PTCB EXAM QUESTIONS
What size filter is considered a sterilizing filter?
0.22 micron
Intron A is stored where?
In the refrigerator
Acetaminophen possesses all of the following except a) analgesic b) anti-inflammatory c) antipyretic
anti-inflammatory
Heparin belongs to which pharmacological category?
anticoagulant
HS stands for what?
at bedtime ( hour of sleep )
What dosage form is formulated to mask an objectionable taste of a medication?
film-coated tablets
What are capsules made out of?
gelatin, sugar, and water
Which one is an antifungal
ketoconazole
What is the generic for Betagan?
levobunolol
Expectorants are used in lung disease to
stimulate respiratory secretions and break up mucus
Which of the following is NOT required on a unit-dosed packaged drug? -expiration date -lot # -storage requirements -strength of medication
storage requirements
A hyperglycemic pamphlet would refer to
sugar levels
An order reads "Tylenol 325mg pr q 4 h prn". What dosage form should be dispensed?
suppositories
The joint action of drugs in which their combined effect is more intense or longer in duration than the sum of their individual effects is:
synergism
A physician prescribes Ceclor 375mg po bid. What is wrong with this prescription?
the Rx lacks a duration of therapy
Where are antineoplastic drugs kept?
• Separate storage area where the drug cartons, shelves, bins, counters, and trays have warning labels and designed to minimize falling and breakage of materials. • Only specific trained personnel allowed access
What does the word "Contraindicated" mean?
• That a drug should not be administrated for the possibility of side effects, adverse effects, drug-drug interactions, drugdisease interactions. • Text book definition: any condition, especially disease, which renders some particular line of treatment improper or undesirable.
What is duplicate therapy?
• Two drugs that (not necessarily would be in the same class) do the same end effect. • ie. simvastatin and gemfibrozil : both lower cholesterol. It makes the pharmacist ask the question, "Are both necessary for this patient?"
How many units per ml in insulin? ( i.e. U-100 insulin )
• U-100 means that there are 100 units per 1 ml of insulin. • A vial is 10 ml therefore there are 1000 units per vial. ( 100 units/ml x 10 ml )
Drugs that end in "-azepam" are what?
• benzodiazepines (class IV) • anti-anxiety agents
PRN refills on methylphenidate last how long?
• no refills are allowed on C-II drugs
Cozaar and Hyzaar :
• they are both ACE inhibitors use for high blood pressure • they do not produce the side effect of cough like the other ACE inhibitors • other ACE inhibitors end in -pril
The technician should check for which drugs in the profile if the patient is on a potassium supplement?
-ACE inhibitors -Dyazide -Maxzide
List 3 known routes of transmission of HIV infections
-bodily fluids -blood transfusions -mom to fetus
The NDC on a medication bottle refers to the:
-manufacturer -drug product -quantity packaged
Which drug requires a follow-up "Cover" prescription when dispensed as a verbal order? phenobarbital b) vicodin c) valium d) all the above
-phenobarbital -vicodin -valium
If a HCTZ prescription states, 'refill prn', for how long may this Rx be refilled?
1 year
What type of measuring device should be used to measure 3 ml of a liquid for compounding?
10 ml cylindrical graduate
The highest strength of Demerol is:
100 mg
Class B balance weighs up to
120 gms (grams not milligrams) (Bulk balance)
What is the smallest weight a class A balance can weigh?
120 mg (2 grain)
Amoxicillin oral suspension is stable in a refrigerator for how many days after reconstitution?
14
What is the shelf-life of an antibiotic after reconstitution?
14 or 10 days
The dose of syrup of ipecac for children is_____
15 ml
What is "room temperature"
15-30 degrees Centigrade
Most superpotent topical steroids have restrictions limiting their use to
2 weeks; 40-50 grams in one week
How long does a laminar flow hood run before use?
30-60 minutes
What is the storage requirement for reconstituted amoxicillin 250 mg/ 5ml?
36 to 46 degrees F
When would an alert be prompted in regard to getting too much APAP?
4000 mg
A pharmacy technician repacks bulk solid dosage forms into unit dosed packages. What expiration date will appear on the package?
50% of labeled expiration date to a maximum of 1 year
How far into the hood should the pharmacy technician work?
6 inches
How long is a DEA Form 222 valid?
60 days
The normal dose of fexofenadine is:
60 mg bid
1 grain (gr) =
65 mg (the range is actually 60-65 mg)
Drugs that end in "-pril" are what?
ACE Inhibitors
What is the process by which a third party payer sets a price for a drug?
Adjudication
If a patient develops hives from Gantrisin, what allergy should be noted on their profile?
Allergy to sulfa drugs ( generic name is sulfisoxazole )
An ampule lid is made out of what?
An ampule is entirely made out of glass ( one piece )
What two of the following drugs have the same therapeutic effect? Then it will list drug names
Having the same therapeutic effect means that the two drugs do the same thing in the body. Most correct answer will be brand/generic. For example, the answer will be listed as A) Zestril/lisinopril.....this is brand/generic so pick this one
Which one is an anticoagulant
Heparin
Codeine, meperidine and oxycodone all belong to which controlled schedule?
II
Which of the following drugs is not an OTC product? a) Advil b) Nuperin c) Ibuprofen 400mg d) Tylenol suppositories
Ibuprofen 400mg
Which of the following drugs is not a laxative? a) Dulcolax b) Metamucil c) Imodium d) Colace
Imodium
What is the term for the leakage of IV fluid into muscular tissue?
Infiltration
Are there any special requirements concerning an IV with fats in it?
Instability
What is angina?
Insufficient oxygen to the heart muscle causing sudden, severe substernal pain radiating to the left arm
What is an agonist?
It is a drug that is capable of binding to, and activating, a receptor
What is Noroxin used for?
It is an antibacterial used to treat UTI's, sexual transmitted diseases such as gonorrhea
Which of the following drugs is a benzodiazepine? Fiorinal b) Percodan c) Demerol d) Klonopin
Klonopin
Which drug reduces blood pressure and grows hair? a) Inderal b) Catapress c) Loniten d) Aldomet
Loniten (minoxidil)
What does antipyretics do?
Lower fever - for examples see NSAIDS
Which is a CI?
Marijuana
Which book gives information on general disease categories and their treatments?
Merck Index
What is the vial pressure of hazardous drugs?
Negative pressure will prevent the spraying of medication out of the vial onto the technician
Amlodopine is what?
Norvasc (Calcium Channel Blocker)
Which governmental agency is responsible for safety in the workplace?
OSHA
What drug is used to treat dyspepsia (ulcers)?
Pepcid
A patient on warfarin therapy should never take which of the following medications? a) Percocet b) Tylenol c) Demerol d) Percodan
Percodan
Which law allows nasal inhalers to be dispensed without a child-resistant container?
Poison Control Act of 1970
Pseudoephedrine is contraindicated to what disease state?
Pseudoephedrine is Sudafed and this is cannot be taken with hypertension or heart disease
Which urinary analgesic will turn urine orange?
Pyridium
Who is responsible for drug recalls?
The FDA determines the health hazard potential of the product and assigns a drug recall
What is mupirocin?
The brand name is Bactroban and is an antiseptic cream or ointment for the skin.
What is Prime Vendor Purchasing?
The pharmacy enters into agreement that they will purchase 80-95% of its pharmaceuticals from a single wholesaler.
PRN refills on CIII , CIV , and CV mean what?
They are refillable to a maximum of 5 refills or 6 months
What is an antagonist?
They block the action of an agonist getting to the receptor to elicit a response, therefore no response is made
The use for syrup of ipecac is:
To induce vomiting in case of an overdose of medication or poison
What schedule are the following drug products? Vicodin ______ Valium ______ Codeine _____ Lomotil ______
Vicodin __3___ Valium __4___ Codeine __2__ Lomotil __5__
If a patient is deficient in cyanocobalamine, what should the patient take?
Vitamin B-12
The most accurate way to measure a liquid?
With a graduated cylinder reading the bottom of the meniscus at eye level on a level surface.
Which of the following is a Scheduled IV controlled substance? a) Lomotil b) Xanax c) Demerol d) Haldol
Xanax
Is contact lense fluid poisonous or dangerous to kids? Is there a label saying so?
