drug class easy apbrevations to find

Food and Drug Administration (FDA) Drug Enforcement Administration (DEA) The Joint Commission (TJC) State Boards of Pharmacy (BOP)

Below, we review the following five regulatory bodies of pharmacy: Food and Drug Administration (FDA) Drug Enforcement Administration (DEA) The Joint Commission (TJC) State Boards of Pharmacy (BOP) National Association of the Boards of Pharmacy (NABP) Let's get started! Food and Drug Administration Perhaps the most widely known of the regulatory bodies of pharmacy, the FDA is responsible for ensuring safe and effective standards in: Food Medicines Biologic products Radioactive products Cosmetics It oversees the regulation of products. As such, if there is a potential hazard to the public, the FDA can inform the manufacturer, pharmacy, and general public. Moreover, the FDA also uses a system known as MedWatch - a system in which the FDA is informed of any adverse effects that patients experience. The pharmacist, technician, or other healthcare professional is obliged to report adverse events through MedWatch. Medication events should never go unreported. As a prospective pharmacy technician, you must ensure that all medication events are reported to the FDA. Drug Enforcement Administration The DEA - or Drug Enforcement Administration - was formed as a consequence of the Controlled Substances Act, 1970. The function of the DEA is to oversee and enforce legislation relating to controlled substances. For example - if controlled substances go missing or are stolen within the pharmacy setting, Form 106 must be completed and sent to the DEA as soon as possible. Similarly, the DEA sets out the 5 schedules of controlled substances - with Schedule I drugs being the most potent and addictive, Schedule II drugs requiring special ordering requirements by the pharmacy, and Schedule III through to V drugs which do not have these special ordering requirements. The DEA also has the following two functions: Prosecute offenders who breach legislation. Reduce the use of illicit drugs in the United States. As a prospective pharmacy technician, it's incumbent upon you to understand the important role the DEA plays in the safe use of controlled substances. After all, if the pharmacy technician is unaware of the legislation, they may act in breach of that legislation. Furthermore, pharmacy technicians may be obliged to comply with any investigation undertaken by the DEA. The Joint Commission The TJC - or The Joint Commission - is the organization in the United States that accredits and certifies healthcare organizations. The TJC remains an independent organization that functions to ensure the best possible treatment outcomes for patients. It achieves this by accrediting healthcare organizations that meet its high standards. For example, when surveys of hospital pharmacies take place, the TJC will monitor the degree of quality of how medications are managed. Improper management of medicines has the potential to put patient safety at risk. The Joint Commission is obliged to act where breaches of quality have been identified. As with the DEA, pharmacy technicians may be obliged to cooperate with any investigation undertaken by TJC. State Boards of Pharmacy As the name suggests, the State Boards of Pharmacy (BOP) are those pharmacy boards that cater to the needs of their own state - establishing state-specific laws and regulations that influence and impact pharmacy and the safe use of medicines. More pertinently, the BOP is also responsible for certifying and licensing pharmacy personnel - which, in some states, includes pharmacy technicians. The BOP is responsible for state exams for pharmacy professionals and ensuring that licensed professionals retain a consistent standard throughout their careers. National Association of the Boards of Pharmacy The NABP is the last of our regulatory bodies of pharmacy; an association that assists boards of pharmacy (BOP) by ensuring there are consistent standards among each state board. However, the NABP does not have the force of law behind it. Instead, it acts as a professional means to discuss the trajectory of pharmacy and how best to improve it on a state-by-state level. Conclusion That concludes our review of the various regulatory bodies of pharmacy. For the PTCB exam, it's important that prospective pharmacy technicians: Understand the role of each regulatory body What role the pharmacy technician plays How technicians are obliged to comply with these laws It is these three criteria that are examinable on the PTCB test. Take a few moments to study each of these organizations - preferably in flashcard form - and review and revise on a weekly basis.

Beta-blockers+ Calcium channel blockers risk of heart failure

Beta-blockers - such as metoprolol - should be avoided with calcium channel blockers (verapamil/diltiazem) as the combination increases the risk of heart failure and a slow heart rate (bradycardia).

Broad-spectrum antibiotics+ Warfarin produces vitamin K.

Broad-spectrum antibiotics - such as penicillins and cephalosporins - kill gut flora which otherwise produces vitamin K. This means that these antibiotics increase the risk of bleeding with warfarin.

FAT SOLUBLE

FAT SOLUBLE VITAMINSVitaminScientific NameFunctionVitamin ARetinol/retinalsVital for vision, skeletal growth, and regulation of mucous membranes of the oral cavity and eyes.Vitamin DCalciferolVital for bone and teeth formation by assisting absorption of calcium and phosphorus.Vitamin ETocopherolsAntioxidant properties.Vitamin KPhytomenadioneVital for blood clotting (coagulation).

Statins andGrapefruit juice Atorvastatin Simvastatin Lovastatin increasing the risk of side effects such as muscle pain and aches.

Grapefruit juice contains furanocoumarins which interact with enzymes that reduce statin metabolism - increasing the risk of side effects such as muscle pain and aches.

Digoxin+Loop or thiazide diuretics increase the risk of digoxin toxicity

Loop diuretics (furosemide) and thiazide diuretics (hydrochlorothiazide) increase the risk of digoxin toxicity by causing low potassium levels.

Macrolides+Statins inhibit CYP enzymes

Macrolides - such as clarithromycin - inhibit CYP enzymes that metabolize statins. Therefore, the risk of adverse effects of statins increases when taken with macrolides.

The sulfanilamide disaster of 1937

The sulfanilamide disaster of 1937 was one of the most consequential mass poisonings of the twentieth century. In 1937, there were few regulations on the development, marketing, and release of a medicine to the public. Medicines did not have to undergo animal testing nor did they need to undergo toxicity or premarketing studies, unlike the stringent approval process today. As a result, situations arose - most notably, with elixir sulfanilamide - in which patients were exposed to toxic substances or ineffective medicines. In the case of elixir sulfanilamide, diethylene glycol (DEG) was the culpable toxic substance. DEG is and was a chemical used in antifreeze. In this tragedy, the S. E. Massengill Company used diethylene glycol as an excipient in elixir sulfanilamide. At the time, sulfanilamide was used as an antibacterial drug in the treatment of Streptococcal infections. However, sulfanilamide was only available in tablet form. Given the high demand for a liquid formulation of the medicine, the S. E. Massengill Company decided to manufacture and distribute their own formulation. Drug Manufacture and Distribution Harold Watkins was the chief pharmacist at S. E. Massengill. Up until this point, drug regulations were limited and were passed in the Pure Food and Drug Act (1906). However, toxicity studies were not required. In his attempt to produce a liquid formulation of sulfanilamide, Watkins decided to use diethylene glycol as a solvent and raspberry as a flavoring agent. The preparation was to be called Elixir Sulfanilamide (even though the preparation did not contain alcohol and did not technically even constitute an "elixir"). Watkins was unaware that DEG was toxic to humans, even though there were extant known cases of toxicity and that studies were published several years prior which concluded that DEG was a highly nephrotoxic agent and should be avoided in humans. However, in September 1937, Elixir Sulfanilamide was nonetheless distributed throughout the country. By mid-October, reports were mounting that hospitalizations and deaths had increased due to its consumption. The American Medical Association notified the Food and Drug Administration of these reports and attempts were made to mitigate any potential or future damage. Drug recalls were initiated. Despite these efforts, 105 patients died. An investigation ensued. Harold Watkins, the chief pharmacist, committed suicide whilst awaiting trial. After the trial, the S. E. Massengill Company was not held legally responsible for the tragedy because of the limited regulations requiring drug manufacturers to perform toxicity studies. Massengill claimed that they could not be held responsible for the disaster because the effects of the medicine were entirely unforeseen. This placed culpability with federal authorities who, they argued, did not have the requisite legislation in place to prevent such a disaster in the first place. However, Massengill were found guilty of misbranding their medicine as an elixir, as it did not contain any alcohol to qualify as such a medicine (an elixir is defined as a sweetened, hydro-alcoholic solution). Under the 1906 Pure Food and Drug Act, they paid the minimum fine for this branding breach. Consequences There was an enormous public outcry from the sulfanilamide disaster. As a result, Congress passed the Food, Drug and Cosmetic Act (1938) which required drug manufacturers to perform efficacy and safety studies, including by conducting animal testing. The results of these studies must be submitted as part of a New Drug Application, where the FDA determines if the medicine has been shown to be safe and effective in the treatment of a given condition. This Act required drug manufacturers to lift their standards to a new level, preventing any future risk of avoidable toxicity reactions. S. E. Massengill continued to operate as a family-owned pharmaceutical company. In 1971, the company was acquired by Beecham Group which itself merged into SmithKline Beecham in 1989 and, since 2000, merged into GlaxoSmithKline. The sulfanilamide disaster remains a seminal moment in US pharmaceutical history. The tragedy ushered in standards that placed the highest responsibility on the drug manufacturer to establish whether their medicines were fit - and safe - for purpose. It remains one of the key turning points in drug development history, whose consequences reverberate to this day.

Top 100 PTCB Facts!

Top 100 PTCB Facts! Fluoroquinolones are an antibacterial drug class that end in the suffix - floxacin (eg. ciprofloxacin, moxifloxacin). Tendon damage and rupture is a notable side effect. Must avoid with multivalent ions such as calcium and iron. H2 receptor antagonists are used to treat conditions that cause excess gastric acid production, such as dyspepsia (eg. famotidine). Patients taking monoamine oxidase inhibitors should avoid foods that contain tyramine. This helps to prevent hypertensive crisis. Inactive ingredients of a medicine are known as excipients. Examples include preservatives, flavoring agents, and coloring agents. DEA Form 222 must be completed by pharmacies to be licensed to dispense controlled substances. 'po' is the pharmacy abbreviation for "taken orally". Polypharmacy refers to the concurrent use of multiple medicines at the same time. iPLEDGE is the REMS (risk evaluation and mitigation strategy) guide for the drug, isotretinoin, because this anti-acne drug carries a high risk of birth defects. The Beers' list is a compilation of medicines that inform healthcare professionals of the risk that medicine may have to an older patient and what approach can/should be taken. 'prn' is the pharmacy abbreviation for "as needed", and 'ud' is the pharmacy abbreviation for "as directed". 11 - the maximum number of refills permitted for non-controlled drugs. Suspensions always contain a "shake well before use" label because particles suspended in the medicine can cake to the bottom, meaning that, if the medicine is not shaken, the patient does not receive an accurate dose of the medicine. There are three parts to an NDC code - such as 00106-2315-45.The first 5 digits of an NDC code refer to the drug manufacturer.The second set of 4 digits refers to the drug product/strength etc.The final 2 digits refers to packaging size. Auxiliary label are additional instructions on labels that inform the patient on the safe and effective use of a medicine. For example, "avoid sunlight". Side effects with tetracyclines include photosensitivity and tooth discoloration. Pharmacies should complete an inventory of controlled substances every 2-years. Green-leafy vegetables contain vitamin K, which opposes the anticoagulant effects of warfarin. Varenicline and bupropion are drugs used to assist patients with smoking cessation. ACE inhibitors are used in the treatment of hypertension and chronic heart failure. Side effects include a persistent dry cough and hyperkalemia (high potassium levels). Examples include ramipril, lisinopril, and perindopril. Material Safety Data Sheets (MSDS) were a direct outcome of the Occupational Health and Safety Act, 1970. MSDS are forms completed by compound manufacturers that provide detailed commentary on There are four parts to Medicare coverage:Part A covers hospital insurance; Part B covers outpatient or medical insurance; whilst Part C allows private health insurance plans such as PPOs or HMOs to offer benefits. Part D of Medicare covers prescription drugs. Vitamins B and C are water soluble. Vitamins A, D, E, and K are fat soluble. Water soluble vitamins are not stored in the body, and so need more regular replenishment via dietary sources compared to stored fat-soluble vitamins. Statins work by inhibiting the enzyme, HMG-CoA reductase. Side effects with statins include muscle aches and pains, elevation of liver enzymes, and an increased risk of type 2 diabetes in at-risk patients. Statins are used to lower high blood cholesterol. NSAIDs work by inhibiting the cyclooxygenase enzyme (COX) - reducing pain and inflammation. Examples of NSAIDs include aspirin, ibuprofen, and diclofenac. DURs - or Drug Utilization Reviews - are reviews that analyse a patient profile to ensure that medications dispensed to a patient in the past were correct. It was mandated by the Omnibus Budget Reconciliation Act 1990. A tincture is a medicine that is made by dissolving in alcohol, therefore it has a high alcohol percentage. For example: iodine tincture. Analgesics are medicines used to relieve pain. Examples include acetaminophen and morphine. Alcohol USP refers to the use of 95% ethyl alcohol. The DEA - or Drug Enforcement Administration - is responsible for enforcing laws relating to controlled substances. The Orange Book is used to identify products that are therapeutically equivalent. For a non-controlled substance prescription drug, the prescription is valid for up to 1-year from the date of issuance. The subscription part of a prescription refers to instructions given to the pharmacist, such as the number of refills permitted, or whether a generic drug can be used in place of a branded drug. 'ac' is the pharmacy abbreviation for "before food", whereas 'pc' is the pharmacy abbreviation for "after food". Protease inhibitors are used to combat HIV/AIDS. Examples include lopinavir, ritonavir, darunavir, and atazanavir. Z-drugs are used for the short-term (fewer than 4-weeks) treatment of insomnia. Examples include zaleplon, zolpidem, and zopiclone. DEA Form 41 is used to report destroyed controlled substances. Colchicine and allopurinol are medicines used in the treatment of gout. Beta-blockers always end in the suffix -lol. Examples include bisoprolol, metoprolol, and esmolol. PDE5 inhibitors are used in the treatment of erectile dysfunction. Examples include tadalafil (Cialis) and sildenafil (Viagra). All pharmacies are obliged by law to contain a copy of the United States Pharmacopeia. DEA Form 222 is used when ordering both Schedule I and Schedule II medicines. Antitussive drugs are used in the treatment of cough. Examples include codeine and dextromethorphan. gtts is the pharmacy abbreviation for "drops", such as eye drops. Calcium channel blockers are used to treat hypertension and symptoms of stable angina. Examples include nifedipine, amlodipine, diltiazem, and verapamil. Amber medicine containers are used to protect the medicine against the harmful effects of sunlight radiation. There are three classes of FDA drug recall, with Class I being the most serious and Class III being the least serious. Trituration is a process where tablets or other substances are ground down to a fine powder. The Joint Commission (TJC) is the body tasked with the responsibility of accrediting and certifying healthcare organizations. USP <800> sets standards in handling hazardous drugs for healthcare professionals, patients, and the environment. Grapefruit juice interacts with many medicines, including many statins - inhibiting CYP enzymes and increasing the risk of serious adverse effects. Intrathecal administration refers to administering a medicine into the spinal canal. Pharmacokinetics refers to how an organism affects a drug - often summarized as ADME: Absorption, Distribution, Metabolism, and Excretion processes of a drug. Pharmacodynamics talks about what a drug does to the body; the biochemical and physiological effects of the drug on the body. This is important when trying to establish the optimum dose of a medicine. Half-life is defined as the time is takes for the total amount of drug in the body to reduce by 50 percent. For example - a drug has a half-life of 2-hours. After 2-hours of taking the medicine, 50% remains in the body. After 4-hours, only 25% remains and, after 6-hours, just 12.5% remains in the body. Ibuprofen, an NSAID drug, is the active ingredient of the medicine, Advil, and acetaminophen is the active ingredient of Tylenol. Acetaminophen is not an NSAID, though it is an antipyretic - a drug that treats fever. SSRIs are used in the treatment of major depressive disorder. Examples include paroxetine, sertraline, citalopram, escitalopram, fluoxetine, and fluvoxamine. SSRIs are selective serotonin reuptake inhibitors. HEPA filters within laminar flow hoods remove particles that are at least 0.3 microns in size. Sharps containers can be identified as they are typically red in color. 0.45% sodium chloride is abbreviated as ½ NS in compounding. In contrast, 0.22% sodium chloride is abbreviated as ¼ NS. The purpose of the aseptic technique is to prevent microbial contamination. "Asepsis" is the state of being free from disease-causing microorganisms. Ointments can be made using a technique called spatulation; using a spatula to evenly and homogenously mix two or more substances together. The mixture is combined against an even, flat, and smooth surface. A Wedgwood mortar is an effective tool used to grind down and mix powders to form a uniform arrangement of active and non-active ingredient. A 0.22-micron filter should be used when sterilizing an ophthalmic solution. Purified water USP cannot be used when compounding a sterile product. When gowning, the correct order is as follows: don shoe covers, then head/facial hair cover, then mask - then wash hands and forearms - then don the non-shedding gown. Laminar flow hood air quality must be certified every 6 months. Bisphosphonates are used in the treatment of osteoporosis. Examples include alendronic acid, pamidronate, and zoledronic acid. The Joint Commission issue a Do Not Use list, which is a list of pharmacy abbreviations and acronyms that should be avoided as they may cause confusion and risk patient safety. A Leur-Lok syringe should be used when compounding hazardous drugs. OSHA mandates that workers in the healthcare setting are vaccinated against hepatitis B. Before being used, a laminar flow hood should be turned on for at least 30-minutes. Ototoxicity and nephrotoxicity are notable side effects of aminoglycoside antibacterial drugs such as gentamicin and tobramycin. As a rule, the lower the needle gauge size, the larger the diameter. Orphan drugs are used to treat a rare disease. Governments often provide financial incentives for pharmaceutical companies to develop drugs to treat rare diseases, known as orphan diseases. 1 teaspoon = 5mL; 1 tablespoon = 15mL1 ounce = 28.3 grams1 kg = 1,000 grams1 L = 1,000 mL1 gram = 1,000 milligrams1 grain = 64.8 grams1 pound = 454 grams1 kilogram = 2.2 pounds 'c' is the pharmacy abbreviation for "with", whereas 's' is the pharmacy abbreviation for "without". When pulling up patient profiles, enter the patient's full surname first followed by the first letter of the patient's first name. Schedule II drugs cannot be refilled. Schedule III-V drugs can be refilled a maximum of 5 times, and non-controlled refills are permitted up to 11 times. Benzodiazepines work by enhancing the binding of GABA to the GABA A receptor; medicines used to treat a wide range of conditions such as anxiety, insomnia, epilepsy, and seizures. Examples include diazepam, midazolam, and temazepam and oxazepam. Triptans are used in the treatment of migraine. Examples include sumatriptan and zolmitriptan. HAART = Highly Active Anti-Retroviral TherapyAntiretroviral drugs are used in HAART to treat HIV/AIDS.Examples of antiretroviral drugs: entry inhibitors, fusion inhibitors, integrase inhibitors, and reverse transcriptase inhibitors. The one-handed scoop technique should be used if a needle needs to be recapped. To avoid an accidental needle stick injury, never recap a needle using both hands. A Class III prescription balance must be certified on an annual basis. When dealing with controlled substances, it is recommended to double-count the medicine prior to dispensing. To prevent the risk of cross-contamination on counting trays, isopropyl alcohol should be used to clean counting trays. There should be no more than 29 particles of 5 microns (or greater) in size within an ISO Class 5 environment. Drugs used to treat urinary tract infections include trimethoprim, fosfomycin, and nitrofurantoin. Examples of rapid-acting insulins (peak time - 1 hour) include insulin aspart, lispro, and glulisine.Insulin detemir and insulin glargine are long-acting insulins.Isophane insulin is an intermediate-acting insulin. Proton-pump inhibitors are used to treat conditions caused by excess gastric acid production. Proton-pump inhibitors can be identified courtesy of the suffix -prazole. Examples include omeprazole, lansoprazole, and pantoprazole. Cinchonism is a syndrome of side effects associated with the anti-malarial drug, quinine. These effects include fever, fatigue, visual disturbances, and deafness. DEA Form 106 is used to report the theft or loss of a controlled substance. Tall man lettering is used to reduce the error of confusing two drugs with one another based on how they sound or read. For example: prednisONE and prednisOLONE; or cycloSERINE and cycloSPORINE. Beta-2 agonists are used in the treatment of asthma and COPD. Examples include albuterol, salmeterol, formoterol, and terbutaline. Diuretics are used to promote water and electrolyte loss. There are various classes, including:Loop diuretics - furosemide, bumetanideThiazide diuretics - hydrochlorothiazidePotassium-sparing - amiloride, spironolactone Antifungal drugs work by inhibiting ergosterol synthesis. Ergosterol is an important part of the fungal cell membrane. Azole antifungals - such as ketoconazole and clotrimazole - work by inhibiting ergosterol. A decimal point should never follow whole numbers - such as 5.0. Instead, it must be 5 only. Similarly, a 0 is necessary where only a decimal point is present before a number - for example: 0.5 and never .5 An agonist binds to and activates a receptor. An antagonist binds to and inactivates a receptor. For example - beta-blockers act as antagonists at beta receptors, and beta-2 agonists activate beta-2 receptors which causes smooth muscle relaxation in the lungs to improve symptoms in patients with asthma and COPD. Side effects of opioids include constipation, miosis, nausea, dizziness, euphoria, and respiratory depression. Opioids include medicines such as codeine, dihydrocodeine, tramadol, meperidine, and morphine. Opioids work by acting as agonists at mu-opioid receptors. Metformin is a first-line drug used in the treatment of type 2 diabetes, sold under the brand name, Glucophage. It belongs to the biguanide class of medicines. Intravitreal drugs are administered through the eye, and buccal administered drugs are administered to the inside cheek.

