Pass the PTCB CPhT PTCE Questions and answers with CertsForce

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

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

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

Why Other Options Are Incorrect:

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

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

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

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

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

Medication:Lisinopril

Strength:20 mg (Clear)

Route:PO (by mouth) (Clear)

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

Quantity:30 tablets (Clear)

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

Lisinopril is an ACE inhibitorused for hypertension and heart failure.

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

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

Pharmacists must verify with the prescriber before dispensing.

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

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

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

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

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

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

PTCB Exam Content Outline – Prescription Processing & Clarification

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

ANarrow Therapeutic Index (NTI) drugis a medication in whichsmall differences in dose or blood concentrationcan lead to serioustoxicityorsubtherapeutic effects. These drugs requirecareful dosing and monitoringto avoid adverse effects or treatment failure.

Small Margin of Safety:The difference between theminimum effective concentration (MEC)and theminimum toxic concentration (MTC)is very narrow.

Requires Therapeutic Drug Monitoring (TDM):Blood levels of the drug must be regularly monitored to maintain efficacy while avoiding toxicity.

High Risk of Adverse Effects:Even minor dosage adjustments or variations in patient metabolism can cause toxicity.

Strict Pharmacokinetic and Pharmacodynamic Considerations:Factors likerenal and hepatic function, drug interactions, and patient weightsignificantly impact the drug’s effect.

Warfarin (Coumadin) → Risk of bleeding.

Digoxin → Risk of toxicity affecting the heart.

Phenytoin → Risk of severe neurological effects.

Levothyroxine → Risk of under- or over-treatment of thyroid disorders.

Theophylline → Risk of respiratory or cardiac toxicity.

Carbamazepine → Risk of serious neurological side effects.

A. Shorter window of guaranteed stability.→ Incorrect. NTI drugs do not necessarily have a shorter shelf-life or stability concerns compared to other drugs. Stability depends on formulation and storage conditions.

B. Incompatibility with therapeutic monitoring.→ Incorrect. NTI drugsrequiretherapeutic monitoring, not the opposite.

C. Synergistic effect on other medications.→ Incorrect. While NTI drugs can interact with other drugs, not all exhibit a synergistic effect (where combined drugs produce a greater effect than expected).

PTCB PTCE Exam Content Outline – Medication Safety and Quality Assurance(Monitoring NTI drugs).

FDA Narrow Therapeutic Index Drug List(Guidelines on NTI medications).

Lexicomp and Micromedex Drug Databases(Provide monitoring recommendations for NTI drugs).

USP <800> Hazardous Drugs and USP <797> Sterile Compounding Guidelines(Ensure safe handling and dispensing of NTI drugs).

Mosby’s Pharmacy Technician: Principles and Practice(NTI drug classification and monitoring).

Key Characteristics of NTI Drugs:Examples of NTI Drugs:Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

TheNational Institute for Occupational Safety and Health (NIOSH)publishes a list ofhazardous drugsthat require pharmacy staff to wear appropriatepersonal protective equipment (PPE)when handling.Megestrol (Megace) and Dutasteride (Avodart)are both classified as hazardous drugs due to their potentialteratogenic and reproductive toxicity risks.

Megestrolis aprogestinused for appetite stimulation in cancer and HIV patients. It poses arisk to pregnant healthcare workersdue to potential hormonal effects.

Dutasterideis a5-alpha reductase inhibitorused forbenign prostatic hyperplasia (BPH). It can beabsorbed through the skinand iscontraindicated in women of childbearing potentialdue to the risk offetal abnormalities.

Wear gloveswhen handling uncoated tablets or broken tablets.

Use respiratory protectionif there is a risk of airborne particles.