Yes/No
Which drug has a loading dose as part of the regimen? a) Macrodantin b) Zithromax c) Cipro d) Doxycycline
Zithromax
The drug most used for an acute gout attack is
Zyloprim
mneumonic is
a shortened term used to facilitate data entry • Amo500 = Amoxil 500
What dosage forms has the highest concentration of alcohol in its formulation?
a tincture
Work done with antineoplastic drugs is done in
a vertical laminar flow hood. (also called: Biological Safety Cabinet)
Translate the following: a. Gtt ii o.u. q 4 h prn b. M. ft ung c. tsp i q 4 h or 5 h prn itching
a) Place 2 drops into both eyes every 4 hours as needed b) Mix and make an ointment c) Take one teaspoonful by mouth every 4 to 5 hours as needed for itch
How does activated charcoal work in an overdose?
absorbs the poison
What is the term for the process by which substances are taken up and transported to the bloodstream?
absorption
The "C" designation for controlled substances must appear on a controlled prescription:
in red in the lower right hand corner of the Rx
The NSAID most frequently used to treat gout is
indomethacin
Treatment for migraine is most effective if
initiated early in the attack
What do you clean a laminar flow hood with?
isopropyl alcohol
When dispensing an antidepressant; the patient should be informed that
it may take as long as two weeks before the drug is effective
The directions for use for Timoptic is 2 gtts os bid. What is the meaning of os?
left eye
The dispensing label on an outpatient pharmacy prescription requires:
legal name of pharmacy and address
The process of producing a smooth dispersion of a drug with a spatula is called
levigation
The process whereby a drug is transformed by the liver is referred to as;
metabolism
The expiration date on a bottle of Cipro 500mg tablets states 4/09. When does this drug expire?
midnight 4/30/09
Which OTC lowers cholesterol and can cause a flushing reaction?
niacin
Which of the following drugs is used in chest pain? a) meperidine b) diltiazem c) nitroglycerin d) piroxicam
nitroglycerin
How long may a schedule class II drug be refilled?
no refills
How often must controlled substances be physically inventoried?
once every 2 years
Estraderm is available in which dosage form?
patch
What is the Latin abbreviation for "after meals"?
pc
The abbreviation 'PCN" means what?
penicillin
Which of the following 2 drug classes have cross sensitivity? a) tetracycline and penicillin b) penicillin and erythromycin e) erythromycin and penicillin d) penicillin and cephalosporin
penicillin and cephalosporin
Know how to dispose chemotherapy medications and that there is a spill kit to use if you spill chemo drugs to dispose:
place in a leak proof, puncture resistant container, placed in a larger container and incinerated
Insulin and nitroglycerin bind to IV bags made out of ___. Meaning that the medicine sticks to the walls of the the PVC bag. Therefore, must be dispensed in non-PVC containers and tubing.
polyvinylchloride (PVC)
Nitroglycerin may be stored in all of the listed except a) an amber glass bottle b) prescription bottles c) original container d) none of the above
prescription bottles
Medication class of Provera?
progestin
Type B-ADR (Adverse Drug Reaction) is
serious and life threatening
The three parts of a needle are:
shaft, lumen, and hub
How would you dispose of a needle?
sharps container
What is the proper procedure for cleaning a laminar flow hood?
side to side, back to front
ss = 5ml = 15 ml =
ss = 1/2 5ml = 1 teaspoon 15 ml = 1 Tablespoon
A patient hands you an empty vial of Ritalin and asks for the Rx to be refilled. What should you do?
tell the patient that the medicine is not refillable
A patient enters the pharmacy complaining of persistent heartburn. The pharmacy technician should:
tell the patient to speak to the pharmacist
Which drug is likely to cause a photosensitivity reaction? a) Biaxin b) penicillin c) Cipro d) tetracycline
tetracycline
Which drugs listed should be taken on an empty stomach a) tetracycline b) NSAIDS c) Dilantin d) all of the above
tetracycline
Zestril and lisinopril are
therapeutic equivalents
Why are diuretics commonly used in congestive heart failure?
to decrease the amount of fluid in the body by increasing urination
What is "Syrup of Ipecac" indicated for?