op 50 Pharmacy Abbreviation

Top 50 Pharmacy Abbreviations If you find learning these prescription abbreviations difficult, try to learn more about the Latin derivations that underpin them. The more Latin you know, the easier it becomes to translate what these abbreviations mean. You probably know more Latin derivations and roots than you think you do. Many clinical and pharmacy-related vocabulary, after all, also has Latin-based roots. Pharmacy AbbreviationMeaningacBefore mealsadRight earamMorningasLeft earASAPAs soon as possibleauBoth earsbidTwo times dailytidThree times dailyqidFour times dailyq4hEvery 4 hoursqEverycWithdDayDAWDispense as writtengttDroph or hrHouriOneiiTwoiiiThreeivFourodRight eyeopthOphthalmic (eye-related)osLeft eyeoticFor the earouEach eyepAfterpcAfter mealspmEveningpoBy mouthprRectallyprnAs neededpvVaginallyqdEvery dayqsQuantity sufficient to makeqsadAdd quantity to make specific volumesWithoutsigWrite (on the label)slUnder the tonguesol.SolutionstatAt once or nowsuppSuppositoryudAs directedSubQSubcutaneoussyr.Syruptab.TablettbspTablespoonTPNTotal parenteral nutritionw/oWithouttspTeaspoontopTopicalung.OintmentxTimes Conclusion Pharmacy abbreviations is one of the core topics of the PTCB exam. It's vital that you understand how to interpret each of these abbreviations - not just on their own but also as part of wider prescription instructions, too. For instance, let's take the following three examples: ii gtts ou qid ud = apply two drops to each eye 4 times daily as directed 1 tab pr qd prn = insert 1 tablet rectally each day as needed iii tab po tid x 7d = take 3 tablets orally three times daily for 7 days Knowing prescription abbreviations, then, eliminates the risk of dispensing errors. If you are already a member of PTCB Test Prep, please go to the section entitled 'pharmacy abbreviations' and take the accompanying quizzes. Through these PTCB practice exams and explained answers, this will help commit these clinical details to memory and help you master your understanding of prescriptions.

MAO inhibitors Isocarboxazid Tranylcypromine Phenelzine+ Tyramine Tyramine

Tyramine is found in foods such as fermented products, aged meats and cheese, alcohol, soy sauce, and many others. Taking foods with tyramine increases the risk of hypertensive crisis when taken with MAO inhibitors.

WATER SOLUBLE

WATER SOLUBLE VITAMINSVitaminScientific NameFunctionVitamin CAscorbic acidAssists with wound healing, immune system function; and collagen synthesis.Vitamin B1ThiaminePromotes normal appetite; essential for the nervous system to function.Vitamin B2RiboflavinVision / healthy skin.Vitamin B3NiacinDigestion, appetite, healthy skin.Vitamin B5Pantothenic acidHormone formation and nutrient metabolism.Vitamin B6PyridoxinePromotes formation of red blood cells, insulin and hemoglobin.Vitamin B7BiotinEssential to metabolise proteins and carbohydrates.Vitamin B9Folic acidPromotes red blood cell formation; important in pregnancy to prevent neural tube defects.Vitamin B12CobalaminsPromotes red blood cell production; energy metabolism; and collagen synthesis.

S.S.R.I - Selective Seratonin Re-Uptake Inhibitors increase the body's Seratonin level by inhibiting its re-uptake into the Presynaptic cell. Commonly indicated as an Anti-Depressant.

What are Antidepressants? An antidepressant is the name given to a medicine that can help relieve the symptoms of depression, such as low mood, anxiety, and worthlessness. Antidepressants are classified into different types depending on their structure and the way that they work. There are at least seven types of antidepressant: Monoamine oxidase inhibitors (MAOIs) Norepinephrine and dopamine reuptake inhibitors (NDRIs) Selective serotonin reuptake inhibitors (SSRIs) Serotonin and norepinephrine reuptake inhibitors (SNRIs) Serotonin antagonist and reuptake inhibitors (SARIs) Tricyclic antidepressants (TCAs) and tetracyclic antidepressants (TeCAs) And the miscellaneous antidepressants. MAOIs and TCAs were among the first antidepressants developed. They have largely been superseded by newer antidepressants (such as the SSRIs) that have fewer side effects, although these older antidepressants may still suit certain people or be effective when other antidepressants have been ineffective. Antidepressants are thought to work by increasing levels of certain neurotransmitters, such as dopamine, serotonin, and/or norepinephrine, in the brain. What are antidepressants used for? Antidepressants help to relieve the symptoms of depression such as low mood, irritability, feelings of worthlessness, restlessness, anxiety, and difficulty in sleeping. In addition to depression, certain antidepressants may also be used to treat a range of other conditions, for example: Anxiety Bed-wetting Bulimia nervosa Chronic nerve-related pain Fibromyalgia Hot flashes Migraine prevention Obsessive-compulsive disorder Panic disorder Post-Traumatic Stress Disorder (PTSD) Premenstrual dysphoric disorder. Monoamine oxidase inhibitors (MAOIs) MAOIs block the effects of monoamine oxidase enzymes, thereby increasing the concentration of dopamine, norepinephrine, and serotonin in the brain. Generic nameBrand name examplesisocarboxazidMarplanphenelzineNardiltranylcypromineParnate Are antidepressants safe? When taken at the recommended dosage, antidepressants are considered safe. However, some have been associated with severe side effects, some potentially fatal, such as: An increase in suicidal thoughts and behaviors, particularly in children and young adults under the age of 25 years. This is most likely to occur when starting therapy An increased risk of seizures in people with a history of seizures Serotonin syndrome - this is caused by excessive levels of serotonin in the body and is more likely to occur with higher dosages of SSRIs or when SSRIs are administered with other medications that also release serotonin. Symptoms include agitation, confusion, sweating, tremors, and a rapid heart rate The precipitation of a manic episode in people with undiagnosed bipolar disorder Duloxetine: A severe discontinuation syndrome MAOIs: Very severe drug interactions, very severe food interactions, and rarely, rapid but transient increases in blood pressure within 30 minutes to two hours of MAOI ingestion Nefazodone: Life-threatening liver failure, more common two weeks to six months after starting therapy SSRIs and vortioxetine: An increase in the risk of bleeding, especially if used with other medications that also increase bleeding risk TCAs: An increased risk of arrhythmias, heart attacks, stroke, and other cardiovascular effects, particularly in people with pre-existing heart disease; and the triggering of an angle closure attack in people with angle-closure glaucoma For a complete list of severe side effects, please refer to the individual drug monographs. What are the side effects of antidepressants? Not everybody experiences significant side effects with antidepressants, and some antidepressants are more likely to cause side effects than others. Some of the more commonly reported side effects include: Blurred vision Disorientation or confusion Dizziness Drowsiness, sometimes insomnia Dry mouth Excessive sweating Gastrointestinal upset (such as constipation, diarrhea, or nausea) A headache Increased or irregular heartbeat Low blood pressure when going from a standing to a sitting position (called orthostatic hypotension). In most people, this can be managed by slowly increasing the dosage of the medication, giving split doses, and increasing fluid intake Sexual dysfunction (such as reduced desire or erectile dysfunction) Tremor Urinary retention Weight loss or weight gain. Some antidepressants have been associated with a discontinuation syndrome when they have been stopped suddenly. For this reason, it is best to withdraw all antidepressants slowly. Are antidepressants safe? When taken at the recommended dosage, antidepressants are considered safe. However, some have been associated with severe side effects, some potentially fatal, such as: An increase in suicidal thoughts and behaviors, particularly in children and young adults under the age of 25 years. This is most likely to occur when starting therapy An increased risk of seizures in people with a history of seizures Serotonin syndrome - this is caused by excessive levels of serotonin in the body and is more likely to occur with higher dosages of SSRIs or when SSRIs are administered with other medications that also release serotonin. Symptoms include agitation, confusion, sweating, tremors, and a rapid heart rate The precipitation of a manic episode in people with undiagnosed bipolar disorder Duloxetine: A severe discontinuation syndrome MAOIs: Very severe drug interactions, very severe food interactions, and rarely, rapid but transient increases in blood pressure within 30 minutes to two hours of MAOI ingestion Nefazodone: Life-threatening liver failure, more common two weeks to six months after starting therapy SSRIs and vortioxetine: An increase in the risk of bleeding, especially if used with other medications that also increase bleeding risk TCAs: An increased risk of arrhythmias, heart attacks, stroke, and other cardiovascular effects, particularly in people with pre-existing heart disease; and the triggering of an angle closure attack in people with angle-closure glaucoma For a complete list of severe side effects, please refer to the individual drug monographs. Types of Antidepressants Please refer to the drug classes listed below for further information. miscellaneous antidepressants monoamine oxidase inhibitors phenylpiperazine antidepressants selective serotonin reuptake inhibitors serotonin-norepinephrine reuptake inhibitors tetracyclic antidepressants tricyclic antidepressants Recently Approved Veklury Veklury (remdesivir) is a SARS-CoV-2 nucleotide analog RNA polymerase inhibitor... Inmazeb Inmazeb is (atoltivimab, maftivimab, and odesivimab) is a monoclonal antibody... Alkindi Sprinkle Alkindi Sprinkle (hydrocortisone granules in capsules for opening) is an... Gavreto Gavreto (pralsetinib) is an oral selective RET kinase inhibitor for the... More Subscribe to our newsletters FDA Safety Alerts Daily MedNews Weekly Drug News Roundup Monthly Newsletter I accept the Terms and Privacy Policy Email address

What are Pharmacy Prescriptions?