B. Furosemide and buspirone→ Incorrect; these arenot classified as hazardous drugsby NIOSH.

C. Glyburide and acetazolamide→ Incorrect; these arenot hazardous drugsrequiring PPE.

D. Glipizide and zolpidem→ Incorrect; these medications arenot hazardousper NIOSH guidelines.

NIOSH PPE Recommendations:Other Answer Choices Explained:References:

NIOSH List of Hazardous Drugs in Healthcare Settings (2020 Update)

USP <800> Hazardous Drug Handling in Healthcare Settings

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

Comprehensive and Detailed Step-by-Step Explanation:

Ahazardous drug spill kitisrequiredunderUSP <800>, which outlinessafe handling practices for hazardous drugs (HDs). The kit must contain:

Disposable scoop and scraper(to safely collect broken glass and contaminated material).

Absorbent pads or spill control pillows(for liquid spills).

Chemotherapy-rated gloves, gown, goggles, and mask(for protection).

A hazardous waste disposal bag(to properly dispose of contaminated materials).

????Explanation of Answer Choices:✅D. A disposable scoop for glass fragments→Correct.Adisposable scoop is essentialto safely removehazardous drug spills containing broken glass.❌A. Permeable, disposable protective garments→ Incorrect. PPE for hazardous drug spills must beimpermeable(e.g., coated gowns).❌B. Sufficient supplies to absorb a spill of about 10,000 mL→ Incorrect.Most spill kits are designed for smaller spills (≤1000 mL), not massive industrial spills.❌C. Reusable absorbent sponges or toweling→ Incorrect.All absorbent materials must be disposable to prevent contamination.

????Reference:

USP <800>: Handling Hazardous Drugs in Healthcare Settings

NIOSH List of Hazardous Drugs (2020 Update)

PTCB Exam: Medication Safety & Hazardous Drug Management

Lot numbers are required for drug recalls and tracking purposes.

Prescription numbers are pharmacy-specific and not on manufacturer packaging.

????Reference:FDA Drug Labeling Requirements, USP Manufacturing Guidelines.

AClass I recallis themost seriousrecall issued when amedication labeling erroror contaminationcould result in serious harm or death.

Enoxaparin (Lovenox)is ananticoagulant, whilephytonadione (Vitamin K1)is anantidote for warfarin toxicity—confusing these could lead to life-threatening bleeding or clotting issues.

TheFDA mandates an immediate Class I recallfor errors that could causefatal outcomes.

Why Other Options Are Incorrect:

B. Class II?❌Used formoderate health risks(e.g., subpotent drugs).

C. Class III?❌Used forminor errors(e.g., misprinted labels, minor defects).

D. Misbranding?❌Misbranding is a regulatory issue butnot a recall classification.

????Reference:FDA Drug Recall Guidelines, ISMP Medication Safety Alerts.

Lyrica (pregabalin) is an anticonvulsant that causes drowsiness, dizziness, and sedation.

It is commonly prescribed for nerve pain, epilepsy, and fibromyalgia.

????Reference:FDA Pregabalin Drug Label, PTCE Medication Safety Guide.

MedWatch is the FDA’s reporting system for adverse drug events, medication errors, and safety concerns.

????Reference:FDA MedWatch Program.

TheFDA classifies recalls into three levels, withClass III being the least severe:

Class I Recall→Most severe→ Issued when a drugmay cause serious harm or death.

Class II Recall→Moderate severity→ The drug may causetemporary or medically reversible adverse effects.

Class III Recall→Least severe→ The productis unlikely to cause harm but violates FDA regulations(e.g., labeling errors, minor packaging issues).

A. Is issued when there is a reasonable probability that the product will cause serious adverse health consequences or death.❌→Incorrect

Describes a Class I recall, not Class III.

B. Is initiated by the FDA if a manufacturer has violated the adulteration provisions of the Food, Drug, and Cosmetic Act (FDCA).❌→Incorrect

FDA action due to adulteration typically leads to Class I or Class II recalls, depending on severity.

C. Occurs when a product may cause temporary or medically reversible adverse health consequences.❌→Incorrect

Describes a Class II recall, not Class III.

FDA Drug Recall Guidelines– Defines Class I, II, and III recalls.

PTCB PTCE Exam Content Outline– Covers recall classifications and pharmacy responsibilities.

FDA Enforcement Report– Lists real-world examples of Class III recalls (e.g.,mislabeling, incorrect expiration dates).

Why Not the Other Options?Key References: