PTCB Mock Test

Warfarin is teratogenic and can cause birth defects if taken during pregnancy. Alternative anticoagulants like heparin are preferred.

Amiodarone-induced pulmonary toxicity presents as chronic cough, lung inflammation, and fibrosis. It requires immediate discontinuation and lung imaging (chest X-ray or CT scan).

Adverse drug reactions must be documented, and the prescriber must be notified to ensure proper management and prevent future harm.

The second segment of the NDC identifies the drug name, strength, and dosage form. The first set identifies the manufacturer, and the third set represents package size.

Pharmacists must verify questionable dosages with the prescriber to prevent medication errors, ensuring patient safety and compliance with regulations.

Suspensions must be shaken to evenly distribute active ingredients, preventing dosing errors.

The first segment of the NDC represents the manufacturer or labeler, assigned by the FDA. This helps track drug production sources.

Chemotherapy spills require specialized spill kits to safely contain and dispose of hazardous materials.

Amiodarone increases digoxin levels, raising toxicity risk. Verification with the prescriber ensures patient safety.

Long-term corticosteroid use leads to Cushing’s syndrome, characterized by moon face, hyperglycemia, and skin thinning. Dose tapering is required to prevent adrenal insufficiency.

Cephalosporins have a structural similarity to penicillins, potentially triggering allergic reactions in sensitive patients.

Proton pump inhibitors (PPIs) reduce stomach acid, creating an environment that promotes C. difficile growth, leading to severe diarrhea.

Lantus (long-acting) and Humalog (rapid-acting) insulins have different onset times and cannot be substituted without prescriber approval.

Hypokalemia from furosemide increases digoxin toxicity risk, leading to nausea, arrhythmias, and confusion. Potassium levels must be monitored regularly.

Class III torsion balances are used for precise weighing of small amounts of powder in compounding.

Clozapine can cause agranulocytosis, leading to life-threatening infections. Monitoring ANC levels is essential to detect early leukopenia and prevent complications.

ACE inhibitors (e.g., Lisinopril) are contraindicated in pregnancy due to their risk of fetal toxicity and developmental abnormalities.

Lot numbers track recalls and batch quality. Keeping different lot numbers separate ensures accurate traceability.

Amiodarone inhibits warfarin metabolism, increasing INR and bleeding risk. INR should be closely monitored, and warfarin dose may need reduction.

For controlled substance recalls, the affected medication must be removed from stock and quarantined immediately to prevent dispensing until further notice.

Antibiotics are classified as non-hazardous pharmaceutical waste and can be disposed of following standard pharmacy waste guidelines.

Clark’s Rule calculates pediatric doses using weight, ensuring safe and accurate dosing for children.

The DSCSA requires tracking prescription drugs from manufacturers to pharmacies to prevent counterfeit medications from entering the supply chain.

Simvastatin interacts with grapefruit juice, which inhibits drug metabolism, increasing toxicity risk.

Schedule II drugs require strict documentation. If an extra bottle is received, it must be returned to the supplier with a corrected DEA Form 222 to maintain compliance.

Schedule II drugs require a written prescription and cannot be refilled to prevent misuse and diversion.

A near-miss occurs when a medication error is identified and corrected before reaching the patient, preventing potential harm.

Trimethoprim-sulfamethoxazole inhibits CYP2C9, reducing warfarin metabolism, leading to increased INR and bleeding risk. Warfarin dose adjustments and INR monitoring are required when taking interacting antibiotics.

Expired medications are non-dispensable and must be properly removed from stock to prevent harm.

Dabigatran (Pradaxa) degrades when exposed to moisture, requiring storage in its original container with a desiccant.

DEA Form 41 is used to document the destruction of controlled substances through reverse distribution or witnessed destruction.

Hydroxyzine (antihistamine) and hydralazine (antihypertensive) are LASA drugs. Verification with the prescriber prevents dangerous medication errors.

The third segment of the NDC represents the package size and type, ensuring correct identification for dispensing and inventory tracking.

Using an alcohol-based disinfectant prevents cross-contamination between medications and ensures hygiene in medication dispensing.

Rifampin induces CYP450 enzymes, increasing estrogen metabolism, reducing contraceptive effectiveness. Patients should use an alternative or additional contraceptive method.

Most dry antibiotic powders should be stored at room temperature before reconstitution unless otherwise specified.

Class A balances provide precise measurements for small quantities, essential for accurate capsule formulation in compounding.

Only a pharmacist can approve a generic substitution, even if the drugs are bioequivalent.

Class I recalls involve serious health risks or death, requiring immediate removal of the drug from the market.

Expired controlled substances must be disposed of properly using DEA-approved methods to prevent diversion.

Pharmacy technician vaccination authority varies by state, and not all states allow technicians to administer vaccines.

Expired non-controlled medications should be returned to a reverse distributor or manufacturer for proper disposal to prevent environmental contamination and misuse.

Expired drugs should be isolated to prevent accidental dispensing and ensure compliance with regulations.

Temperature deviations impact medication stability. The manufacturer must confirm if the medication is still viable.

Schedule III-V prescriptions can be transferred once between pharmacies if refills remain. The transfer must be documented according to DEA regulations.

Wedgewood mortars are best for grinding powders into fine particles, ensuring even distribution in suspensions.