What are Pharmacy Prescriptions? The legal document that doctors must fill out when prescribing a drug, or more than one drug, is called a prescription (community) or, in the case of hospitals, it's referred to as a medication order. Here in our review of pharmacy prescriptions, we discuss how they are written, processed and entered. Prescriptions are not always written in standard, clear English. Often, pharmacy abbreviations are included. As part of your PTCB test prep, candidates are expected to know these abbreviations and how to interpret pharmacy prescriptions. If you have already studied prescription processing and entry, take a few moments to review our complete guide to pharmacy abbreviations. Though prescriptions are most commonly written by physicians, they may also be written by other healthcare professionals, depending on the US state you reside in. These healthcare professionals include: Dentists Veterinarians Physician assistants Certified nurse practitioners Though these professions can write prescriptions, there are limitations on what medicines can appear on their pharmacy prescriptions. Prescriptions do not need to be handwritten, either. They can also be sent via fax, electronic device or through phone. However, all written or faxed prescriptions must include the doctor's signature. In the case of calls, federal legislation states that nurse practitioners may phone-in the prescription on the physician's behalf, though this must be communicated to the pharmacist and pharmacist only. Details on Pharmacy Prescriptions All pharmacy prescriptions included mandated details. For the PTCB exam, candidates are expected to know each of these details. For example, you may be presented with a question that tests your knowledge of what details should or should not be included with the prescription. Each prescription should include the following details: Name, address, and contact details of the prescriber Name of the patient Date the prescription was made Inscription - name, dosage form, strength, and quantity of medicine Sig - directions of use Subscription - details to the pharmacist on whether refills are permitted, or whether a generic drug can be used in lieu of a trade name. If these details are not needed, DAW - or 'dispense as written' should be noted Drug Enforcement Administration (DEA) number of the prescriber Signature of the physician Pharmacy technicians should know how to interpret prescription documents. Recall that identifying errors is one of the primary roles of the pharmacy technician. Interpreting prescriptions at early stage is one of those critical checkpoints. How to Process a Prescription To correctly process a prescription, pharmacy technicians need to forensically review the document for any possible errors. A systematic approach should be used to eliminate any possible sources of error. In this regard, technicians should search for the following seven criteria: Ensure that the prescription is valid by reviewing date, name, medication, and what quantity of medicine has been prescribed. Verify that the name stated on the prescription matches the name given by the patient. For additional authentication, some pharmacies may ask for photo identification. Date of birth should be recorded. This is necessary for insurance purposes as well as to distinguish between patients who happen to have the same name. Phone number should be recorded. Patients may need to be contacted regarding their treatment. Address should be recorded. This has two functions: first, to ensure that the pharmacy's patient database is up to date. Second, an address is needed for controlled substances (II through to V) according to the Controlled Substances Act. Discuss patient allergies. Discuss with the patient whether they have any allergies. This has two functions. First, to prevent any potential allergy with the medicine prescribed, but also to prevent any future allergies in any future prescriptions. Record insurance details. Insurance details must be collected to ensure that patients do not pay full price of the medicine; they are recorded purely for billing purposes. These remain the seven fundamental rules on how to process a prescription. Next, we discuss how pharmacy technicians should enter prescription details. How to Enter Prescription Details Pharmacy technicians are healthcare professionals one of whose functions is to identify any potential errors. There are two potential errors when entering prescription details: billing errors and patient profile errors. Let's review the primary steps technicians take to eliminate these risks: Patient identification. When searching for a patient in the pharmacy's database, it's important that you correctly enter the patient's surname, as well as the first letter of their first name. A list of names appears, and you should choose the correct name and verify that name with the patient's date of birth. Verify insurance details. This is done when the patient presents their new insurance card. Prescriber identification. In the same manner that technicians search for the patient, the same process should be followed for identifying the prescriber. An insurance audit may be performed, or an oversight on behalf of the pharmacist, if the incorrect provider is listed. Drug to be dispensed. This can be achieved by entering the drug name or entering the National Drug Care (NDC) number, which is an 11-digit number with the following sequence: 28754-2500-45. The first 5-digits refer to the drug manufacturer; the next 4-digits refer to drug/strength; whilst the last 2-digits refer to package size. Quantity dispensed. Due to insurance limitations, the quantity may have to be adjusted. For example, most insurance companies cover quantities up to 30-days-worth of medicine, and not more. Directions for use. This is important because if the pharmacy technician incorrectly interprets the prescription, and the pharmacist also misses the mistake, the patient may be prescribed a harmful dose of the medicine. Daily supply. If the quantity of drug is specified as 30 tablets and the directions for use state BID (twice daily), the daily dose is 2 tablets per day. Refills. Number of refills must be stated and be in accordance with the law. For example: controlled drugs (III through to V) are permitted to have up to 5 refills, with the prescription valid for 6 months only. Controlled drugs II are not permitted to have refills. Non-controlled drugs may have up to 11 refills and the prescription is valid for 1-year from the date it was written. Expiration date. Pharmacy technicians must enter a valid expiration date from the stock bottle. An incorrectly entered expiry date could result in a patient taking expired medicines. In the case of the antibacterial drugs, tetracyclines, this can result in Fanconi syndrome. Patient insurance. The final step through which the patient's insurance is processed to ensure that the medicine can be dispensed through that pharmacy. When reviewing these steps, always consider the potential for error. If these steps were rushed, for example, it is easily conceivable to see how errors can emerge. Pharmacy technicians must be responsible and handle each of these tasks with due diligence to prevent any possible patient errors. Conclusion As part of the PTCB exam, you are expected to have a detailed understanding of pharmacy prescriptions: How prescriptions are written and what details are necessary Who is lawfully permitted to write one? How those prescriptions are accurately interpreted How to correctly process a prescription in the pharmacy How to enter prescription details into the pharmacy patient database If you are already a registered member of PTCB test prep, we recommend that you now test your knowledge of pharmacy prescriptions through our PTCB practice tests and full-length practice exams.

Anti-Diabetics / Sulfonylureas - lower glucose levels in the blood. They are only used to treat Type II Diabetes.

What are Sulfonylureas? Sulfonylureas are a group of medicines used in the management of Type 2 diabetes. Sulfonylureas lower blood glucose levels by stimulating insulin release from the Beta cells of the pancreas. Their action is dependent upon the presence of functioning Beta cells, therefore, sulfonylureas do not work in people with type 1 diabetes. Sulfonylureas stimulate insulin release by blocking ATP sensitive potassium channels in the Beta cells, reducing potassium permeability. This causes depolarization of the cell and increases calcium entry, increasing insulin secretion. Diabinese (Pro)Generic name: chlorpropamide0 reviews9.0Glynase (Pro)Generic name: glyburide0 reviews8.0Glucotrol (Pro)Generic name: glipizide9 reviews7.7Amaryl (Pro)Generic name: glimepiride19 reviews7.6DiaBeta (Pro)Generic name: glyburide0 reviews7.0GlipiZIDE XLGeneric name: glipizide8 reviews4.9Tolinase (Pro)Generic name: tolazamide0 reviews2.0Glucotrol XL (Pro)Generic name: glipizide0 reviewsAdd ratingGlycronGeneric name: glyburide0 reviewsAdd ratingGlynase PresTabGeneric name: glyburide0 reviewsAdd ratingMicronase (Pro)Generic name: glyburide0 reviewsAdd ratingTol-TabGeneric name: tolbutamide

What are controlled substances?

What are controlled substances? The Controlled Substances Act was passed in 1970 and laid out the foundations for how controlled substances should be handled. This includes the storage of these drugs as well as the documentation that needed to be completed for records and safety purposes. There are five classes - or schedules - of controlled substances. Schedule I drugs have the highest abuse potential whereas later schedules have lower abuse potential. The DEA - or Drug Enforcement Agency - oversees how controlled drugs are handled and managed within healthcare settings. The DEA can if it chooses to, opt to add a drug from a schedule or to change drugs within different schedules. Furthermore, drug manufacturers can lobby for changes within these schedules. Here are some example drugs that are included in each of the 5 schedules: Schedule 1 - LSD, heroin, crack cocaine, marijuana Schedule 2 - amphetamines, fentanyl, methadone Schedule 3 - combination narcotics Schedule 4 - hypnotic and benzodiazepine drugs Schedule 5 - Cough preparations with codeine; Lomotil, too Bear in mind that some of these drugs - such as marijuana and cocaine - are now used in some states for therapeutic purposes, or for the purpose of cosmetic surgery. How are Controlled Substances Handled? Due to the nature of controlled substances and their abuse potential, it was vital that an organization - such as the DEA - was established to oversee how these drugs are managed and monitored in the pharmacy setting. For the PTCB exam, candidates are expected to have a thorough understanding of the above schedules - as well as examples of drugs included in each - as well the conditions required of pharmacies and other healthcare settings in maintaining and monitoring how these drugs are stored, documented, and dispensed: When ordering schedule II drugs, DEA Form 222 must be completed and signed by the pharmacist. Forms are issued in triplicate form; with one of the forms retained by the drug supplier, the second by the pharmacy, and the third sent to the DEA. There are ten lines in each order form and the signature provided must be that of the registrant or the individual assigned as the power of attorney. However, many pharmacies now use digital means to order Schedule II drugs. This is known as the Controlled Substance Ordering System (CSOS), permitting more rapid processing of the receipt of these drugs. As paper is not used, it also reduces the risk of error. Upon receiving the order, the pharmacist must confirm that the correct medicinal order has been received. Containers for controlled substances can be identified as they always bear a large red C along with the schedule of the medicine. For schedule III through to V drugs, Form 222 does not need to be completed. Expired or damaged controlled substances must be reported to the DEA using Form 41. Expired drugs should never be returned to the manufacturer. If controlled substances have been stolen, Form 106 must be completed and sent to the DEA as soon as possible. These documents must be stored within the pharmacy for at least 2-years, depending on individual state requirements. Secure prescriptions for Schedule II drugs may be initially refilled up to 6-months after the prescription date. For Schedule III through to V drugs, they may be refilled 5-times within a 6-month period. Prescriptions for Schedule II substances may not be taken over the phone. Telephone prescriptions are permitted to be taken for all other drugs. Conclusion As a pharmacy technician, it is incumbent upon you to understand the role that controlled substances play in the pharmacy setting: Why these drugs are controlled? How are these drugs ordered? What documentation must be filled? How these documents are filed and for how long? By committing these details to memory, it will serve you well on the day of your PTCB exam. MCQ questions on controlled substances can appear right throughout the exam - whether it's the Medication section, the Federal Requirements section, or the Order Entry and Processing section. This is one of the core subjects that you need to have a robust grasp of.

What are sentinel events?

What are sentinel events? On the PTCB exam, candidates are expected to understand the nature of sentinel events, examples of such events, and what measures - such as root-cause analysis - can be implemented to limit the risk of future sentinel events. Definition: Sentinel events are events that cause death, permanent harm, or severe temporary harm in the healthcare setting - to either the patient, the staff, or both. Given the nature of sentinel events, they are not common. However, sentinel events are important and constitute emergencies and require either immediate treatment and/or investigation - which may, of course, involve law enforcement. Examples of sentinel events include: A patient committing suicide Unexpected death of an infant brought to full-term Infant being discharged to the wrong person or family Rape or assault of a patient or staff member All sentinel events must be recorded for analysis. Often, sentinel events must undergo a root cause analysis (RCA); the purpose of which is to analyse the causes of the incident and to implement measures to ensure that the risk of future events is minimized. In effect, it is about learning from mistakes or ineffective measures that led to the sentinel event in the first incidence. What is a root cause analysis? RCA - root-cause analysis - are conducted to find the "root cause" of a problem. By learning more about how the root cause of a problem (such as a patient suicide) occurred, it informs healthcare professionals to implement measures to ensure that these risks are reduced in the future. In this case, to ensure that healthcare professionals are aware of any deficiencies in the system which allowed suicide to take place when it could have been a preventable event. Root-cause analyses are not limited to healthcare. This system of introducing measures to prevent a second outcome or repeat of an event is a systemic approach used across many disciplines. In aviation, for example, root-cause analysis helps to identify the specific causes of plane crashes - whether it was pilot error or mechanical failure or an engineering cause - or a combination of all these factors. This detailed analysis of the cause of events allows for the creation of a new set of standards - which are implemented across airlines across the board to maximize the safety of passengers, pilots, and aircrew. The same process applies to healthcare, too - in the prevention of sentinel events. Whilst it is not always possible to predict sentinel events, it is possible to reduce their likelihood in the future. That is the purpose of any root-cause analysis. It seeks to ask questions such as: Why did the sentinel event take place? What were the contributory factors that created the circumstances for the sentinel event to happen? Who was involved, and why were they involved at the time? Was standard operation procedures (SOPs) complied with, or were they not followed as they should have been? What was the most important causative failure that led to the accident? What preventative measures were introduced at the time to ensure that no repeat of the event could take place? Will these preventative measures be sufficient, or are further, more concrete measures required? How will the results of these strategies be measured? How frequently will this measuring take place and who will implement these measures? A root-cause analysis of a sentinel event is therefore a detailed examination of the sentinel event. It seeks to identify the causes of the sentinel event, to put in place effective measures that prevent any repeat outcomes, and to measure these newly implemented steps to ensure that they are sufficiently effective over a prolonged period of time. Final Thoughts

Anti-Biotics - Anti-Biotics inhibit the reproduction of new Bacteria cells. There are several varieties and Drug Class Definitions of Anti-Biotics.

biocin cipro claoran zoayn

Phenytoin+Warfarin EstrogensProgestogens induces CYP enzymes

henytoin induces CYP enzymes and so reduces plasma concentrations of drugs such as warfarin, estrogens, and progestogens - reducing their clinical effects.

Diuretics - Diuretics are primarily used to treat hypertension. They promote evacuation of water from the body, which decreases the load on the cardiovascular system.

laxic sudefed fursomide hydrothizide

Anti-Convulsants - Anti-Convulsants suppress the rapid firing of neurons in the nervous system (brain). Also known as Anti-epileptic drugs and Anti-Seizure drugs.

lyrcia pregablin nurotin celesa citapram cyymagalta effexor

Aminoglycosides+Loop diuretics cause ototoxicity and kidney damag

minoglycosides (gentamicin, amikacin) cause ototoxicity and kidney damage. Taking aminoglycosides with loop diuretics (furosemide) increases the risk of these adverse effects.

NSAID - Non Steroidal Anti-Inflammatory Drugs are commonly used as pain killers and Fever Reducers. They are non-narcotic and can be sold OTC.

motrion ipbuprohen bayer asprin aleve noproxin celecov

Beta Blockers (B1) - Also known as Beta-adrenergic blocking agents. Block adrenaline receptors, which are part of the central nervous system and mediate a "Fight or flight" response, which would cause actions in the heart. They usually have the suffix "OLOL".

olol Acebutolol (Sectral) Atenolol (Tenormin) Bisoprolol (Zebeta) Metoprolol (Lopressor, Toprol XL) Nadolol (Corgard) Nebivolol (Bystolic) Propranolol (Inderal, InnoPran XL) Irregular heart rhythm (arrhythmia) Heart failure Chest pain (angina) Heart attacks Migraine Certain types of tremors Common side effects of beta blockers can include: Cold hands or feet Fatigue Weight gain Less common side effects include: Depression Shortness of breath Trouble sleeping

Opioid - Opioids provide an analgesic effect by decreasing the perception of pain and increase pain tolerance.

percoset ocycodone and acetimentaphine morhine vidocdin sucaxone fentaly coitn ultram tramadol

antihistamine

A second example is antihistamines. First-generation antihistamines are likely to cause sedation. For many patients, this is a desirable effect as they may have trouble sleeping due to their allergy symptoms. Second-generation antihistamines, such as fexofenadine, do not cross the blood-brain barrier and so do not cause this sedative effect.

Nitrates andPDE5 inhibitors severe hypotension

Nitrates cause hypotension and PDE5 inhibitors - such as sildenafil and tadalafil - also cause hypotension. Therefore, there is a significant risk of severe hypotension if both drugs are taken together.

Non-Hazardous Waste

Non-Hazardous Waste Most medicines in the pharmacy setting are non-hazardous. Typically, non-hazardous waste is disposed in a blue or white bin or, if the substance is to be incinerated, it may be disposed in the trash. Non-hazardous waste of this kind is typically removed using a reverse distributor. Other non-hazardous waste, such as: IV solutions Ringer's lactate solution (Hartmann's solution) Saline Dextrose ...may be disposed by pouring down the drain. They are non-toxic and so pose no additional risks to people and the environment. The mechanism by which pharmacies operate differs. Some states mandate other waste disposal approaches, and so the precise way waste is disposed should be determined by following state legislation. Hazardous Waste Disposing pharmaceutical waste requires a different approach - not least because there are significant risks involved, both to the health of workers and the public, but also to the environment too. Disposal of hazardous waste must comply with the EPA - or Environmental Protection Agency. The EPA has four classifications of waste - P, U, K, and F. Pharmaceutical waste is classified under both P and U lists, and whether the waste in question has a specific hazardous characteristic - for example: whether it has the capacity to burn or ignite. P-list pharmaceutical waste includes: Warfarin Nicotine patches, gum, or lozenges Physostigmine Arsenic trioxide Nitroglycerin Epinephrine U-list pharmaceutical waste includes: Lindane Selenium sulfide Chloral hydrate Mitomycin C Formaldehyde Benzene There are four characteristic waste categories, as set out in the Resource Conservation and Recovery Act, which include: Ignitability - include liquids with flash points below 60-degree Celsius, non-liquids that cause fire through specific conditions, ignitable compressed gases, and oxidizers. Toxicity - harmful when ingested or absorbed. Toxic wastes present a concern as they may be able to leach from waste and pollute groundwater. Corrosivity - include aqueous wastes with a pH of less than or equal to 2, a pH greater than or equal to 12.5 or based on the liquids ability to corrode steel. Reactivity - may be unstable under normal conditions, may react with water, may give off toxic gases and may be capable of detonation or explosion under normal conditions or when heated. EPA assigned D003 as the waste code for reactive hazardous wastes.

