PTCB Certified Pharmacy Technician (PTCE) flashcards

The process of cleaning a Laminar Airflow Workbench (LAFW) with a sterilizing agent, typically 70% isopropyl alcohol, to create a sterile compounding environment.

• Performed before each use and after spills.
• Wipe from back to front, top to bottom.
• Allow to air dry completely for maximum efficacy.

Memory trick: Clean workspace, clean hands, clean air.

Oral suspensions are heterogeneous liquid dosage forms containing solid drug particles dispersed in a liquid vehicle. Due to particle settling, they require an auxiliary label instructing the patient to 'Shake well before use' to ensure accurate dosing.

• Particles settle over time due to gravity.
• Shaking redistributes particles evenly.
• Failure to shake can lead to under- or overdosing.

Memory trick: Auxiliary labels are 'extra help' for safe use.

A technique used to accurately measure quantities of an ingredient that are below the minimum weighable quantity (MWQ) of a balance.

• Involves weighing a larger amount of the ingredient mixed with an inert diluent.
• A portion (aliquot) of this mixture is then taken to provide the desired amount of the ingredient.
• Ensures accuracy when using balances with specific MWQs.

Memory trick: Small Amounts Need Aliquot Accuracy

Medication dosage forms designed to release the active ingredient slowly over an extended period, maintaining consistent drug levels.

• Should not be crushed, chewed, or cut.
• Prevents rapid dose dumping.
• Ensures prolonged therapeutic effect.

Memory trick: ER is for Easing Release, not Rushing Ruin.

Combining two or more CNS depressants (e.g., benzodiazepines, hypnotics, opioids) can lead to additive effects like excessive sedation, respiratory depression, and impaired coordination, especially in vulnerable populations.

• Increases risk of falls, accidents, and respiratory arrest.
• Common with benzodiazepines, opioids, Z-drugs.
• Requires careful monitoring and prescriber awareness.

Memory trick: Two downers together? Alert the pharmacist, don't be a loafer!

Implementing multiple checks or steps in a process so that if one fails, another can catch the error.

• Commonly seen as independent double-checks for high-alert medications.
• Acts as a 'safety net' to prevent errors from reaching the patient.
• Can also involve backup systems or multiple verification points.

Memory trick: Prevent, Protect, Perfect, Practice.

A High-Efficiency Particulate Air (HEPA) filter is a type of mechanical air filter that works by forcing air through a fine mesh that traps harmful particles such as pollen, pet dander, dust mites, and smoke.

• Removes 99.97% of particles 0.3 micrometers or larger.
• Essential for maintaining sterility in laminar airflow workbenches.
• Requires regular testing and replacement to ensure efficacy.

Memory trick: LAFW's Clean Air is HEPA's Best Friend

Specific personal protective equipment (PPE) required when handling hazardous drugs to prevent exposure through inhalation, absorption, or ingestion.

• Double gloving for dermal protection.
• Gowns for body protection.
• Respiratory protection for aerosols.
• Prevents technician exposure to potent drugs.

Memory trick: Gloves Guard, Gown Guides, Mask Makes Safe.

A class of drugs (e.g., omeprazole) that irreversibly block the proton pumps in gastric parietal cells, leading to a significant and long-lasting reduction in stomach acid production.

• Treats GERD, ulcers, Zollinger-Ellison Syndrome
• Taken once daily, usually before breakfast
• Do not provide immediate relief
• Long-term use associated with some risks

Memory trick: Omeprazole: Pumps Out Problematic Acid.

Amlodipine, a dihydropyridine calcium channel blocker, commonly causes dose-dependent peripheral edema (swelling of the ankles/legs) due to vasodilation.

• Peripheral edema is a common, often bothersome, side effect.
• Other side effects include headache, flushing, and dizziness.
• Technicians should identify and refer such concerns to a pharmacist.

Memory trick: Technicians 'Refer' clinical questions, like a relay race.

A CACI is a specific type of isolator used for compounding hazardous sterile preparations, providing both an aseptic environment for the product and containment for the operator.

• Used for hazardous sterile compounding.
• Provides negative pressure for operator safety.
• Filters exhaust air to prevent environmental contamination.

Memory trick: Hazardous drugs need a CACI, keeping workers safe and products neat.

A combination antibiotic known for common gastrointestinal side effects, including diarrhea, due to its broad-spectrum antibacterial activity.

• Commonly causes diarrhea.
• Taking with food can reduce GI upset.
• Clavulanate protects amoxicillin, not gut flora.

