PTCB Certified Pharmacy Technician (PTCE)MedicationsMedium

A pharmacy technician is performing a final check on a prescription for 'cephalexin 250 mg, take 1 capsule by mouth every 6 hours' for a patient with a known penicillin allergy. What action should the technician take?

  1. ACheck the patient's insurance for coverage.
  2. BAdvise the patient to take the medication with food.
  3. CDispense the medication as prescribed.
  4. DAlert the pharmacist due to potential cross-reactivity.
Show answer & explanation

Correct answer: D. Alert the pharmacist due to potential cross-reactivity.

Cephalexin is a cephalosporin antibiotic. While the risk is low, there is a possibility of cross-reactivity between penicillins and first-generation cephalosporins like cephalexin, especially in patients with severe penicillin allergies. The pharmacist must review this for patient safety.

Why the other options are wrong

  • A. Insurance verification is a separate process and doesn't address the immediate safety concern of a drug allergy.
  • B. Taking with food is a general administration instruction, not relevant to the allergy concern.
  • C. Dispensing without pharmacist review in this scenario could be dangerous due to potential allergic reaction.

Penicillin-Cephalosporin Cross-Reactivity

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.

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