PTCB PTCE - Pharmacy Technician Certification (CPhT) Exam

Comprehensive and Detailed Step-by-Step Explanation:

Adsorption occurs when a drug binds to a surface (e.g., IV tubing), reducing its potency.Some drugs, likeinsulin and nitroglycerin,canadhere to plastic tubing, reducing the active dose the patient receives.

📌Explanation of Answer Choices:✅A. Lose potency→Correct.Adsorptionreduces drug strength.❌B. Become contaminated→ Incorrect.Adsorption does not introduce contaminants.❌C. Require refrigeration→ Incorrect.Refrigeration is unrelated to adsorption.❌D. Trigger anaphylaxis→ Incorrect.Adsorption does not cause allergic reactions.

📌Reference:

USP <797>: Sterile Compounding

ISMP Guidelines on IV Drug Stability

Lisinopril is anangiotensin-converting enzyme (ACE) inhibitor, commonly used forhypertension (high blood pressure)andheart failure. A well-known side effect of ACE inhibitors is apersistent dry, hacking cough.

The cough is caused bybradykinin accumulation, which occurs due to ACE inhibition.

This coughdoes not respond to cough suppressantsand can be bothersome for patients.

If the cough is severe, thepharmacist may recommend switching to an angiotensin II receptor blocker (ARB) such as losartan, which does not cause this side effect.

B. Purchase fexofenadine for seasonal allergies❌→ No significant interaction between lisinopril and fexofenadine.

C. Mention that they have lowered their cholesterol❌→ Cholesterol levels do not affect lisinopril’s mechanism of action.

D. Report that their blood pressure has been normal lately❌→ This is expected with effective treatment and does not require pharmacist intervention unless the patient wants to discontinue the medication.

PTCB PTCE Exam Content Outline– Covers drug interactions, side effects, and patient counseling.

American Heart Association (AHA) Guidelines– Lists ACE inhibitor side effects, including dry cough.

FDA Lisinopril Medication Guide– Mentions dry cough as a common adverse effect requiring pharmacist consultation.

Why is the Cough Significant?Why Not the Other Options?Key References:

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

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

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

Why Other Options Are Incorrect:

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

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

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

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

TheU.S. Food and Drug Administration (FDA)requires aMedication Guide (MedGuide)to be provided when dispensing certain medications that have significant safety concerns.Zyprexa (Olanzapine), anatypical antipsychotic, requires aMedication Guidedue to serious risks such as:

Increased mortality in elderly patients with dementia-related psychosis

Metabolic side effects(e.g., weight gain, hyperglycemia, and dyslipidemia)

Neuroleptic malignant syndrome (NMS)

A. Zafirlukast→ Incorrect; while used forasthma(leukotriene receptor antagonist), it doesnot require a Medication Guide.

B. Zestril (Lisinopril)→ Incorrect; anACE inhibitorfor hypertension, it doesnot require a Medication Guide.

C. Zinc→ Incorrect; adietary supplementthat does not require a Medication Guide.

Other Answer Choices Explained:References:

FDA Medication Guide Requirements for Olanzapine (Zyprexa)

PTCB PTCE Exam Content Outline (Medication Safety & Patient Counseling)

Comprehensive and Detailed Step-by-Step Explanation:

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

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

📌Reference:

American College of Rheumatology (ACR) Gout Treatment Guidelines

PTCB Exam: Pharmacology for Technicians

Arashis acommon allergic reactionto medications.Drug allergiesoccur when the immune system overreacts to a medication, leading to symptoms such as:

Skin rash (most common)

Hives (urticaria)

Swelling (angioedema)

Anaphylaxis (severe reaction)

A. Dizziness❌→Side effect, not an allergic reaction.

Some medications (e.g., antihypertensives) cause dizziness, but it isnot an immune system response.

B. Constipation❌→Side effect, not an allergic reaction.

Opioids (e.g., morphine, oxycodone) commonly cause constipation, but it isnot due to an allergy.

C. Nausea❌→Side effect, not an allergic reaction.

Many medications (e.g., antibiotics, chemotherapy) cause nausea, but this isnot an immune-mediated reaction.

American Academy of Allergy, Asthma & Immunology (AAAAI)– Defines allergic reactions to medications.

FDA Drug Allergy Guidelines– Lists common symptoms of drug allergies.

PTCB PTCE Exam Content Outline– Covers adverse drug reactions and medication safety.

Why Not the Other Options?Key References:

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

Schizophreniais a psychiatric disorder treated withantipsychotics, NOT antihistamines.

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

The technician must alert the pharmacist before dispensing.

Why Other Options Are Incorrect:

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

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

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

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

Look-alike/sound-alike (LASA) medications are drugs that areeasily confused due to similar spelling or pronunciation, which increases the risk of medication errors.

Citalopram(Celexa) →Selective serotonin reuptake inhibitor (SSRI) used for depression

Celecoxib(Celebrex) →Nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation

Why Are Citalopram and Celecoxib Considered LASA?Both drugs sharesimilar spelling and pronunciation, increasing the chance of errors inprescribing, dispensing, and administration.

Example of potential errors: A patient withdepressionmay mistakenly receiveCelecoxib (NSAID)instead ofCitalopram (antidepressant), leading to untreated depression and unnecessary NSAID use.

A. Lisinopril and Metoprolol❌→Different drug classes, butnot commonly confused.

Lisinopril(ACE inhibitor for blood pressure)

Metoprolol(Beta-blocker for blood pressure and heart conditions)

C. Acebutolol and Acetazolamide❌→Although their names look similar, they haveless common confusion in clinical practice.

Acebutolol(Beta-blocker)

Acetazolamide(Diuretic for glaucoma, altitude sickness)

D. Naproxen and Misoprostol❌→These are oftenprescribed togetherbut arenot confused with each other.

Naproxen(NSAID for pain)

Misoprostol(Used to protect the stomach from NSAID-induced ulcers)

Institute for Safe Medication Practices (ISMP) LASA List– ConfirmsCitalopram and Celecoxibas common look-alike/sound-alike drugs.

PTCB PTCE Exam Content Outline– Covers error prevention strategies, including LASA medications.

FDA Medication Error Prevention Guidelines– Recommends usingTall Man Lettering(e.g.,CeleXib vs. CitaloPram) to differentiate LASA drugs.

Why Not the Other Options?Key References:

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

Day 1: 2 tablets (500 mg total)

Days 2–5: 1 tablet (250 mg) daily

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

Comprehensive and Detailed Step-by-Step Explanation:

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

📌Reference:

USP <795> Pharmaceutical Calculations

PTCB Exam: Dosing Conversions