Memory trick: Augmentin Aches Gut, Always Eat.

A type of water meeting specific chemical purity standards set by the United States Pharmacopeia, used in non-sterile compounding and for preparing other USP waters.

• Obtained by distillation, ion exchange, reverse osmosis.
• Reduced chemical contaminants.
• Not necessarily sterile or pyrogen-free; unsuitable for injection.

Memory trick: USP Waters: Purity for Purpose

When an aseptic field or sterile component is compromised, such as by touching a non-sterile surface, the compromised item must be immediately discarded, and the sterile preparation process restarted with new, sterile materials to prevent contamination.

• Sterility is absolute; 'almost sterile' is not acceptable.
• Compromised items must be discarded.
• Patient safety is paramount in sterile compounding.

Memory trick: Contaminated? Discard and Restart, No Second Guessing.

Metformin is typically taken with meals to reduce the incidence and severity of common gastrointestinal side effects like nausea, diarrhea, and abdominal discomfort.

• Common GI side effects (nausea, diarrhea)
• Taking with food improves tolerability
• Does not typically cause hypoglycemia alone

Memory trick: Metformin: Mealtime Minimizes Misery.

A procedure for handling discrepancies identified by an ADC during restocking or dispensing.

• ADCs use barcode scanning for verification.
• Mismatch alarms signal potential errors.
• Investigation is required before proceeding.

Memory trick: ADC Alarm Rings, Investigate the Things!

A LAFW is a primary engineering control that provides a unidirectional, HEPA-filtered airflow to protect sterile products from particulate and microbial contamination during compounding.

• Can be horizontal or vertical flow.
• Horizontal LAFWs protect the product only.
• Vertical LAFWs (BSCs) protect product, personnel, and environment.

Memory trick: Laminar flow means 'smooth, clean air movement'.

Amiodarone significantly increases the anticoagulant effect of warfarin by inhibiting its metabolism, leading to a heightened risk of bleeding.

• Amiodarone inhibits CYP2C9, the enzyme metabolizing warfarin.
• Increased warfarin levels lead to higher INR and bleeding risk.
• Close monitoring of INR is crucial when co-administering.

Memory trick: Warfarin's partner Amiodarone makes the blood flow more.

A 'Just Culture' approach to error reporting focuses on understanding system failures and human factors leading to errors, rather than solely blaming individuals, to encourage open reporting and learning.

• Promotes transparent reporting without fear of undue punishment.
• Distinguishes between human error, at-risk behavior, and reckless behavior.
• Aims to improve systems, not just punish individuals.

Memory trick: Report the 'what' and 'how', not just the 'who', for safer pharmacy flow.

Calculating the appropriate daily dose of a medication for a pediatric patient based on their body weight and a recommended dose range per kilogram per day.

• Dose = (mg/kg/day) * weight (kg).
• Ensure the total daily dose is divided appropriately for administration frequency.
• Always compare calculated dose to the prescribed dose range.

Memory trick: Kids' doses need careful checks, weight matters, no dose wrecks.

In non-sterile compounding, the primary focus for contamination control is good personal hygiene, especially thorough hand washing, and maintaining a clean work environment.

• Hand hygiene is paramount.
• Clean work surfaces are essential.
• Different requirements than sterile compounding.

Memory trick: Non-sterile? Clean hands are key, for a safe compound, you see!

Concurrent use of alpha-blockers (e.g., tamsulosin) and PDE5 inhibitors (e.g., sildenafil) can lead to a significant, additive decrease in blood pressure.

• Both drug classes cause vasodilation.
• Additive hypotensive effect is the main risk.
• Patients should be advised on timing and symptoms of hypotension.

Memory trick: Alpha-Blocker + PDE5 = BP Crash, Too Much Vasodilation in a Flash!

An adverse immune response to medications containing a sulfonamide chemical group, commonly seen with certain antibiotics and other drugs.

• Sulfonamide antibiotics are common culprits (e.g., sulfamethoxazole/trimethoprim).
• Reactions can range from rash to severe anaphylaxis.
• Cross-reactivity with non-antibiotic sulfonamides is rare but possible.

Memory trick: Allergies Alert Pharmacist Immediately

A safety culture that recognizes human error is inevitable but differentiates between blameless errors, at-risk behaviors, and reckless behaviors.

• Focuses on system improvement rather than individual blame for errors.
• Encourages reporting of errors and near misses without fear of punishment.
• Aims to learn from mistakes to prevent recurrence.

Memory trick: Report to learn, not to blame.

Levothyroxine (thyroid hormone replacement) must be taken on an empty stomach, typically 30-60 minutes before breakfast and other medications, to ensure consistent and optimal absorption.

• Absorption reduced by food and coffee
• Reduced by calcium and iron supplements
• Consistent timing is crucial for stable thyroid levels

Memory trick: Leave Thyroxine Alone Before Food.

Sterile ophthalmic solutions must be isotonic with the eye's lacrimal fluid to prevent irritation and cellular damage, and must also be sterile and free from particulate matter.

• Isotonicity is critical for comfort and safety
• Must be sterile and free of particulates
• pH should be close to physiological eye pH

Memory trick: Ophthalmic Safety Needs Clear, Calm Eyes.

A pharmacy technician's role when encountering a drug-allergy alert is to promptly identify the potential interaction and immediately bring it to the attention of a supervising pharmacist for clinical assessment and intervention.

• Technicians identify, not resolve, clinical alerts.
• Immediate escalation to pharmacist is crucial.
• Never override or ignore allergy alerts.

Memory trick: Alert the Pharmacist, Avoid the Harm.

The process of cleaning the interior surfaces of a Laminar Airflow Workbench (LAFW) to maintain a sterile environment for sterile compounding.

• Performed immediately before compounding activities.
• Uses sterile 70% Isopropyl Alcohol (IPA).
• Wipe from back to front, top to bottom, to sweep contaminants out.

Memory trick: Clean Workbench Before Compounding Commences

A procedure for handling situations where the prescribed medication does not match available stock or patient information.

• Technicians must identify discrepancies.
• Pharmacist must be notified immediately.
• Never make unauthorized substitutions or dosage adjustments.

Memory trick: Discrepancy Detected? Alert the Expert!

Insulin Glargine is a clear, long-acting insulin that should not be shaken. Vigorous agitation can cause foaming, inaccurate dosing, and damage to the insulin protein.

• Clear solution
• Long-acting insulin analog
• Do NOT shake
• Gently roll if mixing is needed (uncommon for clear insulins)

Memory trick: Glargine: Gently Roll, Never Rock.

Procedures for handling medications found outside their recommended storage conditions, requiring quarantine and pharmacist assessment.

• Storage conditions affect potency and stability.
• Improper storage can compromise medication before expiration.
• Quarantine and pharmacist review are essential.

Memory trick: Wrong Temp, No Pump! Quarantine it, Call the Champ!

A potentially life-threatening drug interaction between linezolid (a weak MAOI) and SSRIs (like sertraline) that leads to excessive serotonin levels in the central nervous system.

• Symptoms: agitation, confusion, rapid heart rate, high blood pressure, muscle rigidity, sweating, diarrhea.
• Requires immediate medical attention.
• Concomitant use is generally contraindicated or requires very close monitoring.

Memory trick: Interactions make trouble, always check the drug bubble.

Sound-Alike/Look-Alike Drugs (SALAD) are medications with similar names or appearances that can easily be mistaken for one another, leading to medication errors.

• Often abbreviated as LASA (Look-Alike/Sound-Alike).
• Strategies to prevent errors include Tall Man Lettering, separating storage, and careful verification.
• Common cause of prescribing and dispensing errors.

Memory trick: Don't get your drugs mixed up!

The defined set of duties and responsibilities that a certified pharmacy technician is legally and ethically permitted to perform.

• Varies by state and employer, but generally excludes clinical judgment and patient counseling.
• Always work under the direct supervision of a licensed pharmacist.
• Includes tasks like prescription data entry, inventory management, and non-sterile compounding.

Memory trick: See something, say something to the pharmacist.

Medications are therapeutically equivalent if they have the same active ingredient, dosage form, strength, and route of administration, and produce the same clinical effect. Different salts (e.g., tartrate vs. succinate) or release mechanisms (immediate vs. extended) are NOT therapeutically equivalent.

• Metoprolol tartrate is immediate-release; metoprolol succinate is extended-release.
• Not interchangeable without prescriber's order.
• Substitution requires pharmacist/prescriber approval and documentation.

Memory trick: Discrepancy found, stop and ask the pharmacist around.

A gas-tight, totally enclosed cabinet providing maximum protection for personnel, product, and environment when working with highly infectious or hazardous agents.

• Highest level of protection (BSL-4 agents).
• Maintains negative pressure relative to the room.
• All operations performed through glove ports; materials transferred via pass-through chamber.

Memory trick: Classes Protect People, Products, and Planet

Drugs that bear a heightened risk of causing significant patient harm when used in error.

• Errors with these drugs are not necessarily more common, but the consequences are more devastating.
• Examples include insulin, anticoagulants, opioids, chemotherapy, and concentrated electrolytes.
• Require special safeguards like independent double-checks, standardized ordering, and specific storage.

Memory trick: HIGH risk, HIGH harm, HIGH caution.

When an automated dispensing or packaging system malfunctions, the immediate priority is to cease operation, secure the affected medications, and report the issue to prevent patient harm and ensure proper repair.

• Malfunctions can compromise medication integrity or patient safety.
• Immediate stoppage prevents further errors.
• Requires reporting to qualified personnel for resolution.

Memory trick: Machine glitch? Stop, alert, then fix, or patient safety will be a mix!

The formula to convert temperature from Celsius (°C) to Fahrenheit (°F) is: °F = (°C × 9/5) + 32, or equivalently, °F = (°C × 1.8) + 32.

• Boiling point of water: 100°C = 212°F.
• Freezing point of water: 0°C = 32°F.
• Essential for accurate compounding and storage conditions.

Memory trick: Celsius to Fahrenheit: Multiply by 1.8, then add 32.

There is a structural similarity between penicillins and cephalosporins (both beta-lactam antibiotics) that can lead to allergic cross-reactions, particularly with first-generation cephalosporins, in patients with penicillin allergies.

• Risk is higher with first-generation cephalosporins (e.g., cephalexin).
• Risk is lower with second- and third-generation cephalosporins.
• Pharmacist consultation is essential for patient safety with penicillin allergies.

Memory trick: Allergy alerts mean 'Stop' and 'Consult' the expert.

A primary engineering control used in sterile compounding, especially for hazardous drugs, that provides protection for the product, personnel, and the environment.

• Used for hazardous sterile compounding
• Provides triple protection
• Utilizes HEPA-filtered vertical airflow

Memory trick: BSC = Big Safe Compounding: Protects All.

A significant drug-drug interaction where antacids (containing polyvalent cations) reduce the absorption of fluoroquinolone antibiotics.

• Mechanism: Cation chelation forms insoluble complexes.
• Result: Decreased antibiotic bioavailability and efficacy.
• Management: Separate administration by at least 2-4 hours.

Memory trick: Cations Capture Quinolones, Cutting Control

Alendronate is a bisphosphonate used to treat osteoporosis. Proper administration is vital to maximize absorption and prevent severe esophageal adverse effects.

• Take with a full glass of plain water (6-8 oz).
• Take at least 30 minutes before the first food, drink, or medication of the day.
• Remain upright for at least 30 minutes after taking the dose.
• Do not chew, crush, or suck on the tablet.

Memory trick: Alendronate: Water First, Upright Always!

Specific timing instructions for rapid-acting insulins (e.g., Humalog, Novolog, Apidra) to optimize blood glucose control around meals.

• Onset of action is 5-15 minutes.
• Peak effect is 30-90 minutes.
• Administer immediately before or within 15 minutes of a meal.

Memory trick: Rapid Insulin: Right Before Real Food

Hazardous spill management involves immediate donning of PPE, containment, proper collection and labeling of contaminated materials, and appropriate disposal to prevent exposure and environmental contamination.

• Always prioritize personnel safety (PPE).
• Containment is key to limit spread.
• Proper hazardous waste disposal is mandatory.

Memory trick: Spill of chemo, oh no! PPE on, then bag and go!

A severe acne medication with significant teratogenic risk, requiring strict adherence to the iPLEDGE risk management program.

• Mandatory for all patients, prescribers, pharmacies, and wholesalers.
• Females of childbearing potential need two negative pregnancy tests and two forms of contraception.
• Medication must be dispensed within 7 days of the pregnancy test.

Memory trick: iPLEDGE: Prevent Pregnancy, Protect Patients

A CDSS is a computer-based program that analyzes patient data and provides healthcare professionals with alerts, reminders, and recommendations to improve patient care and reduce errors.

• Integrates with electronic health records.
• Flags potential drug interactions, allergies, and dosing errors.
• Aims to enhance clinical decision-making.

Memory trick: System flags an allergy? CDSS is the tech that brings it to clarity!

Instructions for taking metformin, an oral antidiabetic, to minimize common gastrointestinal side effects.

• Primary use: Type 2 diabetes.
• Common side effects: Nausea, diarrhea, abdominal discomfort.
• Administer with meals to improve tolerability.

Memory trick: Metformin Meals Minimize Misery

A common dose-dependent side effect of amlodipine, a calcium channel blocker, characterized by swelling in the ankles and feet due to vasodilation.

• Often affects ankles and feet.
• Typically benign but can be bothersome.
• May require dose adjustment or alternative medication by a prescriber.

Memory trick: Side effects happen, inform the doctor, stay safe.

When managing prior authorization issues, pharmacy technicians should clearly communicate the status to the patient, explain the process, and assure them that the pharmacy is working to resolve it, while maintaining confidentiality and professional boundaries.

• Patient communication should be empathetic and informative.
• Pharmacy staff facilitate prior authorization with prescribers/insurers.
• Maintain patient privacy regarding specific insurance details.

Memory trick: Prior auth? Explain the delay, say pharmacy works, and save the day!

Key patient instructions for allopurinol, primarily emphasizing adequate hydration to prevent adverse effects related to uric acid metabolism.

• 'Drink plenty of water' is crucial to prevent kidney stone formation.
• Used to treat gout and hyperuricemia.
• Can also cause skin rash (Stevens-Johnson Syndrome in rare cases).

Memory trick: Labels guide the way, ensuring safe medicine play.

Using barcode technology to electronically verify medication identity and location during dispensing, administration, or inventory processes.

• Reduces human error by matching product codes to system data.
• Commonly used in pharmacies for dispensing and restocking ADCs.
• Also used in hospitals for Barcode Medication Administration (BCMA) at the bedside.

Memory trick: Scan, separate, secure, streamline.

An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.

• Requires immediate investigation (Root Cause Analysis) by the organization.
• Alerts the need for immediate response and investigation.
• Examples: wrong-site surgery, suicide in a healthcare facility, fatal medication error.

Memory trick: Don't just see, then act, then learn.

Certain antacids can interact with warfarin, affecting its absorption or metabolism, potentially altering its anticoagulant effect and increasing bleeding risk.

• Aluminum/Magnesium antacids can decrease warfarin absorption.
• Sodium bicarbonate can potentiate warfarin.
• Calcium carbonate generally has minimal interaction, but dose separation is advised.

Memory trick: Warfarin's Worst with Mixes; Calcium's Calmest.

Antacids can reduce the effectiveness of many proton pump inhibitors (PPIs) by prematurely dissolving their enteric coating.

• PPIs often have enteric coatings.
• Antacids increase gastric pH.
• Reduced PPI absorption means less therapeutic effect.

Memory trick: Antacids Block PPI's Power, Don't Take Them in the Same Hour!

Systemic corticosteroids, such as prednisone, must be gradually tapered down, not abruptly discontinued, to allow the body's adrenal glands to resume natural steroid production and prevent adrenal insufficiency.

• Prevents adrenal crisis (fatigue, weakness, nausea, low blood pressure).
• Even short courses (e.g., 5-7 days) may require tapering.
• Patient education on adherence is critical.

Memory trick: Follow the plan, especially when it's a 'taper' like a gentle slope.

Barcode verification in Automated Dispensing Cabinets (ADCs) is a crucial safety measure where a technician scans the barcode of a medication and the ADC's designated storage location to confirm a match before placement, preventing medication errors.

• Ensures the right drug goes into the right bin.
• Reduces misfills and wrong medication administration.
• Automated cross-check for accuracy.

Memory trick: Always Scan, Confirm, and Place for Patient Safety.

Rhabdomyolysis is a rare but severe adverse effect of statin medications, characterized by rapid breakdown of damaged skeletal muscle. This releases myoglobin into the bloodstream, which can lead to acute kidney injury and other systemic complications.

• Symptoms include severe muscle pain, weakness, dark urine.
• Risk factors: high statin doses, drug interactions (e.g., grapefruit, fibrates), kidney impairment.
• Requires immediate medical attention and discontinuation of the statin.

Memory trick: Statin muscle pain: 'R' for 'Rhabdo' is the red flag.

A potentially harmful reaction that occurs when a patient is prescribed a medication to which they have a known allergy.

• Can range from mild skin rashes to life-threatening anaphylaxis.
• Pharmacy systems often flag these, but human vigilance is crucial.
• Requires immediate pharmacist intervention to resolve with the prescriber.

Memory trick: Allergies Alert! Always tell the Pharmacist.

A type of antimicrobial substance active against bacteria; it is the most important type of antibacterial agent for fighting bacterial infections.

• Treats bacterial infections
• Can be broad-spectrum or narrow-spectrum
• Common side effects include GI upset and allergic reactions

Memory trick: An A+ student Knows Their Drugs.