Omeprazole+Clopidogrel reduces the antiplatelet effects of clopidogrel

Omeprazole - a proton-pump inhibitor - reduces the antiplatelet effects of clopidogrel.

Benzodiazepines - Also know as "Benzos". Benzos are used as anti-anxiety agents, muscle relaxants, sedatives, and hypnotics. They usually have the suffix "PAM".

PAM What are Benzodiazepines? Benzodiazepines (also called "benzos") are a class of agents that work in the central nervous system and are used for a variety of medical conditions. They act on specific receptors in the brain, called gamma-aminobutyric acid-A (GABA-A) receptors. Benzodiazepines attach to these receptors and make the nerves in the brain less sensitive to stimulation, which has a calming effect. What are benzodiazepines used for? Benzodiazepines may be used to treat: alcohol withdrawal anxiety as a muscle relaxant panic disorder seizures sleep disorders to induce relaxation and cause amnesia prior to surgical operations. Common Benzodiazepines Available in the U.S. Generic NameBrand NameCommon UsesHalf-life** The half-life is the amount of time it takes for half of the drug to be eliminated from the body. The shorter the half-life, the quicker the drug is eliminated. All benzodiazepines are listed as DEA scheduled IV controlled substances. As controlled substances, all benzodiazepines have the potential for abuse, addiction and diversion.alprazolamNiravam, Xanax, Xanax XRanxiety, panic disorders6-26h (short-acting)chlordiazepoxideLibraxanxiety, alcohol withdrawal30-100h (long-acting)clobazamOnfiLennox-Gastaut syndrome, adjunct (seizures)71-82h (long-acting)clonazepamKlonopinseizure disorder, panic disorder, neuralgia (nerve pain)20-50h (long-acting)clorazepateTranxene T-Tabanxiety, alcohol withdrawal, partial seizures20-100h (long-acting)diazepamValiumanxiety, sedation, alcohol withdrawal, muscle spasm, seizure disorders20-100h (long-acting)estazolamProSominsomnia (short-term use)10-24h (medium-acting)flurazepamDalmaneinsomnia (short-term use)40-100h (long-acting)lorazepamAtivananxiety, insomnia (short-term use), seizures, sedation10-20h (medium-acting)midazolamVersedsedation, preoperative; general anesthesia induction; seizures2.5h (short-acting)oxazepamSeraxanxiety, alcohol withdrawal5-15h (short-acting)temazepamRestorilinsomnia (short-term use)10-20h (medium-acting)triazolamHalcioninsomnia (short-term use) What are the side effects of benzodiazepines? Drowsiness, sleepiness, or dizziness are the most common side effects reported. This can make it dangerous for people taking benzodiazepines to drive or operate machinery or perform other hazardous tasks. Alcohol may potentiate these effects. Other commonly reported side effects include: amnesia (forgetfulness) confusion constipation nausea sexual dysfunction unsteadiness when walking or standing unusually slow and shallow breathing vision problems (blurred or double vision). Withdrawal symptoms may occur with abrupt discontinuation - symptoms may include convulsions, cramps, insomnia, sweating, tremors, and vomiting. Some people develop a paradoxical reaction to benzodiazepines - this is the opposite reaction to what you would expect. They may become agitated or very anxious, develop hallucinations, have difficulty sleeping or exhibit bizarre behavior such as taking off their clothes in public or taking unnecessary risks.

PTCB Pharmacy Law

PTCB Pharmacy Law Pharmacy law is one of the 9 core subjects tested on the PTCB exam. If you intend on succeeding at the exam, you must learn the fundamental legislation and what impact those laws have had. Here, we review some essential pharmacy laws to know for the PTCB exam. Many students find pharmacy law difficult. Sure - it's not the most exciting and dynamic subject to study. That said, pharmacy technicians need to understand how the pharmacy profession has advanced and why they are obliged to work under specific protocols. Once you begin to appreciate the relevance of pharmacy law, your PTCB exam study becomes much easier. There are 90 questions on the PTCB exam, with pharmacy law accounting for 10 of those questions; a sizable 11.1% of the test. Below, we review some of the essential legislation that you need to know. We review 3 core pieces of legislation that always gets examined. If you would like to test your knowledge of pharmacy law, we've put together a complete course of PTCB exam questions and full-length practice tests to help you master this part and every other subject of the PTCB exam. Now though, let's delve deeper into some must-know legislation. This legislation covers: Durham-Humphrey Amendment, 1951 Kefauver-Harris Amendment, 1963 Poison Prevention Packaging Act, 1970 Let's get started. #1 - Durham-Humphrey Amendment, 1951 The Durham-Humphrey amendment, enacted in 1951, was an amendment to the Food, Drug and Cosmetic Act. This was a much-needed amendment. Up until 1951, many prescription drugs were given to patients in the same manner as OTC medicines. There were no specific guidelines or regulations in place to tightly control how and when prescription drugs were dispensed. Pharmacies were dispensing prescription drugs to patients who did not have a prescription. This amendment changed that. Senators Hubert Humphrey and Carl Dunham - to whom the amendment owes its name - established clear criteria as to what constituted a "prescription drug" and the circumstances in which it can be dispensed to a patient. It outlawed the action of dispensing a prescription ("legend") drug to those who did not have a prescription - remedying this long-standing problem. The label, "Caution: Federal law prohibits dispensing this medication without a prescription", would now have to be present on all prescription medicines. Furthermore, the amendment also permitted prescriptions to be made over the phone, via oral transmission. Similarly, it allowed refills to be called in from a physician's office. These were substantial, but much-needed improvements to existing legislation. This amendment is commonly asked on the PTCB exam. You need to know why the amendment was put forth, what problems it solved, and what other practical functions it had. #2 - Kefauver-Harris Amendment, 1963 The Kefauver-Harris amendment was enacted in 1963; one of the most important pharmacy laws to know for the PTCB exam. This amendment was passed because dubious and potentially lethal medicines were being sold to the public. The amendment sought to guarantee the safety, purity, and efficacy of both prescription and non-prescription medicines; eliminating the risk of dubious or harmful medicines being released into the public sphere. The amendment was also passed in the wake of the thalidomide tragedy, in which tens of thousands of birth defects were caused by thalidomide; a drug marketed to pregnant women for the treatment of morning sickness. Thalidomide is a teratogenic drug; meaning that it is a drug that causes birth defects. Due to the reckless nature in which thalidomide was handed out to patients without due care to the effects it had on pregnant women, stricter drug regulation was required. The amendment was passed against that backdrop. The amendment also carried additional utility, such as: Requiring that pharmaceutical manufacturing sites are registered and permit inspections as and when these inspections are needed. Placing drug advertising under the remit of FDA supervision. The Kefauver-Harris amendment, like the Durham-Humphrey amendment above, regularly gets tested; one of the core pharmacy laws to know for the PTCB exam. For the exam, candidates need to understand why the amendment was passed and what practical solutions it introduced to enhance patient safety. #3 - Poison Prevention Packaging Act, 1970 The Poison Prevention Packaging Act was enacted to ensure that medicines were child-resistant. Up to this point, there were no strict regulations in place that mandated pharmaceutical manufacturers to impose child-resistant packaging. This law mandated that all prescription medicines, and most OTC medicines, are contained within child-resistant packaging. The definition of child-resistant was clear - namely, that it must be sufficiently resistant that at least 80% of children under the age of 5 cannot open it, and that it's resistant enough that at least 90% of adults can open it. Of course, this law does not impact some medicines - such as those in nursing homes or hospitals, to which children do not have access. Other drugs that were not required to have non-child resistant packaging include: Birth control pills Sublingual nitroglycerin tablets Potassium effervescent tablets Specific corticosteroid tablets Of course, patients may wish to have non-child resistant containers for their medicines. Pharmacists can provide these containers. Though if they do, a signed release form must be kept on file. Conclusion We've now completed our review of some of the essential pharmacy laws to know for the PTCB exam. We covered the: Durham-Humphrey Amendment, 1951 Kefauver-Harris Amendment, 1963 Poison Prevention Packaging Act, 1970

PTCB Practice Test MCQs

PTCB Practice Test MCQs The more PTCB practice exam questions you practice, the better. Test questions afford students the opportunity to not only learn from their mistakes but also plug any gaps in their knowledge - a win-win situation. Today, that is precisely what we will focus on - 5 of the most common PTCB exam questions - their style and complete explained answers. The purpose of these questions is not to establish what you know - but what you do not know. It is only through identifying our weaknesses that we can work on those weaknesses to turn them into strengths. There are no advantages to disproportionately spending more time on subjects you prefer. If you know the subject, you know it. Spending more time on that subject only prevents you from spending more time on the subjects you find difficult, or have not yet studied at all - perhaps because you think they may be difficult, or perhaps you prematurely believe those subjects to be boring. If you do find subjects "boring" or "irrelevant", that itself is a problem. After all, pharmacy technicians are expected to have this knowledge and - as an aspiring pharmacy technician - it is incumbent upon you to learn this material as it is relevant to your career, even if you do not find it immediately relevant to your study now. Math is relevant. Laws are relevant. Accuracy is relevant. Pharmacology is relevant. It's all relevant. And it's precisely that relevance that should energize and motivate your study to become the best possible pharmacy technician in your state. Practicing PTCB exam questions are an important part of that process. Questions are an important tool to tease out the detail - and it's the detail that gets tested. Below, we review five sample PTCB practice test questions. Before you read the explained answers, attempt to answer each question first. That way, you can learn from your mistakes and be sure never to repeat the same mistake again. MCQ 1 - Brand Questions! What is the active ingredient of the medicine, Zantac? Cetirizine Zolpidem Omeprazole Ranitidine Brand and generic drug names are among the most common PTCB exam questions. Whilst students are not expected to know all medicines, they are expected to know the most common brands and generic drugs. The four drugs listed in this question are examples of common drugs. One of the problems with brand names is that many of them sound similar. For example - Zantac and Zyrtec. Ranitidine is the active ingredient of Zantac - a medicine used in the treatment of excess gastric acid production such as dyspepsia (indigestion) and GERD, gastroesophageal reflux disease. Cetirizine is the active ingredient of Zyrtec; an antihistamine. You may also be confused by the two remaining answers. Omeprazole has a similar clinical function to ranitidine, in that it reduces gastric acid production. However, omeprazole belongs to the proton-pump class of medicines. Prilosec is one of the most common brand names of omeprazole. Proton-pump inhibitors can be identified as they always contain the suffix -prazole. Zolpidem is a member of the Z-drug class of medicines; non-benzodiazepines used in the short-term treatment of insomnia. Many students who do not know the answer to this question will have chosen zolpidem as the correct answer because its first letter resembles that of the medicine, Zantac. However, zolpidem is thrown in as a distraction, in the hope that students will erroneously choose it. Therefore, there are four take-home points: The need to know common brand and generic names. The ability to distinguish medicines that look and sound the same. To eliminate distraction answers, if possible. To understand different mechanisms of action to treat the same condition. For the 2020 PTCB syllabus, Medications is 40 percent of the exam - including brand and generic drugs, pharmacology, NTI medicines, side effects, drug interactions and much more. MCQ 2 - Pharmacy Calculations! A pharmacy technician is asked to dispense 250mL of medicine, each dose of which must contain 15mg/5mL. How many milligrams of drug is required to meet the needs of this prescription? 75mg 150mg 375mg 750mg Pharmacy calculations are among the most common PTCB exam questions asked on the test. Pharmacy technician students are frequently recommended to learn sets of equations when answering pharmacy calculations. At PTCB Test Prep, we recommend a different approach. Equations are only useful if: The student understands why the equation works. The student understands how to use the equation. If pharmacy technician students "memorize" equations and "plug" in values without really thinking it through, they do not understand the topic. If a slightly different question appears, the student may not have the ability to answer the question. They have become too reliant on "memorizing" equations that they are ill prepared to work out novel or different problems. Equations are only useful if students know how and why the equation works in the way it has been produced. Memorization techniques such as this are among the most unreliable way to answer pharmacy calculations. Instead, students should try to reason through the problem and work it out from a distant, rational perspective. By doing this, it gives students two ways to answer the question: first, independently without any equation and, secondly, to use any equations to confirm the answer they have originally arrived at. Let's reason through the above problem, rather than use an equation. The question tells us to prepare 250mL of medicine. Each 5mL teaspoon of this medicine contains 15mg of drug (hence 15mg/5mL). If each 5mL teaspoon contains 15mg, then 50mL must contain 150mg - and, by extension - 250mL must contain 750mg. We are simply slowly multiplying the values up. Therefore, the 250mL medicine contains 750mg of drug. This means that each 5mL of the 250mL solution contains 15mg of drug. There are 50 doses, then, in the medicine. When the patient is at home and uses 5mL per day, it means there are 50 days supply for the patient to use. Again, rather than using equations to begin with, it is better for students to work out these problems so that concepts are understood. Once concepts are understood, equations can be used to fast-track the process. Students unsure if they are correct about a problem should always use both methods. If both methods arrive at the correct answer, you can safely assume that you have worked out the correct answer. Pharmacy calculations make up an important component of the Order Entry and Processing knowledge domain - comprising part of 21.25% of all PTCB test MCQs. MCQ 3 - Food and Drug Interactions! Patients taking statins are counselled to avoid foods or drink that contain which of these? Grapefruit juice Tyramine-rich foods Milk or antacids Green, leafy vegetables Food and drug interactions are commonly asked MCQs on the PTCB exam. Again, pharmacy technicians are not expected to know all food and drug interactions - not least because there are many thousands upon thousands. However, technicians are expected to know the most common examples - and why these foods and drinks interact with drugs in the way that they do. In this PTCB practice test question, we have asked about one of the most common drug interactions - statins with grapefruit juice. Many drugs rely on liver enzymes to break down and metabolize drugs, meaning this waste can be safely eliminated from the body. However, some foods, such as grapefruit juice, prevent these enzymes from breaking down certain drugs - including statins. Because statins are not broken down, their level can rise to toxic levels in the body - increasing the risk of serious side effects such as muscle breakdown and rhabdomyolysis, which can lead to kidney failure. Though grapefruit juice is the correct answer, the other three answers are highly relevant when it comes to drug and food interactions. For example: Tyramine-rich foods must be avoided in patients taking MAO inhibitors, to prevent the risk of serotonin syndrome. Milk/antacids must be avoided in patients taking tetracyclines, fluoroquinolones, bisphosphonates, and levothyroxine - where they can bind to and reduce the efficacy of these drug classes. Green-leafy vegetables must be limited in patients taking warfarin - an anticoagulant drug. Green-leafy vegetables are rich in vitamin K, which is a pro-clotting nutrient. Therefore, green-leafy vegetables - such as broccoli and kale - reduce the anticoagulant effects of warfarin and increase the risk of blood clots. PTCB practice test questions routinely ask about these common drug and food interactions, so it is worth your time committing these interactions to memory. MCQ 4 - Federal Legislation! Which of these DEA forms must be used by pharmacies when ordering Schedule II controlled substances? DEA Form 41 DEA Form 106 DEA Form 222 DEA Form 224 Controlled substances are among the most common PTCB exam questions tested. Controlled substances have abuse potential, and so the amount dispensed and their availability to the public must be tightly controlled. There are five schedules of controlled substances. Schedule I drugs have the highest abuse potential, whereas Schedule V drugs have the lowest abuse potential. Students should know all relevant DEA Forms. The DEA - or Drug Enforcement Administration - is the agency responsible for combating controlled substance use and distribution. In this question, DEA Form 222 must be used by pharmacies when ordering Schedule II controlled drugs. In terms of the remaining three answers, pharmacy technicians should also know their function: DEA Form 41 - used when recording controlled drugs that are destroyed. DEA Form 106 - used when a controlled substance is lost or stolen. DEA Form 224 - used when a pharmacy seeks to register as a licensed dispenser of controlled drugs. Federal legislation comprises 12.5% of PTCB exam questions. Take your time to learn the necessary DEA forms and legislation that pharmacy technicians are expected to know. MCQ 5 - Patient Safety and Quality Assurance! Which of the following decimal notations is the most appropriate way to represent five milligrams? 5mg 5.mg 5.0mg 5.00mg In this PTCB practice test question, it explores the concept of leading and trailing zeros, a small part of a wider topic on prescription error prevention strategies. Pharmacy technicians should have a detailed knowledge of error prevention strategies - not only for the exam but also for real-life practice, too. Small changes in dose can, for some medicines, produce a harmful clinical outcome. As pharmacy technicians, attention to detail and accuracy are among the most important skills you can have. For the remaining three answers, we must remember the following rule: namely, to never leave trailing zeros from whole numbers. In the case of 5.0, the decimal and zero are "trailing" the 5 and they are entirely unnecessary. The decimal point increases the risk of prescription error because it may inadvertently be read as 50mg. It should only be written as 5mg. Conversely, a prescription for .5mg should always have a lead zero: 0.5mg - otherwise it may be misinterpreted as 5mg. This is just one of many prescription error prevention strategies to know - but it is nonetheless an important one to keep in mind. Final Thoughts Here, we have discussed some of the most common PTCB exam questions. In our review, we have talked about: Brand questions Pharmacy calculation questions Drug interaction questions Federal legislation questions Patient safety and quality assurance questions The PTCB examination has 90 questions, and many of these questions will be sourced from these five topics. Of course, there is much more to learn - and many more PTCB practice questions to work through. Studies show that the more practice questions you take, the better your result on exam day. Answering questions is as much about getting the question wrong as it is about getting it right. Whilst choosing a correct answer is satisfying, it doesn't help you learn. Only wrong answers can fill that gap - and any gaps in your knowledge. By applying the strategies and techniques discussed

ParenteralInjectable PreparationsE

ParenteralInjectable PreparationsEpiduralInjected into the dura matter (epidural space) of the spinal cord. IntravenousInjected into the vein. This allows for immediate adsorption. Intravenous includes IV push, IV piggyback and IV infusion or drip.I ntramuscularInjected into the muscle.SubcutaneousInjected into the fatty layer under the skin. IntradermalInjected into the top layer of the skin at a slight angle .IntracardiacInjected into the heart.IntraocularInjected within the eye. IntrathecalInjected into the space surrounding the spinal cord. Intra-articularInjected into the joint.

Ritonavir+ Protease inhibitors Lopinavir less dose of protease inhibitors

Ritonavir inhibits CYP enzymes that otherwise metabolize protease inhibitors. This means less dose of protease inhibitors can be used to achieve the same clinical effect without causing excess side effects.

Proton Pump Inhibitors - Inhibit the action of the gastric proton pump, thereby reducing gastric acid production. They usually have the suffix "PRAZOLE".

"PRAZOLE". What are Proton Pump Inhibitors (PPIs)? PPIs reduce the production of acid by the stomach. They work by irreversibly blocking an enzyme called H+/K+ ATPase which controls acid production. This enzyme is also known as the proton pump and is found in the parietal cells of the stomach wall. What are Proton Pump Inhibitors used for? PPIs treat conditions that are caused by either an overproduction of stomach acid or exacerbated by stomach acid. Taking a PPI once a day inhibits around 70% of proton pumps, so a small amount of acid is still available for food digestion. PPIs may be used for the treatment of: Acid reflux, also called gastroesophageal reflux disease (GERD) Conditions characterized by an overproduction of stomach acid (such as Zollinger-Ellison syndrome) Duodenal or stomach ulcers including those caused by NSAIDs Studies have linked proton pump inhibitors to serious, sometimes life-threatening side effects. Higher dosages and long-term use increase the risk for many of those complications. Prolonged use of these medicines can cause kidney disease, injury and failure. It can also lead to heart attacks, cancers and bone fractures. What are the problems with proton pump inhibitors? Headache Diarrhea Constipation Abdominal pain Flatulence Fever Vomiting Nausea Rash

50 facts

#1Proton-pump inhibitors (omeprazole) and H2 receptor antagonists (famotidine) are used to treat conditions that involve lowering gastric acid production - such as dyspepsia and GERD.#2An agonist is a drug that binds to a receptor and triggers its natural response, whereas an antagonist is a drug that binds to a receptor and blocks its natural response.#3Statins are drugs used to lower blood cholesterol levels. Examples include atorvastatin, simvastatin, and lovastatin. Statins work by inhibiting the enzyme HMG-CoA reductase. Side effects include muscle aches and pains and elevated liver enzymes. Patients may be advised to avoid grapefruit juice, depending on which statin they are taking, as this can increase the risk of side effects!#4Pharmacokinetics is defined as how the body affects a drug; whereas pharmacodynamics is defined as how a drug affects the body.#5Beta-lactams are antibacterial drugs. The beta-lactam ring, a 4-membered ring, confers antibacterial properties to these drugs by disrupting bacterial cell wall synthesis. Drug classes whose members contain a beta-lactam ring include penicillins and cephalosporins.#6Water-soluble vitamins include vitamins B and C, meaning they need to be constantly replaced as they are eliminated from the body. Fat-soluble vitamins are stored and include vitamins A, D, E, and K. Because they are stored, they do not need to be replenished as often.#7Alkylating agents are drugs used in the treatment of a wide range of cancers. They interfere (via alkylation) the DNA synthesis/replication process. Examples include cyclophosphamide, ifosfamide, busulfan, and#8Z-drugs are used in the treatment of insomnia where patients find it difficult to induce and maintain sleep. Examples include zolpidem, zaleplon, and zopiclone.#9Bisphosphonates are drugs used to treat bone disorders, such as osteoporosis. Examples include alendronic acid and pamidronate. Bisphosphonates should be taken on an empty stomach in the morning, 30 minutes before food or other medicines. The patient should remain upright and take a full glass of water. This is necessary to avoid esophagitis.#10Antiemetic drugs are used to treat nausea/vomiting (eg. cyclizine) Analgesics are used to treat pain (eg. morphine) Diuretics are used to promote water and electrolyte loss (eg. furosemide) Aquaretics promote water loss ONLY (eg. tolvaptan) Eugeroic drugs promote wakefulness and alertness (eg. modafinil) Antineoplastic drugs are used to treat cancer (eg. cisplatin)#11Anticholinergic side effects include constipation, blurred vision, dizziness, urinary retention, and confusion. Drugs that block the neurotransmitter, acetylcholine, causes these kinds of side effects.#12Beta-blockers can be readily identified as they all contain the suffix -lol. Examples include metoprolol, bisoprolol, and esmolol.#13Anticonvulsant drugs are used to treat seizures. Examples include phenytoin, valproate, carbamazepine, ethosuximide, zonisamide, and topiramate.#14"Indications" is a term that refers to what drugs are used to treat. For example - acetaminophen is used to treat pain. "Pain" is therefore an indication of acetaminophen. Similarly, seizures is an indication of the antiepileptic drug, phenytoin.#15There are many different classes of insulin, depending on how fast they work. Short-acting insulins include lisprol, aspart, and glulisine. Intermediate-acting insulins include isophane insulin, whereas long-acting insulins include insulins detemir and glargine.#16Diuretics - which promote water loss and urination - are advised to be taken in the morning, to avoid night-time urination (nocturia).#17Alpha blockers are used to treat conditions such as prostate problems in men, such as difficulty urinating, as well as hypertension (often when other medicines have proven ineffective). Examples of alpha blockers include doxazosin, terazosin, and tamsulosin. #18Memantine is a drug used to treat Alzheimer's disease. It is the active ingredient of the medicine, Namenda.#19Antibacterial drugs can be bacteriostatic - where they prevent bacterial replication - or they can be bactericidal - where they actively kill bacterial cells.#20Opioid analgesics work by acting at mu receptor agonists. Examples of opioids include codeine, dihydrocodeine, meperidine, tramadol, and morphine.#21Iron supplements, antacids, and dairy produce reduces the absorption and efficacy of levothyroxine; a drug used to treat hypothyroidism.#22Metformin is an oral hypoglycemic drug used in the treatment of both type 2 diabetes and polycystic ovary syndrome (PCOS). Unlike other oral hypoglycemic drugs which can cause weight gain, metformin can cause weight loss. Metformin is the active ingredient of, Glucophage and belongs to the biguanide class of drugs.#23Tendon rupture/damage is a notable side effect of fluoroquinolone antibacterial drugs - such as ciprofloxacin and moxifloxacin.#24Sildenafil is the active ingredient of the medicine, Viagra; a drug used in the treatment of erectile dysfunction. Sildenafil works by inhibiting the enzyme, phosphodiesterase type 5 (PDE5). Examples of other PDE5 inhibitors include tadalafil and vardenafil. PDE5 inhibitors should be avoided with nitrates as the combination can produce severe hypotension!$25Benzodiazepines work by enhancing the binding of the inhibitory neurotransmitter GABA to the GABA A receptor. Benzodiazepines can be identified as their suffixes include -zolam and -azepam. Drugs include midazolam, diazepam, and lorazepam.#26Green-leafy vegetables contain vitamin K and so should be avoided in patients taking warfarin. Warfarin is an anticoagulant and vitamin K opposes the anticoagulant effects of warfarin.#27Antiretroviral drugs are used to treat HIV/AIDSs as part of HAART therapy (highly-active anti-retroviral drugs). Drug classes that fall under the category of antiretroviral drugs include reverse transcriptase inhibitors, protease inhibitors, and integrase inhibitors.#28Medicines that target ergosterol are antifungal drugs. Ergosterol is an essential part of the fungal cell membrane. Azole antifungals include ketoconazole, clotrimazole, and voriconazole.#29Calcium channel blockers are used to treat hypertension and arrhythmias. Examples include dihydropyridine CCBs - such as amlodipine and nifedipine and felodipine - and non-dihydropyridine CCBs such as verapamil and diltiazem.#30How a drug works is referred to as its "mechanism of action". For example, ACE inhibitors work by inhibiting the angiotensin converting enzyme - the enzyme that converts angiotensin I into angiotensin II. This has the effect of lowering blood pressure.#31Amiodarone is a drug used to treat arrhythmias, or abnormal heart rhythm disorders. Amiodarone is structurally related to iodine, hence its name "amIODarone".#32Antipsychotic drugs by inhibiting dopamine D2 receptors. Examples of antipsychotic drugs include haloperidol, clozapine, olanzapine, and risperidone.#33NSAIDs are medicines used to treat pain and inflammation. NSAID means non-steroidal anti-inflammatory drugs and includes naproxen, ibuprofen, celecoxib, diclofenac, and aspirin. Acetaminophen is NOT classified as an NSAID!#34DMARDs are drugs used in the treatment of rheumatoid arthritis (as well as other autoimmune disorders). Examples include methotrexate, etanercept, cyclosporine, and infliximab.#35Teratogenic drugs are drugs that cause harm to the developing fetus and so should be avoided by pregnant women. Examples of teratogenic drugs include valproate, ACE inhibitors, and thalidomide.#36Triptans are medicines used to treat migraine and cluster headaches. Examples include sumatriptan, zolmitriptan, and eletriptan.#37Drugs used in the treatment of Parkinson's disease include levodopa (in combination with a dopa decarboxylase inhibitor to ensure as much levodopa makes it to the brain without being degraded outside of the brain); COMT inhibitors such as entacapone and tolcapone; and dopamine agonists - such as bromocriptine, pramipexole, ropinirole, and cabergoline. MAO-B inhibitors, such as selegiline, may also be used.#38Patients taking MAO inhibitors must avoid tyramine-rich foods such as soy sauce, beer, aged meats and cheeses, and sauerkraut, among many other foods/drinks.#39Aspirin is used to treat pain and inflammation. At lower doses, aspirin is used for its antiplatelet effects.#40SSRIs are medicines used to treat depression, anxiety, and panic disorder. Examples include fluoxetine, paroxetine, sertraline, citalopram, escitalopram, and fluvoxamine.#41Antibacterial protein synthesis inhibitors include aminoglycosides, tetracyclines, and macrolides: Aminoglycosides are an antibacterial drug class whose members include gentamicin and tobramycin. Side effects of aminoglycosides include ototoxicity and kidney damage (nephrotoxicity). Side effects of tetracyclines include tooth discoloration, enamel hypoplasia, and phototoxicity. Examples of tetracyclines include tetracycline, doxycycline, and minocycline. Dairy products reduce the efficacy and absorption of tetracyclines. Examples of macrolides include clarithromycin, fidaxomicin, erythromycin, and telithromycin.$42Beta-2 agonists are used in the treatment of asthma and COPD. Agonism at beta-2 receptors causes smooth muscle relaxation in the lungs. Examples of beta-2 agonists include albuterol and formoterol.#43Expectorants are drugs that promote the elimination of sputum in the treatment of productive coughs. Guaifenesin is one such example. Decongestants improve nasal congestion in colds/sinus infections. Phenylephrine and pseudoephedrine are examples of decongestants. Antihistamines improve symptoms of allergic rhinitis and include drugs such as diphenhydramine, loratadine, and cetirizine. Antitussive drugs are used to treat cough. Examples include codeine and dextromethorphan.#44Heparin is an anticoagulant medicine used to treat/prevent blood clots. Low-molecular weight heparins (LMWHs) are a drug class related to the structure/function of heparin and include drugs such as enoxaparin and dalteparin.#45The half-life is the time it takes for 50% of a drug to be removed from the body. For example: if a drug has a half-life of 6-hours and the patient takes the drug at 12pm, then by 6pm, the body will contain 50% of the drug and by 12am, only 25% of the drug remains in the body.#46Side effects of ACE inhibitors - such as ramipril and perindopril and captopril - include elevated potassium levels (hyperkalemia) and a persistent dry cough. Because ACE inhibitors increase potassium levels, they should be avoided with drugs that also cause hyperkalemia including trimethoprim and potassium supplements.#47Medicines have two parts: an active ingredient and excipients The active ingredient is the therapeutic element (i.e. the drug) Excipients are non-active ingredients - such as preservatives, vehicles, and flavoring agents - that make up the rest of the medicine.#48Setrons are medicines used to treat/prevent nausea and vomiting, particularly in patients receiving chemotherapy. Examples of setrons include ondansetron and granisetron.#49Tamoxifen is a drug used in the treatment of breast cancer. It is a member of the SERM class of drugs - Selective Estrogen Receptor Modulators.#50Drugs that are administered via the buccal route are placed between the gums and cheek.

half life equation

(0.7 x Vd) / CL Sildenafil* vs. Tadalifil*HoursBlood % HoursBlood %0100% 0100%3.550% 17.550%725% 3525%10.512.5% 52.512.5%

ACE inhibitors Ramipril Lisinopril +Potassium-elevating drugs risk of hyperkalemia.

ACE inhibitors increase potassium levels, raising the risk of hyperkalemia. Taking ACE inhibitors with other K-elevating drugs then - such as trimethoprim or potassium supplements - should be avoided.

A.2.R.B. - Angiotensin 2 Receptor Blockers block Angiotensin 2 enzymes from specific receptor sites. Avoiding Angiotensin 2 activity helps prohibit vasoconstriction. They usually have the suffix "ARTAN

ARTAN Angiotensin II receptor blockers Print Share Angiotensin II receptor blockers On this page Examples of angiotensin II receptor blockers When angiotensin II receptor blockers are used Side effects Angiotensin II receptor blockers help relax your veins and arteries to lower your blood pressure and make it easier for your heart to pump blood. Angiotensin is a chemical in your body that narrows your blood vessels. This narrowing can increase your blood pressure and force your heart to work harder. Angiotensin II receptor blockers block the action of angiotensin II. As a result, the medication allows your veins and arteries to widen (dilate). Azilsartan (Edarbi) Candesartan (Atacand) Eprosartan Irbesartan (Avapro) Losartan (Cozaar) Olmesartan (Benicar) Telmisartan (Micardis) Valsartan (Diovan) When angiotensin II receptor blockers are used In addition to treating high blood pressure, angiotensin II receptor blockers may prevent, treat or improve symptoms in people who have: Chronic kidney diseases Heart failure Kidney failure in diabetes Side effects Few people have side effects when taking angiotensin II receptor blockers. Possible side effects can include: Dizziness Higher than normal potassium levels in the blood (hyperkalemia) Swelling of the skin due to a buildup of fluid (angioedema) Some people taking the angiotensin II receptor blocker olmesartan have reported intestinal problems. Talk to your doctor if you develop severe diarrhea or lose a lot of weight while taking this medication. Don't take angiotensin II receptor blockers if you're pregnant or plan to become pregnant because the drugs can harm a developing fetus.

Alpha-blockers+ Antihypertensive drugs dangerously low blood pressure.

Alpha-blockers include drugs such as terazosin, prazosin, and tamsulosin - all of which can lower blood pressure. Taking alpha-blockers with other drugs that lower blood pressure can produce an additive effect that results in dangerously low blood pressure. This principle applies to any two (or more) drug classes that reduce blood pressure.

Antiplatelet drugs Clopidogrel NSAID sAspirin Celecoxib Ibuprofen Anticoagulant drugs Warfarin Heparin risk of bleeding is even greater

Antiplatelet drugs, NSAIDs, and anticoagulant drugs individually increase the risk of bleeding. Therefore, the risk of bleeding is even greater if any of these drugs are taken in combination with one another. Furthermore, other drugs - such as SSRI antidepressants - also increase the risk of bleeding with these medicines.

Calcium Channel Blockers - Calcium channel blockers work by blocking calcium channels in cardiac muscle and blood vessels, thereby slowing down activity in the heart.

Calcium channel blockers lower your blood pressure by preventing calcium from entering the cells of your heart and arteries. Calcium causes the heart and arteries to contract more strongly. By blocking calcium, calcium channel blockers allow blood vessels to relax and open. Some calcium channel blockers have the added benefit of slowing your heart rate, which can further lower your blood pressure, relieve chest pain (angina) and control an irregular heartbeat. Calcium channel blockers are also called calcium antagonists. Examples of calcium channel blockers include: Amlodipine (Norvasc) Diltiazem (Cardizem, Tiazac, others) Felodipine Isradipine Nicardipine Nifedipine (Adalat CC, Procardia) Nisoldipine (Sular) Verapamil (Calan, Verelan) When calcium channel blockers are used In addition to high blood pressure, doctors prescribe calcium channel blockers to prevent, treat or improve symptoms in a variety of conditions, such as: Coronary artery disease Chest pain (angina) Irregular heartbeats (arrhythmia) Some circulatory conditions, such as Raynaud's disease For black people and older people, calcium channel blockers might work better than other blood pressure medications, such as beta blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers. Side effects Side effects of calcium channel blockers may include: Constipation Dizziness Fast heartbeat (palpitations) Fatigue Flushing Headache Nausea Rash Swelling in the feet and lower legs

Here are the top reasons for medication error in the United States:

Causes of Medication Error Here are the top reasons for medication error in the United States: Distractions - almost three-quarters of medication errors have been attributed to distractions. Lapses in judgment can occur when healthcare professionals are busy and attempt to get through as much work as possible. Ineligible writing - often, healthcare professionals cannot effectively read what is written on prescriptions. If the patient requires emergency medicine, this can prove to be a very dangerous mistake. Pharmacy abbreviations and acronyms can sometimes add to the confusion. Omissions - medication omissions occur when the ordered dose for the patient is not administered. Wrong time - medications must be administered at the correct time. The therapeutic effects of a drug depend on administering the drug at the right time, and not too early nor too late. This is particularly true for narrow-therapeutic index (NDI) drugs. Unauthorized medicines - it's not uncommon for medicines prescribed and dispensed to one patient are given to a second person at home. This may be the case, for example, where a relative or friend at home experiences similar symptoms to the patient, and so assumes the same medicine will assist. This is an example of the unauthorized use of medicine. Incorrect dose - patients must be prescribed the dose as stated by the physician. The dose should not be higher or lower than this value. Again, with narrow therapeutic index drugs, a small difference in dose can result in a big change in therapeutic outcomes - often damaging to the patient. Incorrect preparation - similarly, one of the most common medication errors is for patients to be given the wrong medicine preparation. For example, this includes using the wrong type of water when preparing reconstituted products in the pharmacy. It can also occur if bacteriostatic water for injections is incorrectly used in place of sterile water for injections. Incorrect administration technique - this occurs when a medicine is not correctly administered to the patient. For example, when administering a drug via the subcutaneous route, injecting too far into the skin means that the medicine is not reaching its target site. Similarly, using an IV route of administration rather than an infusion pump. Expired medicines - as a pharmacy technician, it is incumbent upon you to ensure that patients do not receive expired medicines. Inventory management and stock control are very important for this reason. Expired medicines can cause damage to patients. For example, expired tetracycline antibacterial drugs can cause Fanconi syndrome in affected patients. Inadequate monitoring - it's important for pharmacies to keep stock of drug monitoring for patients. This means keeping adequate stock and ensuring the patient has access to medicine when they need it. It also means that drugs should be ordered at the correct time - and the shipments verified once delivery has been made.

Corticosteroids +Beta-2 agonists Albuterol Terbutaline hypokalemia

Corticosteroids increase the risk of hypokalemia (low blood potassium levels) when taken with beta-2 agonists such as albuterol and terbutaline.

Corticosteroids Prednisolone Hydrocortisone+ NSAIDs risk of peptic ulceration

Corticosteroids increase the risk of peptic ulceration and GI bleeding when taken with NSAIDs.

Common dosage form

Dosage Forms / Routes of Administration Enteral | Parenteral | Transdermal | Inhalation Dosage forms, also known as Routes of administration describe the physical form in which medication will be delivered into the body. Common dosage forms Enteral medications are given orally and pass through the GI tract to be absorbed into the bloodstream and metabolized by the liver. This includes oral, naso-gastric, and rectal routes.Parenteral medications are injected or placed into the body tissues and do not pass through the liver before entering the bloodstream. This can include injections, topical and inhalation routes. Generally in pharmacy, parenteral refers to injection. Topical and inhalation routes are separated into their own routes of administration.Injectable drugs are usually in the form of solutions or powders, which are mixed with a sterile diluent to render an injectable solution.Inhalation routes of administration are inhaled through the mouth or the nose and usually act directly on the respiratory system before entering into the bloodstream. They are often used to treat respiratory diseases, but gases are inhaled for general anesthesia as well.Topical dosages are applied to the skin surface or a mucous membrane. Dosage Form Table:EnteralOral PreparationsTabletsTo form a Tablet the drug is combined with fillers and is then compressed into a hard pellet. There are various shapes, sizes and colors of tablets. Tablets are available in fast acting, slow release, controlled release, enteric coated, film coated, sublingual, chewable and other formulations. Not all oral Dosage Forms / tablets are swallowed. Sublingual (SL) tablets are placed under the tongue, wafers are placed on the tongue and B UCCAL tablets are placed between the cheek and the gum.CapsulesTo form a Capsule the drug is contained in a cylindrically shaped shell, which breaks open and the drug is released. This includes gelatin capsules.CapletA Caplet is an oval-shaped tablet. Oral SolutionsThe drug is dissolved completely into a liquid form. Oral SuspensionsThe drug is mixed with, but not completely dissolved into a liquid. It needs to be shaken before administration in order to suspend the drug particles evenly. SyrupsContain a high concentration of sucrose or sugar to sweeten, for ease of use. ElixirsElixirs contain between 5% and 40% alcohol .TincturesMay contain as little as 17% alcohol or as much as 80% alcohol. EmulsionsAn Emulsion is a suspension involving one liquid in a second liquid with which the first will not mix. (oil in water or water in oil) Oral powdersDrugs which are in a powder form and are usually dissolved in juice or water before administration Lozenge and TrocheLozenges and Troches are meant to be dissolved slowly in the mouth and generally have a local effect. Rectal SuppositoriesSolid or semi-solid bullet shaped dosage forms. They melt at body temperature, dispersing the medication. EnemasDrug is suspended in a solution and infused into the rectum. Transdermal patchA medicated adhesive patch applied directly on the skin to deliver a specific dosage of a drug. They have systemic effects and should be rotated to different sites on the body. InhalationInhaled through the mouth or nose and usually act directly on the respiratory system before entering into the bloodstream. They are often used to treat respiratory diseases, but gases are inhaled for

Drug-disease interactio

Drug-disease interaction - where a medicine has a harmful effect on the progress of a disease. For example - beta-blockers can assist patients with heart disease, but they may worsen asthma in the same patient.

Drug-drug interaction

Drug-drug interaction - where two medicines collide to produce either a desirable or adverse effect. For example - taking aspirin with NSAIDs increases the risk of bleeding.

Drug-food interaction

Drug-food interaction - where a medicine interacts with food or drink, again, that produces either a wanted or unwanted effect. For example - taking grapefruit juice with statins increases the risk of adverse effect such as muscle pain and rhabdomyolysi

SulfonylureasMetforminThiazolidinediones hypoglycemia.

Each of these drugs can individually cause hypoglycemia. Taken together, in any combination, this increases the risk of hypoglycemia further (or any other drug class that lowers blood glucose levels).

Cough and cold medicines

Facts About the Common Cold Cough and cold medicines are among the most widely prescribed drugs in the United States. Pharmacy technicians provide essential counselling services to patients on what medicines will work best for their symptoms. On the PTCB exam, students can expect MCQ questions on cough and cold medicines. Candidates should be able to identify the most common medicines and what they are used for. Students should also understand the nomenclature of the various drug classes - much of which we review below. The typical symptoms of a cold include: Runny nose Cough Nasal congestion Sore throat Body aches Headache Low fever Fatigue The common cold is a viral infection of the upper respiratory tract. Children have the highest risk of developing colds - particularly those under the age of 6 years. Most people recover in 7-10 days, if not sooner. Whilst there is no cure for the condition, it can be treated. MucolyticsCarbocisteineBromhexineAmbroxolAid mucus removal from the airways, bronchi, and throat. DecongestantsEphedrinePseudoephedrineOxymetazolinePhenylephrineImprove nasal congestion in sinus infections. ExpectorantsGuaifenesinAcetylcysteineEnhance mucus/phlegm production to make coughing easier. AntitussiveCodeinePholcodineDextromethorphanCough suppressants. Antipyretic / analgesicsAcetaminophenNSAIDs, ibuprofenRelieve fever and pain. Antihistamines Diphenhydramine Chlorpheniramine Brompheniramine Loratadine CetirizineReduce severity of allergic symptoms such as runny nose and watery eyes.They are also mild sedatives. SyrupsSoothing hot drinks to ease irritation in the throat. They often contain honey or lemon. Sample PTCB Practice Questions On the pharmacy technician exam, students should expect questions on cough and cold medicines. Questions may relate to identifying the active ingredient of the most common cold medicines, or it may relate to identifying the purpose of a drug class. For example - you could be asked the following questions: Q. An antitussive drug is used to treat which of the following symptoms? a. Fever b. Cough c. Nasal congestion d. Pain Q. What is the active ingredient of the medicine, Advil? a. Acetaminophen b. Codeine c. Bromhexine d. Ibuprofen Q. Drugs that enhance mucus production to relieve coughing are known as? a. Mucolytics b. Antipyretics c. Antitussives d. Expectorants Q. Which of these drugs is classified as an antihistamine? a. Cetirizine b. Bromhexine c. Ambroxol d. Dextromethorphan Q. What is the active ingredient of Afrin Nasal? a. Codeine b. Chlorpheniramine c. Oxymetazoline d. Loratadine

laws

Federal Food and Drug Act of 1906• Known as the Pure Food and Drug Act.• Provided authority for federal inspection of meat products and prohibited the sale of adulterated foods.• Required that "Secret Elixirs" containing ingredients like: Cocaine, Heroin, Morphine and Alcohol which were available at most stores as miracle cure-alls be labeled with correct information about their ingredients as well as suggested dosages. Narcotic Tax Act of 1914• Known as the Harrison Narcotic Act.• Provided authority for Internal Revenue Service to collect tax on Opiates thru Tax Stamps.• Required that any entity which produced, distributed, dispensed or sold opiates be registered with the IRS.• Emphasis was on attempting to control the massive flow of opiates in order to protect the public from rising addiction. Federal Food, Drug and Cosmetic Act of 1938• Known as FDCA 1938.• Replaced the Food and Drug act of 1906.• Provided better clarification about misbranding definitions.• Provided better clarification about adulteration definitions.• Gave the FDA authority to require adequate testing of new drugs for safety. The Durham-Humphrey Amendment of 1951• Created a distinction between "OTC" and "Legend Drugs".• Legend Drugs can only be dispensed with a valid Prescription..• Required Legend Drugs to carry the statement: • Also known as the "Drug Efficacy Amendment".• Required drug manufacturers to provide proof of the effectiveness and safety of their drugs before approval .• Required drug advertising to be more closely regulated and disclose accurate information about side effects The Bureau of Narcotics and Dangerous Drugs (BNDD)• Predecessor agency of the DEA.• In 1973 the BNDD merged into the DEA.• DEA (Drug Enforcement Administration) Drug Abuse Prevention / Control Act of 1970• Also known as the Controlled Substances Act (CSA)• Completely replaced the Harrison Act.• Required the use of DEA Numbers• Required comprehensive record keeping and transaction tracking.• Enforced by the DEA under the US Dept. of JusticePoison Prevention Packaging Act of 1970• Also known as the PPPA• Designed to reduce the risk of children ingesting dangerous substances.• Required locking caps on most prescriptions Combat Methamphetamine Epidemic Act (2005)• Enacted to regulate the OTC sales of pseudoephedrine.• Identity and address of each purchaser to be kept for two years.• Daily sales of regulated products not to exceed 3.6 grams.• 30 day purchase limit not to exceed 9 grams• 30 day purchase via mail order not to exceed 7.5 grams

Federal Requirements on the PTCB Exam

Federal Requirements on the PTCB Exam Federal requirements is one of the core knowledge domains for the 2020 PTCB exam. Here, we have put together a quick guide to legislation that governs pharmacies and medicines - registration, ordering, and documentation of controlled substances. Legislation relates to laws - and its laws that govern standards. Consistent standards are necessary to maximize safety and quality protocols. These standards are now in place because, at some point in the past, they were either not followed or adhered to. Often, it takes many mistakes - even tragedies - for laws to change - and it is this federal legislation for pharmacies and medicines that technicians are expected to have a rounded knowledge of. This is particularly true for controlled substances - all of which have abuse potential in some form. For any pharmacy to operate, it must have a state license. Depending on what medicines the pharmacy dispenses, they may be required to obtain additional certification - such as those pharmacies that dispense controlled substances. DEA Forms - Controlled Substances There are many different forms to complete, depending on the task under review. Many of these forms are listed as DEA Forms - forms produced from the Drug Enforcement Administration; a federal agency formed and signed into existence in 1973 by President Richard Nixon. This agency is tasked with combating drug trafficking and distribution in the United States. Pharmacies that dispense controlled substances must register with the DEA using Form 224; a form that can be found online or alternatively through the DEA itself. If approved as a controlled substance-dispensing pharmacy, the pharmacy must keep the certificate of authorization within the pharmacy, in a safe location and always available for review by an inspection authority. Authorized pharmacies carry this license for a period of 3-years, after which it can be renewed using DEA Form 224a (though pharmacies that wish to renew must do so at least 60-days before date of expiry). Pharmacies that require a duplicate authorization certificate must instead fill out DEA Form 223. This may happen, for example, in cases where the pharmacy has already been approved as a controlled substance-dispensing pharmacy, but they wish to re-obtain the certificate of authorization that allows them to do so. DEA Forms - Documenting Controlled Drugs Pharmacies are required to adhere to strict regulations on documenting records and inventories of all controlled substances. These records can relate to: The purchase of controlled substances Medicines received to the pharmacy Medicines dispensed to patients Controlled substances that have been disposed of Different forms are used depending on the type of controlled substance ordered. There are different regulations around each of these controlled substance schedules. For example - DEA Form 222 must be used when ordering Schedule II controlled substances. This form is triplicate (first copy for the supplier, second copy for the DEA, and third copy held by the pharmacy) and must be completed either through handwritten means or through typing. The form must be completed with the DEA registrant at the pharmacy signing the copy - as well as including the pharmacy name and DEA number of the person receiving the order. However, an electronic means of ordering Schedule II drugs has since been introduced - the so-called CSOS, or Controlled Substance Ordering System. This system permits those registered with the DEA to electronically order Schedule II drugs without using Form 222. No more than 10 items may be purchased using Form 222, with the number of items purchased matching the total number specified at the bottom of the form. DEA form 222 is valid for 60-days. When the controlled substance order arrives, the registered DEA purchaser must confirm the date of shipment arrival and confirm the total number of items received. For instance, this is important to establish that no items have gone missing or, worse, have landed into the wrong hands. DEA Forms 222 should not be discarded, even if they have been partially completed or are difficult to read. Pharmacies are obliged to keep these incomplete or damaged forms within the pharmacy for a period of 2-years. Like Schedule II prescriptions, Schedule III, IV, and V prescriptions should also be kept for a period of 2-years within the pharmacy. Drugs within these three classes may be ordered online, through fax, or even over the phone. They are not as serious as Schedule II drugs though, that said, documentation must be kept. For example, invoices for Schedule III, IV, and V drugs must be signed, dated, and stamped (with a red C) and kept within the pharmacy for 2-years. Maintaining Inventory Federal requirements for maintaining controlled substance inventory includes the need to: Inventory records must be kept within the pharmacy for a period of 2-years. Federal legislation states that controlled drugs must be kept secure and locked away or, alternatively, dispersed between non-controlled drugs. This makes these drugs more difficult to find. Typically, pharmacies will keep Schedule II drugs locked up, and Schedule III through to V drugs dispersed throughout other non-controlled medicines. Any inventory review of Schedule II drugs must be done and filed separately from Schedule III-V drugs. Schedule II drugs must be manually counted. In contrast, Schedule III-to-V drugs can be estimated except if their total number of pills exceeds 1,000. In these exceptional cases, manual counting is required. Prescriptions for Schedule II drugs must be signed in ink (or have a digital signature) by the prescriber and handed in person to the pharmacy. The prescription must also contain a valid DEA number. In contrast, Schedule III-V drugs may be sent electronically. Scheduled Drug Refills and Transfers Schedule II prescriptions cannot be refilled. Schedule III-V drugs are permitted to be refilled a maximum of 5-times within a 6-month period from the date of issuance. Partial dispensing is permitted, but the remaining quantity must be dispensed to the patient within a 72-hour window. Prescriptions for Schedule III-V drugs may be transferred between pharmacies. In these cases, the transferring pharmacy must write 'void' on the front of the prescription whilst including details of the receiving pharmacy on the back of the prescription. These details include the recipient's DEA number, and name and address of the pharmacy, and name of the receiving pharmacist. The receiving pharmacist should write 'transfer' on the front of the prescription and record details such as the number of refills (and refills remaining), original dispensing date of the prescription, and details of the pharmacy and pharmacist: name, address, DEA number of the receiving pharmacy. As with other forms, these transfers - both original and transferred - should be kept for a period of 2-years. Controlled substances may be transferred between pharmacies using Form 222. Controlled Substance Destruction Damaged controlled substances must be destroyed and recorded using Form 41. As part of DEA Form 41, various details will be requested - including: DEA number of the pharmacy the pharmacy name and address contact telephone number details of the controlled substance to be destroyed (quantity, strength, name, form, NDC number etc.), date/location and method of drug destruction, and the signature of two witnesses to the event. If a controlled substance is stolen, DEA Form 106 must be completed in accordance with federal requirements. This must be done as soon as possible whilst contacting the nearest DEA authority and law enforcement officers. One of the copies of DEA Form 106 is retained by the pharmacy, with the duplicate sent to the DEA. Conclusion Federal Requirements forms an integral part of the 2020 PTCB test - comprising 12.5% of the entire exam. Much of this study involves controlled substances, risk evaluation and mitigation strategies (REMS), specific pharmacy legislation, and the handling and disposal of hazardous and non-hazardous waste. Here, we have covered much of what you can expect on PTCB practice test questions for the controlled substances aspect of the exam. If you are finding this section tough, it may be worth testing your knowledge and learning from detailed, explained answers. As part of our PTCB online course, we have put together the most comprehensive range of theory and questions to cover this and every other part of the exam. Take a few moments to learn more about our online pharmacy course.

Antihistamines+BenzodiazepinesSSRIsAntipsychoticdrugs sedation

First-generation antihistamines cause sedation. Taking antihistamines with other drugs that cause sedation - such as those listed - increases the risk of sedation.

HIV/AIDS.

For example - ritonavir is a drug used in the treatment of HIV/AIDS. However, ritonavir not used to directly treat the condition, but instead it is used to inhibit liver enzymes that metabolize other HIV drugs, such as protease inhibitors. This means that - when protease inhibitors are taken with ritonavir - a lower dose of protease inhibitors can be used to achieve the same clinical effect, whilst also reducing the risk of side effects. Ritonavir is used to "boost" the effects of other protease inhibitors.

Herbs and Supplements It's worth recalling that herbs, supplements, and other forms of alternative medicine - such as homeopathy - are highly popular throughout the United States. It's important, therefore, for pharmacy technicians to be aware of these herbs and supplements - identifying the drug and knowing what conditions they may be used to treat. Be aware, though, that because these herbs and supplements are often available over the counter, or within the pharmacy without a prescription, there is often contested evidence as to how effective they are. Though we list the common indications associated with each herb and supplement, consider that evidence is often lacking as to the actual effectiveness that they have. Many of these drugs are used in the treatment of coughs and the common cold. Herbs and supplements are examinable on the PTCB test. Here are the top 20 herbs and supplements you need to know.

HERB/SUPPLEMENTINDICATION(S)ALOE VERABurns, such as sunburn; dry skin.BILBERRYOcular disorders; bowel disturbances.BLACK COHOSHPremenopausal symptoms.CHONDROITINBone disorders; arthritic bones.CRANBERRYMaintaining urinary health/reducing infections.ECHINACEAColds; reducing symptoms.EVENING PRIMROSEPremenstrual symptoms.FISH OILCholesterol; blood pressure maintenance.GARLICMaintaining blood pressure; heart health.GINGKO BILOBAImprove memory; cognitive ability.GINGENGFatigue; memory; menopause symptoms.GLUCOSAMINEOsteoarthritis; bone disorders.GRAPE SEEDAllergies.GREEN TEAMetabolic syndromes.KAVA KAVAStress, tiredness, anxiety.MILK THISTLELiver disease.MELATONINJet lag; insomnia.ST. JOHN'S WORTDepression.SAW PALMETTOProstate disorders.SOYMenopausal symptoms.VALERIAN ROOTAnxiety

How are medicines ordered?

How are medicines ordered? Working in the pharmacy setting means that you - as a prospective pharmacy technician - must understand the process by which medicines are correctly and legally ordered. Here, we review how to order medicines the right way. Medicines can be ordered by a vast array of means. These include: By telephone By fax Online By mail Directly to sales representative Directly from the vendor Each time that an order is made, a form - called the purchasing order (PO) form - must be filled out. The purchasing order form always contains the following information: Product ordered (medicine) Quantity of product ordered Cost of product Purchase order number (PO #) Company name Terms of payment Shipping address When the products are delivered to the pharmacy, an invoice is issued - a document that confirms both the delivery and bill of sale (how much the products were purchased for, and from whom they were purchased - each of which is dated). What is direct purchasing? Sometimes medicines are ordered that bypass the wholesaler - what is referred to as "direct purchasing". In other words, the medicines are directly purchased from the drug manufacturer. As above, a PO must be completed. Typically, direct purchasing is used for specific kinds of medicine, including: Medicines with special storage instructions Vaccines Medicines with special shipping requirements Medicines in limited supply Orphan drugs - drugs used to treat a rare condition There may be other incidences in which direct purchasing is used. Where is most stock purchased from? As you can infer from the list above, most medicines are not purchased direct from the drug manufacturer. Instead, most medicines are purchased through a wholesaler - the middleman between the pharmacy and the drug manufacturer. This is known as prime vendor purchasing. One of the advantages of prime vendor purchasing is that it permits the pharmacy to purchase many different drugs from one wholesaler. This makes the purchasing and drug acquisition process much simpler and more cost-effective. All medicines arrive in bulk at the pharmacy, with one delivery, and one invoice. However, to establish a contract with a wholesaler, the wholesaler requires that a significant percentage of all drugs that the pharmacy needs are purchased through them - often 80+% of the pharmacy's medicines. As a pharmacy technician, you must have a solid understanding of how drugs are acquired by the pharmacy and what advantages and disadvantages are associated with each method. Delivery of Medicines to the Pharmacy Now that the medicines have been delivered to the pharmacy, what next? Pharmacy technicians must be adept at maintaining drug inventory. This means accurately receiving and storing medicines. An inefficiently run inventory damages patient safety. Once the shipment of medicines has arrived at the pharmacy, it must first be verified. It's essential that the shipment is intact and has not been compromised in any way. Any abnormalities within the order or shipment must be documented. The following details must be verified: Verification of ship-to name and address on containers Verification of the correct number of containers received Inspecting each box to ensure there has been no damage Cross-checking products received versus those listed on the PO Finally, signing and dating and filing a copy of the PO or receiving slip. Medicines must be verified, too, ensuring that products match - and are of the quality and standard expected - as ordered by the PO: Name of product Brand of product Package size Dosage form Strength and/or concentration Quantity of product Furthermore, it's vital that the expiration dates of medicines are inspected, too. Medicines should be safely and accurately stored in their designated location. At the very outset, those medicines that require refrigeration or freezing should be managed first. It's also important that pharmacy technicians understand the process of stock rotation - the need to place the earliest expiration date medicines in front and later expiration dates toward the back. This ensures that the medicines with the shortest expiration dates are used before they are set to expire. Any stock that has since expired must be removed. There may also be products that are soon to expire. In these cases, it's important to add a small tag to emphasize this fact. Final Thoughts Pharmacy technicians spend far more time handling and storing medicines, as well as overseeing inventory and medicine stock rotation. It's imperative that prospective pharmacy technicians understand the process by which medicines are ordered and how they are received, stored, and managed. On the PTCB exam, candidates can expect questions on inventory management and how to order medicines safely, accurately, and in alignment with existing legal regulations.

How to Process a Medication Order

How to Process a Medication Order By implementing the following steps, the pharmacy technician reduces the likelihood of error. These steps include: Technicians that need to pull up a patient profile should search for the patient by first entering their full surname, followed by the first letter of the patient's first name. Identify the correct patient and confirm that selection by reviewing their date of birth. Each time a prescription is filled, insurance details should be checked. It's important that patients are billed the correct value and, because coverage can change, it's essential that you verify this information. Third, identify the prescriber through the same means as patient identification - namely, enter the prescriber's surname in full, followed by the first letter of their first name. Accurate prescriber identification is important to avoid a potential audit, and to avoid any possible medication lapse on behalf of the pharmacist. Next, pharmacy technicians should identify the medication through either the NDC code or through the drug name itself. The NDC is the official means through which medicines are identified; an 11-digit code where the first 5-digits represent the drug manufacturer; the following 4-digits representing the drug and strength; and the final 2-digits representing packaging size. Technicians should enter the quantity of the drug to be dispensed to the patient. However, on the previous review of their insurance details, this quantity may change. For instance, coverage may specify that only 30-days supply of the drug can be dispensed. Interpreting the prescription directions is next required. This involves a careful understanding of prescription terms and abbreviations and ensures that the patient receives the correct instructions. If this is improperly performed, it risks the patient taking the medication in the wrong manner which can harm their therapeutic outcome. Next, pharmacy technicians should correctly enter the number of days supply of that medicine. This is easily done by dividing the number of tablets by the number of times a day the medicine is taken. For example, 42 tablets taken 3-times daily, is the equivalent of 14-days supply. It's essential that the correct value is entered, otherwise, it may result in insurance rejection. Legislation demands that technicians include the number of refills as stated on the prescription. The expiration date should now be entered. This date can be found on the stock bottle. This is important for several reasons. You do not want the patient to take expired medicine. For example, tetracyclines - which are commonly used antibacterial drugs - taken in their expired form can cause Fanconi syndrome in affected patients. Finally, technicians must process through insurance; the last stage in which the pharmacy is authorized to dispense the medicine to the patient. By carefully implementing these ten steps, pharmacy technicians know how to process a medication order in a safe, effective, and legally compliant manner. Conclusion It's important to know how to process a medication order. We have covered the 10 core steps. As you can see, the focus is always on patient safety, on the accuracy of the medicine being dispensed, and complying with insurance information to ensure that medicines are authorized to be dispensed. Given how busy pharmacy technicians are, with the many daily tasks they juggle, it is perhaps no surprise that errors have happened. However, it's important that technicians ensure that these errors do not happen. The primary goal of a pharmacy technician is to ensure that patients receive the best therapeutic outcomes. Accurate medication order entry and processing is an important part of that goal. If you would like to te

top medical conditions

Medical SymptomDefinition PyrosisHeartburn PyrexiaFever EpistaxisNosebleed HalitosisBadbreath TussisCough OscitationYawn HypotensionLow blood pressure HypertensionHigh blood pressure HypothermiaLow body temperature DiaphoresisExcessive sweating EdemaSwelling JaundiceYellowed skin BradycardiaLow heart rate TachycardiaHigh heart rate XerostomiaDry mouth OtalgiaEar pain TinnitusRinging in the ears TrismusLockjaw EmesisVomiting HematemesisVomiting blood ConstipationInfrequent/hard to pass stools DiarrheaFrequent/loose or watery stools ImpotenceErectile dysfunction PolyuriaUrinating a large volume BlepharospasmEyelid twitch SputumCoughed-up mucus UrticariaHives Pruritus Itch MydriasisPupil dilation MiosisPupil constriction AlopeciaHair loss HirsutismExcessive body hair growth ChoreaAbnormal involuntary movement Incontinence Involuntary excretion of urine/feces DyspepsiaIndigestion Flatulence Elimination of gas from the anus DysphagiaDifficulty swallowing DyspneaShortness of breath Tachypnea Abnormally rapid breathing ArthralgiaJoint pain SciaticaPain going down leg from lower back AnhedoniaInability to experience pleasure NystagmusInvoluntary eye movement ContusionBruise AmenorrheaAbsence of menstrual periods AmnesiaDifficulty recalling past events SomnolenceStrong desire to sleep ApathyLack of feeling, emotion, guilt InsomniaSleeplessness SyncopeFainting

Medication Safety

Medication Safety Medication safety is important - one of the most tested subjects on the PTCB exam. Students must understand what techniques - such as tall-man lettering - are used to limit the possibility of medication error. Medication errors are all too common. There are approximately 1.25 million medication errors in the United States each year. Research suggests that 77 percent of these errors are avoidable. Even with the intense training that healthcare professionals receive, errors continue to come forward and place significant risks to the lives of many patients. Medical errors of all kinds kill up to 100,000 Americans each year and is now the eighth leading cause of death. One of the compounding factors that lead to errors is down to the sheer number of drugs and medicines available. Because of the vast array of drugs, it is inevitable that some medicines will sound alike. And if they sound alike, it becomes far easier to choose the wrong medicine to dispense to the patient. There are several ways of reducing the risk of these kinds of medication error.