to induce vomiting
The nitro patch should not be worn 24 hours a day in order to avoid
tolerance
What is the generic for Dyazide?
triamterene/Hydrochlorothiazide
Grinding of tablets into a fine powder in a porcelain mortar is an example of:
trituration
Which drug dissolves a clot once it has formed? a) heparin b) Coumadin c) Fragmin d) urokinase
urokinase
Which drug is a calcium channel blocker? a) digoxin b) nitroglycerin c) verapamil d) Zestril
verapamil
Know that SQ medications require
very short needle. (5/8" or ½") • Example is insulin
What size is a HEPA filter?
• 0.22 micron • It filters out 0.3 micron particles and larger
Room temperature is:
• 15 - 30 degrees Celsius • 59 - 86 degrees Fahrenheit
Refrigerator temperature is:
• 2 - 8 degrees Celsius • 36 - 46 degrees Fahrenheit
What is a formulary?
• A list of medications that are to be maintained in stock. • Third party payers' formulary is a list of medications that they will reimburse.
Methylphenidate treats:
• ADHD • NARCOLEPSY
Define: • Absorption - • Distribution - • Metabolism - • Elimination -
• Absorption - drug goes "into the bloodstream". • Distribution - drug goes to "where it is needed" • Metabolism - drug is "broken down" by the liver • Elimination - "excretion" of the drug out of the body
Know a list of medications that are stored in the refrigerator
• All insulin including Lantus and Novolog • Miacalcin (calcitonin-salmon) • Phenergan (promethegan) suppositories • Norvir (ritonavir) • Xalatan (latanoprost) eye drops • Combipatch (estradiol-norethindrone) • Foradil (formoterol) • Alkeran (melphalan) • Ortho Evra (norelgestromin/ethinyl estradiol) • Epogen / Procrit (epoetin alpha) • Avonex (interferon) • Neupogen (filgrastim) • Leukeran (chlorambucil) • Thyrolar • Viroptic (trifluridine ) • Enbrel (etanercept) • Etoposide phosphate (Eposin®, Etopophos®, Vepesid®, VP-16®)
What is unit dose?
• Amount of a drug prepackaged for a single administration • Individually wrapped tablets remain sterile and can be returned to stock if not used, therefore decreases costs.
What would you use for a dry, hacking cough?
• Anti-tussive : Robitussin DM , Vicks 44 DM, DM stands for dextromethorphan, • HYCODAN (hydrocodone) tablets- schedule III drug
Know what drugs qualify as an "Automatic Stop Order"
• Antibiotics • Antineoplastics
What is lidocaine used for?
• Anything that ends in -caine will numb the area applied. • It numbs the skin especially for mouth sores or sore throats.
Which antibiotics cause photosensitivity?
• Bactrim DS/ Septra DS ( sulfameth/trimeth ) • tetracycline ( all the - cyclines )
Digoxin is a:
• Cardiac glycoside • Anti-arrhythmic • If you can only pick one and not both - pick cardiac glycoside
What schedule is codeine?
• Codeine by itself is a C-II • Codeine mixed within the medication is a CIII
The manufacturing, dispensing and distribution of controlled substances is regulated by the:
FDA
The directions for use of a medication are " ii gtts au q 4 h x 5d". What is au?
in both ears
What is Maximum & Minimum system used for?
An inventory system done manually. This system has a predetermined order quantity and an order point. The minimum and maximum stock quantity is written on mylars placed in front of the medication. The technician walks around the shelves looking for any quantity that is at or below the minimum number. To order the technician prepares a purchase order for the wholesaler
A customer brings in two prescriptions to be filled. One is for atenolol and the other is for Tenormin. What should the technician do next?
Atenolol is the generic of Tenormin; therefore the patient does not need both due to a possible drug overdose. The technician should bring this to the attention of the pharmacist. THIS IS DUBLICATE THERAPY
What does AWP mean?
Average Wholesale Price
Which B vitamins need to be given IM?
B12
Which drug is a beta blocker?
Beta blockers end in -olol. Know the generic/brand names of this class of medication. You know that the generics end in -olol but the test will list the answers in the brand names.
