto prevent cross-contamination.

????Explanation of Answer Choices:✅C. Decontaminated after each use→Correct.Hazardous drug residues must be removed after each use to prevent contamination.❌A. Activated before each use→ Incorrect. There is no"activation"process for hazardous drug counting trays.❌B. Disposed of after each use→ Incorrect.Counting trays are reusable but must be properly cleaned.❌D. Sterilized before each use→ Incorrect.Sterilization applies to sterile compounding, not hazardous drug handling.

????Reference:

USP <800>: Handling Hazardous Drugs in Healthcare Settings

NIOSH List of Hazardous Drugs (Cyclophosphamide)

Before dispensing a prescription, pharmacy technicians and pharmacists must ensure that it iscomplete, clear, and unambiguousto avoid medication errors.

Medication:Lisinopril

Strength:20 mg (Clear)

Route:PO (by mouth) (Clear)

Directions:Take 1 tab PO q8h (every 8 hours)❌(Needs Clarification)

Quantity:30 tablets (Clear)

Refills:12 (Needs verification but is not the main issue)

Lisinopril is an ACE inhibitorused for hypertension and heart failure.

Standard dosing is once daily (q24h), not every 8 hours (q8h).

A frequency of q8h (three times daily) is unusual and could be a prescribing error.

Pharmacists must verify with the prescriber before dispensing.

(A) Directions for use✅Correct – "q8h" is incorrect for lisinopril and needs clarification.

(B) Medication strength❌Incorrect – "20 mg" is a standard strength for lisinopril.

(C) Route of administration❌Incorrect – "PO" (by mouth) is correct.

(D) Number of refills❌Incorrect – While 12 refills is uncommon for chronic medications, it is not the primary issue.

Lisinopril Prescribing Information (FDA): https://www.accessdata.fda.gov

Institute for Safe Medication Practices (ISMP) – High-Alert Medications:https://www.ismp.org

PTCB Exam Content Outline – Prescription Processing & Clarification

Analysis of the Prescription:Why the Directions Need Clarification:Analysis of Answer Choices:References for Pharmacy Technicians:

According toUSP <800>andOSHA guidelines, exposure control forhazardous drugs (HDs)must begin as soon as the drugenters the facilityto ensure proper handling, storage, and administration safety. This includes:

Receiving:

Hazardous drugs must beunpacked in a designated areathat isseparate from regular medications.

They shouldnot be opened in sterile or positive-pressure areasto prevent contamination.

Storage:

HDs must be stored in anegative-pressure room with proper ventilation.

They must be placed indesignated binsto reduce exposure risks.

Handling and Compounding:

Usepersonal protective equipment (PPE)such as gloves, gowns, and masks when handling hazardous drugs.

Use abiological safety cabinet (BSC) or compounding aseptic containment isolator (CACI)when preparing hazardous drugs.

A. Is dispensed→ Incorrect;control measures must start earlier, before dispensing.

C. Is compounded→ Incorrect; safety measures beginbefore compounding, when the drug arrives at the pharmacy.

D. Is placed on the pharmacy shelf→ Incorrect;exposure control measuresbegin before storage, duringreceiving and handling.

Other Answer Choices Explained:References:

USP <800> Hazardous Drug Handling Guidelines

OSHA Hazardous Drug Safety Standards

NIOSH (National Institute for Occupational Safety and Health) Hazardous Drug List

PTCB PTCE Exam Content Outline (Medication Safety & Hazardous Drug Handling)

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.

When abody area is exposed to a hazardous substance, thefirst actionshould be tothoroughly flush the area with watertoimmediately remove the contaminantand reduce absorption into the skin.

Flush the affected area with water for at least 15 minutes.

Remove contaminated clothing.

Seek medical attention if needed.

Report the incident to the pharmacy manager.

A. Notify the pharmacy manager→ Incorrect;the immediate priorityis to flush the area.Reporting comes after decontamination.

C. Call environmental services for cleanup→ Incorrect; personal exposure should be addressed before worrying about cleanup.

D. Go to the emergency department→ Incorrect; first aid (flushing with water) should beperformed immediatelybefore seeking additional care if necessary.

Proper Emergency Response:Other Answer Choices Explained:References:

USP <800> Guidelines for Handling Hazardous Drugs

OSHA (Occupational Safety and Health Administration) Hazardous Substance Exposure Protocols

PTCB PTCE Exam Content Outline (Medication Safety & Hazardous Drug Handling)

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

Comprehensive and Detailed Step-by-Step Explanation:

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Explanation of Answer Choices:✅B. 10→Correct.❌A. 1→ Incorrect.1 tablet contains 100 mg, not 1000 mg.❌C. 100→ Incorrect.Overdose.❌D. 1000→ Incorrect.Severe overdose.

????Reference:

USP <795> Pharmaceutical Calculations

PTCB Dosage Conversions

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.

Comprehensive and Detailed Step-by-Step Explanation:

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

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

????Reference:

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

FDA Drug Stability Guidelines

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

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

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.

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)

Clopidogrel (Plavix) is an antiplatelet drug used to prevent blood clots, reducing the risk of heart attack (myocardial infarction) and stroke.

It is commonly prescribed afterstent placement, heart attack, or stroke.

Why Other Options Are Incorrect:

B. GERD?❌Treated withPPIs or H2 blockers(e.g., omeprazole, ranitidine).

C. Chronic migraines?❌Treated withbeta-blockers, triptans, or topiramate.

D. Type 2 diabetes?❌Treated withmetformin, insulin, or GLP-1 agonists.

????Reference:AHA Guidelines on Antiplatelet Therapy.

Comprehensive and Detailed Step-by-Step Explanation:

Colchicine (Colcrys, Mitigare)is used to treatacute gout flaresbyreducing inflammation caused by uric acid crystalsin the joints.

????Explanation of Answer Choices:✅B. Gout flares→Correct.Colchicine is ananti-inflammatory drug specific to gout.❌A. Hyperlipidemia→ Incorrect.Statins are used for hyperlipidemia.❌C. Hypothyroidism→ Incorrect.Levothyroxine is used for hypothyroidism.❌D. Peripheral neuropathy→ Incorrect.Gabapentin or pregabalin are used for nerve pain.

????Reference:

American College of Rheumatology (ACR) Gout Treatment Guidelines

PTCB Exam: Pharmacology for Technicians

Thevaricella (chickenpox) vaccine(brand nameVarivax) is alive attenuated virus vaccinethat requiresfreezingto maintain stability.

TheCDC and manufacturers (Merck) require that Varicella vaccine be stored in a freezer at:

Temperature range: -50°C to -15°C (-58°F to +5°F)

Acceptable range:-20°C to -10°C (-4°F to 14°F)

Do NOT store in the refrigerator–Refrigeration deactivates the live virus, making the vaccine ineffective.

Store in a stand-alone freezer(not in a refrigerator/freezer combo) to ensure temperature stability.

B. In the refrigerator (2°C to 8°C/36°F to 46°F)❌→Incorrect.

Refrigerationcompromises the vaccine’s potency, leading to inactivation of the live virus.

C. At room temperature (15°C to 30°C/59°F to 86°F)❌→Incorrect.

Room temperature storage causes rapid degradation of the live virus, rendering the vaccine ineffective.

D. In a warmer (30°C to 40°C/86°F to 104°F)❌→Incorrect & Unsafe.

Thisdestroysthe vaccine and makes it completely ineffective.

Centers for Disease Control and Prevention (CDC) Vaccine Storage and Handling Guidelines– States that varicella vaccinesmust be stored in the freezer at -50°C to -15°C (-58°F to +5°F).

Manufacturer (Merck) Guidelines for Varivax– Specifies strict freezer storage requirements.

USP <797> & USP <800> Guidelines– Discuss vaccine stability and proper storage conditions.

PTCB PTCE Exam Content Outline– Covers vaccine storage and handling protocols.

Proper Long-Term Storage Conditions for Varicella VaccineWhy Not the Other Options?Key References:

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

Maximum dose: 2 tabs twice daily (4 tabs/day).

20 tabs ÷ 4 per day = 5 days.

????Reference:PTCB Pharmacy Dosage Calculations.

TheM-M-R II (Measles, Mumps, and Rubella) vaccinemust bereconstituted only with the manufacturer-supplied diluentto maintain its efficacy and stability.

The manufacturer-provided diluent contains stabilizing agents that preserve the live attenuated virus.

Using normal saline can alter the pH and degrade the vaccine, making it ineffective.

The vaccine must be discarded if reconstituted incorrectlyand not administered.

A. Administer the vaccine as the diluents are equivalent.❌→Incorrect

Normal saline is NOT equivalent to the manufacturer’s diluentand can compromise the vaccine’s potency.

B. Report the incident to the Drug Enforcement Administration (DEA).❌→Incorrect

Vaccine errors should be reported to the CDC’s Vaccine Adverse Event Reporting System (VAERS), not the DEA(which handles controlled substances, not vaccines).

C. Contact the Environmental Protection Agency (EPA) for guidance.❌→Incorrect

The EPA regulates hazardous waste, not vaccine errors.The CDC or vaccine manufacturer should be contacted for guidance.

CDC Vaccine Storage and Handling Guidelines– States thatvaccines must be reconstituted only with manufacturer-supplied diluents.

FDA Guidelines for M-M-R II Vaccine– Confirms that improper reconstitutionrenders the vaccine ineffective.

PTCB PTCE Exam Content Outline– Covers proper vaccine handling and error prevention.