part of top 100

Microzide®Hydro-chlorothiazide(HCTZ)Thiazide DiureticNorvasc®AmlodipineCalcium ChannelBlockerXanax®AlprazolamBenzodiazepine(DEA Sch 4)Glucophage®MetforminAntidiabeticLipitor®AtorvastatinStatinPrilosec®OmeprazoleProton PumpInhibitorAugmentin®Amoxicillin +ClavulanatePenicillinAntibioticTenormin®AtenololBeta Blocker(B1)Lasix®FurosemideDiureticLopressor®metoprololBeta ReceptorBlocker (B1)Zoloft®SertralineS.S.R.I.Ambien®ZolpidemSleep Aid(DEA Sch 4)Percocet®Oxycodone+ APAPPain Relief(DEA Sch 2)Nexium®EsomeprazoleProton PumpInhibitorPlavix®ClopidogrelPlateletAggregationInhibitorSingulair®MontelukastLeukotrieneInhibitorSterapred®PrednisoneCorticosteroidLexapro®EscitalopramS.S.R.IAdvil®IbuprofenN.S.A.I.DCelexa®CitalopramAnti-Depressant(S.S.R.I.)ProAir®AlbuterolB2 ReceptorAgonist(Lungs)Prozac®FluoxetineS.S.R.I.Neurontin®GabapentinAnti-ConvulsantCoumadin®WarfarinBlood ThinnerUltram®TramadolPain Relief(Non-Narcotic)Klonopin®ClonazepamBenzodiazepine(DEA Sch 4)Ativan®LorazepamBenzodiazepine(DEA Sch 4)Keflex®CephalexinAntibiotic(Cephalosporin)Flexeril®CyclobenzaprineMuscle RelaxantSeptra®Sulfamethoxazole+ TrimethoprimAntibioticCombination

Multivalent ions+Levothyroxine Fluoroquinolones Ciprofloxacin Moxifloxacin Bisphosphonates Alendronic acid Pamidronate Tetracyclines Tetracycline Minocycline calcium, magnesium, iron - and are also found in milk and antacids. Multivalent ions reduce the effectiveness of drugs such as levothyroxine, the antibacterial drugs tetracyclines and fluoroquinolones, and the osteoporosis drug class, bisphosphonate

Multivalent ions interact with many medicines, reducing the ability of drugs to carry out their therapeutic goals. Multivalent ions include calcium, magnesium, iron - and are also found in milk and antacids. Multivalent ions reduce the effectiveness of drugs such as levothyroxine, the antibacterial drugs tetracyclines and fluoroquinolones, and the osteoporosis drug class, bisphosphonates.

Prescription drugs are covered under what part of Medicare?

Prescription drugs are covered under what part of Medicare? Part A Part B Part C Part D Disabled patients under the age of 65 on low incomes are entitled to which healthcare plan? Medicare Part D only Medicare Medicare and Medicaid None of the above Which part of Medicare covers outpatient/medical coverage? Part A Part B Part C Both A and B With these sample PTCB questions in mind, let's review the differences between Medicare and Medicaid that you need to know. What is Medicare and Medicaid? Both Medicare and Medicaid are forms of insurance reimbursement that comes from the Centers for Medicare and Medicaid (CMS). Medicare is a federal program for patients: Over the age of 65 Under 65, but disabled Medicare is offered to both groups of patients irrespective of their income level. Medicaid is a government-funded program for patients on low incomes. It's possible to be eligible for both Medicaid and Medicare - what is referred to as dual eligibility. There are 4 parts to Medicare that candidates need to know. Part A - inpatient hospital stays, hospice and nursing home stays Part B - Outpatient hospital and doctor visits, durable medical equipment* Part C - Private companies can offer Medicare (Part A and Part B only) Part D - Prescription drugs Examples of "durable medical equipment" include blood glucose monitors, walking sticks, and wheelchairs etc. Private companies - under Part C - can offer insurance coverage. This is referred to as Medicare Advantage Plan. Other Government Plans Of course, there are other government plans aside from Medicare and Medicaid. For example, there is the TRICARE plan - which covers dependents of those active members of the military, as well as those who have retired from active military service. CHAMPVA is another government program. CHAMPVA was established to assist in paying healthcare expenses for veterans and their families who have been impacted by disability. There are also in-work insurance schemes, too. Take worker's compensation insurance, for example. Here, it may be possible to claim healthcare costs back if you have been injured whilst at work. It's essential that accurate and complete documentation is maintained to ensure that the worker is not billed for these costs. Given the multitude of insurance plans, it's not uncommon for people to have more than one plan. In these cases, it's essential that - when a claim needs to be made - that the primary payer of the healthcare costs is established. Any other costs are billed to a secondary payer. The purpose is clear - to avoid overpaying and to avoid the possibility of duplicate payments. Coordinating this process and ensuring that the correct primary and secondary payers are identified is known as coordination of benefits.

MacrolidesAmiodaroneSSRIs FluoroquinolonesQuinineAntipsychotic drugs Quinine increase the risk of heart rhythm problems, arrhythmias prolong the QT interval

Some drug classes prolong the QT interval - meaning that they increase the risk of heart rhythm problems, arrhythmias. Taking any combination of drugs in those listed increases the risk of QT prolongation as each of these drugs/drug classes individually carries this ris

Strategies to Reduce Medication Error

Strategies to Reduce Medication Error There are two kinds of measures - medication safety measures instituted by pharmacies or organizations, and prevention strategies introduced by the ISMP - the Institute for Safe Medication Practices. As a prospective pharmacy technician, you should have a thorough knowledge of all strategies used to reduce medication error. Institutions may implement strategies such as: Bar-coding both the patient and the medicine to ensure that a correct match is always made before the medicine is dispensed. Using the NDC number for the drug to reinforce the selection of the right medicine. The ISMP has introduced a list of medicines which look-alike and sound-alike - what are called LASA name pairs. Here are some common examples: Drug / Medicine NameConfused Drug / Medicine NameAcetaminophenAcetazolamideAdderallInderalLamotrigineLamivudineLenteLantusQuinineQuinidineRifampinRifaximinTizanidineTiagabineTrazodoneTramadolVioxxZyvoxZantacXanax One of the recommended methods to avoid choosing the wrong medicine is to enact tall-man lettering.

allergic reactions

Substances that trigger allergic reactions are called allergens. Common kinds of allergens include: Animal sources: pet dander, insect waste, cockroaches Medicines: Sulfa-based drugs and penicillin allergies Foodstuffs: shellfish, nuts, and milk are among the most typical Stings: wasps and bees, as well as mosquitoes Spores: spores from fungal growths can spread in the air and cause allergies Greenery: pollen is the most common cause of allergies. Not only that, but resins from specific plants - such as poison ivy/oak - are also common, too. Fabrics: some people are allergic to latex - often found in condoms or gloves. Metals: many people are allergic to metals, such as nickel. Medicines used to treat Allergies Treatment of allergies is symptomatic. There are many effective medicines that can control symptoms. Medicines are available as either over the counter (OTC) or by prescription. The drug of choice depends on the symptoms the patient displays and their severity. Medicines used to treat allergies and hypersensitivity reactions include: Antihistamines - loratadine, desloratadine, cetirizine, levocetirizine, fexofenadine, chlorpheniramine, diphenhydramine. Corticosteroids Cromolyn sodium - which works to stabilize mast cells, thereby preventing release of histamine. Decongestants - such as pseudoephedrine found in medicines such as Sudafed and oxymetazoline, found in medicines such as Afrin. Antileukotriene agents - such as the drug montelukast found in the medicine Singulair. Leukotrienes are substances produced by the immune system which, when released by cells in the body, cause inflammation, bronchoconstriction, and mucus secretion. Coombs and Gell Hypersensitivity Classes There are many kinds of allergy and they do not all product the same response. A classification system was created to differentiate between these different kinds of allergic reactions - a system sometimes referred to as the Coombs and Gell hypersensitivity classification system. In this system, there are 4 types of hypersensitivity allergic reaction: Type I - immediate-response to the allergen that does not take hours or days to develop. Examples include asthma reactions and anaphylaxis caused by pollen, insect stings, or certain kinds of food or drug. Most of the common allergies - such as allergic rhinitis (runny nose etc.) - are type 1 reactions. Type II - hypersensitivity reaction that can occur with an organ transplant rejection. In this case, the body refuses to accept the donor organ, and any cells which are tagged with IgM or IgG (both types of antibody) are bound for cell destruction. Type II reactions are also seen in conditions such as autoimmune hemolytic anemia, rheumatic heart disease, and thrombocytopenia. Type III - referred to as "immune complex" where the complex is formed between the antibody and the antigen. This leads to a series of inflammatory states that damage tissues. Examples include rheumatoid arthritis, lupus, and glomerulonephritis. Type IV - referred to as the "delayed" hypersensitivity reaction. Here, it takes several hours or days for the allergic response to manifest. That's because white blood cells - known as T-helper cells - are involved. Contact dermatitis is the most common example. To summarize - Type 1 reactions form the vast majority of common allergic reactions to foreign substances; Type 4 reactions are delayed, occurring many hours or days after exposure; whereas Type 2 reactions refer to organ transplant rejection; and Type 3 reactions refer to an antibody-antigen complex that damages tissue in autoimmune conditions such as rheumatoid arthritis.

What is REMS?

What is REMS? Under Federal Requirements, one of the core subjects of the 2020 PTCB syllabus to know is REMS - risk evaluation and mitigation strategies. Here, we review the key details that pharmacy technicians are expected to know. Not all medicines are equal in risk. Some drugs pose a greater risk to the public than other drugs. These drugs must be dispensed with special requirements - and these requirements are set out in the risk evaluation and mitigation strategies (REMS). These requirements were set out in 2007 under the FDA Amendments Act (FDAAA). Medications with special requirements include: Drugs with potentially very harmful adverse effects. Drugs that increase the risk of fetal harm (teratogenic drugs). Drugs with a high risk of abuse potential. Drugs with REMS Program The FDA may request that before a medicine is available to the public, that it contains a Risk Evaluation and Mitigation Strategy program. Drugs in this list include: Clozapine - an antipsychotic drug that increases the risk of agranulocytosis. Fentanyl - an opioid analgesic with a high risk of abuse potential. Buprenorphine - an opioid, again, that carries abuse potential. Thalidomide - a drug that carries a high risk of deformed babies. Isotretinoin - a teratogen that also carries a risk of psychiatric disorders. Pseudoephedrine-containing products - because pseudoephedrine can be used in the illegal production of methamphetamine. Some drugs have their own REMS program. For example: in the case of isotretinoin, the REMS program is called the iPLEDGE. Case Study - Isotretinoin The functions of iPLEDGE include: Ensure that communication of the release of the drug is consistent across all healthcare professionals - including the prescriber, patient, pharmacy, and the drug wholesaler. To ensure effective communication on the teratogenic effects of isotretinoin and its risk of severe psychiatric effects. Promote the safe and effective prescribing and use of isotretinoin. For instance, such is the serious nature of isotretinoin, that patients are expected to sign a consent form accepting the known risks of adverse effects. Furthermore, it is incumbent upon healthcare professionals to robustly counsel patients on the effects of the medicine and how to correctly take the medicine. In addition, patients are required to have scored negative on two separate pregnancy tests before the drug is prescribed, as well as having taken two forms of birth control for at least one month before they are permitted to take isotretinoin. Prescriptions must be in written form and cannot be electronically sent or phoned in to the pharmacy. Risk evaluation and mitigation strategies - as the name suggests - is about implementing strategies that reduce the risk of potential harm to either the patient or, in the case of isotretinoin too, the developing fetus. Conclusion As a pharmacy technician, you are expected to know: Definition of REMS - risk evaluation and mitigation strategies. Function of REMS - to limit adverse effects and risk with a select group of medicines which carry higher risks. Example REMS drugs - which include opioid medicines, pseudoephedrine-containing drugs, drugs that harm the fetus - such as thalidomide and isotretinoin.

What is hazardous waste?

What is hazardous waste? Medicines can become hazardous waste. Medicines are chemicals and - like all chemicals - they have the capacity to cause harm just as much as they can cause therapeutic effects. The only difference between a medicine and a poison is the dose administered to the patient. Working in the pharmacy setting, technicians must have a robust knowledge of hazardous waste and non-hazardous waste. On the PTCB exam, candidates can expect questions on this topic - not only as a principle of federal legislation but also as a matter of medication safety protocols. There are many different ways in which pharmaceutical waste can be drawn into the body via many different routes, including: Absorption through the skin into the bloodstream Inhaled into the lungs Burn the skin Cause harm to the fetus (teratogenic substances) Given these risks, two pairs of gloves must be worn when handling hazardous substances - offering must-needed extra protection. Throughout this Unit, medication waste is defined as medicines that are unused, or expired, or can no longer be used for the intended clinical purpose. It does not apply to stock that is returned to the pharmacy or to medicines sent to a reverse distributor.

What is tall-man lettering?

What is tall-man lettering? Tall-man lettering refers to the practice of using capital letters on part of a drug or medicine name to help differentiate it from a similarly sounding/looking drug or medicine. There are two kinds of tall-man lettering - those recommended by the FDA and those recommended by the ISMP. For example: prednisoLONE and predniSONE ALPRAZolam and LORazepam HYDROcodone and oxyCODONE PARoxetine and FLUoxetine traMADol and traZODone As you can see with these examples, capital letters are used to highlight the most significant difference between the two drugs or medicines to make their names easily identifiable and distinguishable from one another. This is an effective medication safety strategy that can significantly reduce the risk of error. Of course, tall-man lettering must be used in conjunction with other medication safety strategies. These include the use of bar codes, NDC codes, using and verifying both the medicine and active ingredient name on labels, and limiting the use of error-prone prescription abbreviations.

What is the DEA?

What is the DEA? As part of the 2020 PTCB exam syllabus, candidates are expected to know about DEA Numbers - what they are, why they are used, and how to interpret a DEA number. Here, we review precisely these facts. As their name suggests, DEA numbers are assigned to healthcare professionals by the US DEA, or Drug Enforcement Administration. The function of the DEA is to combat drug trafficking and distribution of controlled substances throughout the United States. Established in 1973 by the Reorganization Plan No. 2, and signed into existence by President Richard Nixon, the DEA became the umbrella organization through which the Controlled Substances Act (1970) could be enforced. What are DEA Numbers? DEA numbers are assigned to healthcare professionals by the Drug Enforcement Administration, allowing these providers to prescribe controlled substances. DEA numbers follow a defined structure: 2 initial letters Followed by 6 digits Concluding with 1 check digit For the first 2 initial letters of the code, the first of those identifies the type of registrant: A - Deprecated B - Hospital/Clinic C - Practitioner D - Teaching institution E - Manufacturer F - Distributor G - Researcher H - Analytical lab J - Importer K - Exporter L - Reverse distributor M - Mid level practitioner P - Narcotic Treatment Program R - Narcotic Treatment Program S - Narcotic Treatment Program T - Narcotic Treatment Program U - Narcotic Treatment Program X - Suboxone/Subutex Prescribing Program PTCB exam questions often ask about these letters. For example, you may be asked to identify which letter represents the Suboxone/Subutex prescribing program. It's important that you commit these values to memory. Next, we need to discuss the second letter, which represents the first letter of the registrant's surname. If the prescriber was Andrew Markle, the second digit of his DEA code would be M. If a business address is used instead of a name, "9" is instead used. The next 6 digits of the DEA code are followed by a final check code. Again, check codes are asked about on the PTCB test. There is a simple way in which you can work out that last digit. How to Determine the Last Digit Let's look at this DEA number: AL455178_ What is the last digit? To find this, we must take the following steps: Add the first, third, and fifth digits 4 + 5 + 7 = 16 Add the second, fourth, and sixth digits - then multiply x 2 5 + 1 + 8 = 14 x 2 = 28 Add these two totals together 16 + 28 = 44 The second digit of this total number is the check digit, appearing at the end of the DEA number; in this case - 4 (therefore, his DEA is AL4551784). Prescriptions that are for controlled substances must have all standard prescription details plus the prescriber's DEA number. Furthermore, the prescription must be hand-signed. It cannot be stamped.