Incorrect concentrations can lead to overdosing or underdosing. The incorrect solution must be discarded, and a new one prepared to ensure patient safety.

Statins (e.g., atorvastatin, simvastatin) can cause muscle pain (myopathy) and, in rare cases, rhabdomyolysis, a severe breakdown of muscle tissue.

Schedule II drug transfers require DEA Form 222 to document and track controlled substance movement.

Vancomycin is primarily eliminated through the kidneys, so dose adjustments are necessary to prevent toxicity in patients with renal impairment.

Separating LASA medications prevents accidental mix-ups, significantly reducing medication dispensing errors.

(15 mL × 4 doses/day × 5 days) = 300 mL. Proper calculations prevent under- or overdosing.

Levothyroxine dosing errors can have serious effects on thyroid function. The pharmacist must assess and correct the issue.

Cloudiness in IV solutions may indicate contamination or precipitation. The safest action is to discard the bag and compound a new one.

(4+3+2+1+1) = 14 tablets. Understanding dose tapers is essential for proper dispensing.

Metformin must be stopped before contrast dye use, as it increases the risk of contrast-induced nephropathy and lactic acidosis in kidney-impaired patients.

Barcode scanning verifies medication accuracy by matching it to the prescription, reducing dispensing errors and improving patient safety.

Unlabeled syringes pose serious safety risks. Proper disposal and documentation prevent accidental administration.

OSHA (Occupational Safety and Health Administration) establishes regulations for handling hazardous drugs to protect healthcare workers and prevent exposure.

Nitrofurantoin can cause hemolysis in patients with G6PD deficiency, leading to anemia and jaundice due to oxidative stress on red blood cells.

Rhabdomyolysis from statin use causes severe muscle breakdown, leading to myoglobinuria and kidney damage. CK levels help confirm muscle injury.

An investigation into how the error occurred is necessary before reporting it as a medication error. The pharmacist must review the case to ensure corrective action.

Emergency Schedule II prescriptions may be taken verbally but must be followed up with a written prescription within 7 days to remain compliant with federal law.

Schedule II prescriptions require a valid DEA number. The pharmacy must verify the prescriber’s registration before dispensing to ensure compliance with federal law.

Controlled substances can be partially dispensed based on insurance limits, with documentation ensuring proper tracking.

Serum digoxin levels determine toxicity. Blurred vision, nausea, and arrhythmias are signs of digoxin overdose, often worsened by hypokalemia, requiring dose adjustment.

Pharmacies must report suspected controlled substance diversion to the DEA immediately using DEA Form 106 to prevent drug misuse and ensure compliance with federal law.

Prolonged PPI use reduces magnesium absorption, causing hypomagnesemia, which can lead to muscle tremors, weakness, and cardiac arrhythmias. Symptoms often resolve with magnesium supplementation.

Class I recalls involve a high probability of causing serious harm or death, requiring urgent removal and patient notification.

All prescription errors must be reported to and documented by a pharmacist to ensure proper corrective actions are taken.

The Cytochrome P450 enzyme system metabolizes many drugs. Inhibitors or inducers of CYP450 can alter drug levels significantly.

Separating high-alert medications reduces the chance of accidental dispensing, lowering the risk of serious harm from mix-ups.

Hypokalemia increases digoxin toxicity risk, leading to arrhythmias. Close monitoring of potassium levels is necessary.

DEA numbers must follow a formula where the sum of specific digits results in a correct last digit. This ensures validity.

NIOSH (National Institute for Occupational Safety and Health) provides guidelines for protective gowns and PPE in handling hazardous drugs.

For Schedule II drugs, any changes must be approved by the prescriber and documented properly. Pharmacists cannot make changes independently.

Warfarin has a narrow therapeutic index, meaning small dosing variations can cause severe bleeding or clotting risks, making it a high-alert medication.

Unlabeled medications must be discarded, as their contents, sterility, and expiration status cannot be verified.

A 1:4 solution means 1 part drug per 4 parts total solution. (30 mL ÷ 5 = 6 mL active drug).

Vaccines should be stored between 2°C and 8°C (36°F to 46°F) to maintain potency and stability.

Patients with opioid use disorder require careful medication management. The pharmacist must assess the appropriateness of oxycodone and consider alternatives if necessary.

(1 capsule × 4 doses/day × 10 days) = 40 capsules. Quantity calculations ensure proper medication supply.

The DSCSA helps track pharmaceuticals and prevent the circulation of illegitimate or counterfeit drugs in the supply chain.

The Poison Prevention Packaging Act (PPPA) requires child-resistant containers to reduce accidental poisonings from medications.

(5 mL × 2 doses/day × 7 days) = 70 mL used. 150 mL – 70 mL = 30 mL remaining. Understanding volume calculations ensures accurate dispensing.

Multiple Schedule II prescriptions must have clearly written future fill dates. Without these dates, the pharmacy cannot dispense future fills.

Adding the thickest ingredient last helps ensure proper mixing and even distribution of active ingredients in a suspension.

Amiodarone contains iodine and can cause hypothyroidism or hyperthyroidism, requiring thyroid function tests during long-term use.

Verifying patient ID ensures compliance with federal regulations and helps prevent diversion or fraudulent prescriptions.