When filling a prescription, what do you do when you notice an outdate?
Bring it to the attention of the pharmacist. Do not fill the prescription with that medication. See if there is additional medication on the shelf that is not expired to fill the prescription with. Return the medication to the wholesaler
Which drug is a loop diuretic? a) Bumex b) Dyazide c) Diltiazem d) Ziac
Bumex
DEA form 222 orders ___. No mistakes can be made when filling out the form. Brown copy stays with pharmacy and green copy is sent to the DEA office.
CII drugs
DEA form #106 is for
CII theft and local police must be notified
Which organization oversees Medicare and Medicaid service?
CMS
Which federal legislation enacted in 1970 regulates the use and distribution of substances with high abuse potential?
CSA
What is the generic name of Ceftin?
Cefuroxime - this falls into the classification of cephalosporin antibiotics
Which drugs are available in patch form?
Climara, Vivelle, Nicoderm, Nitroglycerin, Minitran, Estraderm, Testosterone.
If a syringe is inserted incorrectly into a vial, what may happen?
Coring - a piece of rubber is lodged into the needle.
What is the most important tech function when entering medication orders?
Correctly inputting patient information
Know examples of antibiotics for the ear.
Cortisporin Otic : neomycin/polymyxin B/hydrocortisone
Percodan interacts with
Coumadin
Where is Domboro stored?
Domboro is an OTC antiseptic....it would be stored next to the bacitracin ointment in the first aid section of the pharmacy
Which law allows pharmacists/interns to take prescriptions over the telephone from a physician's office?
Durham-Humphrey Amendment
Which legislation established two classes of drugs?
Durham-Humphrey Amendment
What does water soluble mean?
Refers to vitamins, when taken in excessive they will not build up in the body and become toxic
Only one type of insulin can go into an IV bag. Which one?
Regular
When doing controlled inventory, is the count exact or approximate amounts?
Should be exact on CII- CV
The most used drug for parkinsonism is
Sinemet
Most common drug used in Parkinson's disease:
Sinemet ( Carbidopa/levidopa )
NaHCO3
Sodium bicarbonate
What is the generic name for Aldactone?
Spironolactone
What is Diastix?
Strips that are to be held in the urine stream to measure ketones and glucose levels. ( for diabetic patients )
Which of the following duties may a pharmacy technician not do? enter a prescription data into the computer call the wholesaler for a drug order affix a drug label to a prescription container accept a verbal medication order from a physician
accept a verbal medication order from a physician
Which procedure would you not do when opening an ampule? a) wipe the neck with an alcohol pad b) after wiping with an alcohol pad, dry the neck with a paper towel c) break the ampule with an alcohol pad covering the neck d) filter the contents with a filter needle
after wiping with an alcohol pad, dry the neck with a paper towel
How many times can an unscheduled prescription be refilled on a PRN prescription order?
as needed for one year
Terbutaline belongs to which drug classification? a) antineoplastic b) anticonvulsant c) bronchodilator
bronchodilator
Which of the following medications is an anticonvulsant? a) atenolol b) dextromethorphan c) carbamazepine d) isoxsuprine
carbamazepine
What type of prescription balance must be used for compounding 120 mgs of a 1% topical antifungal cream?
class A
A vial of reconstituted Adriamycin breaks inside a vertical flow hood. What should the technician do?
clean up the spill with a spill kit
The largest amount of energy in an IV bag is:
comes from FATS
What is the most accurate device for measuring liquids?
cylindrical graduate
DEA form #41 is for _____. All 3 copies of form #41 are submitted to respective DEA offices.
destroying CII's
All of the following belong to the class of drugs known as ACE inhibitors except a) captopril b) digoxin c) enalapril d) ramipril
digoxin
The exact amount of a drug administered to get a specific response is the
dose
Which dosage form is formulated to dissolve in the intestine rather than the stomach?
enteric-coated
How often must a laminar flow hood be checked?
every 6 months
When dispensing a Ventolin inhaler, how often must the Patient Package insert (PPI) be included with the drug product?
every time the prescription is dispensed
Nonprescription drugs should not be included in the patient profile. a) true b) false
false
A pre-filled syringe is made out of glass or plastic?