Why Is Normal Saline Not an Acceptable Diluent?Why Not the Other Options?Key References:

Comprehensive and Detailed Step-by-Step Explanation:

Aripiprazole (Abilify)is anatypical antipsychoticused to treatschizophrenia and bipolar disorder.

????Explanation of Answer Choices:✅A. Aripiprazole→Correct.Anantipsychotic used for schizophrenia and bipolar disorder.❌B. Rifampin→ Incorrect.An antibiotic for tuberculosis.❌C. Ketoconazole→ Incorrect.An antifungal.❌D. Zolpidem→ Incorrect.A sedative for insomnia (Ambien).

????Reference:

FDA Drug Database: Aripiprazole

PTCB Pharmacology for Technicians

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

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

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

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

Transfer Limitations:

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

Transfer Documentation:The transferring pharmacist must:

Write"VOID"on the original prescription.

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

Record thedate of transferand their own name.

Receiving Pharmacist Responsibilities:

Write"Transfer"on the prescription.

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

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

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

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

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

PTCB PTCE Exam Content Outline – Controlled Substance Regulations.

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

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

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

????Reference:PTCE Medication Usage Calculations.

Filgrastim (Neupogen) injection is a refrigerated biologicthat must be storedbetween 2°C and 8°C (36°F–46°F).

Other optionscan be stored at room temperature.

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

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.

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

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)

Risedronate (Actonel) is a bisphosphonate used for osteoporosis.

It can causehypocalcemia (low calcium levels)byinhibiting bone resorption.

Patients must take it witha full glass of water and remain upright for 30 minutesto preventesophageal irritation.

????Reference:FDA Bisphosphonate Warnings, PTCB Drug Counseling 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.

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.

To determine theweight/weight (w/w) percentage strength, use the formula:

\text{w/w % strength} = \left( \frac{\text{Mass of Active Ingredient (g)}}{\text{Total Mass of Final Product (g)}} \right) \times 100

Given:

Mass of zinc oxide (active ingredient) = 4.5 g

Total mass of final ointment = 30 g

\text{w/w % strength} = \left( \frac{4.5}{30} \right) \times 100 =0.15×100= 0.15 \times 100=0.15×100 =15%= 15\%=15%

(A) 0.25%❌Incorrect – This is too low.

(B) 10%❌Incorrect – This would be true if 3 g of zinc oxide were used in 30 g total.

(C) 15%✅Correct – The calculation confirms this answer.

(D) 17.5%❌Incorrect – This would be true if 5.25 g of zinc oxide were used in 30 g total.

Pharmaceutical Calculations, 15th Edition– Howard C. Ansel

The United States Pharmacopeia (USP) Chapter <795>– Compounding Non-Sterile Preparations

PTCB Exam Content Outline – Pharmaceutical Calculations

Analysis of Answer Choices:References for Pharmacy Technicians:

Prochlorperazine (Compazine suppository)requiresrefrigeration(store at2°C to 8°C / 36°F to 46°F) to maintain stability.

Other suppositories are stored atroom temperatureunless specified.

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

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.

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.

Comprehensive and Detailed Step-by-Step Explanation:

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

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.

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

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

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

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

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

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

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

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

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

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

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

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

Key References:

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.

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.

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

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.

Cleaning counting trays removes medication residue to prevent cross-contamination, especially with penicillin or sulfa drugs.

????Reference:ISMP Pharmacy Cleaning and Contamination Prevention Guidelines.

Comprehensive and Detailed Step-by-Step Explanation:

Root-Cause Analysis (RCA)is asystematic approachused toidentify the underlying causes of medication errors. RCA focuses onsystems and processes, not individual blame.

????Explanation of Answer Choices:✅B. Focusing primarily on systems and processes rather than individual performance→Correct.RCA aims toprevent future errors by improving systems.❌A. Termination of employment→ Incorrect.Blaming individuals does not address system failures.❌C. Immediate reporting to the state board→ Incorrect.RCA is an internal investigation process.❌D. Criminal charges→ Incorrect.RCA focuses on improvement, not legal punishment.

????Reference:

ISMP Guidelines on Root-Cause Analysis

PTCB Medication Safety Principles

1 oz = 30 mL

4 oz × 30 mL = 120 mL

????Reference:PTCE Pharmacy Conversions Guide.

Risedronate (Actonel)is abisphosphonateused to treat osteoporosis.

Bisphosphonates can causesevere esophagitis and esophageal ulcersif not taken properly.

Patients must take the medication witha full glass of waterand remainupright for at least 30 minutesafter administration to reduce esophageal irritation.

Other medications in the options:

Ropinirole: A dopamine agonist for Parkinson’s disease; no such requirement.

Repaglinide: A meglitinide for diabetes; no such requirement.

Rifampin: An antibiotic for tuberculosis; no such requirement.

????Reference:PTCE study materials; drug administration guidelines forbisphosphonates.

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