glass
What is the proper method of measuring a liquid in a graduated cylinder?
hold at eye level and read the bottom of the meniscus
Pseudoephedrine, a common ingredient in cold preparations, is contraindicated in which of the following disease states? a) hypertension b) asthma c) constipation d) cancer
hypertension
Coumadin and aspirin
• Coumadin (warfarin) interacts with aspirin. Coumadin thins the blood and so does aspirin. If taken together - the blood could be thinned too much and unusual bleeding can occur. • Drugs with aspirin: Percodan, Fiorinal, Ecotrin, Bayer, Bufferin, Excedrin, Darvon • A customer has a prescription for coumadin and asks the tech if it is okay to take aspirin occasionally. What should the tech do? Answer: refer the customer to the pharmacist.
Know a couple of IM medications
• Depo-testosterone / Depo-Provera • Phenergan (promethazine) • Demerol (meperidine) • Trimethobenzamide (Tigan) • These medications require a long needle to reach the muscle under the skin. ( 1" or 1 ½ ")
What you should know about the expiration date:
• Expires the last day of the month at midnight • 50% of the manufacturer date to a maximum of 1 year on repackaging of medication.
Where is Phenergan suppositories stored?
• In the same place as insulin- the refrigerator. • Remember, Tigan suppositories are stored at room temperature and Phenergan suppositories will melt at room temperature
What is the generic name of Accutane? What is the special warning?
• Isotretinoin • Will cause severe birth defects. Women of child bearing age must test negative to pregnancy before starting Accutane. • No refills are allowed and prescription should be filled within 7 days of written date.
What are buccal tablets?
• It is a tablet that is placed in-between the cheek and gum. • Intended to dissolve slowly to stay in the mouth (where the infection) is longer
What does gauge mean?
• It refers to the diameter size of a needle. • The higher the number gauge the smaller the needle diameter.
Know the responsibilities of JCAHO
• Joint Commission on Accreditation of Health Care Organizations. • Ensures medications are used safely, effectively, and appropriately. (Drug Use Evaluation)
15) If a patient came in with a script containing 5 different drugs listed ( one drug is TCN ) what should the patient be warned about?
• Know your auxiliary labels and side effects of medications • TCN: photosensitivity, no calcium products, no antacids, not for children and pregnancy, if expired it is fatal
Know which drugs require a PPI and how often should you dispense it?
• MDI's, Birth Control, Estrogens, Progesterones, Accutane, and IUD's. • Must be dispensed every time.
What is MSDS?
• Material Safety Data Sheets • Available from manufacturer. They describe in detail the ingredients contained in the product and emergency procedures for ingestion or improper handling. • Required by all pharmacies storing "hazardous materials" • Regulated by OSHA
What method does the pharmacy use in order to keep inventory?
• Minimum/Maximum system - described above • Want book • Computerized inventory systems - the shelf minimum is in the computer bank. When the level goes below this level the computer automatically generates a purchase order.
What does NDC mean?
• National Drug Code 99999-9999-99 • First set of numbers refer to the manufacturer • Second set of numbers refer to the name of the drug • Last 2 numbers refer to the package size
What medications can only be dispensed/stored in glass containers?
• Nitroglycerin (IV form and sublingual) • Depakene liquid
How would you use PenG and where would you store it?
• Penicillin G is an antibiotic and would be stored in the refrigerator • Any liquid penicillin in a syringe will be stored in the refrigerator
Where are controlled drugs kept?
• Pharmacies may disperse these substances (including CII's) throughout their stock of non-controlled substances in a manner that will obstruct theft. • CII's cannot be placed in automatic counting devices.
What medication cannot be put in a syringe?
• Potassium Chloride cannot be put in a syringe. • Amiodarone • Alteplace
Know a list of medications that are stored in the freezer
• Prostaglandin • IV bags of gentamicin and vancomycin
Therapeutic Equivalence
• Same active ingredients • Same dosage form • Same route of administration • Identical in strength/concentration • May differ in shape, scoring configuration, packaging, and color • Must have same clinical effect • Good Example : Zestril = lisinopril • Bad Example : Lopid = Lipitor